kmchugh

Jasmine This is one of those topics that will strike a chord with many people. There are those out there who doubt ADD, and will even flat out say people are just drugging kids without regard to the "real problem." Having a son (now 25) who was diagnosed with ADHD, I'm not one of those people. I saw the difference it made, literally overnight, in my son. He went from being a frustrated, unhappy C student to a happy, popular A student. Homework went from being a screaming, two and one half hour experience to a quiet 45 minutes a night. He was finally able to focus. My tribulations are long past, but I can tell you some of the things we ran into. My son was initially given Ritalin for the problem. Although it solved his focus problems, it also gave him headaches. Our initial physician told us he'd just have to put up with it. Later, we found another physician who was willing to work with us, changed my son to dexadrine, and voila! No more headaches, and he was focused (he is now a college graduate working in business). While the drugs may have changed, the central lesson has not. If your physician is a one drug physician, go elsewhere. There are a number of medications used to treat the condition. Discuss possible treatment options for your son. Frankly discuss what the physician does in the event that one drug has unacceptable side effects, or if it simply does not work. Essentially, ask the same kinds of questions you would about any other treatment plan. Hang in there. I know that your son particularly is going through a tough time. It does get better. Kevin McHugh

Statements like these make me approach this thread with some trepidation. No, Fergus, I don't believe you would ever generalize about men, or any other group for that matter. However, the fact that you wouldn't do it, and have not seen it, does not equate to it not happening. It is not a terribly prevalent problem. It isn't nearly as pervasive or as far reaching as the author of the initial article would have you believe. But, there are those nurses with an anti-male bias, and most of us have run into it. Personally, I ran into it early on in my education as a nurse. Long story short, one of the instructors in our school (still there, as far as I know) believed that nursing was a "woman's profession," and worked very hard to make life very difficult for males in her classes. She admitted the truth of this to a class full of female students. And I won't get into all the stories related to me by other male nurses. Yes, it happens. One of the bigger problems men face when trying to make it stop is the attitude "What's the matter, can't take a little kidding from a woman?" Kevin McHugh

Archie: SRNA - Student Registered Nurse Anesthetist DrugreptoCRNA - ApaisRN is correct. Generally, the school you attend as an undergrad won't have much impact on which school you get into for CRNA. Undergraduate grades, score on the GRE, ICU experience, etc have weight. So long as you don't get your undergrad at Bob's Internet School of Nursing, Manicure, and Long Haul Trucking, you should be just fine. Kevin McHugh, CRNA

Wow. Feel like I have to post so that not all us nurses in anesthesia get painted with the same brush. No question, being a full time employee, student, and mom is exceedingly tough, but it can be done. There is a requirement for commitment on your part, but equally on your husband's part. In short, you gotta wanna. I was in my master's program when my five year old was born. Since this was a full time CRNA program, my wife had to work to support the family. The baby had to go to daycare while I was at school, and she at work. Still, it worked. My five year old, now in kindergarten, is a happy, well adjusted kid. When we were home with her, we devoted a lot of attention to her. She has never had a moment's doubt that no matter what else, mommy and daddy love her unconditionally. Same with our other daughter, now two. My wife an I still both work. Yet when we pick up the kids at school and daycare, they still "light up" to see us. And as an added bonus, by working out butts off when they were younger, we now have to work less, yet still make more. We make sure they get lots of attention, and lots of opportunities for education, expansion of interests, and just plain fun. All because we made the decision that going to school was in their best interest. Kevin McHugh, CRNA

Chadday Same advice I have given before. Step back, take a deep breath, and relax. Feel better? Don't sweat one grade of 88, it isn't the end of the world. You can be highly competitive for a slot for a CRNA school without a 4.0 GPA. In fact, do a search of this forum, and you will find some people (myself included) who have hypothesized that a 4.0 might hurt you more than help you. As pointed out by others here, your GPA is only one part of the picture viewed by admissions committees. Another piece of advice. Relax, again. You are putting the cart before the horse. The best thing you can do right now is to put CRNA programs, and fretting over how current grades will affect your chances at getting in. You need to concentrate completely on what you are doing now. Worry about CRNA programs when you have finished you nursing degree, otherwise that worry could kill you. One more time, relax. You are doing fine. Kevin McHugh, CRNA

