SPECIALIST - ANESTHESIA

The Specialist Anesthesiologist is a qualified physician who delivers high quality anesthesia care based on a scientific foundation with reliability, honesty and sympathy; 24 hours a day, 7 days a week. Anesthesia service covers the main Operating Rooms (OR), CS Rooms, Labor and Delivery Rooms (LDR), Endoscopy Room, IVF Room, Radiology department, Intensive Care Unit (ICU), Emergency Room (ER) and wherever requested in the Hospital.

DUTIES & RESPONSIBILITIES

• Operational Duties
• Provides, along with anesthesiologist colleagues, a modern and comprehensive Anesthetic, Intensive Care and Pain management service to NMH patients.
• Demonstrates high ethical/professional standards. Provides the professional duties of an anesthesiologist in accordance with delineation of privileges as recommended by Hospital policies and procedures.
• Provides anesthesia with the full range of anesthetic agents, methods and techniques; observes safety standards in the OR as related to anesthetic agents and equipment.
• Supervises the work in the OR and Recovery Room (RR) to ensure adherence to the by laws, rules and regulations of the Hospital and assures that work performed is in keeping with established standards of accreditations of the Hospital.
• Participates in general Anesthetic On-Duty and On-Call Rota (duty days & on-call rota are subject to change per service requirements).
• Partakes in the provision of out-of-hours Anesthetic services when requested. Covers colleagues’ annual leaves and authorized absences when required.
• Conducts professional supervision and management of Department Registrars, Technicians, and nursing staff as required.
• Delivers managerial responsibilities where appropriate.
• Participates in medical audit, NMH Clinical Governance processes and carrying out accreditation duties as required
• Liaises with medical staff in other specialties and participates in regular clinical meetings and other activities of the Hospital.
• Works as per the job plan provided by the Clinical Director which covers all aspects of a consultants professional practice including clinical work, education and managerial responsibilities, and a clear schedule of commitments.
• Cooperates with other members in the Anesthesia department, and works as a team member directed and organized by the Clinical Director- Anesthesia.
• Reviews personal and professional performance, periodically, against National and International Standards set for the speciality.
• Conducts specific anesthesia service as assigned to give care to a certain patient; covers the pre-operative, intra-operative and post-operative period in the recovery area until discharge to the ward. Responsible for providing anesthesia care to elective as well as emergency cases.

A. Pre-operative Anesthetic Service:

• Interviews and examines patients scheduled for surgery; determines their medical status, and completes the pre-operative anesthetic assessment sheet. Establishes rapport, allays fear and apprehension, and provides patient education.
• Develops an appropriate plan of anesthesia care and informs the patient/ guardian with the proposed plan. The plan of anesthesia care is based upon:
• Discussion of the medical history, previous anesthetic experiences, drug therapy, and allergic conditions.
• Review of the patients medical record.
• Physical examination: Assesses aspects of physical condition that might affect decisions regarding peri-operative risk and management.
• Assessment of the patients airway, scoring of difficult airway and the possibility of a difficult endotracheal intubation.
• Assessment of the spine for regional anesthesia.
• Orders, obtains and/or reviews tests and consultations necessary to the conduct of anesthesia.
• Determines the appropriate prescription of preoperative medications as necessary.
• Instructs the patient/ guardian about NPO requirements.
• Instructs the patient about medications to be continued or withheld.
• Asks for the required consultations.
• Ensures that the above steps properly performed and documented in the patients record.

B. Intra-operative Anesthetic Service:

• Conducts re-evaluation of the patients medical condition and NPO status immediately before the induction of anesthesia.
• Administers required pre-medications.
• Positions the patient safely on the operating table.
• Uses the appropriate monitors before, during, and after anesthesia to evaluate oxygenation, ventilation and cardiovascular system; this includes electro-cardio gram (ECG), Blood pressure (BP), inspired oxygen concentration, peripheral oxygen saturation (oximetry), end-tidal carbon dioxide (capnography), and temperature monitoring. Other invasive and non-invasive monitors (e.g. CVP, arterial line, etc.) are inserted as per medical condition and/or nature of surgical interference.
• Administers local, intravenous, inhalational, spinal, epidural, caudal, or other anesthetic or sedatives according to prescribed medical standards.
• Uses mechanical ventilation appropriately when required and adjusts the ventilator settings according to the patient’s needs.
• Institutes remedial measures to counteract adverse reactions or complications.
• Administers intravenous fluids (crystalloids, colloids) as required.
• Records urine output and calculates fluid balance.
• Estimates blood loss and transfuses blood and/or blood components if required.
• Records timing, type and amount of anesthetics, sedatives, muscle relaxants and other drugs administered, IV fluids, blood loss and blood/blood components given, airway device used and ventilator settings, hemodynamic and ventilator changes, events and complications encountered, and condition of patient on leaving the OR.

