Latest Comments by ssrhythm

ssrhythm 3,049 Views

Joined Jun 28, '09. Posts: 76 (42% Liked) Likes: 104

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  • 5

    Quote from AndersRN
    I truly respect CRNA... One must have a thick skin to be able to work with surgeons every day. These guys sometimes treat anesthesiologists like [insert]; I always wonder how they treat CRNA.
    And let me add this...where I work, we have the very best surgeons I've ever worked with. While there are three that can be a pain in the arse every once and a while, they all have tremendous respect for the anesthesia providers, RNs, Scrubs...everyone in the department. Not only do we all get along well at work, many of the surgeons are very good friends with the anesthesia team members and many of the other OR staff, and getting together outside of work for beers, wine parties, dinners, community events etc. is not uncommon at all. Do not think that every OR and every hospital is the same...if ******* surgeons and a stressful work environment are weighing you down, go small, rural, and autonomous. Life is too short to have anyone talking down to you as their necessary subordinate on a daily basis.

  • 9

    For those of you who have this same sentiment...how many CRNA jobs have you had? How many different regions of the country have you worked in? I ask this, because I see and know so many people who finished school and took the first open job at the major hospital we trained at...often accepting the job before graduating. Some did so because they lived in the area already and did not want to move. Some did so because they were worried about actually getting a job and having a paycheck asap after graduation. The mothership hospital we trained at is a huge ACT practice facility where tensions are always high and pay is ridiculously low. I know money is not everything, but having a CEO offer you 200K with great benefits give you a great, appreciated feeling. I did not leave my training area simply for the money, but I could not see myself working for 160K with no autonomy in a virtual continuation of school where I had no autonomy. I left my home and the area where my mom and dad live and moved to a rural town ten hours away because they were offering me a pile more money and complete autonomy. When I interviewed, it was obvious that the people working at the hospital were very happy and considered their co-workers family. The environment in the surgical department was laid back, friendly, and saturated with mutual appreciation and respect for EVERYONE. The cases are bread and butter, so I am rarely in a case for more than 2.5 hours, but it does not matter because during a 3 hour case, the time flies, as everyone in the room is interacting in a serious but absolutely relaxed and often fun manner. I pre-op all my patients, and despite only spending 5 minutes or less preoperatively with them, I feel that during that time, the act of explaining the anesthetic, answering their questions, and doing everything I can to make them comfortable and relaxed at a time where they are likely the most anxious and stressed that they have ever been...I find that in that short time, I do more for the patient than I ever did in a 12 hour shift as an RN even if I was only taking care of one patient that shift. I have yet, in 4 years of working at this facility, to get up and wish that I did not have to go to work. I can assure you that if I were working at any of the hospitals that I worked in for the ten years before CRNA school or all but one of the dozens of clinical sites that I trained in, I would be having to drag my are into work every morning and would be sitting on the stool longing for the moment that I could go home. My point is simply this...there ARE fantastic jobs out there that are fantastic not simply because of the pay or location or reputation or benefits....but they are great because of the culture within the facility. If you are thinking you made a mistake and are thinking of ditching the profession...open your mind to seeking out your CRNA job utopia. Don't limit yourself to any geographic location, and don't exclude anywhere because of the location. Go interview somewhere that offers autonomy and good compensation and interview them while you are there...find a place where employees are happy and tight with each other and make a move. Give that a shot instead of bailing on something you have worked so hard for and instead of sticking with a job that you are not enjoying. As someone who has worked in multiple hospitals in multiple states...trust me when I say that if you are not happy in your job, there is a far greater chance that you are not happy because of where you are working vs what you are doing. Open your mind and do not give up without trying to find the right fit for you.

  • 3
    ICUman, PatMac10,RN, and AmyRN303 like this.

    I was a 36 year old RRT when my wife and I committed to me becoming a CRNA. We had no children, and while we kinda wanted children, we decided to go for it and reassess when I was done. The move to where I was going to attend nursing school and then CRNA school put us in a situation where we were paying rent at two houses while having a mortgage on a third that was on the market. Financially, we could not have been in much worse shape for such an expensive and risky an endeavor; while my RRT GPA was 3.97, my overall was 2.7...I knew going in that I'd have to make all As in nursing school and even then, it would be no guarantee. We had our first child with 4 months left in my CRNA program, and we now have two beautiful boys, I love my job, and we are loving life. The moral to this story is that you are in no way too old to do it. You have the grades to do it. If you truly have the desire to do it, it will not be easy, but you will do it. If you want it to happen, there are plenty of loans out there to help you get through it. If you truly want to do it, commit to it and give it everything you've got, and you can do it. Do not enter into the journey uncommitted, and your dream, although it will seem like a nightmare at times, will not turn into a nightmare!

