SuperSleeper

I agree. Because the event defined you professionally, it is worthy of mention. It also lets the ADCOM know your heart and soul are truly in this endeavor. Btw. I speak from experience. I also lost my son and my experiences with him are why I went into nursing and am now in anesth. school. SS

Well, as I'm sure you're well aware, there are no guarantees. However there are things that may decrease the risk. Like: strict NPO prior, triple treat (reglan, pepcid, bicitra) before surgery per pt condition, NGT intraoperatively, zofran given intraop, cricoid pressure at intubation, making sure the pt is optimized before surgery, not giving food/drink to a person with questionable airway reflexes postop (my favorite - you'd think it would be a no-brainer, but...), etc... ss

Yes. It could be indicated in a non-abdominal surgery. There is always the possibility of air in the stomach with manual ventilation. Or, if the tube was dropped down the esophagus by accident at the beginning and the pt was re-intubated. Stomach decompression may be done in an attempt to decrease intra-abdominal pressure to aid in venous return. Or....the pt may have a history of significant post-op nausea and vomiting. Or....the pt may have regurged some stomach contents at intubation and the provider wanted to prevent that from happening again at extubation. There are a number of reasons to do this. My list is not exhaustive. Hope that helps some. SS

I drop an OGT for stomach decompression to help out the surgery when indicated and give Zofran for post-op N/V...takes a while to kick in. SS

Poke around in the messages on this board and your question will certainly be answered. There are a couple that are "a day in the life of an SRNA" kind of things. They should give you some reality of it. For me 20 hour days between class, clinical, and studying are not abnormal. And, my bed is usually the only thing I lust after. SS

I started in CVICU as a new nurse. It was so stressful that I cried on the way IN to work for about a month or so. There are some incredibly strong personalities in the ICU setting. Not that you don't find them elsewhere, but ICU's are generally known for it. It takes a bit for your skin to thicken and others to generally trust you. The big issue is that there are MANY opportunities in the ICU to make a "little" mistake and kill someone. That being said, the potassium-enriched fluid is an issue. Granted diluted like that, it shouldn't be dramatic, but potassium can kill. Get very familiar with your fluids. LR also has potassium in it (btw, just fyi). In the ICU, fluids are one of your main resources. I agree that your ICU does not sound new grad friendly. Maybe you would be better off out of that environment until you get your feet under you. I am in no way saying that maybe you can't handle it. From your description, it really sounds like your potential has been squashed there, for the most part. If you stayed there, you wouldn't just have to not make mistakes, you would have to be a superstar to win them over. It is possible and I've seen it happen. Obviously, the choice may not be yours, but, at times, life gives us exactly what we need. Good luck, SS - SRNA

I love the program. I'm more than happy I'm here. I did not use any particular med sheet to prepare. I got my CCRN the year before and used that study book to prepare. I also just started looking up the meds and the issues that I handled in the unit as I got them. Good info to know: When looking up info on meds, focus less on dosing and more on the effects, the indications, and the cellular level of functioning... i.e. does it work on alpha or beta receptors. For that matter, know what those receptors affect in general and where in the body. ss

The last count I heard was 60-70ish interviews for 20-something positions. I don't know, for sure, when they'll let everyone know. Last year, it was within a couple of weeks.

First off, congrats. I'm in the program now. There are a number of interviewers in the panel and they will meet with you all together. They will usually ask you a couple of get to know you questions and then they use your answers to go from there. Therefore, don't bring up anything you don't want to talk in depth about. By in depth, I mean down to the cellular level. Now, they could throw a curve ball at you with any question, but for the most part, your answers drive the show. Most importantly, make it clear you would do anything to be there/a CRNA. They see the best of the best all the time. They're looking for skill, inteligence, calm and motivation. And ALWAYS fess up when you don't know an answer. You will be kicked to the curb if you bs an answer. They don't want to risk any students in their program bs-ing their way in the OR so they cut 'em off at the pass here. Good luck. Maybe I will see you Thursday. SS

I would certainly say that this guy you're talking about is not representative of the "typical" CRNA type. Yes, you will always find a strong personality out there. However, a personality like the one you describe is more likely to get you out of a program or prevent you from getting in than it is to get you ahead. Type A is a pretty good description of most of us in programs. You have to be or you really won't survive the brutal demands time, energy, and emotion - wise. You need to not worry about what you would be up against with your classmates in a program. Once you're in, it doesn't work like that...you're in and you just need to continue to prove you deserve to be there. You aren't in competition with your classmates. My guess is if this guy you're talking about has that strong of a personality, the admission committees would smell it a mile away and not like it. Experienced, driven, intelligent, humble, sure, and strong are the descriptors I would use to paint a verbal picture of those generally chosen for nurse anesthesia programs. Good luck and just do everything to show ad-coms that this is what you are meant to be doing! SS

Word is somewhere around 60 interviews. Could be a little higher. Class size will be about 25. Congrats on getting your letters. Maybe I'll see you at your interview. SS

That''s what I heard, too.

