sleepyrasrn

Hmmmm....anyone know what the deal is with the abrupt, last-minute change of the start date? They moved it up from June 14th to May 10th. That is a huge change this late in the game. Very weird.

I just got my letter today!!! I'm in at CAMC for 2010! I can't believe it. I've got so much to get done in such a short time. Maybe I'll see you in class this year Greezball, maybe next year. Congrats either way!

it's amazing how much misinformation is perpetuated by "would-be crna's" and other misinformed persons. i was told by more than one person (in another forum) to avoid west virginia's camc program since you are unable to obtain prescriptive authority with the doctoral degree that is awarded upon graduation. out of concern i contacted the head of the program to see what she had to say on the matter and found the answer very enlightening. (long story short: ask programs directly about any concerns you have about their validity or how their program is run. relying on third party information is liable to get you into trouble). i was given permission to post the response so any commentary on the subject is greatly appreciated. (i asked permission to post this response to applicable forums and dr taylor sent the following response). :yeah::yeah::yeah::yeah::yeah::yeah::yeah::yeah::yeah::yeah:

The deadline for applications is Feb 1, 2010 for the Charleston Area Medical Center DMPNA program. I'm waiting on pins and needles to hear back from them.:gtch: Has anybody interviewed or been accepted yet?

Typically programs want ICU experience. The AANA standard is a minimum of 1 year in an ICU setting with ventilators and vasoactive drips. Each program has different requirements, but in my research I haven't seen any programs that will consider ED experience as ICU experience. The reason is that they want you to have some experience with management of vasoactive drips, hemodynamics, swanns, etc. And to be perfectly honest, the type of ICU experience you have really makes a difference. A cardiothoracic ICU setting in a large teaching hospital is probably the best experience you can get for boosting your chances. I've seen one program that accepts neonatal ICU experience, but most don't and PACU is typically not considered ICU experience. Otherwise, Medical ICU, Respiratory ICU, Neuro ICU, CCU are the kinds of experience that are acceptable.

I've been told (by CRNA's that I work with) to stay away from Mayo's program since they don't allow their students to do regional techniques. Is this true? Thanks for the heads up about the clinicals. It's good to know Mayo has intense rotations. I learn best in the moment when I have to figure things out myself. If I have someone constantly hovering and telling me the answers all the time, pointing out what to do in every situation, I am less likely to learn from the situation.

Thanks for the reply. I've heard many good things about Cal State's program and I'm considering applying there. Can anyone speak to Barry's clinical experience in Florida or Charleston Area Medical Centers rotations now that the doctoral program has been started? Thanks a ton!

Thanks for the input. When you say "students from other programs" would you mind sharing which programs you mean? I'd like to avoid (if possible) applying to programs that have a tarnished reputation. For instance, the other CRNA program in WV is trying to regain it's accreditation after losing it at the last review. Also, I'd like to find a program that has a strong clinical focus on regional techniques. Any ideas? This kind of stuff is tricky to research. Thanks for all the help. Anybody have any input on Barry's program in Florida?

Various schools seem to have a reputation for either strong or weak clinical components. Some give you the bare minimum to meet requirements and others provide an exorbitant amount of cases in open heart, neurosurg, and regional techniques. While I know that experiences can vary between students in the same program, I'd like to get an idea of CRNA's opinions of the program they graduated from and what their clinical experience was like. This is a time to brag about the school you graduated from!!! Please share!

I'm applying to CAMC's DMPNA program and was wondering what kind of reputation this school has. What are the clinicals like? Do you get to do much with regionals? The program puts a huge emphasis on management education which sounds very appealing but do the management courses detract from clinical or anesthesia didactic experience? Any feedback from somebody in the first DMPNA class or that knows about the program would be greatly appreciated.

I know this is an older thread, but can anyone tell me more about the VCU course. I took general chemistry about 5 years ago and very little organic chemistry was covered. Are these courses doable with minimal or latent chemistry experience? It looks like there are two courses: Foundations for mammalian physiology and foundations for medicinal chemistry. Any further input would be highly welcome and much appreciated. Thanks.

Something that is hard to grasp as a new nurse is the big picture. Cliche' as it may be it really is an area that can take some time to develop. Something that may help is to take a step back every once in a while with your patient and ask "what's our main goal with our pt and how are we going to accomplish it?" The details are important, but rather than getting hung up in the details try to discuss big picture ideas with your preceptor as much as possible." For instance: try to identify some main goals when you come on shift (such as becoming ambulatory by Saturday, achieve ideal lung function by ambulating/IS/C&DB/etc, extubate by shift end, etc) and then identify very specific things you can do on your shift to push that patient closer to their goals. Thinking this way, rather than just doing tasks all day, will really help your patient out and help you get a feel for how all the little tasks fit together to achieve an outcome. You have a huge effect on whether or not your patient progresses a little in your shift or a lot. Especially in the ICU. This isn't as much the case on the floor, but in the ICU you get a significant amount of autonomy and it's up to you to put it to good use.

