It would probably be of no surprise to you that balancing being a father, a rural GP, husband and newly qualified GP anaesthetists (GPA) is not for the faint hearted. Throw into that moving to a country area away from your support network and into a new set of circumstances makes it a little more difficult. But sometimes that isn’t quite enough, how about a heavily pregnant wife and then a new little one?
Well… Welcome to the last five months!
Please don’t get me wrong it has been one magnificent journey and has been instrumental in bringing us close as a family and solidifying in me a strong desire to become a rural GP.
Now the anaesthetics has been quite interesting.
I have had a laryngospasm that didn’t respond to escalating manoeuvres and needed intubating. I’ve had an unpredicted difficult airway in a seemingly easy patient. Then my favourite, the sick laparotomy in the middle of the night that needed lines and transport, intubated and ventilated to the big smoke.
It simply amazes me that with one year’s intensive experience and assessment, I am anaesthetising independently. I certainly do not feel out of control and am not anaesthetising outside of my comfort zone but consider it a privilege to run weekly elective lists and participate in the on-call roster.
See what I haven’t told you about is the support and mentoring that I have received down here. It is a pilot program for newly qualified GPA funded by GPET and administered through WAGPET.
It has eased my transition into working life and allowed for us to have another GPA on-call with us when we started. It was also essential in learning about the idiosyncrasies of our regional hospital, being aware of our environment (equipment, drugs and staff) and importantly patient selection and refusal.
The first patient I sent to Perth was an 80year old woman with appendicitis, which was diagnosed on CT. I sent her firstly and mainly because of her critical aortic stenosis (Valve area of 0.9cm2 and ejection fraction of 27%) and secondly because she was relatively well despite her CT findings. Conversely if she had an acute abdomen, I would have phoned a friend/mentor and cracked on!
Being optimistic about the future and committed to becoming an excellent GPA, I realise that experience cannot be bought and wisdom can only acquired with a teachable attitude.
So being I am being intentional about learning, continuing to read my favourite journals (Anaesthesia and Intensive Care, Continuing Education in Anaesthesia Critical Care and Pain, Tutorial of the week), attending some excellent courses recommended by airway experts like Minh Le Cong and will be upskilling when I can.
I have developed an obsession about my checking routines before giving the first bit of white stuff and a compulsion to organise my anaesthetic trays and drugs in a certain way, both hallmarks of a neurotic anaesthetic type.
Please stay tuned for more musings of a young rural GP anaesthetist trying to bring the best evidenced based care to country WA.
JR (Ortho Ninja)