Clinical Tip #1: Be Early

It sounds simple enough.

But being early permits you to take advantage of a lot.

First, the earlier you are, the more likely you are to learn that your case has canceled because your patient had coffee with cream and you can go back to bed. Kidding. Sort of.

Many of us performing IONM are not employed by a hospital system, but rather are contracted clinicians through a third-party company. Technically, we can show up basically whenever, as long as we get the job done. But…

The best advantages, in my mind, come from the reduced stress and anxiety of setting things up. Ask yourself: “Do I have all of the tools I need for today? Probes, check. Stimulator clips, check. Electrodes, check.”

Do I have ample time to turn on my system and confirm its proper functioning? There’s nothing worse than a patient rolling in the room and your MEP stimulator isn’t connecting and you need a new one. You could have figured that out before anesthesia started!

Being early allows you to shape your workspace and mentally prepare your flow. Early hours are often quieter, offering better concentration and fewer interruptions. Preparedness is confidence, and confidence is calming. Not just to you, but to everyone in the room.

I recently did monitoring for a case where I called before I left for an afternoon start, confirmed on-time, showed up, and the patient was being positioned. It happens. I was wholly unprepared, and although I knew what I was doing, the setup was extensive and I was definitely not calm. In fact – I could’ve been better. Luckily I had a patient surgeon and good data, but I did not know what I was walking into because I had nothing prepared and hadn’t spoken to the patient.

After that case, I remained on high stress for a little while after. I feel that when your workday begins slowly and smoothly, you are much less likely to carry that tension home, which enhances work-life balance.

In general, my rule of thumb is: Clothes changed into scrubs 1 hour before first-start cases, 1.5 hours before afternoon starts. Let me know when you like to show!