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Anesthesia, ICU, OR, Med-Surg
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SRNA4U has 20 years experience as a BSN, DNP, RN, CRNA and specializes in Anesthesia, ICU, OR, Med-Surg.

I have been an RN for 18 years with most of that time spent on active duty in the Air Force. I switched from active duty to the reserves to complete my anesthesia program. I work as a CRNA full-time in a surgicenter in the Bronx, NY area in addition to working per diem in a level 2 trauma hospital. I love the NYC area and there is so much to do. I work with a great group of anesthesia providers. I just finished my Doctor of Nurse Anesthesia Practice (DNAP) degree with Midwestern University.

SRNA4U's Latest Activity

  1. Hello SRNA4U, I'm a new graduate nurse and leaving for BMT  in the Air force next week but my ultimate goal is to get the hpsp for crna school. My recruiter lied to me and didn't open up on a couple of things regarding sign on bonus, citizenship expedition and student loan help. If I knew what I know now 6months ago, I would probably wait till i qualify to be an officer. I applied for citizenship last Oct and will be getting my citizenship soon but since I'm already in the reserve, what your opinion about reservist being able to attend crna school and getting access to hpsp. Thanks

  2. SRNA4U

    Defasciculating dose before Succs?

    We know in anesthesia e4very drug has its side effects and unfortunately, Sux is one of them. I try not to use it unless I have an obese patient with a questionable airway or if I am doing a case where neuromonitoring of motor evoked potentials is being used. We know that guys who are very muscular experience myalgia and should be avoided. I work in the Bronx NY area and at my trauma center job most of the docs routinely like to use Sux but at my per diem ambulatory surgery job, we like to use Roc since most of our cases tend to be ASA 1 and II type patients. Thank God for Suggamadex in our aresenal.
  3. SRNA4U

    How much did NP school prepare you?

    There isn't a direct correlation regarding the GRE exam and a person successfully completing an advanced practice nursing program. I completed CRNA school without the GRE exam and did very well.
  4. SRNA4U

    Do crnas deserve that much salary?

    As a new CRNA, the responsibility of taking care of the patient is on the same level as the anesthesiologist. A regular nurse could not do the same job as a CRNA. What you are observing on the periphery of what a CRNA does, prevents you from seeing what the CRNA is thinking while taking care of the patient. The physiology, pharmacology, pathophysiology, and the anesthesia courses are what separates the RN from an CRNA. You have to know how that patients co-morbidities and medications are affected by your anesthesia medications and gases. Would an RN know how to manage a patient that has Local Anesthetic Systemic Toxicity from the medications injected by the surgeon? Would an RN know what medication is used for this toxicity? Would an RN know how to treat a patient with pheochromocytoma? Would an RN know the differential diagnosis between pheochromocytoma, Malignant Hyperthermia, Serotonin Syndrome, and Neuroleptic Malignant Syndrome. A lot of these syndromes have similar presentations but a CRNA would have the training to differentiate them and the medications used to treat them. So while you may see a CRNA going through the motions, you have no idea of what they're thinking and why they base the decisions of what med to give based on a patients medical history. After having worked as an ICU nurse I thought I knew it all but until I went to anesthesia school and learned how drugs work at the cellular level, I have come to realize that I didn't know as much as I thought I knew. Also, going from the RN role to the CRNA role you are taught to practice as a provider and make decisions on your own, after all, some states allow CRNAs to work independently without an anesthesiologist. As you mentioned about the doc coming to push drugs, where I work, the docs only supervise us 70% of the time so I get to do my own inductions by myself. Every practice is different. So yes, I think I deserve the salary I receive because I have the awesome responsibility of having someones life in my hands and the knowledge and training I have received has prepared me well for my job. Also, RNs can't float swan catheters but I can as a CRNA when doing hearts. Our anesthesiologists do not even gown up. I place the swan catheter myself. So I'm just a little confused on how you can say an RN can do the job of a CRNA. Can an RN manage a patient that has Aortic Stenosis or Mitral Regurgitation. There is so much you just don't know. I have learned so much in 28 months that I know I still have so much to learn. Good luck to you.
  5. SRNA4U

    help, which job do I pick??? CRNA vs. NP/RNFA

    Actually CRNAS can make just as much if not more in the surgicenter or GI clinic. I just finished CRNA school and many of us will be getting second jobs in GI clinic since they are paying over 110 hr in some locations. NPs re not making anywhere what crnas are making.
  6. SRNA4U

