Independent-Practice CRNA - Will brutally answer any question from my perspective

Specialties CRNA

Published

Specializes in Anesthesiology.

Disgruntled indy CRNA. Full scope. I do, or have done, it all. Ask and I will give you my 100% brutally honest answer. Please keep it geared towards practice issues, not school admissions. And go...

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Why are you disgruntled?

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Specializes in Pediatry , Med/Surg , Anesthesia Tec,MBG.

How to work independently !?  What are your favorite practices in the clinic?  Is the CRNA school really scientific?  Are you satisfied?  Do you have all the skills?  Pain management and CRNA, how does it work?

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Specializes in Critical care, Emergency medicine.

What school did you go to? What was good about it? what was bad? (Hopefully that doesn't qualify as a CRNA school admission question)

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Specializes in Family Nursing & Psychiatry.

Were they planning to answer?

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Specializes in Anesthesiology.
On 8/17/2020 at 3:40 AM, JohnCena98 said:

Why are you disgruntled?

Hospital administrators who are purely focused on profit at the extreme detriment of their staff. Large anesthesia management companies who ignore and abuse their staff. Failed or non-existant systems to address recurring problems. Resistance and intolerance to systems that benefit the staff and patients. Being constantly lied to and purposefully mislead by management companies and hospital admins.

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Specializes in Anesthesiology.
On 9/10/2020 at 9:32 PM, barishan said:

How to work independently !?  What are your favorite practices in the clinic?  Is the CRNA school really scientific?  Are you satisfied?  Do you have all the skills?  Pain management and CRNA, how does it work?

What do you mean how do I work independently? I complete all anesthetic duties required to care for a pre-, peri-, and post-operative patients. I currently work in a rural hospital with limited staff, specialties, and resources with a decently unhealthy, noncompliant, and severely overweight population (mostly ASA PS 3s and 4s, with an occasional 5). My favorite cases are traumas and complicated surgeries. My least favorite are sedation for GI and pain procedures.

 

I cannot speak for all CRNA schools, but there is more than a little science-based education to include biochem, physics, o-chem, pharm, and anat, phys & patho.

I am unsatisfied because I work in a system that is designed to fail, and everyone is miserable (even before the pandemic).I am also leaving the Christus system for one that actually cares about its people soon.

You would have to be more specific, but in addition to standard skill sets, I also practice USGRA, POCUS, invasive line placement/monitoring, multiple alternative airway techniques (FOI, retrograde, cric). I incorporate ERAS and opioid-sparing techniques.

Chronic pain management for CRNAs requires a fellowship that I do not have; yet. However, it works the same way as a physician performing these procedures.

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Specializes in Anesthesiology.
On 4/9/2021 at 2:22 AM, Blake Williams said:

What school did you go to? What was good about it? what was bad? (Hopefully that doesn't qualify as a CRNA school admission question)

I'm not listing specifics that can identify me. I would encourage you to ask questions of prospective schools such as average number of nerve blocks performed prior graduation, how many independent practice sites do students rotate through, and how many cases do students get prior to graduation. These will give you decent indicators for how well thr school will prepare you to practice independently vs just sitting a stool.

On 9/17/2021 at 3:19 AM, matthewandrew said:

Were they planning to answer?

I never received any reply notifications until yours. ?‍♂️

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Specializes in Pediatry , Med/Surg , Anesthesia Tec,MBG.

Thats awsome. What was it like being independent? As a person who enjoys complexity, does anesthesia become ordinary after a while? Are you training your anger like tracheostomy? one more CRNA surplus in the future? Is it easier to find a job in the countryside? I've always wanted to live in an American town.

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Specializes in Pediatry , Med/Surg , Anesthesia Tec,MBG.
On 21.09.2021 at 19:00, DisgruntledCRNA said:

Ne demek nasıl bağımsız çalışırım? Ameliyat öncesi, ameliyat sonrası ve ameliyat sonrası hastaların bakımı için gerekli tüm anestezi görevlerini yerine getiriyorum. Şu anda, sağlıksız, uyumsuz ve aşırı kilolu bir nüfusa sahip sınırlı personel, uzmanlık ve kaynaklara sahip bir kırsal hastanede çalışıyorum (çoğunlukla ASA PS 3'ler ve 4'ler, ara sıra 5). En sevdiğim vakalar travmalar ve komplike ameliyatlardır. En az favorim GI için sedasyon ve ağrı prosedürleri.

 

Tüm CRNA okulları adına konuşamam, ancak biyokimya, fizik, o-chem, pharm ve anat, phys & patho'yu içeren küçük bir bilime dayalı eğitimden daha fazlası var.

Memnun değilim çünkü başarısız olmak üzere tasarlanmış bir sistemde çalışıyorum ve herkes perişan durumda (salgın öncesinde bile). Ayrıca yakında insanlarını gerçekten önemseyen bir sistem için Christus sisteminden ayrılıyorum.

Daha spesifik olmanız gerekir, ancak standart beceri setlerine ek olarak USGRA, POCUS, invaziv hat yerleştirme/izleme, çoklu alternatif hava yolu teknikleri (FOI, retrograd, cric) de uyguluyorum. ERAS ve opioidden korunma tekniklerini kullanıyorum.

CRNA'lar için kronik ağrı yönetimi bende olmayan bir burs gerektiriyor; henüz. Ancak bu işlemleri yapan bir hekim gibi çalışır.

Hello.  Thank you very much for answering my question.  I am a nursing + molecular biology and genetics student in Turkey.  I don't know your system in America.  What do you mean by working like a doctor?  Can you open a little more?  Thanks for your answer.

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Specializes in Critical Care.

1. Did you enter school with the intention of practicing independently or did that decision grow as you went through the program?

2. Does practicing independently always translate to doing a lot of general types of cases? Is it possible to specialize when practicing independently e.g., only GI, Plastic, CT surgery, chronic pain managrment? If so would specializing in something specific make you happier in your practice?

3. Can you speak to the pros and cons of practicing independently, maybe just 5 main points to each?

I'm waiting in an airport as I write this to catch a plane to go to a DNAP program interview this Tues. Some of your replies are good food for thought on some of the things I'd like to ask of them during that time. Thanks for the feedback.

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