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Subee, This is not an accurate assessment. The National University, Nurse Anesthesia program students work directly with program faculty, the Assistant Program Director and the Program Director in the operating room. The program is focused on independent, full scope of practice, and accomplishes this mission and vision very well. Graduates and program faculty and community CRNAs can attest to the quality and outcomes of the program.

The National University, Nurse Anesthesia Program is accepting application until July 31. The National University program is based out of Fresno, CA and is focused on training the independent practice nurse anesthetist. Cohort sizes are only 12-15 to allow for near one:one student faculty ratios. Master of Science in Nurse Anesthesia | National University

I am posting this to get feedback on Pharmacology text. I am a practicing CRNA who has been asked to develop and teach the pharmacology course for BSN students at a local college. I would really like to hear from other faculty member who teach or have taught this subject matter, and your recommended text to use for the course. I want this course to be challenging and to have strong pathophysiology integration. Thank You, Bryan

Anyone use spinals for abdominal liposuction? Surgeon likes to prone the patients too to do the flanks. I know some anesthesia providers do this I just have not and would like to hear your thoughts

I cant imagine any anesthesia provider not giving opioids during a case especially when it is a case known to have high postoperative pain.. I cant think of a case were I have not given opioids outside of strictly a regional technique.

The terminology of "Midlevel Practitioner" needs to go away... What a degrading term. As a CRNA I KNOW I am not a "Mid Level Practitioner". I think this terminology comes from insurance companies..

I attended CRNA school in AZ and can tell you that there are jobs. As the program produces more CRNA's in the state the market continues to grow and new opportunities are developing. All new grads from my program had jobs at least 4 months prior to graduation. There are jobs available and most of them are only medically supervised "on paper". Though I did not stay in AZ to practice many of my close friends did and they are happy with their practice envirnments and they are doing all types of cases and lots of regional. The Mayo Clinic in Phoenix may be the least desirable simply due to strong "Medical Direction". Hope this helps

87,000 and my wife worked the whole time to help out with bills. I attended Midwestern Univ. ( a private Univ. ) not known for its cheap tuition.

I am a pasted graduate of Midwestern, and yes the clinicals are all over the southwest. You are infact responsable for your housing and travel which adds a significant expense to the program. It is a very tough and demanding program with extensive travel. It is fully front loaded and the campus is a health science only campus. There are only CRNA's, DO's, OT's, PharmD's, PA's, and perfusionist that attend the school. This provides for a great way to build interdisciplinary relationships early.

Just wanted to get some feedback from other CRNAs on how they would handle this situation: Pt presents from ER for Lap Chole. Pt has flank and abdomenal pain. Past medical hx of GERD and HTN or which he had not taken his labatolol in 2 days. Preop he was hypertensive in the 170's/110 area. Treated in pre-op area with Fentanyl 50mcg for pain and Labatolol IV 20mg in 5 mg increments over 20min prior to OR. On induction RSI with Cricoid technique. 7.5 ett placed and Desflurane used. Induction was without incidence. BP post induction 130's/70's. Within 5min post induction noticable st changes in lead II and V (inversion in II and elevation in V). The anesthetic was deepended and 10mg of Morphine given without any improvement. BP dropped to 60-70/40-50 and 100mcg of neo was given with moderate improvement. Surgeon was notifiied of ST segment changes and saw the ECG tracing on the monitor. He consulted with his attending on the phone and decided to cancel the case since this was not emergant. A nitro infusion was started and over a period of 5min the ST segments began to return to baseline. An intraop EKG was done that showed no sign of ischemia. The patient was emerged from anesthesia and transported to PACU were he remained stable. Cardiac enzymes were sent and were negative. Of note I did not cancel the case but rather the surgeon, however I feel as if my clinical judgement is brought into question by fellow staff especially since I am a new nurse anesthetist. What would you have done?

Just graduated from Midwestern. The clinicals are 12 weeks and about half of them are out of the phoenix area. By the end you can walk into any OR and give anesthesia anywere.

Just wanted to hear from other SRNA's as to how your heart rotation went. I am at a private heart hospital that does about 3 hearts a day and lots of vascular. It is all MDA staff. Only 1 week into the rotation, but we are treated as task masters (intubate, make this gtt, make that gtt). Basically not managing the patient. It is only a 4 week rotation and I really just want to get through it.

