I did not go into a CRNA only group. We are hospital employees but there are only 2 CRNAs here. I don't mind missing out on the big cases I did a lot of big cases as a student and to tell you the truth this is a lot more challenging. Now I have to review the chart order labs find out why the patient had an EKG 6 months ago showing A-fib but not currently treated by the primary doc. So I have to cancel general surgery (I would probably go ahead with a MAC for a colonoscopy) have the patient follow-up with the primary physician and be cleared medically for their surgery.
Many times I find labs that were not ordered for patient's with bleeding issues, on diuretics, kidney problems and what not that were not caught by the primary physician or surgeon. Or I will find patient's that have parkinson's that the surgeon has ordered reglan postoperatively that I cancel the order and use zofran.
It's been a challenge and I really come to appreciate having the anesthesiologist looking at the chart previously before surgery when I was a student. It can be a lot more challenging in the rural area but we are treated the same as physicians we get to know the staff very well and best of all I choose the anesthetic. I will run straight TIVAs (Total IntraVenous Anesthestics) on my patients with a sever history of N&V with surgery and then run into them at the local wal-mart only to have them thank me for the great anesthetic that I provided them.
I go into work on my days off just to do cases because I enjoy it so much. After having about 15 different jobs in my lifetime this is the first that I really enjoy doing and look forward to every day of my life. I highly recommend this career to any of you evening questioning advance practice nursing. I too was worried about not having enough experience going straight to a rural practice, but I am really loving it. What is really nice about being a new grad is the fact that you seen so many different techniques/equipment that the old salts have never seen or heard of before.
Originally Posted by schway
How did you feel going straight from school to a CRNA only group? Also, do you feel that you might be missing out on the big cases that help develop new CRNAs when fresh out of school? I ask because I might be in the same boat as you in a year....