MmacFN

Hey Brian :) Not as an SRNA :) I have been published as a flight RN on 3 occasions now (all peer reviewed) with 2 more in editors hands. One on Permissive Hypotension in blunt and penetrating trauma One on Brugada Syndrome One on Men in Nursing In editors hands now -Tricks of the Trade, Intubation techniques and bag techniques in the difficult airway - The Brain Book (a hand held air medical crew resource guide for my program) - Air medical Crew and pilot communications (title not solidified yet) It is alot of work but VERY cool. The best thing to do is decide on a topic you find interesting. Then you have to pick the type of journal you want to publish in an review what they seem to like. From there its all about writing, rewriting and sending it in only to have it send back for further rewriting! If i can help let me know

Hey Well all the MSN core classes or the Masters core classes (if not applying to a school with an MSN). For instance, i took informatics, health policy and epidemiology. So 3 of them are all done before i even start. Took em all online too!

hehe thanx Im excited as hell! Yoga: Go check out that project, i think u will be impressed.

One of my friends is in the Army and did her CRNA through there as a reserve. In peacetime she said the short stints she did as a CRNA for the ARMY (which i believe has more hospitals than either of the 2 other services now) were quite standard. However, the 2 times she has been deployed she got experience all the rest of us only wish we would get (or maybe not) I called her to ask what advice she would give you. She said a couple of things: 1) Good choice on the Air Force 2) Its a guarentee you will be deployed. 3) The money a military CRNA makes is 1/2 what a private one makes. 4) Its a big committment. Make sure you really want to be in the military. I hope that helps.

no problem We all make mistakes and with the numbers of forums on this board (tuns) it sure is easy to click the wrong one. Have a good one!

Buddy Not sure i believe that your a begging RN, sounds more like your a crap disturber. Aside from that, no it isnt better to goto med school. Free free to ask a physician if they would do it all over again. Many have been quite dissappointed by their jobs because of the environment they find themselves in. Mid levels have been prescribing for many years. PAs with someone as a cosign and NPs have always been prescribing autonomously. CRNAs are moving into the pain clinicl realm and so prescribing will be a nessicity.

Uh huh Would you like me to post journal articles? Oh i might as well since you are such an arrogant fool. Ill just go ahead and add those below for you. BTW, i dont just read journals, i publish in them. SO dont partonize me with "read your research". Lets recap shall we? - You post started with "getting an order" which isnt relevant in the CRNA forum (which your posting in). - It is assumed that anyone who is a SRNA/CRNA (again u posting in the CRNA forum) will be able to recognize the difference between depressed waveforms and clots. - Ive taken care of more art lines than you have seen in your whole career. Dont insult me with BS like "u can't tell me that u will use the abp when it is dampened or positional or clotting or whatever". Thats IRREVEVANT. You post asks which one would be what you treat from. All things being equal the ABP IS THE GOLD STANDARD. NOT a sphygmomanometer. When taking care of sick patients, I rely on MAPs second only to ABPs. Attitude check there fella, you have no idea the level of expertise of those you randomly call "clueless". References T. Nicholls and W.C. Shoemaker. (1998). Recent advances in hemodynamic monitoring and management of the emergency critically ill patient Curr Opinion Crit Care 4: 168-176. Clark JA, Lieh-Lai MW, Sarnaik A, Mattoo TK. Discrepancies between direct and indirect blood pressure measurements using various recommendations for arm cuff selection. Pediatrics. 2002 Nov;110(5):920-3. Vardan S, Mookherjee S, Warner R, Smulyan H. Systolic hypertension. Direct and indirect BP measurements. Arch Intern Med. 1983 May;143(5):935-8. Ochiai H, Miyazaki N, Miyata T, Mitake A, Tochikubo O, Ishii M. Assessment of the accuracy of indirect blood pressure measurements. Jpn Heart J. 1997 May;38(3):393-407. Bridges EJ, Bond EF, Ahrens T, Daly E, Woods SL Direct arterial vs oscillometric monitoring of blood pressure: stop comparing and pick one. Crit Care Nurse. December 1997:17:96-97, 101-102. Hoover L. Comparison of blood pressure readings between cuff pressures and radial arterial catheters with changes in transducer level and patient position [abstract]. Am J Crit Care. 2000:9:220-221. Bridges EJ, Middleton R. Direct arterial vs oscillometric monitoring of blood pressure: stop comparing and pick one (a decision-making algorithm). Crit Care Nurse. June 1997:17:58-68, 68-72. Topol E, ed. Textbook of Cardiovascular Medicine. Philadelphia, Pa: Lippincott-Raven Publishers; 1998. Venus B, Mathru M, Smith BA, Pham CG. Direct versus indirect blood pressure measurements in critically ill patients. Heart Lung. 1985:14:228-231. Loubser PG. Comparison of intra-arterial and automated oscillometric blood pressure measurement methods in postoperative hypertensive patients. Med Instrum. 1986:20:255-259. Gardner RM. Direct blood pressure measurement: dynamic response requirements. Anesthesiology. 1981:54:227-236. Gibbs N, Gardner RM. Dynamics of invasive pressure monitoring systems: clinical and laboratory evaluation. Heart Lung. 1988:17:43-51. McGhee BH, Woods SL Critical care nurses' knowledge of arterial pressure monitoring. Am J Crit Care. 2001;10:43-51.

