All SRNA's: Have you bitten your tongues in half?

  1. Just curious to see how many of you have had "problems" at your clinical sites, whether clinical or just personality conflicts, whether real or perceived by others. How do you handle it and is your tongue as black and blue as mine? Do you get told one thing by one CNRA and then another thing by someone else and then when you do it the "wrong" way because it is not his or her way, it is automatically your fault because you are the "student"? I think the main thing that bothers me is to get "fussed" at for doing something different even though it doesn't jeopardize patient outcomes, just because it is not the way they do things. I am very frustrated with all of it right now. The other thing is all of the he said, she said stuff... Can anybody relate to this? I can't even be myself at clinical for fear of someone turning everything I say around. I just have to be quiet, smile, and say thank you. It is the biggest mind game I have ever had to play.
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  2. 10 Comments

  3. by   loisane
    kkrnkk,

    It has been awhile since I was a SRNA, but I have to admit, what you describe is pretty common. Unfortunate, but common.

    Anesthesia people are, as a rule, very meticulous to detail. So it is easy for us to get trapped into thinking our way is the "right" way, so every other way HAS to be wrong, that is logical, right? (I hope you recognize my tongue in cheek)

    Of course, the best clinical instructors are those that can realize the beauty of anesthesia is there are very few "wrong" ways to do things, and many, many "right" ways.

    These same instructors tend to be education oriented, meaning one of their goals for the day is for you to learn something. While there are those instructors who frankly have far different attitudes. Students are there to lessen their workload, or they are in the way.

    CRNAs are the best people in the world, I am not dogging them. But, hey, we're only human. All people have their own individual strengths and weaknesses. So it is a fact of life that not all clinical instructors are the very best educators.

    But there are many excellent clinical instructors. I am sure you have worked with them. Enjoy those experiences, and relish in them. It will make the other days easier to get through.

    You are right, it is difficult to stand there and take this (pretty much unfounded) criticism. But (IMHO) you are right about playing the game. It is just part of being a student. BUT, I would qualify that with these three points:

    1) You never have to take actual abuse, physical or verbal. There are limits.

    2) It is possible that there are times that the critical instructor is right. It is possible for an individual CRNA to have fallen into a "bad" habit, that students should not be following.

    3) No matter how impossible it seems now, you will learn something from each and every clinical instructor you work with, even the difficult ones. Yes, you have to do the case "their way" when you are with them. But there will come a day that you get to decide what is "your way". And you will have a wealth of clinical pearls to choose from.

    Believe it or not, all those little things add up to alot. Even something as small, and seemingly inconsequential as where you put the syringes on your cart, is part of the way you will eventually evolve your own routine, and will have an impact on how you perform.

    And there will come a day when YOU are the one who is meticulous about the details of your own routine. Just never forget how that impacted you as a student, so you keep it all in the right perspective, and become an excellent clinical instructor yourself!

    loisane crna
  4. by   smiling_ru
    I think loisane summed it up perfectly.
    I have learned something from everyone I have worked with. sometimes what I learn is that I do not want to do something a particular way again, which is just as useful as learning something I will use again.
  5. by   yoga crna
    Loisanne,
    You stated it perfectly. Like you, it has been a long time since I was a student, but I remember how difficult it was with some clinical instructors. The important message is that it really never changes, you have to deal with personalities in every operating room, every day of your career.

    kkrnkk, Just learn as much as you can from everyone, study hard, and remember to have some balance in your life. You will be fine.
    Yoga
  6. by   Qwiigley
    I have experienced what you have, but few and far between. Many of the CRNAs that I have been precepted by has graduated from the school I am attending as there are only 4 on the West coast. (Kaiser, Samual Merritt, Gonzaga and USC). The school I attend, Kaiser has 18 clinical sites for us to attend, all but 5 are Kaisers. That is good and bad. Good because each Kaiser is different- completely! Bad, because if you sneeze in Woodland Hills (N. of LA) those CRNAs in SanDiego say "Bless you." Get my drift? You get a reputation as being good in one site, you are ok. You get a rep for being "bad" whether or not its true, then the next 24 months of your life is hell.
    Just my thoughts. Yes, I smile and say thank you for the information. I always end the day by thanking them for their time and effort and let them know that it was a good learning day for me. (Yes, I've gone home and cried on several occasions when I'd been beat up for 12 straight hours). But its part of the initiation!
    Good luck!
  7. by   lml33
    I can only imagine what my clinical experience will involve. I will begin clinical in January, but I am taking online classes to get them out of the way. Advanced Physiology is interesting, but I spend tons of time reading and studying. It is very involved.

