Content That BigPappaCRNA Likes

BigPappaCRNA 1,356 Views

Joined Jan 13, '13. Posts: 57 (60% Liked) Likes: 89

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  • Jul 17

    "You will not be given good training and a broad range of experiences if it is an MDA dominated training program, as they do not like to train their competition."

    That is the crux of the issue. No matter how you slice it, attending a CRNA program with an MDA residency program in the area will NOT benefit you if you plan to be a full service provider working in an independent practice post graduation. That is why I limited my selection of schools to those without a residency program in the area.

  • Jul 17

    Quote from Bluebolt
    So no advice for the original post about practicing at my fullest capacity and learning advanced skill very well? Come on CRNA's, you must have noticed some paths to success in that way.
    Short Answer: Train at a school that has independent CRNA practice rotations and that stresses independence. Then look for an independent practice after graduation.
    Your practice will always be the most restricted when you work and/or train in CRNA supervised or directed environments.

  • Jul 17

    Quote from msn10
    The entire point of a DNP is to be able to advance clinical instruction AND increase interpretation and implementation of research into practice. It is not just about reducing the time it takes for research to get to the bedside. The very act of understanding how research should be utilized (what matters and what doesn't) is the very definition of increased clinical competency. The fundamental objectives of ascertaining whether or not research should be used is to increase patient safety (by proxy of better and safer practice) and to reduce costs. The master's programs before did not address this they way we needed to. Being safer means you are a better clinician. Cannot see how those 2 are mutually exclusive.



    As with any major change, it has to be fiscally reasonable. The authors and the creators of the PSH are almost all hospital administrators and MD's in academia (Alabama, Michigan, Cleveland Clinic, etc.) They are more focused on patient outcomes and reducing costs. The billing aspect is more about ABO models vs. antitrust laws with regards to contracts and stepping on other MD toes. If done appropriately, the training now would offset future costs for both hospitals and medical groups. The PSH is in no way intended to be a money maker. Just the opposite if not done correctly.


    Its fine, I'm out again. I stayed away from Allnurses for awhile because, quite frankly, just too busy to join in the conversations. Like soap operas they don't change much and really don't help my practice or business.
    I never knew why a nonCRNA was posting on this particular forum anyways, especially when they are obviously pro ACT and anti-independent APRN.

    From the AACN (this sounds very familiar to what I already stated):


    • In many institutions, advanced practice registered nurses (APRNs), including Nurse Practitioners, Clinical Nurse Specialists, Certified Nurse-Midwives, and Certified Nurse Anesthetists, are prepared in master's-degree programs that often carry a credit load equivalent to doctoral degrees in the other health professions. AACN's position statement calls for educating APRNs and nurses seeking top systems/organizational roles in DNP programs.
    • DNP curricula build on traditional master's programs by providing education in evidence-based practice, quality improvement, and systems leadership, among other key areas.
    • The DNP is designed for nurses seeking a terminal degree in nursing practice and offers an alternative to research-focused doctoral programs. DNP-prepared nurses are well-equipped to fully implement the science developed by nurse researchers prepared in PhD, DNSc, and other research-focused nursing doctorates. American Association of Colleges of Nursing | DNP Fact Sheet

  • Jul 17

    You have at the very least seven years to go before you should even apply to nurse anesthesia training... my own advice, since you're asking, move in that direction then ask that same question then.

  • Jul 17

    I'll sum up a typical day for me and tell you why I love what I do, but check out "a typical day in the life of an SRNA" in the SRNA forum if it is still there. There is a long way to go, and it is a demanding road before you become a CRNA, but it is well worth it.

    I usually wake up at 5:45 and leave for work at 6:15 to be here at 6:30. I do cases until we are done, then I go home. There is a whole lot in between arriving and leaving that you will see when you shadow. I love my job, because people who have never met me are trusting that I will get them through a frightening time alive and well. Anesthesia is an art, and beyond the baseline of getting a patient through the surgery alive and well, I pride myself on getting my patients feeling great and relaxed before induction and waking them up comfortable and with smiles on their faces in an efficient manner that keeps the OR rolling and the surgeons happy. While anesthesia can be cookie cutter in many cases, it certainly does not have to be, and I think it should not be. The days where I come in and all my bread and butter cases flow effortlessly to days end are great, but there are days that your repeat c-section hemorrhages unexpectedly and you work like mad inside but calmly outside to replace 3/4 of their blood volume safely and effectively while keeping them stable all the while reassuring them and never letting on that anything is amiss as the pt is awake with spinal anesthesia. The particular case I'm referring to outlasted the spinal and we had to eventually go to sleep. She was awake, extubated, pain free, and stable as a rock an hour later when we left the OR despite having to have an emergency hysterectomy to keep her from bleeding to death. There is nothing like the feeling you get when you are part of something like that and you leave seeing mom and baby together happy and well. Anesthesia is precisely, scientifically-magical, and I feel blessed that I get to do what I do every day and get paid well to boot. Good luck with whatever path you choose.

  • 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.


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