[miloisstinky]

This is more of just a venting thread, maybe a little bit of encouragement or advice would be nice. New grad just starting my CRNA career, on orientation for a month, and being treated like a student. It has been painful, I feel like I've done my dues as an SRNA! I don't know how to transition myself into a CRNA, and not offend my future colleagues. So, i've been sort of passive with the comments, such as "please dont use that when you are with me, i think you should give more narcotics, why didnt you do this or do that...etc.etc". This is my 1st week into orientation, I just don't want it to get worse. I was never a student at this facility, it's just they all know Im a new grad! Should I stand up for myself now (boat rockin just seems way to soon!), or just take it with a grain of salt as if they are looking out for me.....i dont know. Just venting.....

[deepz]

Originally Posted by miloisstinky

......I don't know how to transition myself into a CRNA, and not offend my future colleagues. So, i've been sort of passive with the comments, such as "please dont use that when you are with me, i think you should give more narcotics, why didnt you do this or do that...etc.etc".......

Are they stupervising MDAs you refer to, insisting that you do it their way and not your own way?

?

[DreamMatrix]

I don't want you to take this wrong, but you are a new graduate, who has just started a job...and I know that you feel that you have paid your dues as a SRNA...but you haven't paid them as a CRNA. Just take it with a grain of salt and earn their respect...don't demand it or try to coerce it...it takes time. Unfortunately, longer than you want it to...but, believe me it will come if you do a good job, without complaint and showing respect to those who have paid their dues. We all have gone through it when we started our careers (a long time ago for me). Oh, and by the way...congratulations on your accomplishment and welcome to a great profession!

DM

[catcolalex]

Im also in that transition, but my situation is a little different. Im at a smaller facility with only 2 crna's at a time. It could be worse, I got called in the other night for a 350 lb incarcerated ventral hernia, I was the only anesthesia in house, I put the pt to sleep, couldn't tube, was able to vent, then the attempt at a bougie failed, then I couldnt vent, lma didnt work, had to wake the pt up, and do awake fiberoptic by myself with no anesthesia help, just a useless surgeon and scared nurses. It was a great learning experience for me, but a little backup at times is nice.

[rn29306]

Originally Posted by catcolalex

Im also in that transition, but my situation is a little different. Im at a smaller facility with only 2 crna's at a time. It could be worse, I got called in the other night for a 350 lb incarcerated ventral hernia, I was the only anesthesia in house, I put the pt to sleep, couldn't tube, was able to vent, then the attempt at a bougie failed, then I couldnt vent, lma didnt work, had to wake the pt up, and do awake fiberoptic by myself with no anesthesia help, just a useless surgeon and scared nurses. It was a great learning experience for me, but a little backup at times is nice.

Very impressive.

[maturner]

Originally Posted by catcolalex

Im also in that transition, but my situation is a little different. Im at a smaller facility with only 2 crna's at a time. It could be worse, I got called in the other night for a 350 lb incarcerated ventral hernia, I was the only anesthesia in house, I put the pt to sleep, couldn't tube, was able to vent, then the attempt at a bougie failed, then I couldnt vent, lma didnt work, had to wake the pt up, and do awake fiberoptic by myself with no anesthesia help, just a useless surgeon and scared nurses. It was a great learning experience for me, but a little backup at times is nice.

You must be a Kaiser Grad!

[deepz]

Originally Posted by catcolalex

.... 350 lb incarcerated ventral hernia ... couldn't tube .... awake fiberoptic by myself .....

Welcome to the Big Leagues! Awesome performance.


d

[miloisstinky]

DreamMatrix, great advice, you are so right, i just needed to hear it. But, I do work at one of those rare places where attendings are almost obsolete.....not obsolete, but ONLY there if you CALL them! TONS of automony, it has been the orienting CRNA's that have been harsh, it's almost like they are so "strong" (reason I chose this facility) that they act like attendings, great point I didnt think of.

[DreamMatrix]

Yeah, I can relate...when I first got out of school all the cases everyone else didn't want...I got. Then they were always making sure I was the late person and if anyone wanted to give away their call, the first person they went to was me. It was pretty rough for a while...hang in there.

DM

[zrmorgan]

been at this for 5 months now. try to be cohesive with your more experienced providers...even if they only have a few months on you. soon enough you will have earned the respect as an experienced person. when you get the blues...remember you are getting a paycheck now, but think of it as being paid to learn.

had a woman who was 33 weeks pregnant come in last week with a ruptured spleen and a splenoaortic aneurysm. I was on call that night, and luckily one of the anesthesiolgists I work with was finishing up her case in the OR at the same time. She has been doing this 20+ years, and always has an opinion on what she thinks is a good anesthetic (whether you ask for it or not). Had either of us been on call alone the patient would probably have died. Both mom and baby are doing great thanks to God and the 30 or so people in the room at the time.

I renewed a promise to myself that I made as a student to remain humble and to always appreciate advice given by experienced providers. I also try my best to remain skeptical about reputations, and make independent judgements about who will be reliable help when the stuff hits the fan.

And don't worry about ticking anyone off, or offending them, if you are advocating for your patient's safety. The collegues you need to care about are those who will understand you are doing things in the patient's best interest.