I got an offer for $88/hour as a GRNA then $98/hr after cert. THe position is a 1099 with zero benefits paid (no vacation/ med/dental/retirement/ect). 40 hours per week and no scheduled call. I would like to hear from other recent grads and experienced CRNA's on their thoughts of such a position.

The CRNA's at the AZ Mayo are TIGHTLY supervised. The MDAs want you to call before giving Ephedrine. THe MD pushes your drugs and talks to the patient as they go off to sleep.

I was wondering how valuable the Valley Anesthesia review course was to any of the recent grads out there. Do you think it definately prepared you for the quiz.

Just wondering if anyone has any good tips for IJ line placement. I find myself successful a little over half the time using the standard anatomical landmarks.

End result of the case was: propofol bolus and a little nitrous for sedation. I waited about 20min untill I had a sustained tetany then extubated. The MDA was pushing for me to extubate and not wait the 20 min, however the CRNA I was with supported my decision to wait. Good learning experiece..

Just wondering what the other SRNAs or CRNAs would do in this situations: 64 y/o male ASA III for a hip debridement. Did the case as a TIVA..RSI with cricoid pressure. (Propofol and Succs) 9mg Vec given after twiches returned. Propofol infusion at 100mcg/kg/min, Fentanyl total of 250 mcg tititrated in,Vecuronium redosed 1.5 hours into case. Morphine 10mg titrated in last 30 min of case. The end of the case finally came. Upon checking TOF the twich response was 2/4 (1st twich stronger than 2nd with no 3rd or 4th). Reversal give of 3mg Neostig + 0.6mg Glycopyrolate. Pt returns to spont. breathing with TV of 3-400, lifting head off table and reaching for tube. TOF 4/4 with Fade on tetany. An additional 1mg Neostig + 0.2 Glyco. given. TOF remains 4/4 however fade remains present. I ask him to squeeze my fingers and he responded by with a weak squeeze. What would you do next?????????? Extubate or resedate the patient and wait untill patient was stronger?

I knew I was about due to have a pt have a laryngeal spasm, but I had 2 this week. Just wondering if anyone has any tricks they use to avoid them other than suction oral pharynx, no stage 2 extubation. Both cases were middle age adults. One male one female. Both had eyes open, spont. breathing, decent tidal vol, suctioned. Upon extubation the first had the tale-tale noise, the second did not spasm untill about 1 min. post extubation. PPV applied with significant force. Expiratory stridor. I was reaching for the succs as it broke. Thanks

I will miss NOTHING of bedside nursing. I would be a used car salesman before I return to the bedside. Providing anesthesia care is the most rewarding patient care I have ever had. I dont understand why people think "you dont have patient contact". No I dont have patient contact, I have full contact! One ear to a precordial, the other ear on the pulse-ox, one eye on the patient and the feild, the other on the monitor and gas machine. It is my conversation pre-op and before induction that assures they can trust me with their life. This is much more intensive than any ICU.

I have only been giving about 4cc, 2 upfront and 2 during. Toradol at the end. The CRNA I work with is also perplexed. I swithched to 2cc upfront and then 5mg of Morphine during and have not had the same problem.

Just wondering how much narcotic, specifically fent. you give for a typical Lap Chole. I have experienced 3 cases this week were I had to give a very small dose of naloxone to get the patient back breathing. (ET Sevo 0.1, fully reversed, ETCO2 45- 50 and still not breathing.) I typically have the agent off at the time the trocars are removed from the abdomen.

Contrary to what is being said on the board about the job availability there are plenty of jobs. I am a student at Midwestern (the school that opened a program last year). The ideal jobs are at Maricopa County, VA, and Phoenix Indian Medical. These locations offer full scope of practice. I am from CA and can say that yes, AZ is an MDA dominated state, however things are changing. Look at Gaswork.com and you can see for yourself the oppertunities.

I cant understand why you refer to NP's as "midlevel". I have never been a mid-level nor provide patient care at a "midlevel" standard. This term is rather negative to our profession. The role of the NP is dynamic. The bottom line however is money and patient satisfaction. Yes we do, by virtue of training treat the whole person and our approach is often a little different than a physician. When it comes right down to it though when you are working a busy urgent care or ER and there are 50 other patients waiting to see you there is simply not enough time to discuss "How this cough effects your whole body and environment". That is the reality!

It is EXCELLENT! Tells you nearly everything from position to monitoring to postop pain management.