Experienced CRNA...ask me anything - page 6

Okay...If you've read my posts you know that I will be retiring soon. Now is your chance to ask a practicing CRNA anything. 12 years of experience from solo rural independent to... Read More

  1. by   06crna
    Marusia,

    Since you have multiple questions, my answers are bolded in your quote. Good luck!

    Quote from marusia_tk
    06crna, CRNA -

    At 19 I started working as an RN at a procedural ASC where I work in PREOP, INTRAOP, and PACU - administering sedation and monitoring patients. I have come to understand what it means to be able to distinguish between nurses who think critically and those who can only focus on one thing at a time. As you have stated above, those who pursue Nurse Anesthesia should be quick on their feet, detail-oriented, and not a wallflower. I consider myself ambitious and driven. I am also very reserved (at times shy), and am very aware of this and have fought to overcome my fears over the past half year that I've been working.

    I am messaging you because of this - I realize one quality a nurse should not possess, and especially a nurse working in critical care, is insecurity. I am insecure about my abilities as a nurse. Are you sure you mean insecurity? Or could what you are describing perhaps better be called inexperience and/or uncertainty?Therefore, as much as I fantasize and long for the opportunity to work in a heart-pounding environment where I know exactly what to do whenever anything goes wrong Note: in actuality, anesthesia is not exciting. Or shouldn't be, anyway. It goes well almost all the time. And no one can know exactly what to do when anything goes wrong. No one. ow can I know that I am the right character type for this? Emotional maturity, remaining calm under pressure, being able to handle difficult personalities, using critical thinking skills, possessing good judgement, and presenting a professional demeanor are important. What happens when you over sedate a patient in your current area? Do you panic a bit? Do you feel terrible and beat yourself up about it? How do you handle it when a physician is unpleasant to you? Think about your personality, your strengths, and whether the demands and pressure of independent practice (because even ACT CRNAs practice independently) are something you wish to take on. Both of my parents are exceptional leaders in the areas where they work, and I see some of those same traits they have in myself. At what point is my insecurity age-related, and at what point is it overall character-related? Difficult to say. I was 21 when I started critical care nursing and 34 when I went CRNA. I am not at all sure I would have made it through my program without the life lessons I received while working in Corporate America. Besides stepping out of my comfort zones, and pursuing jobs in the ICU, are there any other resources I can look into to possibly prepare myself for the role of the CRNA? Hmmmm. Interesting question. I cannot think of anything off-hand besides enjoying life and being a well-rounded person. Any tips for very fresh meat looking into future career possibilities would be greatly appreciated. Pay off all your debts and have a funded savings account before you make a change. Then you have time and resources to look around. Research. Investigate nursing roles - both clinical and non-clinical. Decisions are easier the more information you have.
    Last edit by 06crna on Aug 5
  2. by   06crna
    Pres - here you go...

    Quote from PresG33
    I saw you were a clinical coordinator for SRNAs. What are the principal qualities you look for in a SRNA in clinical? Calm professional demeanor, open and willing to trying new things, ability to process constructive criticism (the issue being continuous improvement, not necessarily perfection. I want to see that you have heard me and are making an attempt to learn/improve), ability to focus and concentrate for extended periods of timeWhat are the biggest mistakes you see SRNAs making in clinical Being afraid to try something new, being flippant/defensive, being bored, getting distracted, playing with their cellphone (I will lock it up - no first warnings) . What is the best strategy to not only survive but excel at clinicals? Prepare yourself prior to your program entry by getting your life in order. I mean EVERYTHING. Sort out your finances, get a reliable car, have a stable living situation, etc. Once you are in school, your life IS school, and the students who deal with it the best seem to be the ones with the least chaos in their personal lives. Get plenty of sleep. Prepare for your clinical day as best you can. Don't be afraid to ask questions, but don't expect to be spoon-fed. Be the student everyone enjoys working with because you make their day better, not worse. Good luck!
  3. by   wtbcrna
    Quote from 06crna
    West -

    So few CRNAs hold a DNP currently that it is difficult for me to comment on the topic. I know a few who are pursuing a DNP with the specific intent to teach. I do not know any clinical CRNAs who are pursuing a DNP with the intent to stay in clinical practice.

    If it were me, knowing what I do about clinical practice and the changing anesthesia environment NOW, I would pursue a MSN (not just a program that confers a Master of Anesthesia & not affiliated with a nursing school) and choose a program that offers the best clinical education for reasonable tuition in the shortest time frame.

