Recent bad experience with a program director.

[MmacFN]

hi all, just wanted to vent and bounce this off you.

1st, let me say that i have experience in CVICU, TICU, ER, Trauma Team and the last 4 years as a flight RN.

Now onto the story. So i went to talk to a program director about the CRNA admission reqs and what i might be lacking. The individual seemed happy with everything except the fact that my ICU experience was a bit dated (5 yrs ago). I told her yes, but ive been doing the most advanced critical care nursing in my career as a flight RN. She waved her arms in a show of flying and said "thats is not ICU experience.".

Now this attitude is what i have come to expect from Nursing Instructors who's background (10+ years ago) was only in the ICU (which is this individuals story). Practice as a flight nurse is covered under the advanced practice act. I dont know any ICU RN's who are intubating, practicing rapid sequence induction, managing and placing central lines & chest tubes etc etc. Moreover, we carry about 40 drugs all given at our disgression.

This individuals response was "well, you know how it can be at ngiht in the ICU". I almost died. Yes i know how it is, but we all know when that happens there is a fine line being walked which is called practicing medicine without a liscence. This isnt the sortof thing you expect from a program director.

In anycase, i was angry and decided not to even apply to that program based on how much of an idiot this individual was.

Thanks all for allowing me to vent!

MM

[MmacFN]

Hey Yoga

Excellent points. Well walking out of the room she would not have known i was angry. I didnt respond negatively but what i did do was take her as the person who sets the tone for the school. I have not had another experience like that.

My reasons for CRNA school is not really financial in nature. Maybe this is a bad thing I dont know. What I am looking for is to take a step up clinically. My experience with other midlevels did not suggest to me it was a step up clinically based on the jobs they seem to be doing (urgent care, scut work etc). CRNA seems to have a very selective and professional focus, I like that. Im in a lucky situation, my wife and i are both RNs and we dont want (or have) kids. So the money we make is great and not been limiting in anyway. Being a CRNA is more money, sure. Is that good, sure it is. However, with experience ive learned that money will not keep you in a job you dislike or arent passionate about for long.

I appreciate hearing from someone experienced in this matter. Are my motivations OK? Dont get me wrong, i love flight nursing, ive done alot of research and been published because i love to expand my knowledge base and that of the profession. However, I have decided its time to take the next step and from my perspective that is CRNA school.

Anymore suggestions, information etc would be helpful!

[rayman]

Just a thought....I have read all the responses and while there are some parts I agree and disagree with, there is something that caught my attention and don't see where it has been mentioned. Program directors can be busy people and the have hundreds of nurses and students calling etc. I sure you weren't the only person that had swaggered in there recently and he/she was thinking of a million other things they had to do. You said this person didn't inquire further into your credentials, perhaps they had heard all they wanted to hear AT THAT POINT IN TIME and didn't want to go further. A little follow-up at a more opportune time may be more illuminating and as others have alluded...a little more "yes sir, may I have another please" could help.

[MmacFN]

Hey Ray

Well it wasent that she didnt want to hear it, she just didnt appear to care. I think i was turned off when she made flapping motions with her arms as she said "when your flying that isnt really critical care.".

that turned me off enough to not want to go there and im OK with that.

Just a thought....I have read all the responses and while there are some parts I agree and disagree with, there is something that caught my attention and don't see where it has been mentioned. Program directors can be busy people and the have hundreds of nurses and students calling etc. I sure you weren't the only person that had swaggered in there recently and he/she was thinking of a million other things they had to do. You said this person didn't inquire further into your credentials, perhaps they had heard all they wanted to hear AT THAT POINT IN TIME and didn't want to go further. A little follow-up at a more opportune time may be more illuminating and as others have alluded...a little more "yes sir, may I have another please" could help.

[apaisRN, RN, CRNA]

It just sounds like she verbalized a lack of respect for your experience, which ticks anyone off. My director is the epitome of tact, she'd tell you it was great you had that background and here's why we want recent ICU as well. Don't apply to that school.

[Sheri257]

Dude, you are going to have to, as another post said, "bite the bullet" and do what these schools want you to do in order to become a CRNA. If you won't there are about 4-6 others competing for your slot who will.

To me, this is the bottom line. Of couse, there are debates about what kind of ICU experience you should have and where but ... generally, ICU is the gold standard of acceptance criteria. Of course, there are exceptions but ... the vast majority of schools aren't going to question it like they would non-ICU experience.