    Anyway, I even went through a similar type of problem in nursing school. I butted heads with a few instructors. During my last year of clinical, I decided that I wanted to take on a full assignment on a med-surg floor. My instructor had asked me why I wanted to do this. I stated, "because I want to know what it is like working in the real world as a registered nurse." She did not even commend me for taking on a full assignment. All the other students thought I was crazy for doing this.
    Keep your head held high and study hard. Know your stuff in order to attempt at explaining your rationales for your interventions. Good luck, I'll be right there with you soon! Leslie.
  8. by   kkrnkk
    Thanks Loisane for your entry. It is all very true. Unfortunately, not taking the verbal abuse would just make everything worse, so I will just have to suck it up and get over it. The stress is unbelieveable and it should be considering the responsibility I will eventually have as a CRNA. However, there are some CRNA's at one of our clinical sites who have absolutely no business trying teach any of us anything. Not because they don't know their job, but because they don't know how to teach or interact with people. I have been a preceptor/clinical instructor and I know I expected a lot from the people I taught, but I was always nice and respectful to them. So, I have been on the other end myself and I look forward to the day I can be a clinical instructor for an SRNA and I can promise you I will never treat them the way I have been treated by some. Maybe the reason for the lack of interest in teaching is because they get no compensation for it, I am not sure. But, when they can sit back and do nothing but watch us while we do everything, one would think that would be compensation enough. After all, they are the one's getting the salary. Oh yeah, and today was a great day at clinical! Thanks again for your words of encourage everyone.
  9. by   TraumaNurse
    As usual Loisane offers up some excellent advice. I agree that you just have to go along with the flow. Smile, nod and move on...it's all part of the learning experience!
  10. by   loisane
    kkrnkk, it concerns me that you feel what you are going through falls in the category of verbal abuse. If you think that is truly the case, you could consider a formal complaint. (and of course, we all throw terms around when we are "venting" that we don't really mean to be take literally, so I understand that may be the situation here.)

    Only you know if formal action would be prudent in your situation, or not. It is a judgement call.

    All programs are supposed to collect feedback/evaluations from students on their clinical faculty. Even if you don't pursue a formal complaint, you should be giving honest feedback about this clinical instructor(s). If enough students do this, it will be addressed.

    (And thank you TraumaNurse for your kind words!)

    loisane crna
  11. by   srna
    Hey everyone,

    I just wanted to add my two cents. You will hear different ways of doing things from different CRNAs and MDAs. It is okay do do things differently, just do things the way that the person you are with on that particular day is doing things.

    It is okay to not always know the answer
    It is okay to have a point of view
    It is not okay to argue points with CRNAs or MDAs as you do not matter.

    Attitude is key!

    You could be the brightest one in class, but if you are constantly seen as a rebel, or argumentative, you will be dealt with. If you maintain a closed mouth, and open mind and willingness to read and accept different opinions you will succeed in anesthesiology.

    Mistakes are acceptable as long as they are not flagrant. They happen. It is important for you to know what could have been done to prevent a mistake, or how to fix it. It is not like nursing, which is a profession that does not respect each of their colleagues, and punishes for frivolous reasons.. MDAs and CRNAs do not expect you to know all the answers, or think that you know all of the answers, but expect that you continue to learn and improve yourself based on a variety of different viewpoints and proven theories and then develop your own style as you evolve into a CRNA
  12. by   KSCRNA
    Remember that most of the clinical preceptors are NOT professional educators. They are clinicians who are kind enough to assist in the clinical education of nurse anesthesia students. They are in cliinical practice because they enjoy giving anesthesia and if they have a student everyday, they are not getting to do what they enjoy. Mostly remember, not every day is a good day, they, like you as a student, bring "baggage" with them on a daily basis. Each clinical instructor has their own way of wanting things done. They don't care how anesthetist X or Y does thing, their way is the right way. As a student learn everything each instroctor has to offer and when you get done incorporate the best of each instructors practices into your way of doing anesthesia.

    It is not easy being a student but remember, it is often harder being an instructor. You have to watch while someone takes care of your patient and makes mistakes. Mistakes that could cost you as the clinician a lawsuit. Rarely is the SRNA named in a lawsuit. Most clinical instructors are not paid for their tiime and efforts so please don't forget to thank them. When you are finished, hopefully you will get to serve as a clinical instuctor and remember how you wanted to be treated.

    Nurse anesthesia is a great profession. One I hope you will enjoy has much as I have over the past many years of practice. Remember, your didactic and clinical instructors are the gatekeepers of the profession. From prior experience they know how things work best for them. Listen, Learn and Thank them!

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