DebbieSue

I totally agree. I read the article, and found the silence re: CRNAs to be absolutely deafening. Didn't say anything bad about them, mind you, just completely and totally ignored their existence. Very subtle, very potent.

My vote is for Anywears. I have been an ICU RN for almost 30 years and was developing plantar fasciaitis, or something causing real bad heel pain. I got a pair of Anywears, and have never looked back. I have something like 8 pair in different colors. For a couple years after getting that first pair, I didn't wear any shoes ever except Anywears. Now, I wear them when I work, garden, do housework. I wash them in the dishwasher, and wash the inserts in the washing machine. They are great with or without socks, and with or without the inserts. The website is anywears.com.

I am applying to 3. Have sent in application to 2. Third wanted me to send the recommendations with the app., so had to wait for the last of 3 recommendations. Second week in June the CT surg director mailed out the recommendations. So, 2 of the 3 have everything within the last month, and I am mailing the 3rd tomorrow. For August 2007.

Maybe they are trying to get twice as much reimbursement because it is twice as hard to teach anything to an anesthesiology resident ;) JUST KIDDING, people, REALLY.

Hey Mike, congrats on getting into school..... I've been off the boards awhile, sort of in seclusion during the few weeks before and after my 'sadiverary', but today seemed ready to resume life. I got those anesthesia sheets a month or so ago. They seem great and were highly recommended on what ever site I first read about them.... Good for you to get to spend time with that great doc. Today I made a list of the most commonly used texts and am deciding what one to start with. I figure if I start the 'booklearning' now, I might give myself a break when classes start. Any little thing to help. Maybe the crush won't be as bad.... Debbie in PA

I was pissed off by the Lidocaine thread, but most especially about the organ donation/anesthesia thread. My mouth dropped open when I read that one. How anyone with that degree of ignorance could get into anesthesia school in the first place made me seriously rethink applying..... I recently took PALS, and was interested in the IO route of med/fluid delivery. Is it ever used in anesthesia? I can't wait to have clinical questions to ask you, Yoga. Debbie

I don't know anything about this from an anesthesia standpoint, but as a long-time CTICU RN at a tertiary-quad care cardiovascular care center, I have cared for lots of these pts. I find it fascinating that the patient is, for all intents and purposes, DEAD. We treat is so blasely, talking nonchalantly about 'circ arrest time'..etc. This is the cutting edge of medicine, in my opinion. The history of the development of this is really fascinating. Potentially dead....potentially alive..... Whew. I would love to do a study about how many of these pts have Near Death Experiences.... Debbie

Holy crap! They really nailed you. Well, my CV has 28+ years as a CC nurse and my CV nursing MSN, so I better remember every arcane thing I ever knew and forgot about the heart! :chuckle Digging out the grad school notes....OMG, they may ask me about the statistical tests used on my thesis research.....sh*t.....this could be bad. I was going to say that forwarned is forearmed, but I'm reserving the right to change it to forewarned is ****PSYCHOTIC****( and this is only the interview, for gods sake....)

You would probably love CCM-L.org. It is the Critical Care Medicine List. Quite a fair number of anesthesiologist/intensivists and RNs, and RRTs, and surgeons, etc. etc., from all over the world. Extremely active group, intelligent, rambunctious. Its CCM-L.org. A lot of the members also belong to gas.net. Of all the mail-lists to which I have belonged, about 50 over the years, related to profession, hobbies, etc. etc., it is by far my favorite and the one to which I always return. Debbie p.s. how about that monsterously long thread on the AA thing? I read the whole thing and now see someone is trying to revive that decomposing horse again. p.s.s. love your new avatar. LOL

This damned horse has been kicked over and over and *someone* keeps resuscitating it..... Will someone PLEASE shoot it in the head and put it out of it's (my, our) misery. WHERE are the moderators of this forum????

