What would happen if someone accepted an offer from a hospital, anesthesia groups ect

gaspassah · Mar 28, 2004

roland i agree with free speach. i believe in knowing when and where to speak your mind,

however, in the sense of being a crna student

I care more about free, intellectual inquiry and the discussions that it can generate than I do "material" rewards that ensue from properly "playing the game".

this attitude will kill you and you may not graduate the school you may find yourself lucky enough to get into.

playing the game is integral to your status as a student.

often you will be told to do things you may not agree with, based on whatever theory you may believe. your preceptor is the boss, it's their patient really, we're along for the ride as they are kind enough to offer the "use" of their licensure so we may learn.

when they ask or often tell you to do something it's because they have experience we dont, they are in charge, they know more than we do. to fight that system would be intellectual, professional, educational suicide.

i would ask you to reevaluate your need for intellectual confrontation, growth, or need for open discussion to suck it up and do what your told when told to do it in the clinical environment.

the patient will be safer, your career will be safer.

after the fact ask your instructor for an open discussion on the matter to present your views, but never let it influence your decisions in the clinical arena.

good luck roland.

d

WntrMute2 · Mar 28, 2004

On the other hand I have been the subject of criticism on many occasions primarily for my opinions. In reply to your challenge to demonstrate that I have accepted criticism in the past, I offered above an example of developing my "plan B" in response to Kevin's observations that I wouldn't make it through CRNA school. Also, Wintermute, please note above where I concede that your opinions of my being a "slow learner" may in fact be correct. However, I offered an alternative explanation for my views, which you are free to either accept or reject.
In the final analysis I challenge anyone to honestly conclude that the subject of SRNA's reneging on contracts is not a subject worthy of discussion. This thread offered multiple accounts that this is not rare, and is perhaps commonplace. Whether or not you find this to be reprehinsible behavior or not doesn't change the fact that it IS a relevant topic for discussion. Furthermore, if it cannot be discussed in a forum developed for the open, exchange of often divergent opinions about nursing (and in this case about CRNA's) one must ask where it CAN be debated. Please note also (as I have said several times now) that several potential solutions were offered to reduce this practice which would not exist in the "public areana of ideas", but for this post.

1) I certainly did not criticize you, I believe I criticized behaviors I merely stated that one who knowing cheats or plans to cheat is not someone I want putting me to sleep or possibly taking care of someone who placed their trust in me.

2) Developing an alternative plan is not the same thing as seeing the point that the vast majority on this web site communicated to you.

3) Yes, you did admit you are a slow learner so I'll retract that statement.

4) I still don't really note an instance where you have admitted that ANYONES' POV may have more value than your own or could be correct.

5) You absolutly have the right to bring whatever topic to the table you wish. I even agree with raising the issue of reneging on contracts. However, when the vast majority of opinions runs counter to your thesis, maybe the thesis is flawed. I reread the entire thread and as soon as you are disagreed with, you seem to fall back on the defense of we want to deny you the ability to speak. Nothing could be further from the truth, I think we want you to hear us and consider that occasionally, we may be right. No one said you can't talk about it, but the consensus was that the practice of doing it with knowledge you were going to default was distasteful. No one attempted to censor you, I just disagreed with the idea.

athomas91 · Mar 28, 2004

woah guys...lets back off a little bit..it's getting kind of harsh in here.

i understand where your question came from roland...and although i myself am a "genX" it has been ingrained in me from my parents that i uphold my contracts to the best of my ability and that anything else would be premeditated and wrong. I believe that is where everyone else here is coming from as well. there are of course circumstances where a contract must unfortunately be broken - but to know going into it with that intention just doesn't sit right with most. You are however welcome to your ideas - and who knows - they may work fine for you - but in a business where professionalism and "reputation" are key ...it may not be a risk that will pay off. good luck in your endeavor...

gwenith, BSN, RN · Mar 29, 2004

Roland communication is about having a 2 way street. Please listen to what others are saying - this is MY main beef with your behaviour here. Several times in other threads i have given you answers that you have either ignored or dismissed or ridden roughshod over. If you are truly interested in debate then listen to the other side ask questions listen to the advice given and then go from there.