  • 0

    I graduated from there, but I'm not really sure about specific science requirements. If you meet their requirements...ie. you have a BSN or are and RN with a BS degree, I believe you will have your necessary prereq courses. Most nurses should have taken chems up through biochem or organic, micro, A&P 1&2, statistics etc., so if you meet the degree requirement for application then you should be good to go.

  • 3
    ICUman, kiszi, and Mully like this.

    Do not plan on working or having any income from you working while attending school. You might get some people on here that will tell you that they were able to pull it off, but thinking that you can work any and thinking that you can count on any money from your work is a bad way to approach what you are about to do. There are many threads addressing this and the "typical day" as an SRNA on here, and my advice is to read them all, look at the worst case scenario posts, and plan on that. There is ample money available via student loans that will pay your tuition and cost of living expenses based on what your family income is and what your expenses are, and while getting in debt 200K might sound like a nightmare, getting into school and failing out or getting kicked out half way through is much worse. When you are planning your budget and looking at how you are going to pay bills and make ends meet, do so planning on no income from you; if you get in and get through a bit of school and clinicals and find that you can work a couple of days a month here and there, then it will be a bonus. Apply for as much loan money as they will give you, as you are not obligated to take it all, and it will be there if you need it. The program is difficult enough to navigate, survive and thrive in without having the stress of worrying about finances on top of it. Just remember, it is worth doing whatever you have to do to get it done. Good luck!

  • 0

    Good to hear that manusko. Everything I've seen and heard do not match what you are experiencing in your job. I moved to Indiana after graduating for exactly the opposite reason you want to move south! Maybe after living in the Midwest from birth to adulthood, the southern heat won't wear on you like it does those of us born and raised there. I'm from SC, but unless you live on the NC coast where you can count on the seabreeze or in the mountains where it is ~10 degrees cooler than in the flats, everywhere south of Virginia is swealtering hot and brutal from about mid May-September. I'll take single digits for a couple of months over five months of not being able to walk outside at 3am without being soaking wet before getting to your car. I love the south, but getting carried away by mosquitoes while duck hunting in December suuuuucccckkkssss! I digress...My parents are 75yo and we have given them their first grandchildren... two boys 2y/o and 3months old. I own a great house in Columbia, SC and I would love nothing more than to move back there so my parents and my children (not to mention me) can have as much time together as possible, as they are not getting any younger. Right now, I simply can not afford to move anywhere close to them. I'm making more in my second year out of school than the chief CRNA at one of the better paying facilities that we did rotations at...and he is over 70 and about to retire. He's the only CRNA that I discussed personal salary with, and maybe he was telling me a story, as he knew that I wanted to work there if a position ever opened up. That is SC...NC seems to be significantly lower than SC. Also, do not expect to be doing any PNBs or working autonomously. I'm sure there are exceptions, but I've not seen them. Regardless, you will be signing on for significantly less money compared to what is being offered in the midwest. Money isn't everything, though. I'm taking 5 of my 7 weeks of vacation and working locums for the next two years so that we can be in a position to take that paycut if necessary to move back and be closer to our parents, and I'd do it now...for them...if I could. It's going to be very tough going from autonomy to micormanaged...boo.

  • 1
    subee likes this.

