FlGasman

I had a patient today with no peripheral IV access (he was very edematous) and a TLC SC with one lumen clogged, the surgeon ordered 2 Units PRBC I had carrier and and TPN, I plugged the blood in and the TPN into the blood so i could still have carrier fluid.I was written up. anyone have any feedback? Thanks! JC

Well to answer your question, its a bit more complicated than just saying we all have our places. The whole argument is some people(CRNAs) say other people(AAs) dont have their place and are only there because still other people (MDAs) didnt like how much some people (CRNAs) were making so they created a new profession (AAs). And obviously some people (AAs) refute that claim entirely. I am in school now and cannot work.

Sorry, I didnt know that they had to start over as a new program in the accreditation eyes.

wolford college nurse anesthesia program 4933 tamiami trail suite 200 naples, fl 34103 program information date of last review: 10/2004 next review date: 05/2008 degree(s): master of science program length: 28 months starting month(s): feb sep thats a four year renewal. many of the other schools in fl are new so they have a minimum, but the established ones have more except for wolford. and i presume that they have concerns yes. also i have seen and heard things that concern me as a healthcare provider and for any student who attends wolford.

No they are not new. Their first accreditation was for four years which is standard. They just renewed only for four years which is not standard and suggests a problem. If the program was running the way the accrediation committe wanted it they would get ten years.

im tired. nuff said,1st year almost down. need sleep . zzzzzzzzz

Here is an interesting point- The maximum a school's accreditation renewal can get is 10 years. Four years is the minimum. I believe wolford's renewal was for the minimum of four years which suggest there are some issues the accreditation board had with Wolford. my .02..

ive heard some not so good things about wolford

which states have this option?

Im an SRNA. I was getting attitude from the circ all day today but as usual I just smile and nod. She was being rude, trying to point out what she thought were mistakes, whispering about me, and telling me how to do my job. But I just smiled and nodded all day and remarked to my crna and she said I was handling it just right. So finally she got me Well my crna told me to take the pt back into the room when they were ready and she would be in shortly. The pt was a 300lb m,an who takes dilaudid at home for pain control. As we walked into the room, as I had been doing all along with this CRNA I put oxygen on the man, started hoking him up and gave him 2 ml of fent. Its pretty stressful with all these people running around hooking you up and he was awake and talking so I thought it would relax him and it was part of my induction cocktail anyways. The nurse (circ) says" you cant push anything without a CRNA or MDA" So I say actually that is not true and soon Ill be doing cases with no CRNA in the room and my license wonth change between now and then" SO My crna doesnt come in yet and Im not ready as I have not put the patient in the optimal sniffing position, then the MDA walks in and starts grabbing my in duction agents. SO I am a bit flustered thinking he must be in a rush and as he starts putting the meds in line I say whoa my CRNA isnt here, (this was the last case and we were ahead of schedule so no rush) he looks at me a bit puzzled and then my CRNA walks in, well im not set up totally and the drugs start getting pushed, he was a tough inutbation and I could get it with him out of position, they give me the speech about proper patient positioning (I just listen but think, I know I know!!, You guys rushed me!) so my crna intubates with some difficulty. After the MDA leaves the circ tells me so my CRNA hears. " I told you you cant push any drugs without crna/mda present blah blah. Then I realized what happened. My CRNA didnt care but I was so pissd, and the patient had to undergo unnessesarry trauma because of her( i could have been moire assertive but i was caught off guard) She told me she called the MDA to on me for pushing the drugs. He didnt realize she was trying to get me in trouble because I wasnt doing a nything wrong, he just assumed I was ready for induction and came in to induce. When I told him I didnt know where my CRNA was he though I was planning on doing the induction without her and he was okay with it (her pager wasnt working, I was NOT going to do anythin g besides set up without my crna) so I thought he was rushing me, all because of that spiteful women. Being pretty new I am not used to everyone who is over me and I have been told to intibate without proper positiong due to time b4 so i though this was one of those cases. I am so angry about this, I felt like such a tool and MY CRNA didnt say anything after I was talked down to by the circ but she though the timing was off and said she would later. ARRGGGH thanks for letting me vent

Will Gas for food!!!

this is a bad idea. it will allow AAs to gain a greater foothold into anesthesia because there will be less CRNAs. its ridiculous, I dont think it will improve care, or our situation. Im totally against it

cant you just turn the gas up a bit higher instead of pulling out esmolol?

another way to look at it if we are going to start triviazlizing requirements like (the invaluable) ICU exp: years that have little or nothing to do with paitent care: the whole undergrad med degree vs the first two years of bsn (unless you got an adn then BSN, then you count four producitve years so RN- 2-4 depending on adn plus 2 ICU plus 2.5 grad= 6.5 to 8.5 MD- 0 for undergrad- 4- med 4 residency total 8 so whose less now?? we can go back and forth trying to rewrite everything by discounting requirements but in my book the requirements are 8.5 for CRNA and 11-12 for anesthesiologist. however none of that matters, I am happy with status quo and if one side tries to restrict the other the back and forth hurts both sides....