You say you were in the navy??? How did you cope in that restrictive environement? Believe me nursing has on more than one occasion been accused of having a militaristic attitude, particularly to the kind of equiry you are making.

kmchugh · Mar 29, 2004

I'm done.

KM

SirJohnny · Mar 29, 2004

All:

- Need a beer after reading all these posts.

- You guys remember the "Mario" threads that were on the board about a year and

a half ago?

- Sure seems like the same situation repeating itself over and over.

John Coxey

Roland · Mar 29, 2004

Wintermute, here is my reply:

1. It has been my observation that you have seldom if ever agreed with me on anything in the two and a half years that I've been here. In addition, you said that you would probably not be comfortable working with me because of my ethics. I would say that my ethics cannot be determined by my asking a question about reneging on contracts (in fact I started the thread by saying that the question did not apply to my situation, and in fact that my wife would never allow me to do this even if I desired to do so). Furthermore, I would assert that there are few comments more damaging in a forum dedicated to a profession than saying that you wouldn't be comfortable in working with someone (although I defend your right to make the comment).

2. You may be correct in saying that I don't accept criticism very well. In reality, few people are very good at being criticised and generally only "accept" significant criticism from those in a position to force it upon them (such as instructors and superiors). In fact, most people who know me at work say that I am too TIMID clinically while at the same time being too OUTSPOKEN in class. This situation results from my problem with tasks that involve psychomotor coordination, and the extreme effort it takes for me to master such skills (and the fact that I am not outspoken until I get to know someone. Unless it is a classroom situation where I feel that I'm paying good money to be taught). However, when the welfare of my patients is concerned my passion knows few bounds.

3. Actually, I said that I MAY be a slow learner (on some things I definitely AM, but other things I pick up quickly). I also countered that being dedicated to one's principals to the point of being willing to accept extreme sacrafice for saying what one believes may constitute something other than dullness. The Romans thought the Christians dull, or worse insane for accepting being thrown to the lions rather than worshipping the Roman gods. The British felt that the early aristocratic landowners who rejected their rule were really stupid for abandoning a proven system (the British Crown) for a completely new system that many felt would degenerate into chaos.

4. I freely admit that other points of view are equally valid to my own, and in many cases superior. In addition, my desire is not to get anyone to "agree" with me so much as it is to stimulate them into looking at issues they have not considered or seeing them from different perspectives. While I respect all perspectives I am of course partial to my own (or I wouldn't take the time to offer it). In addition, I seldom state that I agree with something because it does little to further the conversation on the issue at hand (after all if everyone agrees what is left to discuss).

5. My thesis in this thread to the extent that there was one went something like this:

SRNA's taking contracts but not fufilling them is a substancial issue in CRNA schools today. What are the consequences, ramificatons, and potenitial solutions to this behavior. Furthermore, can anything be done to lessen this from occuring (assuming that it is a problem which needs addressing).

I did not endorce the behavior. Read my post again if you care to and you will see the following statement:

"I am not advocating this approach, but consider it to be a worthy intellectual exercise since it is a situation which has likely occured before and probably will again in various locales around this crazy world of ours."

(I raised the question from a value neutral perspective as is often common in academic circles). In fact, mine may be the first potential solutions to LESSEN the occurance of such activity EVER offered in a public venue. Many posters jumped to conclusions about my position, based solely upon the fact that I raised the issue (despite the fact that I clearly said in the opening post of the thread that it DIDN'T apply to my situation). As a society fewer, and fewer people are willing to criticise an "argument" without ascribing negative characterisitics to the person MAKING the argument. For instance, I disagree strongly with the atheist Michael New who argued before the Supreme Court to remove "One nation under God " from the Pledge. However, I don't denigrate him personally for daring to MAKE the argument (indeed I find many of his arguments to be quite valid and thought provoking). In fact, I would die to defend his right to do that very thing.

