A CRNA's opinion please?

stanman1968 · Sep 27, 2008

What do you mean seriously lacking? In what way case types numbers etc.

fungirl · Sep 27, 2008

What do you mean seriously lacking? In what way case types numbers etc.

Lacking in both. I will graduate with maybe just a few more cases than is minimally required for my school. Types of cases: spent 5 days handing things to anesthesia residents and call that a cv rotation. I am still trying to get the minimum 5 central lines, and it is like having to move mountains!! Because, if my education was to come first, then how would they staff the board!!! I did however rotate to a different site for 3 months for some neuro, vascular, and peds cases. But, all in all just needed more higher acuity cases. Spent the majority of my time in a room by myself doing ortho, gyn, necks, adults, and lets not forget that at one point in time 1/3 of my cases were eyes...All the while knowing that if what I did in the case wasn't correct, the whole MD staff would know about it within 3 secs. and discuss why nurses shouldn't be administering anesthesia!! I think my OB rotation will be o.k. Have not gone to any codes on the floor, and only intubated one patient up in the ICU. Peripheral blocks, are you kidding me, yeah right!! No Trauma, because nurses can't take care of trauma patients!! I just know compared to the rest of the students in my class, my experience is subpar compared to theirs. I graduate in two months and will have all my numbers, but I of course am an overachiever and just feel like I had more expectations for my clinical experience. I definitely paid enough money for school!!! I must apologize for the tone of my message, it's just that I get pretty emotional when thinking about what all I have gone through to get the clinical experience that I actually got. I irritated quite a few people along the way just to get the added experience/rotation that I insisted on!!

skipaway · Sep 27, 2008

Sit down immediately with your PD. Demand to be placed in rotations that will fulfill the rest of your needs.

fungirl · Sep 27, 2008

Sit down immediately with your PD. Demand to be placed in rotations that will fulfill the rest of your needs.

Yeah, kind of did that already, but I think the directors just think I am being immature and a problem student. I did get a rotation away for 3 months, but still would have liked more.....Plus I graduate in 2 months, I did the best I could. I even paid an additional $5000 and moved across the U.S. to do the outrotation that I demanded......Can't do anything about the school that I chose at this point! Needless to say, can this lack of experience be made up for upon graduation in a high volume, high acuity OR??

stanman1968 · Sep 28, 2008

Agree get to a new site ASAP, failing that just be honest on your first job and get the experiance you can

foraneman · Sep 29, 2008

" I just know compared to the rest of the students in my class, my experience is subpar compared to theirs."

How is this possible? From what you were saying this seemed to be an issue across the board.....

At this point you should feel a bit safe to assert yourself by requesting (demanding) cases and even refusing to 'assist' a resident. When you graduate, take your concerns to the Council on Accreditation.

Yes, you can gain any of the clinical experience you believe you lack, in a short time, by choosing your first job wisely. I would recommend that you only consider a large/academic institution that is 'CRNA friendly', (or even a medium sized hospital where there are no residents competing for procedures and the CRNAs are allowed to practice as they should). Many new grads have not had the central line or regional experience they would have preferred, dor the very reasons you have stated. You will not come across as incompetant in an interview as a new grad if you simply say "I need more experience doing central lines. I competed with alot of residents and students for procedures and would like to be more proficient." You will be suprised how accomadating the majority of anesthesia departments will be.

Choose your first job poorly and you will feel 'behind' the rest of your career.

loveanesthesia · Sep 29, 2008

You've done the most important thing to solving the problem, recognizing that it is a problem. You can make up if you pick a position well, really let potential employers know what your goals are. If they aren't enthused or supportive then move on. I agree you need to let the COA know of your experiences, it's not to bad mouth the program, but to make it better for those who come behind you. Actually you can help the PD have some ammo to make a case for why things must change. The MD's rely on the SRNAs for staffing so they don't want to see the program get into trouble, so some outside pressure can go a long way to changing things for the better.

yumyum · Sep 30, 2008

If you don't mind me asking, what program do you attend?

Regarding your concerns- I would be concerned too. I think it is good you tried to go above and beyond by moving and so forth- but I would sit down again with your PD and discuss these things further.

fungirl · Oct 3, 2008

You've done the most important thing to solving the problem, recognizing that it is a problem. You can make up if you pick a position well, really let potential employers know what your goals are. If they aren't enthused or supportive then move on. I agree you need to let the COA know of your experiences, it's not to bad mouth the program, but to make it better for those who come behind you. Actually you can help the PD have some ammo to make a case for why things must change. The MD's rely on the SRNAs for staffing so they don't want to see the program get into trouble, so some outside pressure can go a long way to changing things for the better.

LoveAnesthesia: thanks for the reply. Just curious, what would the COA do with a letter describing my experiences?? As far as my clinical site: it is a bit of a different situation, b/c it is very MD driven. Actually, about 40% of the attending MD's would be incredibly happy to see us go and to never never return!!! There is only 4 of us SRNA students at this particular site right now...

Foraneman: Also thanks for the tips, I appreciate it!!! When I stated that my experience is subpar compared to other students, it is b/c my particular school has clinical sites in many states, and other sites do get fabulous experiences.

Yumyum: If you are a student, I wouldn't suggest you apply to this school!! I am trying real hard to keep my frustrations down (i.e. my mouth shut) until my title changes to fungirl, CRNA.

yumyum · Oct 3, 2008

Yeah- I know- but I still can't figure out which school you go to.

loveanesthesia · Oct 3, 2008

Just curious, what would the COA do with a letter describing my experiences?? As far as my clinical site: it is a bit of a different situation, b/c it is very MD driven. Actually, about 40% of the attending MD's would be incredibly happy to see us go and to never never return!!! There is only 4 of us SRNA students at this particular site right now...
Foraneman: Also thanks for the tips, I appreciate it!!! When I stated that my experience is subpar compared to other students, it is b/c my particular school has clinical sites in many states, and other sites do get fabulous experiences.

To do this in the most effective way, you should write a factual unemotional letter (after you graduate, just in case the PD is unreasonable). Include what you see as the problem, ie not fully participating in cases, not enough varitey of cases etc etc. Also include what you did while in the program in your efforts to improve your education. Keep it short, 2 pages max. And send a copy to the PD of the program as well, that may seem a little uncomfortable, but actually you will feel much better about it in the long run, and if the PD is a professional you will earn a lot of respect. Put in the letter that the PD also received a copy, so the COA knows it, that will give your letter a lot more weight. Sounds like the site either needs to improve, or be dropped, and probably dropped. One of the negatives of moving programs into Universities is the Dean's drive for more tuition. PDs can be pushed to take as many students as possible by the Dean, so politically it can be difficult for a PD to tell his/her Dean that next year we're taking 4 fewer students. That's where student complaints and outside pressure from the COA can give the PD the ability to make the case to the Dean. Deans don't want to deal with accreditation issue. If any other students in your situation would be willing to lend you support that would be very helpful as well. You really can have an impact, you are willing to work for what you want, and not just complain. I commend you for that, and while your clinical experience may have been less than ideal, you have the necessary attributes to be an outstanding CRNA. Good-luck.