We could go back and forth on this and that but I was wondering what your point was..... Maybe that we are over paid and under qualified? If thats what you are driving at lets just agree to disagree. This is starting to get ugly and no one here needs your negativity. People have worked very hard to become competent CRNAs and if you have a problem with the profession, its YOUR problem

The school makes a lot of loans available, there are alos loans available outside of school. Some students have signed contracts wich brings up to 30 k to the table. Save a little, credit cards, rent your house out move to a small apartment. Cut back a little. everyone has the same problem. Only 1 person in our program works part time and that person is at the bottom of the class. I suppose its okay to work on breaks (1 week at a time) but I need the breaks personally.

10 start in spring

First off, I have seen residents and read literature on MDs opening up urgent care centers with a 1 year internship only ( encountering a lot of problems too from what I have read). They are allowed to call themselves family practitioners and have a medical license. its not 6 years, you have to have 2 years of icu experience (some say one but no one has less then two and most have 4) so lets try again- 4 years bachelor 2 years icu- 2.5 years masters- im pretty sure thats 8 and a half years. If you are not counting the ICU experience because its paid then you shouldnt count residency- the first two years of nursing out of school is only slightly better pay then a resident's at best. Besides the pay most nurses learn a staggering amount in their first two years out so it is an educational experience and thus an educational requirement. ( alittle food for thought:,perhaps MDs are over qualified for anesthesia? no I haven't memorized the Krebs cyucle as many times and to that detail and I won't have delivered 10 babies but does that make me a less capable provider?) Also lets not forget that nurses have regularly been practicing anesthesia since before doctors ever did. Dr Mayo coined a nurse ( allice magaw I think) the "mother of anesthesia." So all of a sudden there is money involved in it so the nurses are supposed to slide over because the MDs need money. Sorry it doesnt work that way. The ASA (or some American anesthesiologist) coined the word anesthesiologist, the Brits and everywhere else call themselves anesthetist (or anaesthetist) but then again the British MDs practiced anesthesia when american MDs shunned it(that is how nurses came to practice anesthesia to begin with in the US) Nurses never had to step in in the UK and practice it and the British didnt have to develop any words to distinguish themselves. Now, that being said, there were some American docs involved but apparently there were also a pervasive attitude where many were not involved (in anesthesia). I realize that many advances have been made in Anesthesia and I am happy to work with Anesthesiologist nor do I think my training is equal, however study after study by both sides has shown that care and safety are equal. Anesthesiologist enjoy among the highest standard of living of all physicians and make between 2 and 3 times CRNA salaries. It is nothing more then ignorance, fear and greed which drives a wedge between us. I think most CRNAs are happy with the status quo they just want options and to protect themselves from actions that disturb the power balance ( like expanding the AA use and/or practice). Anesthesiologists ( not all but some very loud ones) seem to want to turn the clock back on our salaries and practice limits and put money back in their own pockets and some of the tactics they use are quite hostile and fear based.

I just finished the first 2 semesters of crna school (4.0) . I would suggest brushing up on your organic chem and gen chem and general physics if you have a chance. Also it would help to take any class if you have been out of school awhile to get yourself in study mode. My first semester it was hard reading 5-6 hours at a time and absorbing/weeding out material, other students had been in school beforfe and i feel there brains were more ready for it. Just my.02 hope it helps! FLgas

wow thanks! Thats great Advice. I don't think im on a pedastal at all! I think I will go in on friday and do a run through. I dont think Sunday is a good day. Also should I introduce myself to everyone? Including the surgeon? Hi im xxx im a new srna? " Thanks, FLGAs

Im an SRNA starting full time in the OR next weekI just finsihed my 2 semesters didactic with mimial OR time. Anyone have any pointers? Im a bit nervous. Thanks!\FLGAS

Thats all fine and well but I do care about misconceptions about the nursing field, and thats why I vent here. The public needs education. Thanks for telling me not to waste time on what people think. Thats great advice! ????? Why didnt I think of that! Of course hardly anyone would waste time on such things, I think ill be a nudist, its more comfortable, i dont care what people think about that either now!

wow, thanks! Very insightful!

Yes, in general we think of MDAs as having meager income, they drive old cars and are just about to have to get on food stamps