Gwenith, just above you say that I don't listen to your perspectives. I always read your replies and usually provide a specific response that sometimes even addresses particular analogies that you have offered. If you see someplace where I have failed to do this let me know, and I will go back and address your point (even if it is an old post). Keep in mind that it is possible for someone to listen, understand, and still disagree with a divergent opinion. Keep in mind as well that, sometimes when a great number of people have offered criticisms it is easy to fail to address ALL arguments in a reply. Also, Gwenith I did not find the Navy to be restrictive. With few exceptions the people I served with were exceptionally respectful and oriented upon getting the job done. Even in bootcamp the DI's while strict were also task orientated and respectful (while also having high expectations). I wanted to be a SEAL, but could not due to my vision being too poor without glasses. However, becoming a Corpman helped me to get some basic medical training, and helped to create my ultimate interest in becoming a nurse.

Kevin, what offended you in my last post? I actually said that I felt your criticism was sincere and reflected positively on your character. On some things why can't we just "agree to disagree" without having animosity involved? I really do GET what you are saying. IF I in any way act disrespectful during CRNA clinicals the person controlling my fate will see to it that I don't pass. You say I should get counseling for self destructive behavior. I agree that making the post I did on a potential Gore administration after promising my wife I wouldn't was indeed self destructive. My strongest personality traits are being dedicated to doing what I believe to be correct without regard to the consequences. Some would say that people like President Bush suffers from the same problem, and he managed to become President (plus he was an alcoholic and people still didn't deny him a chance at the job).

Also, I would encourage those of you who conclude that someone will be combative in clinicals or elsewhere just because they are willing to debate in a forum created for the exchange of ideas to rethink their view on this issue. There is a time and a place for everything. If I made an error it may have been in concluding that this forum was the place for engaging in such debate (although I would point out that far more heated, controversial, and personal arguments take place virtually daily in the General discussion area without comment). Some would say that I go too far in defending myself. However, as Donald Trump has said "If you don't stand up for yourself who will?"

Kiwi, BSN, RN · Mar 29, 2004

Roland AKA Voltaire:

I can appreciate your initiative on this board. Your threads get a lot of hits. I think that the main beef people have with you here is an issue of your integrity and intentions. Personally, I was still reelin' from this:

"Unlike, many on this board our PRIMARY motivation for wanting to become CRNA's is monetary as it may help to enable us to live in Oahu (where I was stationed in the Navy)"

...Then soon after, you posted this thread. The hypothetical idea irked me as I put the two threads together: He's going to have an institution pay his way, and then break the contract and move to Hawaii, having become a CRNA just for the money. Now you say that is not the case.

I can relate to you in that I am a BSN student with one year to go until I sit for boards (isn't that about where you're at?) There are not only CRNAs, but veteran RNs who post here. Try to imagine the years of nursing work they have on you - you just aren't there yet. You need to simmer down, as the Bob Marley song goes. A lot of RNs have worked their butts off to even get to Anesthesia school. Yes, go ahead and be provacative, but it leaves a bad taste in people's mouths when you haven't been "there", and your intentions are questionable at best. Nurses seem to have a sixth sense for reading people like a cheap novel.

On a tangent, did you know that Anesthesia schools conduct behavioral interviews? Critical thinking is essential. If they ask you a clinical question about how you'd react in a situation, are you going to ruminate with the answer? Pts who are anesthetized want somebody who can think soundly and can hustle, not a philosopher.

Roland, go shadow an SRNA. CRNAs are great to observe, but at this point in your nursing career, you need to see the making of a CRNA. I observed a student in February. In what she described as an "uneventful day", she arrived at 6am to assess her first pt and try to put an IV in him (he started hyperventilating and became very pale, so the CRNA helped her start his IV and explained the full physics of the process). When attempting to intubate him, she was all thumbs - again, the CRNA had to intervene. She had difficulty intubating the second patient as well, and required assistance. This time, the patient woke up during his suturing (!!!) During the procedures she pushed many drugs at her discretion. To fathom the responsibility, I'm telling you - you have to see it.

Intentions and integrity aside, your initial post on this thread presented a interesting question. And hey, I learned. So thanks for asking it.

