Content That BigPappaCRNA Likes

Content That BigPappaCRNA Likes

BigPappaCRNA 881 Views

Joined Jan 13, '13. Posts: 51 (61% Liked) Likes: 81

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  • Jul 1

    1. There are no studies comparing independent CRNAs and independent AAs, and there never will be. Independent AAs do not exist.
    2. APRNs/CRNAs are not mid level anything. CRNAs have have been around longer, as a group, than anesthesiologists and CRNAs never have needed anesthesiologists to practice anesthesia. Mid level is used as a term to try denote that APRNs are lower and less qualified than our physician counterparts.
    3. The salary of AAs might be lower than the average CRNA salary, but that does not mean they are the lower cost provider. CRNAs are the lowest cost provider since CRNAs cost less to train than MDAs and don't require supervision/direction to work. AAs always have to have an anesthesiologist to supervise/direct them actually making more costly to employ.
    4. The lowest cost anesthesia practices are in order of lowest to highest cost: CRNA only, mixed CRNA and MDA both working independently, ACT (supervision/direction by MDAs. This is where all AAs have to work), and MDA only practices.
    5. AAs maybe gaining ground in some states, but APRNs are gaining full autonomy much quicker. That more than levels the playing field.

    https://www.aana.com/resources2/rese...j_10_hogan.pdf

  • Jul 1

    Quote from AAC.271
    if AA's start gaining steam, then who do you think the greedy hospitals look to let loose? the CRNA's, especially if the AA organization starts conducting studies showing how safe they are compared to Anesthesiologists/CRNA.

    AA's can never practice independently as CRNA's can, so that isn't going to be an issue.

  • Jun 29

    I'm the same way where I can teach myself almost anything. I am in school now and I just wanted to say I agree with an above poster though--teach yourself advanced anatomy, pharmacology, pathophysiology. They'll help a lot in the ICU, which is a requirement for all CRNA schools. I put a lot of effort into my CCRN, CSC, and CMC certifications. Anesthesia textbooks won't help in the ICU and you should try to be the best ICU nurse possible. Good luck, you'll do really well if you keep up the hard work.

  • Jun 29

    You're right, you can teach yourself these concepts but you were asking about anesthesia text books and that is a waste of time for someone in your shoes right now. You don't start reading about advanced topics before you read the basics. That is why buying these anesthesia texts are worthless to you. After teaching yourself advanced anatomy and advanced physiology then sure move onto advanced pathology. Once you get those 3 subjects down then you can move onto the anesthesia speciality where you will tie together everything you learned in A&P and pathology into anesthesia practice. Until you can fully understand the basic sciences, books like Miller's Anesthesia will be way over your head and will end up being very large and very expensive paper weights.

    Quote from fredb
    My rationale is as follows, I understand that the CRNA program is very difficult, I figure I can make it an easier process by learning academic side of things now. The reality is one can teach themselves any subject, at a level of proficiency, within 3 to 4 years. I know this because I have done it with theology (philosophy generally) and with economic theory. That isn't to say I am a master at these subjects, but I have devoted 3 to 4 years of detailed study in each of these areas. As a result I have a very strong grasp of these fields. That is, I can speak with any Ph.D. in these areas and keep up with the conversation. In specific areas I can even add my own ideas. This comes with study, even self-study. If I am interested in a subject, I can pick it up in three years. I don't believe anesthesia is somehow harder to pick up than other subjects. Especially since this information is so abundant online. I am not trying to come off as being unappreciative with the advice that has been given. I am just a bit taken back. I have never seen multiple people discourage reading and the learning of a field of interest. I am not dedicating too much time to nursing at the moment, as it is very easy and most of it is simply the application of logic. I guess what I am trying to say is, I am not an average student. Perhaps this perspective will stimulate some other points of view.

    Thank you,
    - Fred

  • Jun 27

    Quote from afiore1
    Hello & thanks for reading. I graduate May 6 and am job hunting.

    Is anyone aware of a children's hospital that is looking/willing to hire new grads intent upon a peds specific career?

    My background is:
    • peds ED nursing tech (~2 years)
    • peds cardiac icu at Vanderbilt (~2 years)
    • 3 month SRNA rotation (120+ cases) at Level 1 Peds Trauma Center (Kosair Children's)


    I am relatively flexible about relocation.
    Currently applied to:
    1. U of Minnesota Masonic Children's
    2. Minnesota Children's
    3. All Children's in St. Pete, FL (no jobs posted but submitted resume)
    4. skipped TX Children's (fiancee doesn't want to do Dallas)

    Any guidance, suggestions, etc. are appreciated! Thanks.
    I would try Dayton's Children's Hospital in Dayton Ohio. I don't recommend specializing right after school since it will severely limit future employment prospects, but that is your decision.

