Interesting Cocktails

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Specializes in CRNA.

Hello, everyone.  I just switched jobs and have worked as a CRNA at a Level 2 trauma facility for a couple of months.  Many of the CRNAs and MDAs at this hospital are not comfortable using "newer" medications (precedex, ketamine, remi, etc).  I have explained some of my own cocktails, but I feel that if I can show these drugs are effective in many different situations, other providers will be more open to using them.  So, I was wondering if anyone out there had some unusual concoctions that you find work great.  I would also like to hear of any unique ways of using these drugs (I.e. in preop, IM, intranasally, etc).  Thanks! 

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Specializes in Former NP now Internal medicine PGY-3.

I would bring papers showing they work. Unfortunately medicine in general is full of anecdotal evidence and "I've done it this way for xyz years and am not changing"

Sometimes it is hard to rock the boat even if the waves are made of evidence based practice

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I guess I'd ask why is it important that other people practice the way that you want them to?

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Specializes in CRNA.

I guess I’d ask why I would respond on a post with a stupid question. 

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Specializes in Anesthesia.

https://goopioidfree.com

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14 hours ago, AlwaysSunny said:

I guess I’d ask why I would respond on a post with a stupid question. 

Wouldn't call your question stupid, naive maybe...but you did clear up my question...thanks. 

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Specializes in CRNA.
4 hours ago, offlabel said:

Wouldn't call your question stupid, naive maybe...but you did clear up my question...thanks. 

Feel free to move along since you have nothing helpful to add. If I needed a life lesson, I’d call my father. Thanks. 

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Specializes in Former NP now Internal medicine PGY-3.
On 12/18/2022 at 6:46 PM, offlabel said:

I guess I'd ask why is it important that other people practice the way that you want them to?

May have something to do with getting weird looks for rocking the boat with a different practice style or pacu nurse compliance ? I’m not sure but that is what I assume. Less likely the OP trying to get people to do what he or she wants. 

I’ve found hospital staff aren’t often very open to new things even if the new things may be currently better in general. 

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Specializes in CRNA.
36 minutes ago, Tegridy said:

May have something to do with getting weird looks for rocking the boat with a different practice style or pacu nurse compliance ? I’m not sure but that is what I assume. Less likely the OP trying to get people to do what he or she wants. 
 

I’ve found hospital staff aren’t often very open to new things even if the new things may be currently better in general. 

Exactly. I work in an MDA directed facility. Thought it might make it easier to get some of them on board if I could demonstrate a more diverse use for these meds. But I should have known better than to ask on this forum. 

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1 hour ago, AlwaysSunny said:

Exactly. I work in an MDA directed facility. Thought it might make it easier to get some of them on board if I could demonstrate a more diverse use for these meds. But I should have known better than to ask on this forum. 

Before you take your ball and go home, just consider something for a second. You say you've been there for two months. You're the new gal and you've assessed all of the existing group's skill and knowledge level in those two months and now you want to show 'em all how it's done? Don't be that CRNA. You've let us know you're not the type of gal that takes advice, but trust me, quietly doing your cases, being helpful and establishing yourself as skilled and knowledgeable will go a lot farther than trying to school people, many of whom may have done their first anesthetic when you were in high school. And if you've got such great ideas on your own that you are going to enlighten these people with, why are you looking for 'cocktail recipes' on allnurses? They may be more sophisticated than you're giving them credit for. But knock yourself out.

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Specializes in CRNA.
2 hours ago, offlabel said:

Before you take your ball and go home, just consider something for a second. You say you've been there for two months. You're the new gal and you've assessed all of the existing group's skill and knowledge level in those two months and now you want to show 'em all how it's done? Don't be that CRNA. You've let us know you're not the type of gal that takes advice, but trust me, quietly doing your cases, being helpful and establishing yourself as skilled and knowledgeable will go a lot farther than trying to school people, many of whom may have done their first anesthetic when you were in high school. And if you've got such great ideas on your own that you are going to enlighten these people with, why are you looking for 'cocktail recipes' on allnurses? They may be more sophisticated than you're giving them credit for. But knock yourself out.

 I enjoy using these medications and wanted others’ input on ways to get my new coworkers to enjoy them too. I don’t think I know more than anyone else, hence the asking for advice.

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Specializes in Anesthesia.

There are FB groups for CRNAs that you can get more input from. These comments on here are extremely mild compared to some you will get on there though. 
You likely work in a medically directed or supervised environment and in those areas it’s going to be difficult to get people to change unless it is directed/encouraged from the top down. 
I had similar problems when I worked at Kaiser. There was excellent evidence to encourage practice changes, but no one would change their practices until it was dictated from the Chief MDAs or someone similar. 

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