Your arguments about the scope of the AA's practice would be more compelling if the scope of practice of AA's was controlled by CRNA's. In fact, it is not. It is controlled by the same group who conceived the very idea of AA's, specifically, anesthesiologists. AA's were conceived to essentially be anesthesia PAs, with the same kinds of practice standards and limitations as the PA. Your chief proponents, the ASA, are the ones who limited your scope of practice, and required you to work under the direct supervision of anesthesiologists. Accordingly, your education prepared you for that type of practice. If CRNA's are involved at all, it is simply to ensure that you practice under the guidelines already set up for you. Just as we do. As to the issue of where AA's can practice, see it from another viewpoint. CRNA's were not as pliable as the ASA hoped, and did not knuckle under to pressure. Worse, our position was backed up by the courts. At about the same time as the failed legal challenges, anesthesiologists conceived of the idea of AA's. You connect the dots. The ASA has tried to legislate us under their control and has tried to force us under their control through the courts. In every case they have failed. Now, it is blatantly apparent that if they can't bring us under their umbrella (and thereby increase their billing potential), they will try to elbow us out by other means. Forgive us if we don't bow to the inevitable. Kevin McHugh Edited to add: Read more carefully. I didn't say that we started the practice of anesthesia. I said we were the first full time practitioners of anesthesia, and the first research done and published on safe administration of anesthesia was done by a nurse anesthetist. I can go on, but I hope you get the point.

Betty Sorry to hear about your son. Hope all goes well. My wife was a nurse for several years in the burn center at St Francis, they have a great staff there. Tell them hi from the McHugh's. The burn docs there are great as well, pretty much no matter which one you get. Kevin McHugh

jwk You know, perhaps this attitude has something to do with why AA's face such an uphill battle with the CRNA community. There is much all of us in the anesthesia community can do to better work together. However, your reduction of the history of the history of nurse anesthesia practice to political indoctrination effectively drives us further apart. Attitudes like yours are why we as CRNA's fight so hard to protect that which is rightfully ours. Ours by history, ours by present practice, and ours by fiat of the courts. Nurses were the first full time providers of anesthesia. Nurses are still the ones actually at the head of the table for the majority of anesthetics delivered in the US today. Statistically, CRNA's provide safe, reliable anesthesia. Knowing these facts does not constitute indoctrination. It is simple knowledge of the history and present practices of one's own profession. And you belittling these facts does not in any way alter them. Yes, I am the same person who wrote the thread about the need for the ASA and the AANA to get along. But also know that I know where the friction between the two organizations starts. It starts when, after 100 years of practicing safe, independent anesthesia, CRNA's are told by the ASA that we must now practice only under the supervision of an anesthesiologist. And why is that? Given the track record of safe anesthetics, it certainly cannot be that we have suddenly become unsafe. Ah, but there is the billing issue. An untapped gold mine. Perhaps you could be a bit less offensive, and try to learn something here. Kevin McHugh, CRNA

Bandit I am an Army veteran (not a CRNA while in the military), and I can tell you one thing for certain. When you are told about a "90 day deployment rule," think "guideline." Where ever possible, the military may try to follow that guideline, but you will sign the same contract as everyone else. In that contract, there is a clause that essentially revokes all promises made. It clearly states that the needs of the Army are paramount, and therefore if it is determined that you are needed to deploy for 90 days or 900 days, that is how long you will be deployed. Bear in mind, I am not in any way trying to dissuade you from joining the military, nor am I trying to get you to sign up. I am simply trying to make you aware of the realities of the contract you are signing. But, in all some of my best memories are of my time in the military, and I still count some that I served with as the best friends I have ever had. Kevin McHugh, CRNA