Good luck, you guys. I'm currently in the program. I don't know for sure when the interviews are supposed to happen. I heard rumors of having everything done and acceptance letters out by the end of October. Don't quote me on that, though. The interviews are tough. But, that is to be expected at any school. If you have surfed through the board here, you have probably seen a sage bit of advice quite frequently: If you don't want to talk about it in detail, don't bring it up. What ever you do discuss, be ready to discuss in fine detail. For example, with medications, know them intimately down to what receptors they act on (alpha adrenergic, beta-1 or 2 adrenergic, etc...) and what effects these ellicit. This goes for disease processes you encounter in your patient populations, as well. Know that you will probably experience one of the most nerve-wracking moments of your life, but you will survive. It is very important to KEEP YOUR COOL during the interview. Don't freak out and if you don't know something, TELL THEM SO! Like many have said before me, adcoms can smell bs a mile away and they hate big heads. If possible, try to let them see your personality. I know this all sounds fairly vague, but that is what the interview is like...vague and from any direction. I really enjoy this program, the faculty have been nothing but nice, supportive and encouraging. Like I said, good luck! SS

Thank you!

DocHolliday- You greatly underestimate a profession that is working in conjunction with you to provide optimal patient care. It's not about the doctor or the CRNA. It's about the patient. And, no matter what you throw back at CRNA's as a profession, we ARE better trained to deal with the patient while MDs are better trained to deal with the disease. CRNAs, as well as nursing as a profession, know this and accept it. Neither aspect is better, both are needed for excellent patient care. That's why the team works. That said, CRNAs are trained to perform anesthesia. No amount of posturing will change that. Evidence shows they are quite capable and quite good at it. Every CRNA I know has no problem asking for help from the more experienced (CRNA or MD) if necessary. Those who don't have no business being in the medical field. That goes for MDs and RNs, as well! In my years I have found only 2 CRNAs with inferiority complexes, they're very rare. I agree with you, they present a danger in that mindset. I have witnessed far more issues with MD superiority complexes. I have never understood it. Yes, they know more about what they do, but they still get naked for showers and go to the bathroom like the rest of us...they are no better humans than the rest of us because they are doctors. I have no sense of having to prove anything. Pride is never an issue when it comes to my patients. It shouldn't be for anyone. I do whatever is necessary to provide optimal care. Sometimes that is alone, sometimes that is with assistance. I don't see an MD as someone with "a little more education" than me. My best friends are MDs. I am fully cognizant of your journey. I respect MDs for what they are trained to do. However, that does not always make them better. I do not wish I went to med school. I could have. I was offered a full ride. I turned it down. I wanted to be the person who took care of the patient and not the disease. Yes, yes, there is more to it than that, but at the decision point, that was my reasoning. Also, I wanted a life. I do not regret a moment of it. It is unfortunate you do not know who I am because your picture of me is completely off the mark. It could not be further from the truth. I reiterate that it is important to know a person's background before you judge. You might be quite surprised to know to whom you are actually speaking right now. SS

GASping Believe me, I would never confuse myself for an MD, nor would I want to. Yes, you are right. Individuals who took the minimum track to get to CRNA time-wise spent a couple of those years in non-nursing training. However, that is NOT the path most have taken. You are grossly mistaken when you plaster the title "skilled worker" on a CRNA. They are advanced practice nurses with knowledge, abilities, and judgments that many MDs will never dream to acquire simply by virtue of their paths of training, experience, and personalities. These attributes are like gold with patient diagnosis and care. This on top of their anesthesia training. (Note: I didn't say they know more than MDs or even as much as MDs know about all they know!) You have no way of knowing the background of all CRNAs. Your comment is inflammatory here and you know it. Stereotyping and insults. I was obviously incorrect in my judgment about your communication style. SS

I wouldn't say that I'd be offended. I'd be a little ****** that I had all the extra training in NA school and it didn't move me up. But that's a different emotion. On that note, though, I have a friend who is a CRNA and loved the unit so much that she PRN's in one...as an RN. We don't lose the nurse in us, most of us just choose to do something else with it. Many people do get burned out on the unit and decide to move on at that point. Many embrace the experience knowing that it is a time to learn what is necessary for advanced practice. Every journey is different. As for me, I was burned out on the politics of management vs. staff, but not the actual nursing. If they would just let us all take care of our patients without distracting us with piddly-crud all the time, all would be better off for it. IMHO. I was not truly burned out when I left. I hope that answers your question to some degree. SS-SRNA

