Anaesthetic Technician

Lissey: Hi, I’m Lissey Small, and I’m from Northcote College and I’m looking into being a trainee anaesthetic technician.

Clinton: Lissey has come to Auckland’s North Shore Hospital. Her two mentors today, Sheeraz Raheem and Natalie Duley, are both trainee anaesthetic technicians.

Sheeraz: Hi, you must be Lissey, oh yes? My name is Sheeraz.

Lissey: Nice to meet you.

Natalie: Come on through.

Clinton: In a hospital, trainee anaesthetic technicians spend most of their time in operating theatres helping the anaesthetists induct, a technical term for putting people to sleep.They need a sound knowledge of theatre procedures, anaesthetic and nerve-blocking machines, drugs and equipment. So for Lissey it’s straight to the busy 12-operating-theatre centre.

Sheeraz: So there’s three main types of anaesthetic – there’s general anaesthesia, regional anaesthesia and local anaesthesia. With a general anaesthesia, the patient goes off to sleep and so they’re completely unaware of what’s going on.

Lissey: So before an operation, what is the first thing you do?

Sheeraz: The first thing we do is a comprehensive machine check.

Sheeraz: Right, so this is our anaesthetic machine, it's one of the newest ones we have and it’s called the Asis. And our job is to check it every morning, before the start of the list.

Clinton: The anaesthetic machine delivers a precisely controlled level of gas that puts patients to sleep. It provides accurate and instant monitoring of what the machine is doing...

Sheeraz: This canister contains the volatile anaesthetic agent that the machine delivers.

Clinton: ...Plus all the patient's vital signs – blood pressure, heart rate and breathing.

Lissey: How important is it to get the statistics?

Sheeraz: It’s very important because the anaesthetic drugs that we administer, they take away your breathing reflexes, and your airway reflexes. It also affects your physiology so it causes your blood pressure to drop, or even rise sometimes and it’s important that the anaesthetist and us, that we know what’s exactly going on in your body so we can titrate the anaesthetic to suit that.

Clinton: In theatre 7, Sheeraz gets on with his machine checks before an orthopaedic operation. In theatre 11, Lissey gets a lesson on an anatomically correct dummy of how the anaesthetic gas is administered.

Natalie: So Lissey, once they’re asleep, we’re going to be able to intubate the patient – so that’s making sure we can have gases going in and out of the patient safely. We’re going to use what’s called a laryngoscope blade, and we hold this in our left hand, and we come in to the patient from the right…

Natalie: …sweeping their tongue to the left…

Natalie: …if you look over my shoulder, you can see the vocal cords.

Lissey: Wow!

Natalie: Do you want to give that a go?

Lissey: Sure…

Clinton: Trainees need to have a sound knowledge of human anatomy and how the body works.

Natalie: I started from a three-week orientation where we knew absolutely nothing, and that provided a really good platform to grow on the skills that we have now. I’m now, not left to my own – I’m still supervised within the theatre – but I’m far more competent in helping the anaesthetist by myself.

Natalie: There you go…down nice and low…

Natalie: …can you see the cords?

Lissey: Yep, that’s actually really cool.

Natalie: So that’s when I’d pass you the tube…

Lissey: Yep.

Natalie: …you’ve got to feed it down through the cords, and I’m going to pull the stabiliser out, and attach this to the top of the tube and we’ll see what we get.

Natalie: Perfect.

Lissey: So what was it like the first time you did it?

Natalie: The first time I didn’t quite get it in, the second time I was inflating the patient’s stomach. So it does take a lot of practice.

Sheeraz: The trainee scheme is probably one of the biggest perks of the job. You get paid from the day you start, you get reimbursed for your tuition fees, you get opportunities to go to lectures and attend seminars where consultant anaesthetists teach. It’s a very enjoyable time and I’m really enjoying it so far.

Clinton: The trainees are mentored by facilitator, Michelle Peck.

Michelle: Hello Mr Pert.

Mr Pert: Hi.

Michelle: How are you doing there?

Mr Pert: I’m feeling reasonably comfortable.

Michelle: And what are you having done today?

Mr Pert: I’m having a hernia repaired.

Michelle: I love my job. I’ve been doing this job for over 20 years now and every single day it’s different. The patients may be having the same procedure – we could have a whole list of patients having a hernia repair but every single patient is an individual and they have different types of medical histories so it’s never mundane – it’s always different, it’s never the same thing for every patient.

Clinton: Back in theatre 7 the machine checks are done and Sheeraz greets a new patient.

Sheeraz: Hi Melissa, my name’s Sheeraz, I’m one of the second-year trainee anaesthetic technicians, I’ll be helping the anaesthetist look after you today, alright?

Michelle: We’re just going to pop the brakes on…

Sheeraz: The role itself is very much a patient contact role and that involves comforting the patient, reassuring them, making sure that they’re comfortable, so you play quite an important role and often if they’re happy before they go off to sleep, they wake up happy as well.

Sheeraz: We’ve got the patient in, we’ve transferred her across, made sure she’s comfortable, and now the next thing that we’re going to do is get the monitors on. We’ll start of with the pulse oximeter, and what I’ll do is I’ll get you to put it on to the left hand of the index finger and that’s because it’s the same side as the lower.

We don’t put the blood pressure cup on the same side because when it squeezes, then it can occlude the flow of drugs up the vein.

Lissey: OK.

Sheeraz: The last bit of monitoring that we’ll put on are these ECG leads. This goes on the right side.

I think you need to have a lot of empathy and you need to be able to relate to patients and talk to them, calm them down, reassure them, be a helping hand. It’s almost like a nursing role in a way – there’s a lot of compassion. I think that’s a very important part of providing the highest level of service to the patient.

Michelle: You’ve got to be adaptable, you’ve got to be flexible, you’ve got to have a fantastic sense of humour to do this job and you’ve got to be ready for anything at any given time.

Clinton: Nurses, radiographer, anaesthetist and surgeon are now all on hand. During surgery trainees need be able to identify the warning signs that indicate people are at risk during anaesthesia.

Sheeraz: The role of the anaesthetic technician can be likened to the relationship between a scrub nurse and a surgeon. You are the skilled assistant to the anaesthetist.

Clinton: With the surgery done the patient is allowed to come round and the monitoring is removed.

Michelle: I always remember, when I was training, my workplace assessor saying to me just always imagine that the patient on the table is your family member. I must have seen thousands of patients over the years and every single patient that comes in is a family member to me.

Clinton: Well Lissey has been through the job at quite a rate of knots, so how do our mentors rate Lissey?

Sheeraz: Lissey was very enthusiastic and she wasn’t squeamish at the sight of blood. She was also able to apply what she saw in this environment to what she has learnt at school. So overall I’d think she’d make a great trainee.

Lissey: It’s been an awesome learning experience. It was so much fun to do all the hands-on stuff and learn more about being an anaesthetic technician.

Clinton: To be a trainee anaesthetic technician you need to have NCEA Level 2 physics and Level 3 biology, and gain a position as a trainee at a recognised training hospital. You need to complete a diploma or graduate diploma in applied science, anaesthetic technology. You learn on the job working with an assessor who mentors your training. It is a growing profession where the role is evolving.