Dinkymouse STICK BY YOUR GUNS! You are absolutely correct in your assessment of this lady's pain. Even if the other nurses are correct that this lady might become addicted, SO WHAT?? She has cancer with widespread mets, and her potential for recovery is nonexistant. Your co-workers are completely out of touch with current thoughts and practices on pain management. When given for real pain (and there is no pain more real than the pain of bone cancer), narcotics are not addictive. They treat the pain, and nothing more. Further, current thought is that if a patient with cancer does become addicted, that is less of a problem than failure to adequately treat pain. Frankly, these nurses are living in the 30's. Their attitude towards pain is barbaric, and the thought of this woman spending her last days in this kind of pain is hideous. Inadequate pain management has become a reportable issue, and unless I am grossly mistaken, these nurses could all be reported to the BON for malpractice. As I said, stick to your guns. You are doing exactly what you, as a nurse, should be doing. You are advocating for your patient. Kevin McHugh, CRNA

Not always correct. Some schools, such as my alma mater (Newman University, Wichita, Kansas - Shameless plug) will accept RN's who have non-nursing bachelor's degrees. However, there are other schools that will only consider candidates with BSN's. The best advice I can give is to contact the schools of nurse anesthesia you are considering. Talk with the directors of those schools, and find out what they require. Many programs will take a balanced view of your scholastic record. A 2.68 from your first degree might not look too good, but by maintaining a 4.0 in pre-nursing and nursing programs will help enormously. Kevin McHugh, CNRA

This comment caught my attention, so I went and looked at the website. I don't know who wrote it, but they got quite a bit wrong. Kevin McHugh, CRNA

While I don't know the specifics of cost of malpractice insurance in Florida, don't let that alone slow you down. The fact is that most places you work will pay your malpractice premiums. About the only people I know paying their own premiums are those in practice for themselves, such as CRNA's working locum tenens. Kevin McHugh

And just to back up Hoop Jumper: "WASHINGTON (AllPolitics, June 25) -- The line-item veto is unconstitutional, the Supreme Court decided Thursday, ruling that Congress did not have the authority to hand that power to the president. The 6-3 ruling said that the Constitution gives a president only two choices: either sign legislation or send it back to Congress. The 1996 line-item veto law allowed the president to pencil out specific spending items approved by the Congress." For the full story, see the following link: http://www.cnn.com/ALLPOLITICS/1998/06/25/scotus.lineitem/ Found after an 8 second search of Yahoo. Would have been quicker, but initial search contained a typo. KM

Deb Excellent points, all. In fact, I agree with everything you put in this post. However, what has yet to be demonstrated anywhere is one vet who is going without treatment to which they are rightfully eligible. KM

Which glove is it that fits, Eric? Overdramatizing my experiences, or sniping at people who did that which others were afraid to do? Kevin McHugh

"There is no problem so large that it cannot be overcome by a suitable application of high explosive." US Army, unknown "As long as you are talking, you aren't learning anything." J.P. McHugh, my father. KM

No, that's not fact. You are in fact repeating a lie. In fact, if you go way back to the beginning of this thread, you will find an article referenced by Begalli that demonstrates that veteran's funding is increasing. While it's not much of an increase, any increase would be the exact opposite of reduced spending. As I quoted from the article earlier: "Although the proposed 2006 federal budget calls for a 1 percent increase in the overall veterans affairs allotment -- from $67.5 billion to $68.2 billion -- some programs are recommended for cuts, in part to compensate for rising disability and pension costs." Earlier you wrote in response to me about the problems your brother and father were having being seen as retirees in military hospitals. That's a different issue, and one that I strongly agree with you about. That is a case of promises made not being kept. However, that was a problem before I got out of the military in 1993. As I recall, GWB wasn't the President in 93. It was part of the "peace dividend." Which president gave us that? Part of the downsizing of the military included downsizing the medical branches of the military, and therefore they were able to care for fewer patients. Hence, retirees moved further down the list. Though they can go to the VA. Kevin McHugh

Not aware of any new drugs in development, but then the pharm companies don't often take me into their confidence. A few things I would like to see: Monitoring integrated into OR tables. Rather than the current morass of cables running from above the anesthesia machine, it would be nice to see a single cable from table to monitor. Connections for the actual monitoring end devices (cuff, pulse ox clip, etc) could be integrated into the bed. But that would require mfgs to standardize their connections, which isn't likely. IV warming that requires no special tubing or attachments, and that does not require prewarming of IV fluid outside of the room. Provider controlled automated data input for charting (I DON'T want something that acts like big brother, slavishly recording everything. I want to control what data is input for charting purposes.) Whatever it is it must be easy and quick. Any other ideas? KM