BWhahhaa That was a good one!

Hmm Well, CRNAs do not need an order to decide the course or tx or how to get there. As for the question, well... simply put there isnt one. Research has clearly shown that cuff pressures can be off upward of 20 points actual BP. ABPs are the only true measurement of BP. Tx should always be guided by the ABP and, in fact, there is no need for a cuff when one us present.

Hmm I went from CVICU to the ER and thought just the opposite. Ive been at this for 9 years and i found the ER a much more challenging place to work. Lets be honest, anyone who has worked in the ICU > 2 years knows full well that every patient is simply a standard Dx which means a standard set of complications occur. The is little or no mystery. PAs and drips are similarily boring. After doing them for awhile there is little of interest. A least in the ER (and in flight where i work currently) things change and you never know what your going to get. ICU experience is helpful for getting some access to PAs and drips you may not see in the ER. However, any suggestion that it is the only place critical care resides is based in ignorance. The ICU can be a protocol driven place filled with people who simply "call the Doctor" anytime something happens. The rare few (yes rare) who do critically think in nursing can be found in all aspects of the profession and eventually migrate to advanced practice roles or leadership roles. I find the blanket ICU requirement offensive because it is unjustifiable. Learning a PA or a neo/vasopressin/whatever drip is monkey work. Anyone can be taught it. Its no different than all the new things ICU RNs have to learn when they come to the ER. Critically thinking and being an investigative driven provider who strives to know the "whys" as opposed to the technical protocols cannot be taught. You either are, or your not. Geesus, i can see to get off this soapbox.. Nothing personal just a rant ;P

Ooops!

Hmm I did a search as well and didnt see anywhere that a CRNA could write a script. Does this happen?

Hey Hey n/p man. Its something that comes up all the time here. :)

With respect roose. thats a little slanted view. Here is where i see it differently. - The ICU experience hasent been deemed important enough to be mandated by the AANA. This is only a requirement of individual schools, which varies greatly. The AANA actually includes ER as eligible. After calling them (AANA) about this discrepency, they told me the reason they use "acute care" is to encourage schools to evaluate every student individually based on their expeirence as opposed to making blanket requirements which (ICU only) which are not predictive of success (see next point). - ERs vary in their acuity, much like ICUs. You could work in an ICU for 20 + years, never see a PA cath, never use anything outside dop and levo and, therefore, be no more prepared than the ER nurse you depict. - People vary in their aptitude or attitude as well. I have worked with both CVICU and ER nurses that do little more than follow the protocols and call the docs. These are not people you want in a CRNA program. Working in the ICU does not guarentee anything, we have all seen that. - ERs are not what they used to be. I have taken IABPs in the ER with 3 other patients due to no CVICU beds. Now it was easy for me with the backgound in IABPs, however, this trend isnt changing its continuing. Conversley, Ive had DNRs in the ICU for 2-3 shifts where my job was to be a personal care tech more than a critical thinker. - The problems you mentions about drips and vents as well as BPs etc are NOT the norm. First off, you dont take care of the vent either, thats the pervue of RTs in 90% of facilities. Second, it is neither acceptable or usual that ERs RNs lack knowledge of vaso active drips and titration. I know your trying to be helpful here but you are blanketing an enitre professional group on Nurses based on your 2 years of experience, none of which has been in the ER (something I did as well until i worked there). I have been doing this for quite some time, CV and ER have been my primary areas. I almost washed out of the ER as a CVICU RN, which BTW, is typical of ICU RNs who come to the ER. You may have had some bad experiences but remember, they exist on every side of the fence. :) Having said all of that, I agree that an applicant will be more competitive with PA experience and, tyically, the CVICU, SICU, TICU are the only places where someone can get it.

Thanks! Yah the sheets are cool. He is a great fellow. Im in the OR with him this week to tube and learn about the anesthesia equipment. Should be fun!