BigPappaCRNA 2,203 Views
Joined Jan 13, '13.
Posts: 81 (69% Liked)
Intrathecal generally means the use of Duramorph injected, with or without local anesthetics. If they receive Duramorph (aka preservative free morphine) placed intrathecally, than they are on respiratory precautions, generally for 24 hours because the Duramorph can last that long. The initial analgesia from the Duramorph takes place at the level of the spinal cord, and on the narcotic receptors in the substantia gelatinosa in the posterior horn. Slowly, over hours, the Duramorph in the CSF works its way cephalad, and begins to enter the CSF in the brain, and bathes the periaqueductal gray in the walls of the ventricles, and this is where its later, delayed effect takes place. If a spinal is used for the procedure, but there is no long acting narcotic administered, only local, than you would not need to worry at all about the the long term, delayed effects.
One of the biggest advantages to a front loaded program, is that the program can really send you to a lot of different sites, and get you much better clinical experiences, possibly preparing you to be a much more independent provider. An integrated program is limited in the clinical sites offered, to a couple of hour geographic range, due to the student still having to attend class every week. This works out fine for some programs, Kaiser comes to mind, where there are no end of local, close, clinical opportunities. Other programs, especially in the Northeast, have one or two clinical sites. You do not get nearly the well rounded, high variety mix of both preceptors, or cases. Front loaded programs will send you far and wide, which may suck at the time, but you are getting the cream of clinical experiences, full practice often times, as well as CRNA only, independent often times.
I would urge you to think long and hard about this decision. I have been a clinical instructor for several programs for more than 20 years. I have seen several dozen students enter the programs in their late 40s. Sadly, most of them wash out, and it has never been because of academics. Academically they have been some of the strongest. They have washed because of everything else in their life.
When in your mid 20s to mid 30s, you are very flexible, very adaptive. This is good, because most all CRNA programs are inflexible. Breathtakingly inflexible. As you get older, no fault of your own, you become far less inflexible. Maybe you need money, maybe the kids are taking up your time, maybe you moved for school, maybe you are driving far because you didn't move, maybe your parents get sick and need help, maybe you get sick and need help, and on and on and on. When younger, it is far easier to deal with these. When older, the inflexibility of aging just does not blend well with the inflexibility of most programs. It is a bad combination. And I believe stats on the high attrition rates for "older" students would bare this out.
Additionally, while it is illegal to age discriminate, one must ask themselves how employable they will be entering a stressful and dynamic work environment for the first time in their mid 50s. Most employers will happily higher people of that age if they have the 20-25 years of sage experience to go with it. You will not. You will have all the normal issues facing a new grad of any age, but then you will have that same inflexibility and neediness of someone older. There is very little upside for the employer, and too much downside. If presented with several candidates, you may fall on the list.
Not trying to be cruel, or squash your dreams. Not at all. But before you move, quit your job, spend 100-200K, stress your family, etc, you need to really know why you are doing that, and do the benefits outweigh the drawbacks. It has been my experience that they do not.
People, stop feeding the Troll.
I have been hearing different opinions and different statistics about salary of CRNAs.But nothing is conclusive yet.I agree that variation occurs due to location, facility etc.What you think your colleagues are making approximately?. I mean INCOME ,not average base salaries. Income includes everything for example overtimr, two jobs etc.And please only serious replies. No bad words or advices please.Thanks
If you can't "breeze" through your BSN, you should not consider CRNA school. Look into other areas of focus. CRNA school is on the order of several magnitudes more difficult. BSN as four years of easy easy easy.
How the hell did you breeze through your BSN? And how the hell can I do the same? LMAO
This is completely ludicrous statement.
If you are a "people person" there is a good chance that you will not like being a CRNA. I am very outgoing and that is why I became a NP. I also love science. However, even the hospitals and private clinics do not want people persons anymore. They want robots lol! I have always been told I spend too much time with patients, BUT I always get good reviews.
11% is drastically low. Just by being a 1099 you will have to cover your employers FICA contribution. This year that would be an additional $8,636 on your tax pill in FICA. Add to that vacation, ed leave, med insurance, dental insurance, vision insurance, life insurance, disability insurance, CME money, etc. all must be considered. Most 1099 jobs require about 25-50% additional to make them better, although, they do open things up to a world of tax advantages. Also, just because your spouse is providing the health insurance, doesn't or shouldn't mean you should accept less for your services.
One final note, you might check about the malpractice component. If that is the only hospital in which you work, and they are supplying your insurance, you will be considered a hospital employee, regardless of the form designated to pay you. This means that you would not be able to take advantage of a lot of the benefits that come with being a 1099.
The programs these days are intensive and demanding. You will not be an absentee parent, but you will also not be super engaged.
But, this is an opportunity to teach them a valuable lesson of hard work, sacrifice, setting and achieving goals, and value of graduate education. Please don't sell yourself short with how important all those things are to your childs long term maturation.
You sound like a fine candidate. I see no reason to change the unit in which you work, unless you don't like it, and want to change. 3-4 years (by the time you start) will be more than enough. A big MICU in a University Hospital is more than enough to teach you lines, drips, vents, and multiple systems. Overall, if your bio above is accurate, you will have no difficulty getting into whatever program you want.
It simply does not matter the ICU, despite what people continue to think. CT ICU is not preferred. It is good, but so are lots of other things. A general surgical/trauma ICU is "best" but even that does not really matter. Have sick patients. Do lots of things, and do them well. Learn lots of organ systems. CT ICU teaches generally one system. Again, it is great, but not all that. Most days in anesthesia are terribly boring, and do not resemble anything like what one sees in the ICU. Just work at a nice sized hospital with a good mix of cases and systems. You will be fine.
As far as experience, the minimum required by a program to get in is just that, the minimum. You don't need decades of experience, but 3-4 years is ideal. Even though some accept with 1 year, you really have to ask why are they doing that? Why not be a stronger applicant, and in the process, end up being a much stronger CRNA?
Depends on how high the incision will be, but most of these can easily be done with a high lumbar. Even lower for the Aorto-bi-fem.
Yes. Lots and lots of physics. The responder above very eloquently stated just some of the daily applications using physics.
Seriously, if, if, if you don't think you could score well in physics, you should maybe direct your future to a different specialty.
Switch to an adult ICU for two years, and then apply. Take a grad level science or stats class in the meantime, and do very well. Those will go a long way.
Every application can have one hole in it, but currently yours has two. Both fixable. But since CRNA school is essentially 100% science, shouldn't you find out if that is the problem before you quit your job, move, and pay 20K for your first semester, only to flunk out?
Actually, it was very good advice that was given. School is stressful enough without having the non-stop and unending worries about money. No one ever regretted saving more. Never. No one ever regretted having more meaningful work experience as they transition to their new role. And lastly, depending on what school they attend, no one ever regretted having a safe and reliable, newish car, in good working order. Some students put over 50K miles on their cars during a CRNA program. Car worries, repairs, and poor attendance because of transportation problems do not serve any SRNA very well. Good preparation and acknowledging cold, hard reality, will be far more helpful to a successful SRNA, than just not asking tough questions and living in the state of denial. "Just do it" won't pay the bills, and certainly won't pass the tests.
Usually if a salary is listed, that is the amount for whatever standard shift that place offers. Then, extra work will usually be compensated for in various ways. It is a very wide bell curve of what normal is. Just call and ask
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