Be_Moore

Just wanted to add in to this that Google Drive is cheaper on all plans, and offers more free storage up front (at 5gb). So just to let everyone know that there is a very solid competitor to drop box that is cheaper. It's what I use for backing up all of my files (also finishing my first year of CRNA school). But whatever you do, do use a file backup system. You'll probably want that stuff until you pass boards.

I didn't have a math test in my interview, exactly. I was asked questions about gas laws (why they expected me to know this, I have no idea). ABG interpretation and being able to calculate an anion gap from a chem7 is also essential. Other than being asked about the partial pressure of gases at room air and needing to calculate an AG, there wasn't any other "math." Mostly just "numbers" (ABG interp, PA Cath numbers, etc).

It's all about the job experience. A job in a busy/large ICU will be much more impressive on a resume than a job in a small ICU that transfers its sick patients to larger hospitals. CRNA schools love applicants from teaching facilities (university hospitals) and Level I trauma centers. To help get an ICU job as a new-grad, I mirror the above recommendation of getting a job as a nurses aide while a student. This gets your foot in the door. If you do a great job as a tech, the manager will be more apt to hire you as an RN than an outside applicant since you already know the unit. Otherwise, new grad jobs are tough to come by in the ICU.

I don't know anything about a math requirement, but it could be. Here's how the TWU interview works. You will interview with a panel of people. One of them will be a professor from TWU, one will be a clinical coordinator at your interview site, and the rest will likely be CRNA's and possibly an MDA from that facility. At my interview in Denver, there was minimal math. I had to calculate an anion gap from a Chem7, but that was it. That being said, your clinical coordinator could really like questions about math and ask them, but I somehow doubt it will be hardcore stuff. Be able to calculate an anion gap, be able to do dosage calculations on the fly. You should be fine with that...there isn't a lot of calculus in the program. Your best bet would be to find someone who is in the program at your site and can tell you about that specific interview, what was asked, etc, because the questions that come at you will obviously be specific to the person asking, and each site will have different people asking questions.

They don't weigh it that much, I don't believe. I know a person who got an interview (and accepted) with a 900 (old scoring where the minimum requirement was a 1000)...but that person also dropped out in the first semester. It only matters insofar as whether you will get an interview or not. Once you get the interview, it's all about personality and impressing those interviewing you. With your combined score being >300 and having a solid gpa, you are a shoe-in for an interview. Goodluck!

I've heard that it is one of the biggest strains on relationships around. I'm lucky in that I don't have kids, but I can see how it would be really tough with them. I don't get to see my girlfriend much, but luckily she is an MD so therefore is very understanding of what I am and will be going through. If it is your passion, go for it! But don't expect life to be easy, and hopefully your partner will understand before hand what will be involved and will be supportive of you throughout the process.

Well, I'm an SRNA, not a CRNA, but since no one else has responded... Anesthesia doesn't really seem like the adrenaline game, definitely much more of a thinking game. It's been described as 99%/1%. 99% routine and 1% sheer terror when something goes wrong. It's probably realistically more like 99.9% / 0.1%. That being said, there are places you can up the ante, so to speak. Working a community hospital in the middle of nowhere where you are the only anesthesia provider in house (no MDA to belittle you, which to be fair, only happens in hospitals with poor cultures). There you could definitely be exposed to some serious business, getting the page in the middle of the night to help intubate the trauma in the ED and rush him to surgery to stabilize before they fly the patient out to a bigger hospital. Of course, you're also just as likely to get woken up to place an epidural in a pregnant lady or to not get paged at all. Have you ever thought about Acute Care Nurse Practitioner with a focus on ICU? They place lines, intubate, all that nonsense, but still live in the ICU. They admit, round, transfer, discharge, etc. They are sort of like the PA's for Intensivists.

I'm guessing that means book smarts. Knows the answers to questions about receptor activation, etc. I'm 27 as a first year. Most of us are probably in the 26-30 range, though there are more than a few 30+ and 40+, and a handful of 50+. And, of course, the one token 24-year-old.