Mke, you are not thinking in the advanced practice mode yet. The core courses in the MSN programs are not 'fluff'. If you only look at it all from a putting-people-to-sleep aspect, they might not help you do that any better. Masters level core courses help you 'grow up' as a nurse, help you see the big picture and your place in the big picture. All doctorate programs are not heavy into research. The Ph.D. is. But that is not the doctorate degree of the allied health practice doctorates. There are research doctorates and there are practice doctorates. They do not have the same focus. More important things call.....like going downstairs to watch 'Big Love' My brain is fried.

The point that Jen and Vicky are missing is that the DNP is being created specifically to replace the advanced practice MSN level of education. This is the whole point: advanced practice RNs practice at a very high level. Let's put them on an even playing field with, let's say, doctorate-level pharmacists, PTs, chiropractors, optomotrists, etc. since they practice at the same level as these others already. It's the BSN-to-MSN-to-doctorate progression that is going to change in nursing. The MSN is going to disappear--at least in the advanced practice specialties (i.e., NP, CRNA, CNM, CNS). It will not be a 'dumbed-down' doctorate--what we have now is a 'too-smart' practice-Masters in nursing.APNs (with a Masters degree) are as advanced in their practice as other allied-health doctorates. The powers-that-be in nursing want advanced practice nurses to get the credit they deserve, and the money, and are trying to convert the practice-Masters to a practice-Doctorate for this reason. It's essentially going to be a change in-name-only, since the nursing-practice-Masters is already equivalent to the practice-Doctorate in other fields. That's why I say there will be 'grandfathering'. You have to think of grandfathering in this specific situation--and forget about the 'grandfathering' that has happened at other times in nursing. CRNA practice is already doctorate-level practice, as is the practice of NPs and CNMs and CNSs. Nursing has unfortunately for decades and decades thought of the doctoral level as being only about research and the Ph.D. That is now known to be a fallacy: research is one but not the only way to be a doctorate-level nurse. The powers-that-be finally got their heads out of the ivory towers, looked at what APNs actually DO, were pretty darned impressed, and realized that the 'levels' as they have been set for all these years are wrong. Advanced practice is not somehow 'less' than doing research. Again, it is just different. What CRNAs do, for example, is certainly not 'less' than what a researcher does. It is simply a different body of knowledge. In fact one could say, since actual practice is what nursing is really all about, that advanced practice is just as good as, if not more illustrious than, research. That certainly is a new way of looking at things, isn't it??? The AACN has acknowledged this and is trying to make things right. I personally think things got off kilter because, for many, many years, the Ph.D. was the only doctorate degree that one could get in a nursing program. I mean, nursing schools in universities offered a BSN, an MSN, and a Ph.D with Education and Administration tracts. These well-educated nurses were as far removed from actual practice as they could possibly be. Meanwhile, some of the nurses in the trenches, so to speak, were moving into advanced practice roles totally outside the 'control' of the University crowd and outside of the 'usual' BSN-MSN-Ph.D. route. These were the nurses becoming nurse midwives, nurse anesthetists, nurse practitioners, and clinical nurse specialists. They learned the job on the job and not in the university setting. That doesn't mean, however, that these advanced roles did not require alot of very high-level knowledge. Only fairly recently has the dissemination of that high-level knowledge happened in MS programs. Even so, the knowledge is not MSN-level; it really is doctorate-level knowledge and, thus, the DNP-related goals of the AACN are appropriate. The AACN is actually playing catch-up trying to get the advanced practice programs positioned correctly within the levels of the schools of nursing. It has taken a long time to do this because the bulk of doctorate-prepared nurses in this country are not advanced PRACTICE nurses, but instead are advanced RESEARCH nurses. All those Ph.D.s really did not know where to position these programs but had the bias that if it was nursing practice, it couldn't be as demanding as nursing research. That's the reason that 3 out of the 4 advanced practice roles at first required only a certificate, and only much later required a Masters degree. Finally, advanced practice nursing has grown up and gotten the full attention of the-powers-that-be in nursing. This is why I believe that the move toward the DNP is a VERY good thing for the profession as a whole and the advanced practice roles specifically. It certainly is about time. The logistical issues, such as finding doctorally-prepared teachers, will not derail this coming change because it is really a fundamental change in nursing as a whole: finally acknowledging the supremacy and importance of hands-on patient care for even the highest 'level' nurses. The focus has moved away from seeing only the 'ivory tower' Ph.D.s as the 'stars' of the profession. ...thus spake Debbie....