Roland · Mar 29, 2004

Ether, thanks for a fair and balanced reading of my opinions. With regard to the issue of saying that I want to be a CRNA for the money, I consider that to primarily be an ethical stance. Here's why. Many nursing students (even at the undergraduate level) are in fact entering nursing in large part because of the financial security that it offers relative to their current situation. However, few will admit this to be the case. In fact, in a previous post I offered how when my wife declaired this on the first day of clinicals, that she was neerly "jeered" from the room! She supported her position by asking how many would stay in nursing school IF they won the lottery. Initially, no one said that they would give up their desire to be a nurse. However, now after four semesters more than HALF of her class has told her privately that they now agree with her initial position that were it not for the money that they wouldn't enter nursing (and that they would quit if they won the lottery). I REALIZE that stating that you want to be a nurse in large part for the money is an unpopular position and will only hurt my chances of being successful. However, I consider doing so to be an ETHICAL necessity to avoid being a hippocrit (actually, I think peoples motivations are no one's business, but their own however since few subscribe to this perspective including many nursing and CRNA programs, motivations must be addressed).

Also, I know that being an SRNA is difficult perhaps too much so for my shall we say "challenged" psychomotor skills. I can only do my best to master the clinical skills required to succeed. In addition, to Kevin's warnings that I am doomed that is also why I developed my "plan B" since my wife rarely misses a stick, IV start, foley placement, or anything else clinically related (she doesn't even have to practice much she can just watch someone else do a skill and almost instantly "repeat" the process on her own, it drives me insane.) On the other hand despite her high IQ, and standardized test scores she struggles much more than do I on the academic aspects of nursing school (I typically score 97% + and she struggles to make high B's/low A's even with better study habits than I have). Put us together and we would make a good SRNA student apart we are "longshots" to even get in a program.

I was aware that CRNA schools conduct "behavioral interviews" as you say. In fact, I have personally communicated with over a third of the CRNA schools in the country (and will in fact communicate with ALL of them over the next year or so in an effort to gain profound insights into the CRNA admissions process.) I do well in interviews, but again that won't save me from my clinical weaknesses, only extra diligent practice, and perhaps prayer can do that (to say nothing of the imminent social issues that Kevin sees me facing). Also, I wish to shadow as many CRNA's as is possible. In this area I haven't found many, and have yet to ask any for permission to do so ( I have considered offering money a $100.00 or so for the priviledge rathe than just ask but my wife believes this is ill advised saying something to the effect of "if prostitution were legal you would just pay girls rather than date or get married wouldn't you", and I must admit she is probably correct since I abhor even the potential for rejection).

coffeedrinker · Mar 29, 2004

Roland: "One who knows much says little" -- please take some advice from a very wise man--King Solomon