    I will relay that there is a great deal of negativity on the part of anesthesiologists I work with (and am friends with) re: DNP. They do not like the idea of a clinical "Doctor Nurse". It angers them. In an ACT setting, I could foresee a real problem with being a DNP and calling yourself Dr. Nurse Anesthetist.

    I think WTBCRNA on this board holds a DNP. Will be a much better resource for this question than me.

    Best of luck!
    The DNP/DNAP is becoming more common. I work with a few DNPs at Kaiser and all the military nurse anesthesia programs switched to a DNP curriculum about 4-5 years ago. The early adopters of the DNP, like myself, mostly had non-clinical reasons to get the DNP now that more and more programs are making the switch from MSN to DNP we are seeing more DNPs working clinically without any immediate plans to teach or go into administration.

    I would suggest getting the DNP/DNAP if someone is just now considering becoming a CRNA, if you are ready to apply to CRNA school within the next 1-2 years then I would just pick the best school you can get into regardless of the degree.
  4. by   Bluebolt
    DNP is the way to be! There's your slogan.

    Come, join us in the future, they're serving stale bagels in the conference room.
  5. by   nomadcrna
    I have to comment on a couple of things. Jobs with 250k and 30 hours? Yes, they do exist. It's very common in rural areas to do 2 weeks on and 2 weeks off. Usually contracted at around 200k.

    Amniotic embolism is very rare. New treatment is very effective. Toradol, atropine and zofran. It's called AOK.
    Last edit by nomadcrna on Aug 5
  6. by   passthehaldol
    Quote from Kooky Korky
    Thank you. Lots of good information.
    someone got their homework assignment done for them
  7. by   Pghfoxfan1
    Where I work, the CRNA's refuse to witness Anesthesia Consents. Where is it written where this is not allowed?
  8. by   nomadcrna
    You should not witness your own consent. If the consent has a place for you to sign saying you "consented" the patient, that is different. I also won't witness the patient's signature, a nurse or another needs to witness it.
  9. by   Nurse4486
    Thanks for your time and honesty answering questions.

    I am currently a NP and looking to go back to school for CRNA. I have always been interested in anesthesia but was worried about losing patient interaction. I have reconsidered because I would like a job that is more shift work and I don't take it home with me as well as challenged daily. Do you know anyone that is a NP/CRNA and do you see any added benefit of having the two degrees?

    Thanks.
  10. by   nomadcrna
    I was a CRNA for 18 years and went back for my FNP. A few years later I also got my ENP.
    Having a general medical knowledge will absolutely help your anesthesia practice. You will have a much greater knowledge of disease processes and treatments.
  11. by   Nurse4486
    Do you work as both a NP and CRNA currently and how do you do that? Do you feel as if it is difficult to stay up to date on everything being in two different roles?
  12. by   Nurse4486
    I am not sure if my question went through so if it did I apologize, but do you currently work in both roles as a NP and CRNA? If you do what does your typical work week look like as well as do you feel it has been difficult to stay up to date in both fields?
  13. by   nomadcrna
    I do work in both roles. Each role also utilizes the other. For instance in the ER, I'm great with trauma and airway management due to my years as a CRNA. I'm much better at medically managing a patient in the peri-operative period due to my NP.

    I provide solo anesthesia coverage in a small CAH. I'm the only anesthesia provider. I cover OR, Ob and ER for critical care, trauma etc. I usually take 8-10 weeks off a year. Some of this time, I cover the ER at two neighboring rural hospitals that utilize NPs as the sole provider.

    Staying up to date is easy. The CME can usually be used for both.

    My typical week depends. If I'm covering anesthesia, I'm on 24/7 call. We have visiting surgeons that come certain days of the month. We do pediatric dental cases every Monday. Scopes every other week. Occasional pain management consults such as ESIs and such. I cover OB for epidurals and c-sections. I cover the ER for trauma, codes, airway management. i also do quite a few peripheral nerve blocks for fracture reductions, dislocations etc. We have FP clinic providers at the hospital I cover anesthesia at. A couple of them are not as strong in ER medicine and I'm happy to help. Chest tubes, FAST exams etc.

    if I cover ER. I will do either 24 or 48 hours of coverage. Usually see 15/day so it's not overly busy. Occasional trauma or other more serious condition that gets shipped out.

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