Gump

The good news is that YOU WILL PASS! My advice is this: Go Thru each section in the sweat book one-at-a-time, not only to memorize, but be sure to understand the concepts inside AND out, up AND down, AND sideways. Of course, you need to memorize names of drugs, dosages, etc. but it's paramount to have a good understanding of the concepts. Also, go thru the latest mixed reviews a couple of times and at least once more thru the memory master - again, to master concepts as well as memorization... I recommend 8 hours per day, with 2 fifteen min breaks and 45 min for lunch (seriously, just like a job) for at least three weeks, more if you think you need it...and remember, no shortcuts - just do it! When you take the test again, read the question and form your own answer first, then look at the choices to see what fits. This is how a friend and I did it (on the advice of several other CRNAs). Good luck to you bro, and keep you head up... -Gump

They are different, but maybe not "obviously" to a junior student. not trying to start a pissing match, just letting the OP know that it's still important to know your weight-based dosages...

We actually used the weight based dosages in my peds rotation where precision is more necessary.

fyi... american society of anesthesiologists adopts practice advisory on intraoperative awareness and brain function monitoring tuesday october 25, 12:56 pm et newton, mass.--(business wire)--oct. 25, 2005--aspect medical systems (nasdaq: aspm - news) today announced that the american society of anesthesiologists (asa) house of delegates has approved a practice advisory for clinicians that addresses intraoperative awareness and the role of brain function monitoring, including aspect's bis technology. intraoperative awareness occurs when patients do not receive enough anesthesia to remain unconscious, leaving them at risk of becoming aware of what is happening and remembering this experience after the surgery is over. the practice advisory is designed to provide guidance to anesthesiologists regarding this important safety concern and was approved at the asa annual meeting in atlanta, georgia today. "the asa approval of this document represents a significant step forward in addressing intraoperative awareness and the role of brain function monitoring and reinforces the society's leadership in advancing patient safety," said nassib chamoun, president and ceo of aspect. "we believe that the guidance provided by the asa, combined with the sentinel event alert issued to healthcare facilities by the joint commission on accreditation of healthcare organizations, supports the need for healthcare facilities to make brain monitoring available in every operating room that serves patients at risk for awareness." practice advisory guidance to clinicians the practice advisory acknowledges the reported incidence of intraoperative awareness of one to two cases per thousand patients receiving general anesthesia. the document also recognizes the significant psychological harm that some patients may experience following an episode of awareness. to address this safety concern, the advisory document states that: patients should be evaluated for awareness risk factors. those patients identified as at risk should be informed and anesthetic depth should be monitored using multiple modalities. although brain function monitoring is not indicated for use on all patients undergoing general anesthesia, the decision to use brain function monitoring for selected patients should be made by individual practitioners on a case-by-case basis. the advisory reports that the majority of asa members (69%) surveyed believe that brain function monitoring is valuable and should be used to help reduce the incidence of awareness in patients at risk. appropriate patient follow up should be conducted in patients who report awareness, including assessment, reporting and counseling. according to the practice advisory, clinicians should conduct a preoperative evaluation to identify patients at risk for intraoperative awareness. the report cites studies and case reports that suggest that certain patient characteristics, surgical procedures and anesthesia techniques may be associated with an increased risk of awareness. potential risk factors for awareness listed in the report include: substance use or abuse; patient history of awareness; difficult intubation; cardiac surgery, cesarean section, trauma and emergencysurgery; reduced anesthetic doses in the presence of paralysis; use of muscle relaxants; and total intravenous anesthesia (tiva) and other anesthesia techniques. clinical evidence supporting bis monitoring the asa practice advisory provides documentation that bis is the only brain monitoring technology or clinical intervention that has been shown in large scale, prospective clinical research to reduce the incidence of awareness. specifically, research cited in the asa practice advisory (and published in the lancet in may 2004) documented that use of bis monitoring to help guide anesthetic dosing reduced the risk of awareness with recall in high-risk patients by 82 percent. the food and drug administration (fda) granted clearance for bis monitoring being associated with the reduction of the incidence of awareness with recall in adults during general anesthesia and sedation. this is the only technology to receive this type of clearance from fda. "this asa document provides a pathway for caring for patients who may experience awareness and elevates the role of brain function monitoring to a new position of importance within anesthesia practice," said scott kelley, md, aspect's