Well, if the DNP does not take off nationally, it will be because the current Masters-prepared APNs will put up a fight. In every article I have read about the DNP, the one question everyone asks is, "What about the current APNs?" I have a friend who is currently setting up one of those replace-the-MSN DNP programs, and there will be few, if any, additional courses. I very highly doubt if the AACN (the credentialling org) is going to make it hard to convert. The whole point that everyone acknowledges started this all is that APNs AT THEIR CURRENT PRACTICE LEVEL are comparable to other allied health practice doctorates. I wouldn't be surprised if the trend becomes BSN-to-Ph.D when the BSN-to-DNP becomes common. This whole thing is about getting rid of the Masters level. As long as other professions have ed programs that are Bachelors to Doctorate, then the push is going to be to do that in nursing, too. I don't think that a regulation mandating a switch to DNP will work in anesthesia because so many of the programs are not MSN and the instructors have non-nursing Masters degrees. There will be no official or unofficial 'grandfathering' of those Masters up to the DNP. I'm sure that the AANA will eventually get around this somehow. As far as faculty goes, I know that the program my friend is starting is going to be taught by 'grandfathered' DNPs. She will be one of them. And I am talking a very prestigious School of Nursing--one of the top 10 in the nation. An interesting point, however: the head of the anesthesia program is not talking about the DNP yet, probably because the AANA is not completely on board yet. The only anesthesia programs that could make the change quickly are MSN ones. My friend is working on the NP and CNS switch. This bandwagon is already rolling.....and programs are jumping on all over the place. And doing what they have to do to make it happen. As far as podiatry goes.....like nurse anesthesia, nurse midwifery, nurse practitioning, and the CNS, it is a deep but narrow knowledge-base. I don't think that doing foot surgery as it is done by them is any more advanced than what a CRNA or NP or CNM or CNS does....it is just different. All the allied health advanced practice (including nursing) is deep but narrow. MDs/DOs knowledge base is deep and broad. That's what MDs get out of all the additional years of school and residency. That's what they should get credit for. That's what they get paid for-- and why they are paid more. This is an interesting discussion.... Debbie, RN, MSN, CNS