    Highest rank Nurse(any branch)

    I did inactive reserves while in anesthesia school. I'm done with school as of next week. Took a job in New York City. Will be taking boards in May. I'll probably stay in NYC for 3 or 4 years and then I'm am hoping to go to either Germany or South Korea as a civilian and work for the military.
  7. SRNA4U

    Drexel CRNA Class of 2014

    Hello, I've been off active duty since Nov 2013. When I was in, CRNAS were getting 50,000 bonuses every year. But now they have too many crnas so I'm not sure if they're still offering it. I just took a job in NYC in the south Bronx where they're are giving me a 10,000 bonus plus a yearly retention bonus. They have a really nice benefits package plus I don't have any call, no weekends, and no OB. The money us in Texas, Michigan , and Boston where crnas are making over 170,000 a year for base pay rate. Not including overtime and call. There are so any options but you have to find the place that suits you. For example, my primary clinical site is a level 1 trauma facility with 32 ORs. The place I'm going to in NYC is only 8 ORs and is a level 2 trauma facility. I'm looking for something of a slower pace.
  8. SRNA4U

    Drexel CRNA Class of 2014

    I live in the suburbs of philadelphia which is way cheaper than living in the city and you get more space and it's much safer. For Christiana, the school selects who will interview and stay there. I'm at chrisitiana and we only rotate out for peds. All of the rest of the rotations are at Christiana. Christiana is the best clinical site Drexel has and you actually interview with the anesthesia group there. Drexel may select 12 people to interview buy they normally select 10 students but it was off this year that they selected 11 students from Drexel and 2 from Jefferson anesthesia program. When you graduate you are offered a job to stay at chrisitiana as long as there are no clinical issues and if you have a good attitude.
  9. SRNA4U

    Drexel CRNA Class of 2014

    When I applied, it was back in Oct 2010 and I got my letter to interview around Dec/Jan time frame for a March interview date. I know the school does interviews in June as well. There were 12 selected for March and 12 for June interviews. They normally accept 20 students. If you get selected for an interview it's more than likely you will get in. I interviewed to start with the 2013 class but was unable to get out the military at that time so I ended up deferring for a year and started in the 2014 class. Being an OR nurse will definitely put you ahead of the class. I was running my own room by the end of my 1st year while the rest of the class started doing their own cases this year of our second year. Post masters definitely make your loaf a lot easier. Im.just doing 1 anesthesia class while.my.classmates still have 2 classes plus clinicals. 1st year is definitely the hardest but the 2nd year us much nicer. During the classes, they will give you study guides for the exams so you'll know what to focus on since there is so I've material. I think the 1st semester we learned over 80 drugs mechanism of action, dosages, and pharmacokinetics such as metabolism and elimination. Good luck to you. Drexel I think is the best school.
  10. SRNA4U

    Is CRNA school as difficult as people said?

    I study only 3 to 4 hours a night but mostly I spend the weekends catching up. Every school is different. Im in an integrated program and I worked per diem through out the program as an OR nurse without any problems. I'm a senior now and it definitely is much nicer now compared to the first year. No care plans this year except for specialty rotations. We start running our own room end of this month. Last fall we started doing breaks and lunch relief. Anesthesia is the best job in the world
  11. SRNA4U

    Any active duty Air Force CRNA's?

    Adjunct faculty meaning you are a clinical preceptor
  12. SRNA4U

    Any active duty Air Force CRNA's?

