June of 2020 will mark my 3-year anniversary working in Intraoperative Neuromonitoring, IONM! IONM is, to most people, a rather illusive career. As we all know, it takes some extra explaining when asked, “So what do you do?” When first introduced to this career path, I was a part of the general population that had never heard of Intraoperative Neuromonitoring.
Entering my training, I was eager to learn all I could, as fast as I could, about this whole new world. I am still of course, continuing to learn new techniques, programs, and better ways to communicate daily; but here are a few things looking back on my first year and training that I would tell myself.
- Don’t rush your set up, get it right, it won’t take that much longer and it’s worth not questioning it later in the case. This will help limit unnecessary troubleshooting in the middle of the case.
- All patients are different and that is OK. Find a clean reliable baseline-a lot of our patients are not healthy, and their traces might not look like your textbook response. Find what their unique baselines are.
- Lean where your responses are coming from. Generators are not only important for your CNIM test, but the best reference for understanding your traces and how to troubleshoot changes.
- Learn the basics now, master them and the rest will come. Don’t overwhelm yourself by going too quickly.
- Use your pre-op interview to your advantage. This is a great opportunity to get as much information about your patient as possible and adjust your monitoring style to help optimize traces. Be adaptable.
- Loud, clear and concise statements. Your window is short, and the OR is loud. Be heard and get to the point.
- The OR is an intense environment, don’t let it bother you (or at least don’t let it show).
- Bring humble confidence (and kindness). Be confident in your skills, data, and relay what you see.
Of course understanding neurophysiology, knowing your equipment well, and being a master at troubleshooting are all essential parts of being a “Rockstar” Surgical Neurophysiologist. BUT, as we discussed, the OR is an environment like no other. Present your data whether it be baselines, alerts or closing with confidence. You know your traces, so be confident and this will help you gain the trust of your surgeon and the whole OR team.
Written by Riley Ridge, CNIM