This poll by it's very nature would be misleading and incorrect. Go back to the beginning of the thread. THERE ARE NO CUTS BEING MADE IN VA FUNDING. Asking whether someone was in favor of the cuts would be like asking whether or not we were in favor of the ongoing invasion of Great Britian. Of course, we'd all be against it, IF IT WERE REALLY HAPPENING! Kevin McHugh

Perhaps you didn't read my earlier posts on this thread. I'm curious, what was promised to me that has not been delivered? After all, I'm a 14 year veteran of the Army, medically discharged, and now considered a disabled vet. What am I missing? Kevin McHugh

1. Methinks we have a lurker here who may not be telling us the real story of who we are. Trying desperately to downplay and undermine the education received by nurses in general, as well as CRNA's, in order to find some way to feel superior, and good about themselves. Hence, the following post: Rather sad and pathetic when viewed from a realistic angle, isn't it? 2. Let it go. If they want to "bash" nurses there, well, it's their board, let them have at it. Hard knocks will teach them otherwise. Kevin McHugh

Folks, you are all going to do fine. Study you Valley Review. Take a deep breath, relax. By the way, while you are relaxing, give yourselves a pat on the back for what you have accomplished so far. Well done. Kevin McHugh

I don't believe I've "over dramatized" my experiences. Been pretty matter of fact about it. As to you "feeling guilty," well I can't make you feel that way. Perhaps you have some reason to feel guilty? Perhaps its that you feel a need to slight those who had the courage to do things you wouldn't/couldn't do? Kevin McHugh

It seems like about once every six or eight months, someone goes over to the Student Doctor Network and finds some particularly inflammatory remarks about nurse anesthetists. Then, we get a thread here with a title like "Look at What Those Nasty Guys Are Saying about Us!" Okay, everybody take a deep breath, step back and relax. First, realize that Student Doctor Network is just that; a forum for STUDENT doctors. Just as we did when we were student nurses and student CRNA's, they are bound to run into things during their education that will surprise them, and perhaps frustrate them. They need a place to go vent about these things. Add to that the fact that new residents in anesthesia have only what they have been taught to go by. If they're taught that nurse anesthetists are mean, evil and out to take the practice of anesthesia away from physicians, then they're going to start out with a bias against CRNA's. That bias will show up in their posts. But in continuing their residency, most physicians find that nurse anesthetists are an important part of the anesthesia care team. Frankly, I'm sick to death of the arguments between CRNA's and anesthesiologists, particularly since these arguments are promulgated by our professional organizations. Down here in the trenches, nurse anesthetists and anesthesiologists get along quite well. I have found that most anesthesiologists I have worked with prefer to work in a collaborative environment, particularly when presented with complex or difficult cases. Having the initials CRNA or MD behind your name does not guarantee that you know everything. Most CRNA's and MD's are more than happy to hear other viewpoints. Generally, I have found the more experience you have, the more willing you are to listen to other viewpoints. As to some of the most inflammatory comments made, don't worry about it. Generally, these people will do more harm than good for their "cause." If the American Society of Anesthesiologists were to completely get their way, and place all nurse anesthetists under the medical direction of anesthesiologists, there are a number of hospitals that would have to close down. Surgeons at these hospitals would find themselves without a place to practice. As a result, the ASA would quickly find themselves at odds with the American Hospital Association, and the American College of Surgeons. Smaller hospitals, with just a few OR's generally cannot afford to hire an anesthesiologist to supervise the two or three nurse anesthetists that they have on staff. Were there suddenly to be a nationwide requirement as desired by the ASA, these hospitals would have to shut down their operating rooms. I know this for a fact, because I have worked at hospital like that. And should that hospital have to close it's OR's, the hospital itself would likely have to close within about six months. The short version is don't worry about what's posted at the ISDN. Just as we need a place to vent, so do physicians. If an anesthesiologist goes on the board and refers to nurse anesthetists in a derogatory manner, let it go. Frankly, we need a lot less infighting and a lot more cooperation. Kevin McHugh