I don't see any reason why any time should be added to the current educational programs in order to convert them from MSwhatever to DNP. I think that the DNP acknowledges that the level of practice is very high, certainly equivalent at least to chiropractors, optomitrists, podiatrists, etc., etc. And even if the DNP were not rewarded until after one year of practice--that wouldn't be adding any actual time to the process. You could still take the CRNA boards and start to practice. I think it should be: same educational requirements as now + one year of actual practice = DNS. You would be a CRNA after passing boards and before the year of practice, getting paid, etc. And the DNP would be awarded to you after a year of practice. It's like being a Ph.D. even before you have completed your dissertation--people do get to call themselves "Ph.D.s (pending)" before they are totally done. It could be the same with the DNP--you would call yourself a DNP, but to keep that credential, you would have to complete a year of practice. And there would be a deadline by which time one would have to complete the practice year. And if the Masters-prepared advanced practice nurses get grandfathered in when the DNP starts (at which time the Masters programs will disappear) why then all anesthesia faculty would become grandfathered-DNPs and would/could continue as faculty. It is my understanding that the DNP education is going to replace the Masters education. Not be in addition to it. And since one big sticking point is going to be NOT creating a system that totally screws all the Masters-prepared APNs currently in practice, I really think that there WILL be a stipulation to somehow grandfather the current MSN APNs to being DNPs. I think the TRUE stumbling block most likely to occur is not a longer program, or lack of faculty, but the bugaboo of how non-nursing Masters programs, like MS in Anesthesia, or MS in Health Science, or any of the other non-nursing Masters degrees that CRNAs come out with, how they are going to transition to DNP? I mean, will only MSNs be able to grandfather to DNP?? Anesthesia is the only advanced practice nursing specialty that allows non-nursing Masters. I'm pretty sure that midwifery Masters are all nursing Masters, and I'm sure that the nurse practitioner and nurse specialist Masters are all nursing Masters. Anesthesia has a number of non-nursing Masters degrees. I don't understand why this is, since it is a NURSING specialty. Anyway, this is all just pipe-dreaming. Unitl I start to actually see the BSN to DNP happening, this is moot. And also, regardless of what credentials one has, to others in the healthcare systems, a nurse is a nurse is a nurse, etc. I doubt if most docs even know what the term 'advanced practice nursing' means........And no way within the hospital will we ever be allowed to be called 'Doctor' anything. (Although I know of PhD psychologists who have priveleges and are called Dr. within the hospital and while in the company of psychiatrists.) Having CRNAs given the title Doctor would make the ASA and AMA go ballistic--but it would be great for APNs to actually get the recognition for what they have been doing all these years. God, I have forgotten what my reason for 'reply'ing actually was......

The move toward making the DNP the standard ed. level for all advanced practice RNs is the 'next big thing'. I, for one, agree with it. First of all, it's about time that there is a CLINICAL doctorate in nursing. In this case the 'NP' in DNP stands for Nursing Practice (not Nurse Practitioner). So there will be 2 tracks: one the research-focused Ph.D., and the clinical practice DNS. In this day and age of Doctor of Chiropractic and Doctor of Podiatry, advanced practice nursing really NEEDS to go in this direction. Please let's not diss the other advanced nursing practice specialties. When you do that, it just shows that you are seriously lacking a broad viewpoint and experience in the field and/or don't have the maturity that is required of advanced nursing practice. You can't compare apples and oranges. What gives anyone on this board the right to downplay the schooling and expertise that nurse midwives need everyday in their practice? Or acute care NPs? Or neonatal NPs who essentionally do everything that an MD can do as far as management of tiny vulnerable premies and procedures, etc.? CNSs develop and design system-wide programs that can and do change the entire practice of all the nurses in a system. I'm sorry about the people who want to zip from not-yet-a-nurse to CRNA, but I don't see any reason why there should necessarily be options to make that transition quick. I , for one, don't think that transition should be able to be quick. It just smacks so much of "I'm an auto mechanic, but want something that pays better and I heard that you can become a nurse anesthetist, whatever that is, in 7-ish years beginning-to-end, and really rake in the bucks...." Or a marine biologist, or an engineer, or a paramedic. I think that part of the reason that nurse anesthesia is considered the 'poor relation' of advanced practice nursing specialities is that so many people seem to ignor the N in CRNA. Wanting the 'glory', but not willing to do the up-front 'growing as a nurse'. And not doing anything to grow nursing as a profession after becoming CRNA. It's the same as saying, "Let's see, I have always dreamed of delivering babies...what is the absolute quickest way I can get to do that? Oh, and by the way, I'm just going to have to try to put up with those pesky requirements that I go through nursing school, become a nurse, and practice for a year." Holy god, keep that person away from me when I'm pregnant!!!! And there is no way that any anesthesia DNP program would be equal in time to becoming an anesthesiologist. Puhleeze! 4 years pre-med, 4 years med school, and then residency, which is always at least 3-4 years. And besides, there are huge fundamental differences between nursing and medicine. OK, off my soapbox. I wish the DNP thing was happening right now. I'm just hoping the current, Masters-prepared APNs get grandfathered in somehouw.