Practice outside the OR?

[NeuroNP]

Is your practice as a CRNA strictly limited to the OR? I know MDAs often work in ICUs as well. Also, they tend to get called for difficult airways and line placement. Do any of these scenarios apply to CRNAs as well?

Bryan

[Pete495]

yes they all apply. That's why a CRNA position is so attractive these days. try doing a search on the board for related topics. If you don't find anything, come back here, and we'll try to answer.

[NeuroNP]

yes they all apply. That's why a CRNA position is so attractive these days. try doing a search on the board for related topics. If you don't find anything, come back here, and we'll try to answer.

I tried searching, but came up empty, if you know where the old conversation is, could you post a link?

bryan

[sjt9721, BSN, RN]

Ours come to the ED when a patient presents with a 'spinal headache' and needing a blood patch.

We've also had them come down(stairs) to push Propofol for an elective cardioversion. The patient had been cardioverted many, many times in the past and refused Versed & Fentanyl. Evidently he got nutty with that combination. He asked for "the white stuff"!:)

[TraumaNurse]

CRNAs respond to airway emergencies anywhere in the hospital, OB, ED, ICU, Med/Surg etc. They work in ASU (ambulatory surgery), EP lab, and perform neuraxial analgesia for OB.

In most cases, however, CRNAs do not "work" in ICUs like MDAs do. Ologists can be the medical director of an ICU or PACU, whereas CRNAs have a limited role in that setting (usually just airway emergencies). This may be different in smaller more rural hospitals, but I doubt it. Even in the all-CRNA practices that I know of, the CRNAs do not "run" the ICU.

One of the greatest things about Nurse Anesthesia is the wide scope of practice and autonomy. Although CRNAs can enjoy a full scope of anesthesia practice, they are sometimes limited by hospital or group bylaws (Not state or federal law..except in office based practice in NJ :angryfire ).

[NeuroNP]

CRNAs respond to airway emergencies anywhere in the hospital, OB, ED, ICU, Med/Surg etc. They work in ASU (ambulatory surgery), EP lab, and perform neuraxial analgesia for OB.

In most cases, however, CRNAs do not "work" in ICUs like MDAs do. Ologists can be the medical director of an ICU or PACU, whereas CRNAs have a limited role in that setting (usually just airway emergencies). This may be different in smaller more rural hospitals, but I doubt it. Even in the all-CRNA practices that I know of, the CRNAs do not "run" the ICU.

One of the greatest things about Nurse Anesthesia is the wide scope of practice and autonomy. Although CRNAs can enjoy a full scope of anesthesia practice, they are sometimes limited by hospital or group bylaws (Not state or federal law..except in office based practice in NJ :angryfire ).

Anyone know of a case of combining a CRNA and ACNP education in critical care? How would this kind of practice work?

[TraumaNurse]

You can use the knowledge from multiple degrees in any setting, however, if you are hired as an ACNP in ICU, you can only perform those duties dictated by hospital policy in that job description, even if you are also a CRNA. This also happens between nursing departments. When I was a flight nurse, I could intubate, needle a chest, start a vasoactive gtt and many other things without an MD order (We worked under protocol and used our own judgement), when I was working in the ICU in the same hospital, I could not take it upon myself to start a gtt or intubate someone in resp. distress. No matter what other education you may have, you have to work under the job description for that title which you are working that day. The more education and training you bring to any job is always a bonus.

[heartICU]

Anyone know of a case of combining a CRNA and ACNP education in critical care? How would this kind of practice work?

Don't know of any CRNAs that worked in ICU, but we did have ACNPs working as part of the intensivist team at my hospital (they were in our five cardiothoracic intensive care units). They would start lines, round on patients, insert chest tubes as needed, write orders, etc. Never saw one intubate or attempt airway management though, but that's not to say they couldn't. We always just had residents immediately available, and they usually did it for the experience.