Ahhh, finally getting to dip your toes into actually practicing anesthesia instead of just studying it! Nerves will be nerving, hands might be shaking, but guess what? It will be alright! Clinical rotations are where school gets real. Here are the five things I wish every SRNA knew walking into the OR.

1. Never be afraid to look dumb

My number ONE piece of advice I can give to anyone starting clinical rotations (which also applies when you are practicing on your own) is to never be afraid to 'look dumb.' Looking or sounding dumb is a fear every provider will face in their career, but I will tell you this: you will learn more than you can ever imagine if you just put yourself out there.

Here is the part nobody tells you. The preceptor standing next to you already knows what you do not know. They can see it in how you hold the laryngoscope, how long you study the vent settings, how you hesitate before you push. Pretending otherwise does not hide anything. It only costs you the chance to be corrected while someone experienced is standing right there.

The students who struggle most are rarely the ones asking too many questions. They are the ones who nod along, go quiet, and hope nobody notices the gap. That gap does not close on its own. It follows you into your next rotation, and eventually into your first job, where the stakes are higher and the safety net is thinner.

So ask the question. Say “I have not seen this before.” Say “walk me through why you chose that.” Every time you do, you trade five seconds of discomfort for something you keep for the rest of your career.

2. Bd brave to speak up

Be brave. Have the courage to ask questions. Have the courage to say something. Have the courage to look like you do not know what you are doing. Before you know it, you will be the expert.

Speaking up is not only about asking questions. It is also about saying something when something feels off. If a vital sign does not match what you expect, if a syringe does not look right, if the chest is not rising the way you thought it would, say it out loud and say it early. You will be right often enough to matter, and on the occasions you are wrong, you will learn exactly why.

This is a habit worth building now, while you have a preceptor two feet away. Anesthesia rewards providers who notice things and name them. The culture you want to work in is one where a newer provider can raise a concern without hesitating, and the fastest way to recognize that culture later is to practice the behavior now.

3. Be humble, on the good days especially

You will have great days. You will have bad days. Whichever day lands in your lap, stay humble. If you look like a rockstar, be humble. If you need help, be humble enough to ask for help. You will gain respect by just being humble.

The bad days take care of themselves. Nobody has to remind you to stay grounded after a rough case. It is the good days that catch people. You get three tough airways in a row, everything goes smoothly, and you start to believe you have it all figured out. That is usually right before anesthesia reminds you that you do not.

Humility in this field is not modesty for its own sake. It is a clinical skill. It is what makes you check the circuit again when you are already confident it is fine, and what makes you call for a second set of hands before you need them rather than after.

4. Stay flexible

I know that most anesthesia providers prefer structure. But you have to come into each day of clinical loosey-goosey. Your assignments may change, the providers you are with may change, but one thing that should not change is your ability to adapt and have a steady, good attitude.

Your room assignment will move. Your case will get bumped. The preceptor you prepared for will be pulled somewhere else and you will meet someone new at 6:45 in the morning. None of that means the day is going badly. That is simply how an operating room runs.

The students who get the most out of rotations treat every reshuffle as another set of hands to learn from. The ones who struggle spend the morning frustrated that the plan changed and miss what is right in front of them.

5. Take something from every provider you work with

Everyone practices anesthesia differently, so remembering to be loosey-goosey and pick up all the little differences each provider can give you will carry you through your career and never leave you.

Keep a running list. Nothing formal, just a note on your phone at the end of each day: one thing you saw that you want to borrow, and one thing you want to do differently. After a year of rotations you will have a hundred entries, and what emerges from that list is your own practice.

You will notice something else along the way. The providers you learn the most from are usually the ones who are still learning themselves. That does not stop at graduation, which is why continuing education like LifeLinc Academy and leadership development like LEAP exist for practicing providers.

Walking in on day one

Be brave.
Be humble.
Be flexible. And never be afraid to adapt.

Your training runs deeper than you think. When the plan changes mid-case, take a breath, fall back on your fundamentals, and adapt. That instinct is what rotations are for.

If you are an SRNA looking at where to land after graduation, take a look at our open clinical positions and the kind of teams you would be joining.