Once you have to start debating over whether other experience is just as good, etc. it's pretty much game over. You've lost the argument right there regardless of whether you're right or not.

You can say ... I don't want to go to that program anyway but, the fact of the matter is, you need them a hellava lot more than they need you. They are the gatekeepers and you have to give them what they want.

Just my opinion.

:typing

[Sheri257]

Just a thought....I have read all the responses and while there are some parts I agree and disagree with, there is something that caught my attention and don't see where it has been mentioned. Program directors can be busy people and the have hundreds of nurses and students calling etc. I sure you weren't the only person that had swaggered in there recently and he/she was thinking of a million other things they had to do. You said this person didn't inquire further into your credentials, perhaps they had heard all they wanted to hear AT THAT POINT IN TIME and didn't want to go further. A little follow-up at a more opportune time may be more illuminating and as others have alluded...a little more "yes sir, may I have another please" could help.

I think this is another excellent point. Not only are these people flooded with phone calls, etc. but it's their job to weed out hundreds of applications where any excuse to put you in the "no go" pile will make their job easier. It's not fair, but that's the way it is.

:typing

[MmacFN]

Hey Liz

too true. However, they want my money and they want students who will reflect well on their institution. I have recently found 4 programs who feel FN experience is preferred if you have it. The difference, i believe is less about how good ICU experience is (since i do have that) and more about the background of the director and what they know about other areas.

I can certainly name off 2 ER's locally that have IABPs come back and carry 6 drippers. I can also name some ICUs where the patients sleep at night and the experience is little to none. Its all in WHAT your experience is not WHERE it was. ICU does not = good experience by definition. I know, ive worked there.

I am lucky enough to have been published in a few journals and apart of some large research projects. I plan to do more and i think that has been helpful with the programs consideration of me as well.

In anycase, I'll find a place that is realistic about experience as opposed to having blind criteria. BTW the national assoc. suggests a minimum of one year experience and say nothing about ICU. Most programs include ER & PACU as acceptable backgrounds.

[DebbieSue]

There is no way that this guy's experience is not full blown critical care. Period. Trauma and CTICU experience, followed by flight nursing. Unless his ICU experience totalled less that about 1.5 years. Maybe that is the issue--did you go into flight nursing just after that requisite one year of ICU experience? In that case, they may think that it was not quite enough being that it was 4+ years ago. Otherwise, that director is whacked.

I think 'they' in general want enough ICU experience to make one at least proficient in critical care nursing. I personally do not believe that less than 1.5 years results in proficient practice. Of course, one could have 10 years of CC nursing and not be much more than competent. A lot of experience does not = expertise, but you rarely find expertise without a good amount of experience. That being said, I can not imagine surviving as a flight nurse if one was not pretty damn sharp in critical care nursing.

I would have been offended by the arms in the air motions. That was plain rude. Unless she has been a flight nurse, how in the hell would she know anyways? Maybe SHE has been out of ICU practice too long to know what kind of train-wrecks get flown into tertiary care centers these days.

I work at a facility that has an absolutely top-notch Life Flight program, and I know the Life Flight RNs will always bring the patient to me better than they found them. And they have to be generalists, too, cardiac, pulmonary, neuro, trauma, ortho, you name it, they see it all.

Hang in there, friend, you will find that program that fits.

BTW, this is worrying me......I have decades of ICU, SICU, and CTV ICU experience, and an MSN, but have been very part time since my dear husband died in June...(being with the kids, etc.)--I think I would go ballistic if someone suggested that I don't have enough 'current' experience.......

gasp.....adjusting attitude, adjusting attitude, adjusting attitude. adj.........................gasp.....

[MmacFN]

Sorry for your loss.

Yes i was slightly frustrated. I have just over 2 years ICU experience. I moved between 2 mainly during that time, CVICU and TICU. The rest is ER, Trauma teams and flying.

This lady freely admitts she has been out of CRNA practice for 5 yrs. Who knows how long it has been since she has been in the ICU. She also feely admitts this is her retirement job. Not exactly gung ho.

in anycase, ive since found 4 who were excited about my application, especially the FN part. They all said the same thing, "we have had many FNs come through the program and they are consistantly top of the class" was nice to hear from some program directors

Anywho, thanks for the backup. I was surprised to see so many question my experience and none defend it. (though i did get alot of PMs defending it).

thanks to all who gave their advice