medical director and a practicing anesthesiologist. "when clinicians evaluate the strength of the data supporting bis technology and consider the lack of evidence for other practice interventions and monitoring modalities, we believe that they will recognize the patient safety benefits of bis technology and move toward broader utilization of bis monitoring as an adjunct to conventional monitoring." aspect will post a commentary providing additional details about the advisory on the company web site (http://www.aspectmedical.com) following public disclosure of the advisory by the asa. aspect conference call as announced last week, aspect medical systems will host a conference call and live webcast tomorrow, october 26, 2005 at 12:00 p.m. et to discuss the advisory. to participate in the call, please dial 1-800-289-0494 (domestic), 1-913-981-5520 (international), or access the webcast at www.aspectmedical.com on the investor page or at www.earnings.com. telephone replays will be available by dialing 1-888-203-1112 (domestic), or 1-719-457-0820 (international), access code 9419112. the webcast replay will be available from october 26, 2005, 3:00pm et until november 2, 2005. about bis monitoring using a sensor placed on the patient's forehead, bis monitoring translates information from the electroencephalogram (eeg) into a single number that represents each patient's level of consciousness. this number - the bis value - ranges from 100 (indicating an awake patient) to zero (indicating the absence of brain activity). using the bis value to guide administration of anesthetic medication, in conjunction with other vital signs, allows clinicians to make better-informed decisions to achieve optimal anesthesia. about aspect medical systems, inc. aspect medical systems, inc. (nasdaq: aspm - news) is a global market leader in brain monitoring technology. to date, the company's bispectral index (bis) technology has been used to assess more than 12.2 million patients and has been the subject of approximately 2,000 published articles and abstracts. bis technology is installed in approximately 68 percent of hospitals listed in the july 2005 u.s. news and world report ranking of america's best hospitals and in approximately 40 percent of all domestic operating rooms. in the last twelve months, bis technology was used in approximately 12% of all u.s. surgical procedures requiring general anesthesia or deep sedation. bis technology is available in more than 160 countries. aspect medical systems has oem agreements with seven leading manufacturers of patient monitoring systems. the company is also investigating how other methods of analyzing brain waves may aid in the diagnosis and management of neurological diseases, including depression and alzheimer's disease. for more information, visit aspect's web site at http://www.aspectmedical.com. safe harbor statement certain statements in this release are forward-looking and may involve risks and uncertainties, including statements regarding the company's expectation that the asa's guidance concerning intraoperative awareness and the role of brain function monitoring should have the effect of accelerating the adoption of bis monitoring and will support efforts to improve the safety and quality of anesthesia care. there are a number of important factors that could cause actual results to differ materially from those indicated by these forward-looking statements. for example, the company may not achieve widespread market acceptance of its bis monitoring technology among anesthesiologists, including members of the asa who review the practice advisory statement. the company also faces other barriers to market penetration and acceptance. the company may not be able to compete with new products or alternative techniques that may be developed by others, including third-party anesthesia monitoring products approved by the fda, and also faces competitive and regulatory risks relating to its ability to successfully develop and introduce enhancements and new products. cases of awareness with recall during monitoring with the bis system and significant product liability claims are among the factors that could limit market acceptance. there are additional factors that could cause the company's actual results to vary from its forward-looking statements, including without limitation those set forth under the heading "factors affecting future operating results" in the company's quarterly report on form 10-q for the fiscal quarter ended july 2, 2005, as filed with the securities and exchange commission. in addition, any forward-looking statements represent the company's views only as of the date of this press release and should not be relied upon as representing the company's views as of any subsequent date. while the company may elect to update forward-looking statements in the future, it specifically disclaims any obligation to do so, even if its expectations change. therefore, you should not rely on these forward-looking statements as representing the company's views as of any date subsequent to the date of this press release. aspect, bispectral index and bis are registered trademarks of aspect medical systems, inc. all other trademarks, service marks and company names are the property of their respective owners. contact: aspect medical systems emily anderson office: 617-559-7032 cell: 617-515-2000 [email protected] source: aspect medical systems

It is absolutely the same 2-volume book... You will be given instructions during orientation on how to get it...you must have a "blazer id" which you will create once you are enrolled... -Gump