    As well all know there are biases in the U.S. New and world Report and they are not the gold standard for dictating which crna programs are better. Some.schools don't even participate in the surveys from the US News and World Report. If they looked at how many people make it through anesthesia in the military and board pass rates, I'm quite sure the military programs wouldn't be listed in the top. I think you are more qualified to speak on military anesthesia programs but not comparing which anesthesia education system is better when you didn't attend both of them. We are all trained to provide anesthesia care whether you attend military or civilian anesthesia programs but our patients again tend to be much sicker just as when I worked in the icu in the military, our patients were no where as sicker as patients in the civilian icu. Most of our icu patients in the military were majority step-down patients and the same goes for surgical patients. Are you all doing stroke codes in your anesthesia practice? The consistent acuity levels of our surgical patients are still much sicker than your military population which is why the military leadership allows military crnas to moonlight in the civilian sector as well as when you are preparing to deploy, you are sent to civilian hospitals to train like Baltimore shock trauma for CSTARS. If the military thought your military anesthesia practice was sufficient, then you wouldn't need to come to the civilian hospitals for that training. As far as the types of cases I will be doing after graduation is the same since I do clinicals with an anesthesia group that has an exclusive contract with the hospital and surgical centers for the organization which is one of the groups that offered me a job. Not sure if you have done transplants or not but they are not cookbook recipe anesthesia and involves a lot more than fluid management. Also the anesthesia practice where I train is not dictated by the docs to the crnas. The ACT model from where I train is not bad. We really work in a collaborative way to care for the patient. I think the military program have you geared to think of ACT as a dictatorship but its not like that where i train. We are able to practice and provide anesthesia the way we want to. If i want to hang a Remi drip i dont have to ask the doc if its ok. I just do it. If the surgeon wants MAC and i feel an LMA is better then the pt gets an LMA and the MDA backs us up. We can consult with our MDA if we have questions and we are not told by our MDA how he wants the anesthetic delivered or what meds we can or can not give. But I will say that during my time in the military, there was a crna from Travis AFB who lost her crna license and her RN license for negligence and she was military trained. Pt went into laryngospasm in the PACU and suffered anoxic brain injury. You can Google the case. According to the case report she had multiple instances of misjudgement when caring for her patient.
  13. SRNA4U

    Clinical Anxiety

    Hello, I'm a senior SRNA. It actually does get better by your senior senior year. The junior year does come with challenges but make sure you are confident, prepared, and well versed with your meds. The anesthesia profession love to see confidence portrayed as many will be looking to you for direction when things go wrong and you have to be able to manage and direct people to get things done to care for the patient. We both know there are some people who are not good preceptors and some really don't want to train students and then there are those who act like they came out of the womb born as CRNAs and were never students. In addition to ICU, I also come from an OR background as an OR nurse so I was totally comfortable in the environment. I remember in my class we had one student whose anxiety levels were so high that she actually passed out in the preop area while interviewing her patent. She had to be taken the ER. Of course this raised red flags because the staff felt like how can we leave her in the room with a patent if she's going to keep passing out. The poor girl was also intimidated with the pimping that came from the CRNAs and MDAs. Now she is doing a lot better. The min thing is to get your anxiety under control because patients can also pick up on this and this can make them even more nervous. Make sure to read up on your cases and know the procedure inside out. Portray confidence. Hopefully things will work out for you. I remember when I finished nursing school I always wanted to be an ER nurse. When I went to the ER and I actually hated it. It was just not for me. Hopefully this wont be the case but some people in anesthesia can make it really hard for you when they are trying to weed out people who they think wont be able to cut it. Fortunately for me, I'm with an anesthesia group that has an exclusive contract with the clinical site where I train so I don't rotate out for anything except for peds which is nice because all of the staff know our skills and where we are clinically. The good thing about not rotating out is not having to deal with the new round of pimping by staff who don't know you or where you are clinically. The downside about not rotating is you don't get to see how other sites do things. The first year of anesthesia school is the hardest but now that I am a senior its totally different. No more care plans this year except for specialty rotations and cases I haven't done before. The pimping is no more on medications and basics but now on perfecting your art of anesthesia and timing your wake ups to prevent delays in case turnovers. We're down to 2 classes this semester and in the spring we're down to 1 semester. I'm telling you it does get better but if you really want this, you're going to have to take it but don't let your anxiety get you kicked out of your program. Words of advice from our program director was to never let them see you sweat. Keep it inside and when you get a break, go into a closet and cry or vent or whatever you need to do but never let them see you sweat. One of the MDAs I work with says his big thing is you may not know what you're doing but if you display confidence as if you know what your're doing, it decreases staff anxiety in the room and it goes much further with the docs. I remember when I did my first nasal intubation. I was so nervous on the inside that I was sweating but I never let it show how nervous I was. The MDA said I did an excellent job and that he didn't know that I was nervous after I placed the tube when I told him. You'll do fine but you have to keep the anxiety level hidden because we all know the CRNAs talk about students with each other as well as the MDAs discuss students with other MDAs as far as who's good and who's struggling. I was the only student in my first year to get offered a job with the anesthesia group whereas most job offers are in the senior year. I was told by the MDA that everyone has been talking about how advanced I am with my skills and the confidence I display which let me know they watch everything about you and they all talk. You definitely don't want to get labeled in a negative way.
  14. SRNA4U

