xyhartnurs

Can't we all just get along!? :1luvu:

I wanted to address your sidenote first: WHY is this a sidenote? Do you feel you have ADD? Have you been diagnosed as having ADD? If so, then yes, medication can be effective. If you are basing this information purely on another's interpretation of your attention and focusing skills, then no, medication will not be effective. Yes, it is true. Distractions and extraneous stimuli are a given in the ICU... they are a given anywhere in nursing. Welcome aboard! You have mentioned two preceptors who have given unsatisfactory performance appraisals. Do you have a primary preceptor who is best suited to evaluate your performance as it has (or has not) progressed, and what does he or she think? Having said that, how many preceptors have you had? Inconsistency in your precepting experience may be attributing to your "poor" performance. Are you evaluated daily, whether formally or informally, as to how you performed for the shift? If not, isn't it a reasonable expectation that your preceptor provides such feedback? Have you been provided specific instances when you were performing sub-par? There are many gaps in your original post, but not gaps I want you to fill in front of the AllNurses.com world. These are questions I want you to ask yourself and your preceptor. I wouldn't be surprised if your performance may be the afterbirth of poor direction, management, and precepting. Though you should work towards your future in nurse anesthesia, you should address the "here and now" issues you currently are experiencing in the CVICU. Overcoming your hurdles and showing improvement will make you stronger professionally and personally, and give you a one-up on your future aspirations. Good luck and don't give up.

:offtopic: Kudos to those who have clarified the roles and responsibilities of DOs. They are parallel to and equally integral within the healthcare team as MDs!

Sounds kinda like nursing school, right? Modified boot camp. Remember the first time you passed meds as a nursing student and you were grilled and regrilled :trout: . You have worked hard to be where you are. Butterflies are normal. Focus yourself and your energy on making the best of your education, not in worrying over the hearsay. Good luck and keep us posted!

Yoga, If I didn't like it, I wouldn't have engaged myself in the discussion. Your insight is always appreciated and frankness unequaled. So far as if I "have to ask the question"- I appreciate your recap of basic nursing care... before giving any pharmacologic, it is expected practice, CRNA or RN, to understand the medication. It has been pointed out in this thread that if anesthetic is to be administered, anesthesia [specified] staff must be present. Point well taken... Versed and fentanyl, even in "small" doses, can tank narcotic naive patients, pushing them uncomfortably close, if not into anesthesia. How often have we attended codes in Endo or TEE where a little was obviously too much? This is when we, the RNs who have not yet achieved ultimate wisdom in anesthesia (like Master Yoga :wink2: ), must keep our cool and remember that airway is always number one.

Thanks for the great info... How about etomidate.... or midazolam and fentanyl? Where is the line between "conscious sedation" and "anesthesia?" Curiouser and curiouser

Would etomidate be a better choice?

Thanks schway or schwizzle... Your "P.S." has provided me great redirection to the central task at hand... "getting into a program." My focus for Charleston was never the beach, rather the education. Location is a secondary perk. :yelclap: You are now an SRNA at MCV? When did you matriculate? In what part of town have you settled? Maybe you are privy to a cheaper section of Richmond than I have lived for 20 years? PM me and perhaps we can further discuss your experiences. Thanks again, Reggie

skipaway--- According to the VCU Department of Nurse Anesthesia, stat is not required. schway----Here's some food for thought about cost of living in Richmond v. Charleston. The data below is according to a $50,000 per year salary in Richmond: "The equivalent income is $46,216.21. You may take a 7.57% decrease and still maintain your standard of living." Check out http://www.bankrate.com/brm/movecalc.asp?a=0&d1=50000&d2=105.895635220297&d3=97.8818947490143. Thanks for everyone's input thus far. Celam

Yeah, it's surprising about cost of living, but I have researched and found that the cost of living, mortgages included, is much better in Charleston. With the West End of Richmond exploding, and a new supermall on the way in the Northside, home prices and cost of living in Richmond will soon spiral out of control. VCU's admission criteria is on target with other schools: 1 year ICU, GREs, orgo... MUSC additionally requires stat and 2 years. It's probably wisest to hang tight... We'll see. Thanks for the input.

Hello all. This is my virgin post... go easy on me I currently live in Richmond and work at VCU in the CCU. I have this burning desire to get out of Richmond as it's not the city for me; I have lived here all of my life and am ready for a change. VCU's CRNA program is ranked #1 by U.S. News, but this is from an older survey in 2003 (objectivity and validity of the survey is, of course, unknown). I can, however, attest to various nurse anesthetists who have either come from or are in the program that is is outstanding. There is word from the Program Director that a nurse anesthesia practice doctorate (DNAP) will be available as an optional 3-year program, making it great for "one stop shopping." Here's my quandry. I love South Carolina and the charm of Charleston. Homes are cheaper as is the cost of living, and I have heard relatively good things about MUSC thus far. My partner is graduating from nursing school in one year. Here are my options: 1. Stay in Richmond, continue to rent, and go to VCU. 2. Move to Charleston in one year, buy a house, and go to MUSC. Providing the housing market improves, I need some suggestions or playful prodding from those with experience with either program. I'm a sucker for used car salespeople, so, give me some input- I'm far too indecisive to make the decision on my own. Thanks!