"Clinical Anesthesiology" = Morgan, Mikhail, Murray - this is (in my opinion) a must have for supplemental readings.... "Miller's Anesthesia" = you will be able to get for free online (very good source) these (above) are what helped me get through the first year.... along with the instructors presentations/handouts "Anesthesia Secrets" by James Duke, M.D. - I got this one just because a senior friend of mine recommended it - and I would recommend it as well - the focus is/are questions that you will be asked in the OR during clinicals "Anesthesiologist's Manual of Surgical Procedures" by Jaffee and Samuels - a must have for when clinicals start ----hope this has helped.... Gump

Roland, This has all been touched on before in one form or another, but I like the way you have asked these questions and I will answer it now... Mainly to show other "borderline" applicants that it can be done, even without a 4.0 undergraduate GPA... - School: UAB (only one applied to) - Current Year: 2nd year junior (in clinicals now) - Overall SRNA GPA: 4.0 - Undergraduate Nursing/Science GPA: 3.41 (had to retake 2-3 science courses to bring it up from 3.1 or 3.14 - something like that) - Experience: 9 years acute cardiac care - GRE: 954 I hesitated to answer this post, but I realize that there are others out there that don't have the best grades, but do have the desire; so maybe this will be a little Hope for them. -Gump

I'm a UAB student and would say that you would see/experience almost the whole gamut at either of the two schools. UAB students get pediatric experience from Children's Hospital in Birmingham or from LeBonheur Children's Medical Center in Memphis, TN. I'm from the Tuscaloosa regional component, so I do my clinicals in Tuscaloosa. As Sprout mentioned, there are many regional components (Mississippi, Florida, Georgia, Dothan, Montgomery, Tuscaloosa, Huntsville, Mobile; that's all that I can think of right now) but they do their clinicals in their repective local hospital(s). The minimum requirements are WELL EXCEEDED as far as what experiences you must have...and I'm sure this is the case for Samford as well. I hope this has helped you... Good Luck, -Gump

I'm a current UAB student and am in the third week of clinicals... Don't fret too much about starting classes, yea it's pretty nerve wrecking, but after the first couple of classes, you will find your groove... Oh, and don't worry, you'll still have a job; it's called studying! And if you're like me, you'll spend more time at this new job every week then you did at your old one... But, it is fun and challenging and time will FLY by... The only advice that I would like to share with you is this: Do NOT get behind in your studies... You will see what I mean after the first few classes... The material is not impossible, it's just a lot... You will become very creative with your time management... Good luck to you.. -Gump

Thanks guys. I did purchase this book and it does look like it will be a very useful reference. -Gump

I've heard that "Anesthesiologist's Manual of Surgical Procedures" by Jaffe and Samuels was a good reference to use for anesthesia management plans. Can you guys (that use/own it) tell me what you think about it... -Gump

Now that is an awkward and stressful situation... It's cool that you are handling it well... Don't worry too much about how you think your classmates view this. Just continue to be nice, sociable, and take it one-day-at-a-time... I find it pretty suspect that she broke it off with you a week before classes started, but will not assume anything... I'm of the belief that things happen for a reason. God has a plan for all of us and we are not supposed to know what it is. Be positive and stay sharp! -gump

Very well said TraumaNurse...

Oh, that's hilarious now... I chased a lot of things in under-grad myself... and grades were never a problem, until it came time to apply to graduate school... You know, the funny thing is, now that I've been back in school for two semesters, I'm making the best grades I have ever made, I guess you could say that my priotities are now in order... For all of you guys out there who think that because of your low GPA, that CRNA school is hopeless...well let me tell you that that is just for the birds...... never give up hope, and do WHATEVER IT TAKES to accomplish your goals/dreams. Take it from one who's doing it. It took me about 5 years to get my crap together (retaking a few classes here and there, getting married, having a son, etc.); my GPA sucked too, but I did what it took to show that I had the drive and determination to accomplish my goals...You know, it was very hard working full time 11-7, putting my self through school, retaking classes, trying to be dad, etc. but it can be done...it may just take a little longer than you want it to...just keep on keeping on, and next thing you know, you are where you want to be...Man I could ramble on for a while on this subject, but I won't... -Gump