  • Jun 4

    Funny, this poster posted the same thing found in the OP over at SDN, yet his status over there says "attending physician"...lmao.

  • May 26

    A Neuro ICU can be very much a Surgical ICU depending on your institution and how patients are split up between units. While I don't think anyone is debating that some schools may not like Neuro ICU experience, it seems to be a minority or particular to a certain region. Have you looked at Columbia? Its also in the same geographical area of the schools you quoted and they accepted me with just Neuro ICU experience.

    Essentially, I don't think the "type" of ICU experience matters as much as what you learned during that time. How to manage ventilated patients, invasive lines, learn to think critically, etc. Also, acuity matters more than type of unit in my opinion. If only 2 out of every 100 patients are on a ventilator but its called a CVICU, would that really be better experience than a large, busy Neuro ICU? Just my thoughts. Good luck with your application!

  • May 25

    Anastasiak, you should familiarize yourself with something called the burden of proof, don't worry I'll tell you since you obviously don't know, "he that asserts must prove". I wasn't the one who asserted that neuro is lower on the list, you and your friend however are, therefore it is your responsibility to prove. So while you seem insistent on throwing your two cents in, please show me ANY and I mean ANY proof that "they list them that way for a reason". It's called the list are being done arbitrarily.. Profound concept I know... I didn't see anywhere in your great source where it says, "ICU and CVICU are the top choice area of specialty". All your "source" showed was another arbitrary list. Thanks for your insight.

  • May 25

    I can't speak for others, but I got into every school I applied to with only Neuro ICU experience. Actually, one of the program directors stated SRNAs that used to be Neuro ICU nurses had the highest NCE pass rate percentage out of any ICU specialty. I bet there are some schools that prefer a certain type of ICU experience, but I doubt it would make or break your application. Plus, you can always get your CCRN certification to demonstrate your knowledge of general critical care patho/management.

  • May 25

    Quote from Brooklynn89
    My manager started the same day I did!! I told HR that was my intention when I interviewed. I think I am just gonna suck it up and ask her. The worst she can say is NO and I won't know unless I ask.
    Thanks everyone for your input!
    Actually, the worst that she can say is yes, and then write you a crappy recommendation. How are you applying with only 2 months experience? Because clearly you are applying to schools where your NICU experience won't count if you moved to a CVICU. Why not wait until you have at least 6-8 months at least? At 2 months your supervisor can't even speak to your independent clinical decision making skills. On any evaluation it is going to ask how long your supervisor has known you, and it won't work in your favor when that answer is 2 months.

  • May 25

    Were you upfront with your manager when you interviewed for your position? Did she know that you were transferring with the intention of gaining enough experience to apply to school, or did she believe that you had a long-term interest in the unit?

    If the former is the case, go ahead and ask for the recommendation. If the latter is the case, go ahead and ask, but don't be surprised if you get a less-than-glowing reaction and recommendation.

  • May 25

    I don't think it's wise to ask for a recommendation while on orientation. My friend transferred from PICU to our CVICU and asked for one about 2 months after getting off orientation. My boss reluctantly agreed but admitted it was generic as she had barely been working there. Why not wait another year?

  • May 25

    I think you should wait a while, so that your new manager can see what you are capable of as a fully functioning nurse rather than a trainee. Otherwise you will be putting him/her in a very awkward position. Admission to CRNA programs in my neck of the woods require at least 2 years of full time work as an ICU nurse. They give higher consideration to CCRNs - which also requires experience to qualify for the certification exam.

  • May 25

    Honestly, I don't think it really matters what type of ICU you work in it mostly matters that the applicant is knowledgeable/proficient in the broad spectrum of critical care...i.e. pressors, sedation, vents, lines, etc and you will see all of this and more in Neuro. I currently work in a CICU in a state of the art new heart and vascular tower and I don't have near as many patients with the variety of gtts here as I did when I worked in neuro. IMO neuro is the hardest specialty and requires tremendous critical thinking ability....

  • May 25

    Sweetether you are painfully misinformed. Neuro ICU experience is in no way "last on the list". I don't know where you're getting your information from but please educate yourself before stating things as fact. I am a current SRNA and sit in on the admissions committee for incoming students (in a very, very well respected program) and neuro ICU experience is valued just as highly (if not more so) than any specialty ICU. And the fact that you think it ranks in the same category as PICUS/NICUS betrays your ignorance, most schools require adult ICU experience, therefore making PICU/NICU ineligible as prerequisite experience to gain admission to CRNA school and thus they are not even remotely in the same category.


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