How does CRNA programs build upon ICU skills

[mark2climb]

I am a RN in the process of application/interviewing for CRNA programs. I understand that knowledge of critical care, ie meds, patho, resuscitation, is necessary for practice as a CRNA. How do most CRNA programs build upon that critical care knowledge in the program? Does knowledge of critical care pharmacology act as a foundation for understanding of anesthesia? How does the two skill and knowledge sets get incorporated?

I think I have an idea of how it's done but I'm curious to hear from both seasoned CRNAs as well as new grads on how that gets done both in practice and in school.

Thanks.

[deepz]

http://www.gaspasser.com/unique.html

[mark2climb]

deepz,

Could I PM or email you about CRNA roles here in CO?

Mark

[piper_for_hire]

Short answer - they don't. I can see why you made that assumption - since ICU experience is required for most schools. But what you'll find is that anesthesia school doesn't really build upon anything you may know already. You will be taught from scratch - from the ground up. Some things you will know, some things - well - you thought you knew. For example - just about everything I knew about sedation and intubation from the ICU is pretty much useless as a NA. It's a while different ball game. This makes sense when you think about it since all of your classmates will have different experience. We have some that haven't touched an adult since nursing school 20 years ago, for example. They're gonna rock in their peds rotation!

-S

[jemommyRN]

Short answer - they don't. I can see why you made that assumption - since ICU experience is required for most schools. But what you'll find is that anesthesia school doesn't really build upon anything you may know already. You will be taught from scratch - from the ground up. Some things you will know, some things - well - you thought you knew. For example - just about everything I knew about sedation and intubation from the ICU is pretty much useless as a NA. It's a whole different ball game. This makes sense when you think about it since all of your classmates will have different experience. We have some that haven't touched an adult since nursing school 20 years ago, for example. They're gonna rock in their peds rotation!

-S

If this is the case, then why do so many seasoned CRNAs get upset when a new grad wants to apply after only one of two years of ICU experience? I did hear that anesthesia school was a different animal than critical care nursing. Just curious.

[piper_for_hire]

For the same reason that many old school nurses seem to believe that you should "do a year in med-surg" before you specialize. (this point of view makes no sense to me as I feel that med-surg is it's own specialty. I suppose in the past it was an "easier" job but it sure isn't now.) The truth is that everyone is different and has different experiences so putting an arbitrary minimum time limit only gets you so much in terms of patient management - which is what the critical care experience is for since you are not going to learn how to do the basics of patient management in anesthesia school.

-S

[jemommyRN]

For the same reason that many old school nurses seem to believe that you should "do a year in med-surg" before you specialize. (this point of view makes no sense to me as I feel that med-surg is it's own specialty. I suppose in the past it was an "easier" job but it sure isn't now.) The truth is that everyone is different and has different experiences so putting an arbitrary minimum time limit only gets you so much in terms of patient management - which is what the critical care experience is for since you are not going to learn how to do the basics of patient management in anesthesia school.

-S

Thank you for answering this question. I understand (what the big fuss is all about) better now.

[Frigle]

I just started Anesthesia school and that person is right. We are starting from the ground up. Some things you will know and most you will not. I am almost done with my first semester and I already want to go where I attained my BSN and ask for a refund. LOL

[dfk, RN, CRNA]

i have to add too that the more experience will shine through.

OR nurses and CRNAs and docs can definitely tell who is more comfortable with nursing "duties" and bedside pt care and just plain being in the OR.

it may sound like anesthesia doesn't do these things, but they do.

[mark2climb]

How do you mean starting from the ground up? I'm sure there is some basic overlap, right?

Do you mean that vitals mean different things when a patient is under anesthesia? Do you use the medications for different reasons? Do you approach the patient differently than a nurse?

[Frigle]

I guess what I'm trying to say is that it is a whole new skill set than the ICU nurse is used to. You are adding to your knowledge, but it is so much information it just feels new. I just find myself saying to myself "if I would have known that I would have done that a lot differently." Anesthesia is a whole different world compared to ICU nursing. You use the same drugs differently. You use a lot of different drugs that you have never heard of. Vital Signs are always gonna be Vital Signs, but now you know a lot more about them. So far Anesthesia school has been and eye opening experience. I am very happy that I took this leap. Don't get me wrong, ICU nurses know a lot. They just don't know anything about anesthesia.

[ready4crna?]

Mark-

They expect things like basic arrythmia mgmt, basic pathophys, but let me tell you- they will teach as if you know nothing. And for the most part, trust me, they are right. (I am speaking as a seasoned RN/paramedic with experience across a broad swath of care populations.)

You learn to rethink some of care you delivered in the ICU and learn the deeper levels of the "why's".