Nursing Experience for CRNA school - page 2

So honestly I am just venting with this post. There is a nurse in my hospital that just got into a good CRNA program in the area and has been a nurse since January. The app deadline was in September... Read More

  1. by   nurserobinson281988
    AA's are unable to practice independently in any setting. CRNA's practice independently in 70% of settings they practice in. It sounds like your opinion is that of someone who doesn't have a lot of ICU experience, but feels that your experience should be sufficient. I don't expect you to feel any other way about this topic, but factually, most others do not feel the same as you do about this topic. Recovering hearts is a VERY small piece of the ICU pie. I understand CRNA schools take a lot of their students from CVICU's, but I feel that is because they work very closely with anesthesia providers and thus have an easy time getting strong refs from those people. I work in a CICU in a hospital that is a major cardiac transplant center in the Midwest, and I am very familiar with the dynamic (in our hospital) in the CVICU. A physician is always present. They are dictating titrations of drips and there is not a high level of autonomy on the floor. They rarely have balloon pumps, Impellas, etc. They are not allowed to wedge their PA caths. When they do have IABPs, Impellas, hypothermia, etc, they call our unit to consult our nurses about the workings of these assist devices and protocols. In the CRNA profession, you will have a high level of autonomy, so I don't necessarily think the CVICU is the gold standard when it comes to prepping nurses for CRNA school---but that is all neither here nor there. Please understand that everything stated above is my opinion and nothing more than that. I want everyone to follow their dreams. My goal in waiting five years to even apply for CRNA school was to learn as much about critical care as possible--not to do my minimum requirement to get into school (even though that was always my ultimate goal). the purpose of that is to be able to identify when a patient is going downhill.
    Again, my disappointment is with the admissions board, not the new nurse who is too new to know what he doesn't know.
    Last edit by nurserobinson281988 on Nov 10
  2. by   Rico713
    Well my unit is a medical surgical icu but 70 percent of the patients are cardiothoracic surgicals because of how big our cardiac program has become. I work at night so no physician around other than a genral hospitalist who you dont call for those patients. Our surgeons give us all the drips on our MAR even if they are not being used. This alllows us to start whatever drip we feel is neccessary for said patient. Call one of them without actually thinking and trying to solve the problem with some interventions and they will give you an ear full for not thinking and ive witnessed it with others. We have no residents or anything either so i have about as much autonomy as a bedside nurse can expect with those patients with the way our surgeons set it up. The way ive experienced is if you can take a fresh heart thats a bleeder or not doing well at all and understand what youre doing the other pts are not as difficult. My opinion.
  3. by   nurserobinson281988
    then you have never taken care of a patient with mixed hemorrhagic and cardiogenic shock and an EF of 5%. But ok, a bleeding post cabg patient is the worst;-)
  4. by   JWOkStRN
    Quote from Rico713
    Well my unit is a medical surgical icu but 70 percent of the patients are cardiothoracic surgicals because of how big our cardiac program has become. I work at night so no physician around other than a genral hospitalist who you dont call for those patients. Our surgeons give us all the drips on our MAR even if they are not being used. This alllows us to start whatever drip we feel is neccessary for said patient. Call one of them without actually thinking and trying to solve the problem with some interventions and they will give you an ear full for not thinking and ive witnessed it with others. We have no residents or anything either so i have about as much autonomy as a bedside nurse can expect with those patients with the way our surgeons set it up. The way ive experienced is if you can take a fresh heart thats a bleeder or not doing well at all and understand what youre doing the other pts are not as difficult. My opinion.


