 Here we go. So first things first, I start my day, I usually have to go and pre-op patients, and a pre-op is basically an evaluation that we do before patients have surgery. So the night before a surgery day, I usually get an email that tells me what cases or procedures I'm gonna be doing for the next day, and then I can review those patients' histories and also find out more about them before the day of surgery. Most importantly, I'm trying to find out if there's any issues that need to be fixed to make them better optimized for surgery so that they're ready to go in the morning. The day of surgery in the morning, when I see my patients, I'm checking to make sure they're stable, making sure their vital signs are stable, their lab work is all within an acceptable range, and I'm also making sure that they are not, you know, sicker or any worse in their condition before surgery. So before anyone gets anesthesia, we have to make sure that they're a suitable candidate and that there's no contraindications. We wanna make sure that there's nothing that's gonna make it a very unsafe operation and that's what the preoperative evaluation is all about. Before we give any anesthesia, we usually do what we call a preop evaluation, and that's when we're reviewing the patient's medical history. We look into their chart, we ask questions of the patient in an interview, and we find out about the recent exposures to anesthesia, how they were tolerated. Also the medical history that would be important for us to know before we give a safe anesthetic. So usually that's looking at the cardiac or pulmonary or heart and lung systems to make sure that they're healthy and stable enough for us to give anesthesia safely. Today in particular, I'm gonna be working with a resident who is learning on all about anesthesiology, who will one day become an attending, and I'm also working with the CRNA. So I have two rooms, two locations that I'm responsible for. An attending anesthesiologist is someone who's a physician who is going to be supervising other anesthesia locations. So usually we're supervising anywhere between one to four locations, and they can be staffed by residents, anesthesiologists, or CRNAs, nurse anesthetists. So we're working together in the team, and usually as the attending, I'm overseeing what's going on in any of the settings that I'm supervising just to make sure everything is stable and also to help with the plan of care. Wow. So I'm pretty much just making sure things run smoothly and supervise the activities of the resident or the CRNA. Yeah, oh wow. Really, so far I'm surprised you weren't more symptomatic. Okay, took it down, yeah. Those are the days that I'm working with them. Other than that, I typically work alone probably half of the time, 50% of the time, to my own cases. In the state that I practice in, which is New York, it is not allowed for nurse anesthetists to work independently, although that is the case in some states in the United States. New York State does not allow for that, so they will be working usually under the supervision of an attending anesthesiologist. So I'm present for the time when the patient is going off to sleep. I monitor frequently during the procedure, the progress of the anesthetic and the procedure and to see how the patient is doing, and if there's any emergency that comes up, that's definitely the time that I'm gonna be available to come in to see what's going on, help troubleshoot and treat the conditions that may come up. So that's the same role that I play when I'm supervising a resident. However, the major difference is that with the nurse anesthetists, I'm not actually educating them. They've already gone through training and they're already fully educated, but the resident is a learner. Otherwise, I'm often giving the people in the room that I'm supervising a break, so they won't get out for a morning break, lunch break, and an intermittent break, so they need to go to the bathroom because otherwise no one will be watching the patient and someone must be watching the patient 100% of the time. So there's always an anesthesiologist, or a resident, or a CRNA in the room with the patient during the entire procedure, although a lot of people don't think so. Then I always check on my patients after the procedure in the post-anesthesia and recovering unit, see how they're doing, make sure their pain is controlled, and make sure there's no problems. So now I'm heading over to actually do the exam on my next patient. I reviewed the chart and I wanted to go and check in and see how the patient is doing. Then after I examine my patient, I usually go and sit down and write down all the information that I collected and try to gather my anesthesia plan thoughts. So what am I gonna do for this patient? How am I gonna go to sleep? How am I gonna maintain their anesthesia? And how am I gonna monitor them to make sure that everything that needs to be watched can be watched closely and carefully? Then next I'll discuss the anesthesia plan with my resident or my CRNA to decide what we're going to do and in actuality, how we're going to be able to pull off a really safe anesthetic. So there's a discussion that goes on every time. I love to listen to my residents, give me their plans and talk me through their thoughts on what they're thinking and why they wanna do things. And with CRNAs, I really enjoy working with them. I think that the discussion is really important and we can come to a great plan together. So it's all about the plan. And when you're planning for anesthesia, you always have to have not just a plan, but many plans. So we usually say plan A, B, C and Z. So all the plans that we could think of, if this goes wrong or this goes the way we expect it to go, what we're gonna do next to make things better and like how we're gonna fix any problems. So we have multiple things that we think about when we're trying to make a plan. And we always think about what would happen if it doesn't go the way we expect. That's generally how it goes. Then once all of that's decided upon, we go ahead and go in and take care of people and put them to sleep. So that's pretty much it. That's a nutshell of what I do on a regular basis. Thank you guys for watching this video and I will see you next time in the next one.