    Any active duty Air Force CRNA's?

    [quote=wtbcrna;6683505 2. Yes, you would receive a little more training, but military nurse anesthesia training is overall probably the best nurse anesthesia training there is. Hi WTBcrna I'm just wondering how you came to the conclusion that the military CRNA program is overall the best nurse anesthesia training there is as you did not attend a civilian anesthesia program? My school has a 100% pass rate on boards the last 5 years and our attrition rate is less than 8% whereas we both know the military program has a much higher attrition rate. At my clinical site, we even have block rotations where the SRNAs perform all of the peripheral nerve blocks and we are doing heart cases whereas most military programs don't have heart programs except Travis AFB. At my clinical site, we have CRNAs on the heart team and they are the ones actually floating Swan catheters. The only difference between civilian anesthesia practice and the military practice is the ability to practice autonomously. The training in school is the same while some programs may place more emphasis on some areas while others may not. Also, our patients in the civilian sector are a lot more sicker than what you see in the military population. As you train and work in the military sector, most of your patients are ASA 1 and 2s unless you have a retiree with some co-morbidities. The patients I am taking care of in the civilian sector are ASA 3 and 4s. You all don't get experience with patients who just used crack cocaine or marijuana the morning of surgery. We also do a lot of kidney and liver transplants whereas transplants are not routinely performed at the military hospitals except at Walter Reed where we were still doing kidney transplants. I'm in the inner city training in a Level 1 trauma facility that is also the designated stroke center for the region and I am getting a real good anesthesia experience that the military crnas are not exposed to and I think my anesthesia program is doing a great job in preparing me for practice. So do I think the military program is the best for anesthesia training, I would say no. The only difference is you don't have to consult an MDA for anything but I love the collegial relationship I have with my MDAs and we always bounce ideas off of each other in caring for the patient. I also like the acuity of the patients I am getting and the complex cases I'm seeing everyday. I'm halfway done with my anesthesia program and have 4 job offers including returning back to active duty AF but the civilian experience is much better including pay and benefits.
  15. SRNA4U

    Areas to live in NYC for a CRNA

    Hello, I'm a Student Registered Nurse Anesthetist and I'm almost at the end of my first year in nurse anesthesia school. I have a desire to work in NYC as a CRNA and wanted to know do most advanced practice nurses live in the city or do they commute from surrounding areas such as Brooklyn or NJ? I would like an apartment that has more space so I figured Brooklyn would probably be the better bet for me. Which areas in Brooklyn would you consider safe, have lots of good restaurants, and is in close proximity to the train station? From doing various job searches it seems most of the jobs for CRNAs are at NY Presbyterian and in Brooklyn. I currently live in Philly and only know about Midtown Manhattan and some parts of Upper West Side. If I could live in the city, I would prefer Upper West side near Columbia or Hells Kitchen area in Midtown West Any help would be appreciated.
  16. I'm in an integrated program and having or experience has definitely been to my advantage. I'm already running my own room in my first year which normally we do in our second year. Also the ICU nursing in the military has definitely helped as well.