Yes, I was the first alternate for the T-town component. I received a call about 1 week before classes started and was offered a slot. The reason that it was offered to me was because one of my classmates changed over to a different regional component at the last minute leaving the Tuscaloosa spot to be filled by an alternate. I don't know how many alternates were accepted with my class, but there were at least two. Look, I know it's frustrating but just hang in there! I had to apply twice before being accepted. Don't get down on yourself, just keep your head up and do WHATEVER it takes to accomplish your goals. Beleive me, YOU WILL GET IN, if not this time, then most likely next time; you are obviously qualified because you got an interview! When I found out that I was an alternate, I called Dr. Williams and asked what caused me not to be accepted originally; he told me that I was as good or better in all areas that they look at except GPA; (my GPA at that time was 3.5) which tells me that someone's gpa from T-town was probably 3.51 or 3.6, something like that) - anyway, that's just the way the game works; they don't know you from Adam's house cat, so they have to go by gpa's, interviews, etc. to base their selections on. Things happen for a reason, and when it's meant to be, it will! If you have any further questions, just hollar... -Gump

I'm not sure/familiar about B'ham; Just be sure to get experience with vasoactive gtts, vents, invasive monitoring, etc. Units such as CVICU, NICU, Trauma ICU, MICU would suffice... Several of my classmates work/worked at UAB, Princeton, St. Vincent's, and Children's to name a few. -Gump

Six were accepted from the Tuscaloosa component this year. -Gump

He just recently earned it... And your right, that had no influence on my decision either...

I feel that the program and faculty are great! Dr. Williams has been the director there for a long time and he has put together a great bunch of instructors. Most, if not all of the program's instructors are graduates of UAB's anesthesia program. Yes, the last several classes have been large, but I have had no problems getting one-on-one time from the nurse anesthesia instructors if needed (that goes for the other instructors as well; biochemistry, gross anatomy, physiology, research, etc.) They are all top-notch professors/instructors. Another positive that I enjoy is that we get to dissect our own cadavers in gross anatomy; it's important to me to have that experience (I understand that a lot of other programs don't get to do this). UAB has many, many local as well as regional clinical sites for your training. You don't have to have a Bachelor's degree in Nursing to be accepted (as long as you have a Bachelor's in a related field and are an RN with 1 year critical care) - that is a positive for some... I will start clinicals in June, and from what I hear from the senior students, it is demanding, fun, and exciting! - and I'm very much looking forward to it. As for negatives, I can't think of many, this was my first choice program/school. It's a front-loaded program (some view that as negative), it's 27 months long (could be positive or negative depending on your thoughts). As for me, I'm grateful to be at UAB and feel that I absolutely made the right choice. I hope this helps; if you have any other questions, please don't hesitate to ask. -Gump

Dr. Williams IS a very laid back guy. He teaches several sections in our pharmacology class, and he does the professional aspects portion. He is a good guy with a lot of experience and he enjoys what he does. He likes to cut-up occasionally with a joke or two; it's not uncommon to laugh-out-loud at least once during his lectures. -Gump

Thanks guys, these explanations have been a big help! I'm going to insert some of both of these into my notes and beat it into my brain before next Thursday's test... -Gump

I'm having trouble with this in my mind... I understand that if a drug with a pKa of say 7.4 were put into plasma with a pKa of 7.4, then 50% of the drug will be unionized and 50% will be ionized; the unionized form crosses membranes easier while the ionized doesn't (which is good or bad, depending on what action we want from the drug); the part I'm having trouble with is "at what pH is the drug more unionized vs ionized?" alfentanil has a pKa of 6.5; does this mean that when injected into a body pH of 7.4 = more unionized which = faster onset? for lower pKa drugs to be more unionized, do they need to be injected into closer to normal body pH's? This is probably very simple, but I'm stuck and I don't have my G&G's with me today; can you guys please help...I can't see the forest from all the trees today! -Gump

Thanks Guys. -Gump

What gross anatomy website(s) can anyone recommend? I've got Netter's Atlas; and the drawings are very nice, but I would like to be able to see actual photographs for home study. -Gump

kjt2004, Believe me, I know how you feel. Follow this link if you want to know some of what I had to go thru: https://allnurses.com/forums/showthread.php?t=56482 There is hope! If this is what you want, never give up and never give in! I didn't, and now I'm completing my first semester of Nurse Anesthesia School! It was a long row to hoe, but I made it (as well as many others) and you can too! Keep the positive attitude! Happy Holidays -Gump P.S. It is perfectly okay to call up the director(s) to find out what the deal is, just be cool about it.