KSCRNA

We are answering your question but most of all, we are protecting OUR profession. CRNAs cannot think like shift workers. We in most cases are there until the job is done. Being a CRNA for 30+ years, I can tell you that we as a profession are changing and we need to monitor it. CRNAs enjoy the profession, not necessarily the money. With the changes in healthcare reimbursement, who knows what will happen to the salary structure by the time you get into anesthesia. I can honestly tell you that the chances of you making $300,000 is very slim. To earn those kind of salaries you ususally have to work in rural practices and be on call all the time. If it seems like I am lecturing, that is because I am and I have earned the right.

http://www.crnatoday.com

They are not luminaries in the field of the advancement of anesthesia since virtually all advances in the field over the past 60 years were made by those other than CRNAs....they are not prolific in research compared to physicians, do not initiate many relevant prospective randomized clinical trials, and are not known for their cutting edge prowess. But they are wonderful technicians that are extremely well paid for their efforts. There is a great deal of quality research that is done by CRNAs:eek: but you, the anesthesiologists, refuse to allow it to be published in the anesthesia literature. It is IMPOSSIBLE for a CRNA to be a 1st author in either Anesthesiology or Anesthesia & Analgesia. Why is this, because you are threatened? Don't sit here and preach unless you are willing to see the body of research that would be available because you have NO IDEA!! Yes, CRNAs proudly do anesthesia on a daily basis. We take good care of our patients and we, not most anesthesiologists, stand up for their rights. I have seen anesthesiologists who did not want to wait for the patient to change just rip open the curtins leaving a totally exposed patient. If this is your idea of caring, then I am proud to pat their hands.

Everything you need to know about being a CRNA is available on the AANA website and that should be the first place to look. You seem to be looking at the easy way to make the BIGBUCK$ and this is not a good attitude to have when entering this profession. :confused: CRNAs enjoy a great deal of personal satisfaction and salary is only a small part of that. If your only questions about becoming a CRNA and CRNA practice are about how much money you will make and how many hours you will have to work, them maybe this is not the profession for you.

Unfortunately, as with most organizations the AANA and most state organizations are ruled by the 90-10 rule. That is 90% of the work is done by 10% of the membership. The remaining 90% of the population then acts unhappy with the outcome and blames the leadership of the state or national organization. To become unified only at the time of a crisis is too late. It is more important than ever that ALL AANA members (including students) become active on the state and national level and become advocates for the patients and the profession. Run for office, become a state or national committee member, learn the FACTS of the issue and then lobby for those issues to the appropriate people. We are at a crossroads in our profession where we are developing a better relationship with the ASA but that does not mean we stop advocating the issues of patient safety and our role in it. Don't be fence sitter, become active. This applies to students as well as graduates. Students, don't complain because you have to give up a weekend to go to the state meeting. It should be an honor to be there and to be welcomed into the profession. It is part of your professional development. It is NEVER too late to become a good member of your organization. The AANA does a lot for you, help it out.

The key to intubation, especially of the morbidly obese is position. Getting a good sniffing position, not just the head elevated is key. Using just a pillow as we do with a small patient is inadequate. You need to build a ramp of blankets on either side of midline until you get a good sniffing position. The ramp needs to be open in the middle to accomodate the fat role that is between the shoulder blades. Compression of this fat role will displace the airway anteriorly. A good way to provide upper airway local anesthesia for awake intubation is with a nebulizer. With the patient in a sitting position and their nose held shut. Have the patienr inhale through a nebulizer with 4cc of 4% xylocaine. The mist is drawn down into the upper airway.

End-tidal concentration is a better representation of brain concentration while inspired concentration represents that amount in the lungs.

With the new program director taking over in June, the length of experience may change. :)

What you are proposing is calculating and in my opinion unethical. The employer is basing their future employment strategy on your availability after graduation and in return they are paying you for that availability. You are denying a job to someone who may actually want to work for the group. As a professional in nurse anesthesia you will be expected to make ethical decision that your patient's rely on. If you start your career by being unethical how can a patient (or for that matter a co-worker) ever trust you.

Remember that most of the clinical preceptors are NOT professional educators. They are clinicians who are kind enough to assist in the clinical education of nurse anesthesia students. They are in cliinical practice because they enjoy giving anesthesia and if they have a student everyday, they are not getting to do what they enjoy. Mostly remember, not every day is a good day, they, like you as a student, bring "baggage" with them on a daily basis. Each clinical instructor has their own way of wanting things done. They don't care how anesthetist X or Y does thing, their way is the right way. As a student learn everything each instroctor has to offer and when you get done incorporate the best of each instructors practices into your way of doing anesthesia. It is not easy being a student but remember, it is often harder being an instructor. You have to watch while someone takes care of your patient and makes mistakes. Mistakes that could cost you as the clinician a lawsuit. Rarely is the SRNA named in a lawsuit. Most clinical instructors are not paid for their tiime and efforts so please don't forget to thank them. When you are finished, hopefully you will get to serve as a clinical instuctor and remember how you wanted to be treated. Nurse anesthesia is a great profession. One I hope you will enjoy has much as I have over the past many years of practice. Remember, your didactic and clinical instructors are the gatekeepers of the profession. From prior experience they know how things work best for them. Listen, Learn and Thank them!

Ask about the clinical experiences. 1. How many and what kind of blocks do the students get? 2. Do you get to float swans and central lines? 3. How much pediatric experience do you get? 4. Do you have to compete with residents and do they get priority on cases? Also ask about the program. 1. What is the pass rate on boards? 2. What were the passing scores? Don't ask how the program is ranked by Newsweek. That is a bogus ranking at best.

A number of Oklahoma students have gone to the Newman University Program in Wichita and had their families stay in Oklahoma.

Tenesma, Where do you get your statistic that anesthesiologists are involved in 90% of all anesthetics. In Kansas, mostly rural, CRNAs do 65% of all anesthetics WITHOUT an anesthesiologist, primarily because they do not want to go to the rural areas. I work with and for MDAs and we have a good collegial and trusting relationship. I don't think many of them buy into the radical rhetoric and misinformation of Dr. Lema with the ASA.