I absolutely loved, and still love, being an RN! Of course, there were the little things that I could have done without, but all-in-all, this career has been extremely rewarding for me. I think a big part of it is where you work. I don't know what the ICU settings were like for others, but in mine, it was constant thinking interrupted by the occasional sudden fulll linen change. Even working with the families wasn't too bad. There were some I would like to have strung up by their toes, but not many. I enjoyed figuring out their "ways" quickly in order to attempt to come across as friend instead of the enemy. There was a joke in my unit that my PR skills were so good, I could get the pope to convert to Judaism if given the chance.:chuckle I agree, though, about the physical aspect of flipping those 300 pounders regularly. My back couldn't do it anymore. A common misconception is that CRNAs don't turn pts. They do. There is just more help. I am very excited to be moving in to an arena where I can focus one-on-one with my patient right there and manage everything while being "in the moment" as opposed to constant distraction. I think that if you are not challenged as an RN, it is definitely time to continue your education and move on upward. There are way too many options in nursing to stay in one place an allow yourself to be miserable IMHO. Good luck in your journey. SS - RN, SRNA

1)Pay lots of attention in class. 2)Study, study, study 3)Keep your grades as high as possible to stay competitive 4)Stay humble...understand that you do not know everything so ask questions to learn everything you can. Good luck. SS - SRNA

Interesting. Did your lecturer give a rationale for not giving the ntg? I would love to hear it. The reason for giving it is to dilate the coronary vessels to allow flow around/through a blockage (clot/stenosis). Granted, if the BP is low it is not recommended given its ability to bring it lower. However, nitrates are generally used to buy time AND to help r/o MI. SS

confirmed AMI = ASA 325mg, not 80 UNLESS pt has a confirmed clotting disorder or hx of GI bleed. 81mg is indicated for post MI maintenance after approx 1-2 weeks of 325mg. Some docs even go as long as a month. Otherwise it is used prophylactically BEFORE pt ever has an MI. SS - RN, CCRN, SRNA

I wasn't outright saying you were wrong, I've just seen over and over and over that PACU wasn't an area that qualified. Good for those nurses if those schools take them. Then I rescind my attempt at humor. In that case, I would have to say that if the same vent issues and drips and acuity are handled by nurses in each area, then there is still no way to know who will fare better. It's an individual thing. Btw, stellar PIV starting is a great skill to have, but can be developed pretty easily. So, I'm not sure that would weigh too heavily. Are you a PACU nurse?

To answer the general question you're asking, there is no way to know who will have the better time of school. It's beyond tough for everyone and each person brings their own background and coping mechanisms in with them. More specifically, though, PACU does not generally qualify for CRNA school. ICU experience is the requirement. If there are schools that take PACU experience, I am not aware of them, myself. So, I guess that would make it harder for the PACU nurse to succeed, seeing as he or she wouldn't even get accepted! SS

For me, it was three things: 1) one-on-one care 2) lots of critical thinking and 3) get to work with the toys (technology) SS

Thank you, GASping, for an intelligent reply. I think most agree with the fact that not all MDAs can be lumped into the bad apple category. We all appreciate the schooling that MDs endure/aquire. As for your alluding to the lack of critical thinking about disease in nurses, though, one cannot forget that while we get a more holistic training in nursing school, CRNAs have spent time in hands on training in the ICU. This is where we develop that process. Sure we didn't go over it as much in school, but we were thrown to the wolves and learned it do-or-die. I, personally, believe that with the acuity found in hospitals today, the sporifice amount of in-depth, detailed disease process study is a sorely lacking point of undergraduate nursing programs. But that is another thread. It can't be discounted that in one way or another, CRNAs have spent a minimum of 7-8 years of training through school and hands-on experience to get where they are. This is the minimum, most spend a lot longer than that. Many MDs do not realize what the nurses really do. They, understandably, get a snapshot look at it -- when rounding and when the nurse calls. I myself have, over the years, saved many people through dx the immediate problem w/o the help of the MD. I can look at a pt and, if available, the numbers, and pin things down to individual organ or disease process pretty darn well...and I am usually right. Nurses get placed in situations where there is little to no help. I have delivered babies on my own, I have had my hands inside someone's chest removing clots during a tamponade code, I have had to figure out what the heck was going on and save someone who suddenly crashed while on CVVHD because the machine malfunctioned...but still said everything was fine. I am not going on a high and mighty run here, I'm just giving examples to point out that critical thinking about disease process was my daily gig for years while working in the CVICU...as it is for many nurses. On top of that, we have to be holistic to remain within the definition of our career. There are CRNAs out there that clock-in, do their time, and go. Most I have known, though, will stick it out as long as necessary. I would be careful about statements like, "They do the bread and butter that I don't care to do." That subtly smells of Bush's comments that we need the illegal immigrants to do the jobs the rest of us don't want to do. I know you didn't mean it that way and I took no offense, but some could -- very easily. I wholeheartedly agree with you about the clashing only bringing us down. A united front is always stronger. And, yes, if you make more, we will make more. I do have one question, though. In the rural areas where MDAs don't want to practice and CRNAs perform the vast majority of anesthesia care solo, why shouldn't they get the same money? They would be doing the exact same work as MDAs and are held to the same practice standards. Not setting up for argument just legitimately curious. Like I said, thank you for an intelligent response. We need more non-inflammatory dialogue in order to progress education about our profession. SS - RN, CCRN, SRNA