    GO COCKS! I used to live in Asheville, and being a WW Kayaker married to a beach-gal, I would love to one day return to Asheville or the OBx. As an RT at Mission back in 03-05, I went through the OR to get my required 10 facility intubations during my orientation there; I remember thinking that compared to other ORs I'd been in, that place was full of very tense and unhappy CRNAs. Now that I'm a CRNA, just reading the job postings from Asheville and the surrounding areas, it is obvious that unless you really, really loooovvvvve Asheville or own a home there that you can not get out of, that is not a CRNA friendly place to go. Read between the lines and you'll plainly see..."for a whopping 120...maybe 150K if you are very experienced and work a pile of OT, you can come here, work multiple shifts at multiple facilities of our choosing, all while being micromanaged and treated like a subbordinate by we Godly Anesthesiologists. But hey, you will get 4 weeks of vacation and a week of CME leave...no, no CME money!...to recharge your batteries and rest your aching bunghole! Act fast, because there are obviously too many desperate CRNAs being churned out and Asheville is cool, so these opportunities won't last long. Sincerely, the great and mighty monopolists of Asheville Anesthesia Associates." It really sucks, because it is a wonderful place to live. As far as Raliegh...good grief! I remember looking at jobs around there in the months prior to graduating, and after about two weeks, I quickly skipped past any job posting that stated "raliegh" or "research triangle," as there was never anything posted that was any better than any other job posting in any other state.

  • 0

    10 mg versed and 250mcg fentanyl followed one minute later by 200mg propofol followed 30 seconds later by 50mg rocuronium followed 30 seconds later by 100meq KCL followed 10 minutes later by the morgue staff. Three minutes and the murderer was comfy, unconscious, still, then dead...every time. The price would be minimal. Is this really so difficult?

  • 0

    Maybe this explains why there is currently a "shortage" of glyco that our pharmacy can only get through one "black-market" type of distributor for...get this...$600.00 for a box of 20 1cc vials! There has to be some kind of law being trampled on here. Anyhoo, this news goes a long way toward explaining the current shortage.

  • 0

    Quote from detroitdano
    Awesome stuff. Kind of one-ups Suggamadex with the benzylisoquinoline-reversal potential.

    I can't believe we still don't have Suggamadex despite all the research out there saying it's perfectly safe and more cost-effective.
    The folks who have profited from succs and glyco and neostigmine for all these years are putting their hard-earned money to good use up on the hill. Anyone who thinks otherwise has their head buried in the sand. It is all about the money!

  • 0

    I had become, over the last year, a little more open to putting an LMA in slightly obese patients and pts with well controlled DM, but one of our general surgeons told me about a CRNA here years back that had an obese diabetic aspirate and later die from complications related to the pneumonia that followed. He said he witnessed the lawyer ask a series of questions about the patient that were taken word for word from the LMA package insert. The CRNA got burned. Now, I don't care if it is a three minute cysto case, if the patient is obese or diabetic, they are getting intubated. If it looks to be a difficult airway, I'd rather deal with that up front and in control rather than when the procedure is going on. There are far too many "safe" options available to be going up against what you will face if an LMA anesthetic goes bad on a patient who fits the criteria warned against on that package insert.

  • 0

    Quote from ruler of kolob
    Recertification is something I welcome. It might actually reduce our numbers and help counteract the over production of graduates. If you are afraid of a test... maybe you should not be doing this.

    Anyone should be able to sit down, read something like Morgan and Mikhail and pass a test. I doubt the test will be challenging.... even those who do nothing but colonoscopies and eyes will be taking it.
    Good Goob! Seriously?! There has to be a better and more direct way of preventing the over-production of CRNAs. I know My school, USC SOM adjusts their class sizes according to demand. Maybe we should figure out a way to keep schools from trying to maximize their profits with total disregard to the market. Allowing the sole credentialing body to apply new credentialing standards that in no way, shape, or form enhance the quality of care that is given by CRNAs with the hopes that the new standards somehow keep CRNA overproduction down is a back-asswards way of hoping a problem gets solved. The new standard in no way reduces the number of new grads flooding the market that will drive salaries down; it will only serve to discourage damn good CRNAs with far more experience and ability than those "ready and able" to pass the test from continuing their careers. This new standard is nothing more than a way to drum up more revenue under the false pretense of higher standards. It is total horsehocky. As far as the AANA not caring about ACT practice CRNAs...what do you expect them to do? I left SC, because practicing in SC meant calling a MDA to come in and slam induction agents, leave you to clean up the mess, and calling them to come in and watch you extubate/emerge the patient. ***** If you really want to change that BS, leave. Refuse to be a part of that whole fraudulent bunch of BS. It is the states nursing policy that dictates how CRNAs can practice, and if we stop going along with and supporting the ACT model by our participation in it, things will change. There isn't a hospital administrator in America who wouldn't want to go with an all CRNA anesthesia model if was an option. Eventually, every state will be an opt-out state, because the feds will eventually see the ACT model for the inefficient sham and waste that it is. Until then, quit looking for the AANA or someone else to fix the problem...quit supporting the ACT practices with your participation in them.