    No one is trying to dumb down experience here. I'm sure you have gotten to see and experience great things. However, I caution you on thinking that because you've cared for a specific population of patients that all others are easy in comparison. There's a fine line between confidence and arrogance. You will be humbled at some point in your career. We all like to feel that bc we are ICU nurses, we are the baddest of asses. You've got to realize that this is much bigger than ego. It's about the patient and their life. I hope you accomplish great things, but I also hope you will look back and think about how you were at 1 year in the ICU vs 5 years (should you choose to be beside that long). Experience and maturity will change your perspective.
  5. by   nurserobinson281988
    and you're actually proving my point. if you think that is the sickest patient there is, you are too new to know what you dont know, and that is the problem.
  6. by   Rico713
    Your missing my point actually i know there are sicker pts ive taken care of them lolllll ive had septic pts that were sicker and crashed quicker but guess what helped me in those situations taking care of hearts. When i was coming out of school had multiple docs say if your learn your hearts the rest is not as difficult. Heres what it comes down to a crna got one year icu experience went to school and has now been a competent crna for 3-4 years when you get out of school with no crna experience yet but 5-6 years icu experience. Are you gonna be a better crna at that point since you have technically more overall experience?
  7. by   loveanesthesia
    Quote from Rico713
    Ok well AA's in a ACT model do everything a crna does without having to have experience prior to matriculation. Not sticking up for them but just stating a fact
    You have some facts wrong here. You are correct that AAs don't have patient care experience. But AAs don't practice the same as CRNAs anywhere. Sometimes a CRNAs practice is limited to an AAs practice for political reasons and it sounds like you've bought the big lie. In KC KS when a group brought in AAs they changed from 4 CRNAs to 1 MDA and went to 2 AAs/CRNAs to 1 MDA. The reason was they hired AAs and the AAs needed direction (they had some bad patient events) so they couldn't leave them alone. The MDs didn't want them to be different from the CRNAs, so they started supervising the CRNAs 2:1 also. They made AAs and CRNAs equivalent to push the "big lie".
    Anyone who attended an RN program and has a year experience in the ICU is light years ahead of an AA.

    More than 1 year experience is nice but maybe not always necessary. The OP states a 'good program' took a less experienced candidate. I bet you think it's a good program because they have a good board pass rate. The young candidates do well on boards and that fact probably played more of a role in the decision than the fact that his mother is a CRNA. He's going to make the program look good.
  8. by   nurserobinson281988
    I think it's a good program because of the quality of clinical experiences you receive in the program compared to other schools in the area. I do not bother with comparing pass rates if it is the difference between a 92 and a 98%, for example.
  9. by   loveanesthesia
    Fair enough, clinical experience is important. But many candidates compare programs by pass rate. And ability to pass boards is more of a focus more than the past with the national average at 82.6% and the COA requirement at 80%. Pass rate is a real concern for programs.
  10. by   elijahvegas
    waiting for the sky to fall causes more worry than the sky actually falling.

    so he got in because of connections? who cares. you're in, he's in, and that's that.

    another way to look at it is this.
    if you're certain you got in by merit and he didn't merit an acceptance to the program, it will show by him failing out.

    if you're certain his experience isn't enough, then it will show when he performs academically and clinically.

    Now here's the kicker--if he does make it through school, both academically and clinically, that means YOU'RE the one that's wrong about him not having the merit to be in such a program. Because if 8 months of experience is enough for him to cut it, then it really doesn't matter who he knows and how he got in, because it means he's good enough to be there.

    And if he fails, then it doesn't matter who he knew because he won't be in the program anymore.

    See how that plays out ?
  11. by   nurserobinson281988
    I disagree, obviously. But thanks for your opinion. The point is that there are people who actually meet the requirements of the program who arent getting in.
  12. by   elijahvegas
    Quote from nurserobinson281988
    I disagree, obviously. But thanks for your opinion. The point is that there are people who actually meet the requirements of the program who arent getting in.
    And you dont find the requirements arbitrary if people that dont meet them are still able to complete the coursework proficiently and competently?

    I dont need any medical professional to have a 4.0 gpa and top of his class. I need someone who knows what theyre doing and can do it well. This is what i expect from people who render my care as well as coworkers.

    Everything else is cannon fodder and splitting hairs
  13. by   nurserobinson281988
    Whether I find the requirements arbitrary is not the point, since I am not the person making admission decisions.
    When you are rejected from one of these schools and you call and ask what you can do to improve your chances, they say, "well your GPA is .1 less than the average of the people who were admitted, and you should retake that chemistry class you got a C in (10 years ago)", blah blah blah. They also say that they want you to have a year of ICU experience but the most competitive applicants will have two years of experience.
    As for your comment about "do you want someone with a 4.0 or someone who knows what they are doing?"..I would personally want someone who knows what they are doing but schools also want someone who has a high gpa because their pass rates on anesthesia boards are an indication of how good the program is. I agree with what you're saying about needing someone who can do their job well. When speaking with nurses in this nurse's ICU, they say he is just an average new grad-nothing amazing. So when thinking about his stats, I am fairly confident that he is the person who has a 4.0 but who hasnt been doing his job long enough to know what to do in a variety of critical situations.

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