gotosleep · Mar 29, 2004

Wintermute, here is my reply:
1. It has been my observation that you have seldom if ever agreed with me on anything in the two and a half years that I've been here. In addition, you said that you would probably not be comfortable working with me because of my ethics. I would say that my ethics cannot be determined by my asking a question about reneging on contracts (in fact I started the thread by saying that the question did not apply to my situation, and in fact that my wife would never allow me to do this even if I desired to do so). Furthermore, I would assert that there are few comments more damaging in a forum dedicated to a profession than saying that you wouldn't be comfortable in working with someone (although I defend your right to make the comment).
2. You may be correct in saying that I don't accept criticism very well. In reality, few people are very good at being criticised and generally only "accept" significant criticism from those in a position to force it upon them (such as instructors and superiors). In fact, most people who know me at work say that I am too TIMID clinically while at the same time being too OUTSPOKEN in class. This situation results from my problem with tasks that involve psychomotor coordination, and the extreme effort it takes for me to master such skills (and the fact that I am not outspoken until I get to know someone. Unless it is a classroom situation where I feel that I'm paying good money to be taught). However, when the welfare of my patients is concerned my passion knows few bounds.
3. Actually, I said that I MAY be a slow learner (on some things I definitely AM, but other things I pick up quickly). I also countered that being dedicated to one's principals to the point of being willing to accept extreme sacrafice for saying what one believes may constitute something other than dullness. The Romans thought the Christians dull, or worse insane for accepting being thrown to the lions rather than worshipping the Roman gods. The British felt that the early aristocratic landowners who rejected their rule were really stupid for abandoning a proven system (the British Crown) for a completely new system that many felt would degenerate into chaos.
4. I freely admit that other points of view are equally valid to my own, and in many cases superior. In addition, my desire is not to get anyone to "agree" with me so much as it is to stimulate them into looking at issues they have not considered or seeing them from different perspectives. While I respect all perspectives I am of course partial to my own (or I wouldn't take the time to offer it). In addition, I seldom state that I agree with something because it does little to further the conversation on the issue at hand (after all if everyone agrees what is left to discuss).
5. My thesis in this thread to the extent that there was one went something like this:
SRNA's taking contracts but not fufilling them is a substancial issue in CRNA schools today. What are the consequences, ramificatons, and potenitial solutions to this behavior. Furthermore, can anything be done to lessen this from occuring (assuming that it is a problem which needs addressing).
I did not endorce the behavior. Read my post again if you care to and you will see the following statement:
"I am not advocating this approach, but consider it to be a worthy intellectual exercise since it is a situation which has likely occured before and probably will again in various locales around this crazy world of ours."
(I raised the question from a value neutral perspective as is often common in academic circles). In fact, mine may be the first potential solutions to LESSEN the occurance of such activity EVER offered in a public venue. Many posters jumped to conclusions about my position, based solely upon the fact that I raised the issue (despite the fact that I clearly said in the opening post of the thread that it DIDN'T apply to my situation). As a society fewer, and fewer people are willing to criticise an "argument" without ascribing negative characterisitics to the person MAKING the argument. For instance, I disagree strongly with the atheist Michael New who argued before the Supreme Court to remove "One nation under God " from the Pledge. However, I don't denigrate him personally for daring to MAKE the argument (indeed I find many of his arguments to be quite valid and thought provoking). In fact, I would die to defend his right to do that very thing.
Gwenith, just above you say that I don't listen to your perspectives. I always read your replies and usually provide a specific response that sometimes even addresses particular analogies that you have offered. If you see someplace where I have failed to do this let me know, and I will go back and address your point (even if it is an old post). Keep in mind that it is possible for someone to listen, understand, and still disagree with a divergent opinion. Keep in mind as well that, sometimes when a great number of people have offered criticisms it is easy to fail to address ALL arguments in a reply. Also, Gwenith I did not find the Navy to be restrictive. With few exceptions the people I served with were exceptionally respectful and oriented upon getting the job done. Even in bootcamp the DI's while strict were also task orientated and respectful (while also having high expectations). I wanted to be a SEAL, but could not due to my vision being too poor without glasses. However, becoming a Corpman helped me to get some basic medical training, and helped to create my ultimate interest in becoming a nurse.
Kevin, what offended you in my last post? I actually said that I felt your criticism was sincere and reflected positively on your character. On some things why can't we just "agree to disagree" without having animosity involved? I really do GET what you are saying. IF I in any way act disrespectful during CRNA clinicals the person controlling my fate will see to it that I don't pass. You say I should get counseling for self destructive behavior. I agree that making the post I did on a potential Gore administration after promising my wife I wouldn't was indeed self destructive. My strongest personality traits are being dedicated to doing what I believe to be correct without regard to the consequences. Some would say that people like President Bush suffers from the same problem, and he managed to become President (plus he was an alcoholic and people still didn't deny him a chance at the job).
Also, I would encourage those of you who conclude that someone will be combative in clinicals or elsewhere just because they are willing to debate in a forum created for the exchange of ideas to rethink their view on this issue. There is a time and a place for everything. If I made an error it may have been in concluding that this forum was the place for engaging in such debate (although I would point out that far more heated, controversial, and personal arguments take place virtually daily in the General discussion area without comment). Some would say that I go too far in defending myself. However, as Donald Trump has said "If you don't stand up for yourself who will?"

you have too much free time on your hands.

Roland · Mar 29, 2004

Why, do I feel like a wounded Widerbeast that has stumbled into a river full of hungry Crocs (and I'm not talking about Wintermute, Gwenith et al.. who at least take the time to elaborate on their criticisms).