  • 1
    shesking likes this.

    First, I am a CRNA in autonomous practice. I get your argument, and I agree with your last statement wholeheartedly. I'm referring to the numerous NPs that I've worked with that graduated high school, graduated nursing school, immediately enrolled in grad school, earned their MS degree, became certified as a NP, secured a job, and then fumbled around for years writing orders that made no sense wile not being able to see the forest for the trees. I had two RN classmates who were amazing producers in the classroom and who hid and ducked every patient care opportunity possible during clinicals take this exact route. One actually made the comment at the beginning of a clinical day "that's what I want to do...I want to be the one telling others what to do and not be the one being told what to do." Ok, we all understand that, but maybe you need to actually learn what it is that you need to do before assuming that role. Like I said, there are a lot of NPs out there who know what is going on and have the knowledge and understanding to truly manage critically ill patients. There are also a lot of them that writing orders based on what they think they know, yet could not handle a crisis situation if the world depended on it...the ICU nurses are covering their asses every day. Again, to your last comment, it is spot-on assuming that the admissions boards are doing their jobs well and not letting in the ICU nurses that can't think for themselves and are completely dependent on the protocol sheets in front of them and not letting in the NPs who have never had any true patient care experience and who are relying on the nurses to handle what they do not understand.

  • 0

    Quote from nomadcrna
    You do understand that there are many NPs that work as intensivists? You do understand that there is a particular type of NP (ACNP) that is trained from the get go in Critical care? I'm talking about all the various procedures, diagnosing and treating intensive care patients? Even a primary care NP is way ahead of the ballgame in regards to understanding disease pathophys and treatment. So who would you want doing anesthesia for your mother who has prior MIs, CHF, diabetes and HTN? A new CRNA who had 2 years of critical care experience or NP who actually diagnosed and treated many patients with those issues? It is a no brainer.
    If Juan(ACNP) went back to CRNA school. I would pick him the day after he graduated for the above patient over the vast majority of experienced CRNAs.

    I would take an ACNP or FNP (to CRNA program)over a regular RN who has 2 years of critical care experience with all else being equal.

    While many schools may admit students with ER experience or NP experience, those students are competing with a LOT of nurses that have true critical care experience.
    I guess it all depends on the individuals involved. We've all known NPs who were so jam-up-and-jelly-tight with their skills and knowledge that you'd rather have them handling your care than any MD in the town. We've all known NPs who you know you will have to help make decisions about your patient in a manner that allows them to think that they are coming up with the pt care decisions on their own, because they are too proud to take advice from a lowly nurse and too ignorant and ill-prepared to figure things out on their own. Of course, the same can be said about nurses. I doubt, however, that the critical care RNs with two years experience are going to get the type of recommendation letters that they need if they aren't the cream of the crop in their respective units. I don't know where NPs would get recommendation letters that speak to their ability to titrate drips and do hand's on management of critically ill patients in a feces-hitting-the-wind-machine situation. Having the knowledge and book smarts is important, but it is not the same thing as having the knowledge and book smarts AND applying those qualities at the bedside while multitasking in a crisis situation. I'm sure that there are many CCNPs that have and use those bedside skills, but the majority I've worked with either did not possess that ability and/or never applied that ability, so how do you know? I've never met a CVICU or STICU nurse with 2 years experience in their unit that did not have the skills and knowledge necessary to do this work if they wanted to. Again, it really comes down to the individuals being compared, but if I had to play the odds, I'd take an RN with 2 years CC experience over an ACNP or FNP with two years experience. It really does not matter, though, because if they get into and through CRNA school, they will be ready and able to handle the job.

  • 0

    Well. I just read that on the AANA site and came over here to say that I was obiviously mistaken. Too bad. If what they are claiming is and has been true this entire time, why the defensive e-mail from the NBCRNA and COA in the first place? What are the details behind the "frayed relationship" that they are mending? We can speculate till the cows come home, but does anybody know the facts behind all this friction and weirdness between them?


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