Just curious what the concensus is out there with thoracic transplant nurses. I am relatively new to the thoracic specialty (8 mos thoracic, but RN for 5 years with Neuro ICU background prior) and I haven't figured out the balance between tolerating a low MAP and CI versus giving fluid to bolster the index of a lung transplant pt. I know giving fluid potentially sacrifices the health of the new lungs even when it improves numbers. I have a pt who was transplanted a week ago (relatively healthy young pt in 30's) and got a large pair of lungs...so large that they opened the pt back up for several days to allow the inflammatory process to ease before closing the chest again (after repeat periods of SVT 170's and CI

Getting into the ICU right after school is a competitive task in most states I've worked. But nursing is still seemingly desperate for bodies and the last two ICU's I worked in were staffed nearly half by RN's with less than a years experience or fresh from school. ICU's that hire new grads usually have high turnover because people go there to get experience for further schooling. Usually these are the best ICU's to work for (usually teaching facilities) and their consortium or internship is required to work on their unit. With the consortium they usually require 2 years commitment. Difficult to get around this as you are an expensive investment. I went through a program at The University of Utah when I lived there and they required a 2 year commitment or required paying back the 12,000 dollars it took to train us if we left early. Yup, 12 grande! But if your trying to get to CRNA school, 12 grand is just a drop in the bucket. And they would prorate the payment owed based on how long you stayed. If you stayed for a year then you would only have to pay back 6,000. The extra year you are going to be making money as a CRNA would more than make up for this. So, if you are dead set on getting into the ICU right out of school I would try to precept in an ICU and then apply to consortiums/internships all over the country in trauma 1 TEACHING FACILITIES. There are many good ones out West. The floor I work for here in Seattle hires new grads like they are going out of style. Then apply to school after 6 months to 1 year of experience. Odds are you won't get in on your first try (in which case you won't have to worry about the 2 year commitment) and even if you do get in on your first try most schools don't start for nearly a year after interviews take place. At least I've found that to be the case. So by the time you start school you'll have been on your unit nearly two years and can pay back the pittance amount charged you when you ditch early. Don't know if this helps but its how I've seen things done in a lot of areas successfully. good luck!

I grew up in the Ogden area as well. Funny thing. I graduated from Weber State University too. It's been 4 years ago. I finally decided to move out of state up to Seattle for a more acute working atmosphere, though. Hence, the position I am in. I'm still stalling, though. I've got some time to make up my mind before I decide on who to approach for a reference.

Thanks for the suggestions. That's a good point that I'll be working there for quite some time before school starts "IF" I get in. I think that angle just might be worth trying. That's good to know Midwestern has so many clinicals out of state. That just may discourage me from applying there. That was the main reason I hadn't planned on applying in my hometown of Salt Lake City. The clinical sites are ALL out of state at Westminster. Anyway, wish me luck. I'll keep you updated on what I come up with. Thanks again.

Thanks for the reply adamrj8282, A lot of what you say makes sense. I guess I just need to find the gumption to approach the boss. I'll probably wait until the last minute possible to talk to him. I can't believe I didn't think of this beforehand when I applied for the job. All I could think of was how much better the experience on a cardiothoracic unit would be compared to a neuro unit. I should've just applied. oh well. move forward from here. Where did you end up applying? I still wonder if I could get away with just using the old references. Hmmmm.....once the word is out that I'm going to school I'll still be on the unit a year and a half before school starts. Maybe that fact would ease the blow. Anyway, thanks for thinking it through with me. If anyone else has some input I would greatly welcome it. Has anybody applied to a school that demands a current supervisor reference and gotten in without it (with alternative references instead, I mean). Thanks again!

