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BulletinNovDec2017

Kudos The Remarkable Art of Maria-anesthesia John M. Rayhack, MD jrayhack@icloud.com To experience the ‘Remarkable Art of Maria-anesthesia” imagine that you just entered the operating room about to have an outpatient surgical proce-dure. Your surgeon had advised that you could probably be AWAKE dur-ing your surgery. You look around at the bank of monitors, a computer, and suddenly you realize that you are in a very vulnerable situation and feel frightened. Your palms are a bit sweaty and the cold room makes your fingers and toes just a bit colder. You realize that you are totally dependent on com-plete strangers to help you through this experience. Today, your main hope is a nurse anesthetist named Maria Gonzalez. Maria is a registered nurse who re-ceived additional specialized train-ing in anesthesia to obtain her title, CRNA. You had a chance to meet Maria Gonzalez with her in the pre-operative waiting area when she reviewed your medical and surgical history. The surgical team is apply-ing blood pressure cuffs, arranging surgical instruments on the table, and charting the flow of action on a corner computer. Maria suggests a warm blanket and asks you if you would like to hear a particular type of music or if you would like to have a pillow under your knees. Her voice is very soft and reassur-ing. She attaches wires to the EKG pads attached to your chest. You can hear your heart beat as the monitor taps out your rate. Maria assures you that she can give you medication at any time so that you can be sleeping or you can stay awake with minimal or no sedation to calm you. But, you think, “What or who can possibly relax me at this moment in time?” Maria asks you about your job, your hobbies, your family, your children, or your grandchildren. Maybe you just returned from a vacation and she asks you to reflect on the pleasant ex-perience of being with your family or friends. As your surgeon, I am sitting on the other side of a drape that has been placed around your arm. I listen to Maria’s conversation with you and at a pause between sentences I tell you that I am about to gently inject some local anesthetic into the surgical site. Without you realizing it, the conversation drifts to something that interests you and the operation has started. Maybe you are a teacher and Maria asks about some teacher that was influential in your career, or maybe where you went to school. Occasionally you will learn a bit about Maria and discover that she went to high school at St. Petersburg High School. Because Maria is passionate about animals, she may ask about your pets and their names. Maria relates that she recalls one seemingly prim and proper patient who named her pets Beavis and Butt-Head and everyone in the room burst out in laughter. “Laughter in the operating room?”, you think. But with Maria, this is no surprise. Maria will recount her stories of trapping feral cats at the St. Joseph’s Hospital grounds and relo-cating them to her rural home. At one time she had 5 dogs and 12 cats! Sometimes she will also share her stories about hand feeding a deer named Sweat Pea in her back yard. You might learn that Maria was originally intending to become a veteri-narian but switched to caring for humans while at the Univer-sity of Florida. Oh, and if you want to talk football she is more than happy to tell you about her beloved Tim Tebow. This is what makes Maria stand out from the rest; your surgical experi-ence has somehow transformed from one fraught with nerves to a relaxed, engaging chat with a skilled conversationalist. Sometimes the topic is serious and you relate some very per-sonal information about a sick parent or child, or the loss of a loved one because, somehow, you sense that you can trust Ma-ria to be a compassionate listener. Maria always seeks to find your area of interest and listens to your experiences, worries, recommendations, and thoughts. It is almost always about you but once in a while you may hear Maria’s self-deprecating story about an early cooking misadventure. You perceive correctly that she is humble and honest. While Maria is engaging you in conversation, she is vigilant, constantly monitoring your heart rate, blood pressure, EKG, and oxygen and carbon dioxide saturation. If your blood pres-sure starts to rise, she is quick to add some medication to lower it. She is the consummate professional ready to act in case of an unexpected event. She makes this process of speaking with you while still monitoring your care look so easy; it is not. It is an ART that is not classically taught in nursing school. The basis of this skill is her empathy for and love of people, life, and her passion for her profession. Maria is an example of a professional (continued) 22 HCMA BULLETIN, Vol 63, No. 4 – November/December 2017


BulletinNovDec2017
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