whip65

I am not a CRNA and you are right I don't have an EXACT idea about CRNA practice. There is a lot of animosity on this forum and many others related to CRNA vs. MDA. I understand that this is a heated political argument- just trying to point out the fact that there are other things to consider (needs of the patient- its not all a ******* match and this is why I want to become a CRNA and not an MD) and that there are some legal differences in practice for CRNAs and MDAs. I am not trying to minimize the importance or competence of either. I believe, with my limited knowledge that CRNAs are more than competent to carry out their duties without supervision of an MDA and I misspoke when I said that all CRNAs need to be supervised by an MDA. Thank you for clarifying the facts:)

CRNA schools are very competitive. Just do well in your ADN/BSN and rock your GRE and science courses. Get good ICU experience.

I love night shifts- and I love to be prowling allnurses on night shifts even more! Just a thought but does ACLS say with a symptomatic (SBP 50-60) narrow complex tachycardia call for a possible cardioversion? Apparently other interventions worked- but if this was a new onset of a-fib... although I realize hypovolemia might have been the original problelm. I don't know. What a great site that everyone can bounce ideas off of each other!

As an ICU RN, IFR rated pilot, and an aspiring CRNA I feel that I can comment on this post. I have great respect for the MDAs and Pulmonologists that work in my ICU. The schooling and dedication that these MDs endure is truly amazing. The fact is, however, that MDs are still required to oversee most of a CRNAs practice which justifies the difference in compensation. As an ICU RN, I get great satisfaction from working WITH MDs to provide the best outcome for my patients which is what we should all be focused on- not a getting into a ******* match with each others' chosen professions. Both MDAs and CRNAs serve a vital role in today's healthcare and neither should be discounted. As far as Pilot go and holding a life in one's hands- this is a completely different field. The job marked for pilots (especially the airline pilots flying the heavy metal) is super-saturated and like a previous poster said is a child of supply and demand. If you do get to the point without quitting after being furloghed numerous times, you can become an airline pilot making in some cases well into the six-figures (although not nearly as much as an MDA and with much more debt from training and with WAY more insecurity in your job). This really boils down to how much you want to be in your chosen profession. I would also challenge and MDA to spend an entire 12 hour shift with a terminally ill patient on pressors and on a HFO and their family consoling them and helping them through the difficult such a difficult time. We all bring different things to the table and the important thing to remember is that we do this for the patient- not the paycheck or the title.

Hello allnurses, I am planning on applying to CRNA school this year and am trying to get all of my ducks in a row. I entered the ICU as a new grad and LOVE it! If and when I turn in my app this year I will have two years of ICU experience in a Med/Surg ICU at a Level I trauma/transplant center (three years upon entry). My unit is the only ICU in our hospital (out of two hospitals on the campus) and has some of the most acutely ill patients in the facility and covers the Code and RRT calls for our hospital (out of 8 adult specialty ICUs). I have been involved in unit council/practice committee, RN competency facilitator, I have been a preceptor for students, and have prior military experience. I have also taken a graduate level physiology course in the past year. My BSN GPA is 3.65 and my science GPA is similar. I am taking my GRE in a week and plan to get my CCRN this summer as well as meet with the program director of the CRNA program and shadow multiple CRNAs and hopefully one of the MDAs that staff our unit for a recommendation. The organization where I work has a CRNA program and requires a reference from my current NM. I have a good working relationship with my NM but have heard from co-workers that she does not write stellar recommendations citing things like "so and so could use a little more experience" etc., even with RNs with more experience than me. My question is: If I am less than hopeful for a great recommendation from my NM, (and I know how important recommendations are to get granted an interview), what are my options? I plan on bringing this up when I talk to the program director, but being such an integral part in getting an interview- how can I bolster this aspect of the process? I was thinking of getting a recommendation from a charge nurse (who would actually know first person my skills as and RN in addition to the NM recommendation). Any other thoughts? I was also thinking of bringing this up when I ask my NM for a letter and giving her reasons why I think that I am ready for this next step in my career. This is very important to me and obviously makes me very nervous to apply. ANY advice would be greatly appreciated. Thank you!

As a veteran- YES! This is the military. Do these applicants not realize this? Maybe they are so focused on becoming a CRNA that their judgement is impaired. If this is the case, maybe they are not fit to be a CRNA or soldier, let alone an officer in the United States Army.

Assuming that the post about the lack of privacy is unbiased... In regards to the post about the pt in pain not being 'qualified' for study- people go to Mayo to get miracles, and when reality hits people can understandably get frustrated. Ever heard of Kubler-Ross??? denial-ANGER-bargaining-depression-acceptance... I think the pt might fall into the anger category in the latter case. Just an outside observation. Its difficult to hear as well as respond to these isolated negative posts.