C. Post-operative Anesthetic Service:

• Attends and supervises the patient while being transported to RR/ Post Anesthesia Care Unit (PACU) or ICU.
• Evaluates the patients post-operatively for recovery from anesthesia, assesses complications and reports them to administration; makes recommendations as indicated.
• Orders analgesics as required and manages any possible complications in the RR/ PACU until discharge to the ward.
• Conducts follow up of continuous analgesia administration regimes, such as patient-controlled analgesia and epidural analgesia.
• Answers calls from wards, regarding conditions related to anesthetic care given to the patient.

On-Call Duties

• Manages use of Epidural analgesia during labor and delivery.
• Conducts pre-operative check- up for patients referred by surgeons for check-up before booking/scheduling or admitted the night before surgery.
• Covers calls from ER, ICU and other areas of the Hospital for conditions related to anesthesia service or resuscitation.
• Considers the patient’s safety as the first priority while working.
• Includes the patients in discussions concerning appropriate diagnostic and management procedures.
• Assesses, plans, implements and evaluates patient care needs.
• Maintains a work environment that promotes high standards for patient care and ethical behavior.

Compliance with Medical Ethics

• Ensures implementation of Ministry of Health regulations, Hospital Medical Staff Bylaws, rules & regulations and Anesthesia department policy & guidelines.
• Ensures implementation of the standard concepts, practices, and procedures within the field of anesthesia.
• Exhibits appropriate personal and interpersonal professional behavior; practices medicine ethically and stays consistent with the obligations of a physician
• Recognizes limits of personal skills and knowledge by appropriately consulting other Physicians while caring for the patient.
• Constricts to his/ her limitations and seeks the consultation of Consultant-Anesthetics, in cases such as:
• Neonates/infants and children under the age of 12 years, with ASA status more than 3 or with uncontrolled medical problems, undergoing major operations under general anesthesia.
• Patients above the age of 70 years, with ASA status more than 3 undergoing major operations under general anesthesia.
• When technical difficulties are encountered.
• Shows a pattern of maintaining current personal clinical skills and knowledge by taking part in continuing medical education.

Other Duties

• Gives consultation and advisory service to medical colleagues in other specialties in the Hospital.
• Responds to referrals from Department physicians.
• Actively participates in the teaching & audit activities of the Department and as a member of Cardiopulmonary resuscitation team
• Attends Departmental meetings to discuss the rules & regulations, obstacles in work, incidents & complications encountered and suggestions to improve the quality of service; includes scientific presentations and refresher course lectures, whenever possible.
• Accepts all other additional assignments found necessary by the Clinical Director- Anesthesia, Medical Director & Assistant Medical Diector and which relates to a specialists interest.

INTERNAL:

• Visiting & NMH Doctors/Physicians
• Heads of Departments

• Patients and their Relatives & Friends
• Medical Representatives

Education : :Bachelors’ Degree in Medicine with specialized training in Anesthesia. Fellow/Member (preferably of the Royal College), PhD, MD degree or equivalent in Anesthesia Knowledge of advances in medical education & training and ability to operate within a teaching/training culture. Advanced Cardiac Life Support (ACLS or ALS certificate) is desirable Licensing: Valid License from Ministry of Health- Kuwait to practice as an Anesthesia Specialist.

Experience : Preferably 8 years experience with a minimum of 3 years experience post Fellowship/ Membership/PhD or MD certification in the anesthesia specialty.

OTHER SKILLS:
Management Skills: Cognitive, Prioritization, Problem Solving, Decision Making and Teaching skills; Team Player. Leadership skills with the ability to motivate and develop junior medical and other staff. Ability to manage Multi-disciplinary groups and work as part of a multi-disciplinary team
Audit and Clinical Governance: Interest in, and knowledge of medical audit. Understands the principles of evidence based audit and principles of Clinical Governance.
Soft Skills: Excellent Communication and Inter-Personal skills. Ability to communicate effectively with all levels of staff, patients and relatives. Ability to work as part of a multi-disciplinary team with appropriate inter-personal skills for effective team working. Ability to gain the trust and confidence of colleagues and patients
Computer Skills: Competent in all relevant IT packages, including Microsoft Office (Word, Excel, Outlook), Internet and patient administration systems.
Language Skills: Good in written and spoken English

Works primarily in an air conditioned, well-lighted and comfortable health care facility, while also exposed to infections and close contact with the patients. May have to work long hours and be available on call to deal with medical emergencies.Occasionally involves prolonged standing/walking, lifting supplies/equipment.