inserting invasive lines in school

My school does teach line insertion at some of the clinical sites. As I look at places to work, most do not want CRNAs doing lines. (A-lines are usually done by CRNAs). So I think that it is not a real disadvantage in finding a job. However, I want to work in a plave that offers a full scpoe of practice so learning that skill is important to me. You have to decide what's important to you.

even if you learn to put in s.g. caths, cvps, and nerve blocks like a champ, like wntrmute said most places won't allow you to utilize your full scope of knowledge. the mda who sits on the board of directors at the hospital you work for mandates what a crna can and can't do at that particular facility.

You can always choose a job that allows you a full scope of practice. We do lines in my program, and one of my top priorities in looking for a job is full scope of practice.

If you do not want to do them, then you choose a different position, there is something for everyone.

From your responses it sounds like you prefer full scope practice to a limited practice. Why do you prefer this? If I graduate from CRNA school without having learned the full scope of practice, would I be considered a less capable CRNA? It seems to me that I would. If during a case, a swan is required to better manage the patient, I would like to do that instead of having to step aside and have the MDA do it. Is that your opinion too?

I still a newbie SRNA, but it is important to me to be able to be able to practice anestheisa to the fullest. Lines are part of the job. Apparently, much less of the job than I originally thought (most pts receive anesthesia with the basic IV), but a part of the job nonetheless.

If you don't mind sharing, which program are you looking into?

Well, I think that if you graduate without the skills, you could probably find a job where they are willing to teach you.

My personal belief is that I am more marketable if I am capable of doing everything within my scope of practice.

I also believe that the less we do, the less we will be needed. Meaning if you have a CRNA who just does general anesthesia on relatively healthy patients, does not perform blocks/insert lines or otherwise function at full capacity. It is easier to justify replacing that crna with an anesthesia assistant.

I am also a bit of a control freak, if my patient needs something, I want to be able to provide it and not have to call someone else to do my work.

These are just my opinions.

I totally agree with your opinions. I just don't understand why some schools don't prepare their students to practice anesthesia to their fullest capacity. Any thoughts? The school I was considering is very affordable, but now I must weigh this with the limited training I would receive.

A large part of what interests me in anesthesia is the autonomy. I don't just want to do simple cases on healthy patients all the time. I would not be satisfied with a career like this, even if the money was good. I want to be valued and respected for my ability and knowledge, something which is lacking in my role as an RN.

My guess would be that the MDA's at the facililities where clinicals are performed do not want the students to do lines. (probably do not let the CRNA's there do them either) It is a control issue in some places, I believe blocks can be an issue in some places too.

If it were me I would look for another school. One that will train you to do everything. It seems to me that if the docs at this one do not let students start lines, there are probably other issues that you have yet to hear about.

It is funny that this topic came up because yesterday an MDA was putting a central line in my patient and we got on the subject of CRNA's and line placement. They said the reason why CRNA's at my facility aren't allow to do the procedure is because of the complications that "could" arise and how they would treat them if something was to occur while inserting(pneumo etc). He made it sound like CRNA's didn't know how to place a chest tube or are never taught that skill in school. I feel that if you are being taught how to insert lines in school then we better know how to treat the complications too. I for one think we should know how to insert them and should be allowed to on a regular basis in any hospital or setting.

Am I wrong in this??....

But I thought the AANA mandated a SRNA put in 25 Art lines and 5 CVPs to be able to graduate and the AANA "recommended" placing 5 swans

Here's the link:

http://www.aana.com/accreditation/trial_stds/appendix.asp

Sounds like your right, although is looks like the CVP insertion could be simulated and S.G. insertion optional...Maybe I did get some misinformation from the student I spoke with. She didn't mention anything about a-line insertion, but it sounds like it is a requirement. This just sort of shows how CRNA programs can differ b/c of what's "required" and what's "preferred." I'm going to look for a program that meets or exceeds the AANA's requirements and preferences. Does anyone know of programs that meet or exceed AANA preferences?

Exactly how common is it that hospitals limit scope of practice? I am considering CRNA school because I want more autonomy than a regular RN, but it seems that CRNAs are regulated much more than I thought. How difficult is it to find a hospital that does not limit scope of practice? For those CRNAs out there who are working in restrictive practice settings, are you happy and do these restrictions bother you? Do hospitals just restrict you inserting lines or are other aspects of your practice restricted as well? Thanks for the input!