I would respectfully disagree that MICU experience is not equal to SICU/CVICU experience. Of course it depends on which MICU you work but i frequently float to our MICU and there are numerous very "sick" patients with multiple vasoactive gtts and complex respiratory issues. They also get ER admits and fly-ins which can be very similar to landing a post-op patient on a SICU, just without incisions/drains. Also you can get anything from a pt that had a seizure and developed apical ballooning syndrome to someone in fulminant liver failure. These are VERY sick and intense patients. Medical intensive care can be even more intriguing because of all of the underlying medical issues patients have and can require a lot more critical thinking than a standard CABG post-op on a fast track to extubation and epi wean not that CABGs can't be very complex!

Most Summer III's are not from MN, they come from all over the country.

I work with about 50/50 nurses that have had previously general care experience and those that went straight into critical care. The great majority of nurses who worked on the floor wish they would have started in critical care. I myself was a new grad to the ICU. When I have talked to my fellow classmates- there were some who were dead set on working ICU and some that were dead set on psych, OB, or general care. I think it is more of a way of thinking than it is a progression from general care to ICU. Nurses have different interests just as primary care MDs and Pulmonary/critical care MDs have different preferences in career goals. I even know a colleague who was a new grad to the ICU who wants to go back to school and teach. Is this RN disadvantaged because he/she didn't work in general care?? I highly doubt it! I guess we'll see! P.S. How many of your nursing professors even practiced nursing? I know a great deal of mine went straight to a PHD program right out of their BSN. Its amazing that 'nurses' who have never even practiced in the 'real world' are training the new crop of nursing professionals. That statement is probably for a different posting...

Hmmm?? Liver failure + sepsis?? Sorry I don't have my cheat sheet handy but usually if trying to fluid resuscitate to a CVP of 12 the pt is septic and then you start titrating your norepi. Plus ascites already present could be a sign of liver disease. We have a sepsis 'protocol' where you are supposed to keep the CVP > than whatever (12) and then blood/urine/sputum cultures etc. and then start your antibiotics ASAP. Maybe you will have to progress to CRRT if the kidneys took a hit from hypotension and if the liver was already cirrhotic or the pt has MODS with liver and lung involvment you will progress to administering multiple blood products, more fluid, and starting low volume lung protective ventilation strategies. I'm relatively new but work with a lot of Heme/liver tx patients and this is my limited input. Systolics > 100 sound fantastic though:) After reading the other posts, fluid resuscitation usually depends on the CVP and once you are at goal- whatever research says- pressors are added (mrbubbles explains this well). Also, as a nurse I notice that residents constantly ask me if the CVP is "accurate"...... make sure that you have your transducers leveled and zeroed so that everyone can make informed decision. Another thing that I constantly hear at my 'teaching' hospital is the benefit of colloid vs. crystalloid in pts with septic shock d/t the capillary leak etc. Especially in these hard economic times where we are talking about reforming healthcare we need to advocate for therapies that are proven and cost effective. Remember residents are learning just as we as RNs are constantly keeping up with current research!

Hi! I started at Mayo last year as a new grad. Mayo has a great orientation program and the staff are very supportive. There is a general orientation for all new staff and then a department of nursing orientation where you learn the charting system, Mayo policies, etc. Then is also a more in depth orientation/internship for critical care and progressive care nurses. Once you get to your floor you are paired with a preceptor for several weeks and you gradually become independent! Its great to work for an organization with so many resources and you really feel like part of a team. Because Mayo has such a huge presence in Rochester, they try to make you feel a part of the community as well. Its a relatively small city so that is something to get used to but the Twin Cities are only a little over an hour away and there is virtually NO traffic while still having all the conveniences of a big city in town. Most nurses I've met are from MN, WI, IA, SD, ND but there are tons of people that come from all over the country. On my unit we have people from all of these places plus NV, WA, MT, NY, and even Poland! Overall the organization is a fantastic one to work for if you can stand living in a smaller city and the opportunities for advancement are endless. Also you get to work with patients with rare diagnoses and some of the best health care professionals on the planet! Hope this helps, good luck with your job search!

N.D._RN, Hi! I have just started looking into AF Reserve or Air Guard flight nursing. I am just getting out of an enlistment in the Army Guard and have just gotten my BSN and passed boards. I am from the Minneapolis/St. Paul area and am curious about which unit you are looking at 934th Reserves or 109th Air Guard and about how much flying would be involved. It would be great to hear more details if you have any!!! Thanks!