CRNA70

You have not taken 3 extra years of schooling and earned a masters degree in nurse anesthesia. Nor do you have the graduate level understanding of pharmacology, physiology, pharmacokinetics, pharmacodynamics, pathophysiology, and anesthesia that I do as a CRNA. You should be very careful in making a statement that since you have intubated people that you are qualified to administer a general anesthetic induction agent. I sew at home---how about I close your abdominal wound when you have surgery? (I'm not trying to argue with anyone here, really. But, people seem to have a misconception about their boundaries, scope of practice, etc.) If you are interested in advancing your training, go the distance and earn the right to administer this drug with the proper, safe credentials.

No offense, but I went to 3 more years of schooling, earned a masters degree in nurse anesthesia, and gained the advanced knowledge of pharmacology, physiology, and airway managment it takes to manage this drug. Propofol is used to induce general anesthesia. It is a dangerous medicine. Yes, it can be used as part of a monitored anesthesia sedation administered by a qualifed anesthesia provider. ACLS aside, you are not trained on how to mask ventilate (correctly), open an airway with your hands, support the airway, make determinations about the airway status, etc. You should consider obtaining the proper credentials instead of trying to confer a degree/training in something you don't have. You in fact should be very afraid to administer things that you are not trained in. You should also know that propofol has no analgesic properties to "enhance patient comfort". You should also know that if a patient were to suffer a bad outcome under your care in administering this drug, you wouldn't have a leg to stand on legally. Your MD colleague would hang you out to dry.

By definition, then, propofol should not be used if the intent is conscious sedation. RNs can administer conscious sedation--you and I as CRNAs or our anesthesiologist colleagues can administer the deep sedation and general anesthesia with propofol by right of our advanced training and certification. I disagree with the notion that staff RNs are pushing this stuff. (This is not meant as any disrepect to our RN colleagues--it is a safety issue.)

Have Level 1 trauma MICU/SICU experience looks WAY better than the community hospital you described. I am a CRNA/Educator and I interview and screen applicants for our CRNA program. Take my advice--do the level 1. It's not only important for interviewing purposes--it's your foundation for CRNA school.

In the facility where I work, we share a CRNA program with a medical doctor anesthesiology program. We are prohibited from calling SRNAs residents (even in the residency portion of their training) because this was deemed confusing to patients. We refer to nurse anesthesia trainees as SRNAs. Remember that a patient has a right to know who you are (and you are a student or a trainee, if you like). I also introduce my students as "nurses training in our nurse anesthesia program". This conveys (sometimes, depending on the patient) that the person is indeed a registered nurse with an earned degree (and not a student nurse). Hope that helps.

Hi. Another thing to consider==certain employers will fund your schooling up front or afterward with loan reimbursement if you sign on to a contract to work with them for x number of years, for example. You can approach them and ask for this. You can also take out what's termed "alternative" loans from Citibank, for example, to add to the 18,500 that is max for traditional student loans. I did this. I then worked at a place that paid me 10K a year extra for three years to cover my loan expenses.

Continuous low=dose infusions of Propofol are common the ICU Setting. What must be understood is that Propofol is a GENERAL ANESTHETIC in bolus form and high-dose infusion. Professionals must be trained in airway management (most staff RNs are not), and intubation. Therefore, in my opinion, other than the low-dose ICU infusion, it should be managed by anesthesia providers (CRNAs/anesthesiologists) who can rescue and manage the airway. This is a patient safety issue.

This 1.5% number reflects AANA surveyed CRNAs in the last mailing. What I don't remember is if this specifically relates to full-time academic faculty--it would seem so, because you're right==many CRNAs contribute via instruction solely or partly in the clinical setting.

Hi. You could go the AANA website www.aana.com to find a list of CRNA programs. There is a contact person associated with each program.

Hi. Only 1.5% (staggering) of all practicing CRNAs are involved in education of SRNAs. I think contributing in this regard helps guarantee that there will be new CRNAs! The future of our profession depends on it! Be a teacher! I am!

Hi. There should be a comfortable level of "nervous" whenever you are training. This is natural and demonstrates your ability to recognize your limitations. Acting bold or all-knowing when you're not is dangerous to patients' lives. With continued training and experience in nursing and nurse anesthesia, things get easier. However, you can never take what you are doing for granted==even the most routine anesthetic can quickly turn into a disaster with lack of vigilance. Hope that helps.