Dilemma: Okay, I've been an RN for 4 years now and a year of that was in a trauma 1 Neurosurgical ICU. I decided to move up to the Northwest and accepted a position in a teaching hospital in their cardiothoracic icu. I've been here 3 months and the idea with the move was to work here for 3 or 4 years and then apply for CRNA school. Now, I've decided I want to apply this year instead of waiting and if I'm going to do it I had better get started. I have great references from the Neuro ICU and I'm shadowing a CRNA. I finished my BSN with a 3.7 cum gpa. I've been on the acute stroke response team, I'm currently managing very heavy patients in a 24 bed cardiothoracic icu in a teaching hospital, I traveled for 2 years, I helped put together a critical care conference at my last place of employment, I'm getting my CCRN and taking the gre soon... I would wait a couple of years as planned, but I've got 2 little ones with a third on the way and I'm not getting any younger. Also, I meet all of the requirements to get in. No real reason to wait, but I've put myself in a position by moving jobs. I don't dare tell anyone on my unit I'm planning to go because it is major voodoo here. Bad juju to even mention CRNA school. SO annoying. Also, the unit is half a million over budget for the quarter and my boss is freaking about finances. He calls every single shift to make sure staffing is correct and that there aren't too many nurses coming in. so, I am a little bit leary about mentioning my desire to pursue CRNA school to my boss, let alone ask him for a reference. Especially since I've only been on the unit for 3 months. One of the schools I am looking at is Midwestern in AZ and they require one of the 3 references to be from my current supervisor. What do I do? Do I just send 3 other references in and try to explain myself in the interview? That sounds like a surefire plan for failure or at least awkwardness. What do you all recommend? Also, any other place I apply will probably find it weird if all my references are from neuro and none are from cardiothoracic. what to do? Thanks in advance for your advice.

Thanks very much for the info. I have an interview at OHSU next month but haven't heard anything back from Emanuel. Is there a trick to getting an interview there? I filled out the online application and more than meet the requirements for the posted position. It looks like there are several needs. Not sure why I haven't heard back. I try to call human resources and can't get anywhere with them. Also, what can you tell me about working union versus non-union? Is Oregon a right-to-work state? I work in Utah (essentially, a non-union state. At least for health care anyway) and know nothing about them. Pros versus cons of working in a union? Any help is greatly appreciated. Thanks for taking the time to respond to my original post. It answered a number of questions I have about emanuel.

I work in a trauma 1 neurosurgical ICU and we use the NIHSS on any patient suspected of having a new stroke. We have a stroke team that I run on and the NIHSS seems to be a fantastic way to quantify patient symptoms and a good way to give the family reasonable expectations of what the patients outcome will likely be. We don't use the scale for normal assessment of neuro patients. Our assessment includes assessment of GCS, mental status/cognitive questions, cranial nerves assessment, and assessment for upper and lower extremity drift. We do this Q1 or Q2 hrs based on acuity.

My wife and I are planning to relocate to the Northwest at the beginning of the year and I've been looking at RN positions at OHSU and Emanuel Portland in Oregon, and Harborview Medical Center in Washington. They are the Trauma 1 centers for the Northwest. I'm curious about their Trauma/Surgical ICU's. I'd love to hear from anyone who knows what these ICU's are like and if the working atmospheres are agreeable, what the staffing is like, how are the units set up, etc? Any info would be much appreciated.

I've seen it once and it was mistaken at first as aspiration related until the chest xray came back. A lady in her 70's came in after being found unresponsive in her chair at a nursing home with food all down the front of her. She, apparently, was given a little too much pain medication, her respiratory drive all but stopped and she became hypoxic. She was admitted to the ICU with assumed respiratory distress from aspiration, but the chest xray showed clear lungs and pulmonary edema. She was intubated in the ED and then extubated shortly thereafter on the unit as her respiratory drive rapidly improved. It was short-lived and weird. The assumption was that her decreased respiratory drive caused a negative pressure environment in her lungs (how I don't know) and it caused pulmonary edema. That's what the trauma docs claimed.

Thanks Skipaway for the corrected URL. Interesting web site. Thanks to everyone else for the input. It sounds like a feasible goal to end up in pain mgt as a CRNA so I'll have to do some research on the schools that put higher emphasis on these techniques and line placement. Any further comments would be much appreciated.

It sounds like there are a lot of mixed views on the subject. I tried the URL you typed in a few times and couldn't get it to work. Has it changed or did you miss a letter or am I doing something wrong (most likely). Thanks for the input and help. It was mentioned that only a few states are allowing pain mgt...anyone know which states those happen to be...say, maybe Oregon or Washington? Thanks again!

My goal is to focus on outpatient pain mgt as a CRNA after finishing school and I'd like to attend a school that teaches intensively the pain mgt techniques that are common in an outpatient chronic pain clinic. IS anyone doing this now as a CRNA? I've been reading some anesthiologist forums and find that many have expressed hostility :angryfireto CRNA's who want to learn such procedures. It sounds like most schools don't put an emphasis on this aspect of anesthesia and I'd really like to know what it takes to get this kind of training. On this anesthesia forum I referred to there was mention of CRNA's who went to anesthesiologist conferences and signed up as an MD (this sounds fraudulent to me:nono:) to get in and learn the techniques. What options are out there and how tightly controlled is the education for pain management. Is there any state legislation restricting this kind of practice? Any insight would be greatly appreciated. Thanks!