I have the TNCC and I can say it was a joke. Had about 1 year ICU experience at the time and it's nothing that you don't already know (if you have nursing experience), it's just placed in a format that is kinda new. As far as skills, you just have to do a full assessment and list treatments for any problems found. Nothing new. The CEN, however, will not be a joke. It will probably take a bit of studying. I have my CCRN (equivalent certification, but for ICU) and this level of cert gets specific. Interestingly, the CEN does not have a minimum requirement for experience (but recommends 2 years) or hours worked. It has about a 70% pass rate. Get a good book, and put 1-2 months studying into it. Put more into it if you are a new nurse, less if you are seasoned (5+ years in a Level I or II trauma center and you probably won't even need the book).

Hello friends. I plan to apply to CRNA school next year, and KPSAN is my first choice. I'm curious if there is any advice that I could get from any current students, or graduates, about the application process and things I can do to strengthen my resume. The thing about KPSAN that concerns me most is that they don't use the GRE, so it makes me wonder what criteria they look at. Anyone willing to give advice (and/or post their stats for those who were admitted) would be much appreciated. My stats: Overall GPA: 3.3 ICU Experience: Currently have 19 months Medical ICU at a Level I trauma center. Will have over 3 years experience before program starts (shooting for 2012). Previously 14 months floor nursing experience as a charge prior to ICU. GRE (even though it doesn't matter for KPSAN): Can't remember exactly, 1160-1180 with 5.5/6 written. Certifications: All the standards (BLS/ACLS/PALS), CCRN, TNCC, and planning to get my CMC next year (when my hospital gives me more educational money to spend on it). Volunteer experience: Red Cross volunteer CPR instructor. Anything I can do to help out my curriculum vitae? I'm also on a few committees, one doing research on ICU fall rates and prevention (with any luck we will be published before I get accepted), on the Nurse Council as an MICU rep, and am joining the Magnet committee (our hospital is starting the push to go Magnet). KPSAN is my first choice of school, as I was born in SoCal and would love to work my way back there. Add to that nothing but glowing reviews of the program and it's just where I want to be. Thanks!

Critical Care transport, Flight nursing (helicopter or fixed wing).

The pressures could be different, but usually you would see the opposite pattern. The fem a-line would have a crap pressure while the brachial cuff pressure would be okay. That's when you are thinking something like aortic dissection. I would almost never trust a cuff pressure if the systolic is reading lower than say..70mmhg. They just lose accuracy really quickly. The first diagnostics you have to check are your square-wave form test on your line. Get a good square? Squiggles not over or under damped? If not, trust your a-line. Perhaps she was mottled and cool because she was so constricted by being maxed on norepi and neo that blood couldn't get to her periphery? Such is the danger of high dose pressors is that it creates a large quantity of core-shunting. And if you have a person on that much support, rare is the case that you will ever have a sat with a waveform...and when you have one, it will usually be off by at least 5% (and usually closer to 12%) in my experience.

I second the previous post. They are going to ask critical care related questions, not so much anesthesia related questions. Get a good CCRN book and read that. If you can pass your CCRN before interviews, that would be optimal. Passing your CCRN means you are probably pretty prepared for the questions at the interview. Also, don't be afraid to admit that you don't know the answers to their questions. You will get interviewed by a panel of people who know way more about everything than you do, and they are looking to humble you. They will ask you questions, and then more specific and harder questions, until you crack. It's not that they are trying to embarrass you, it's just they want to find out how much you know and also how you respond under pressure. So do your best, but don't try to BS them as they will see right through it. Just keep your cool, answer the questions you know the answers to, and let them know when they've stumped you. And good luck.

Nurse Informatics. Designing and implementing computerized systems. critical care nursing perspective is invaluable in that area.

1) Either satisfy them all or find the most common themes between them and pick the route in which you will satisfy most of them. Most nursing schools run very similar pre-req patterns anyway. 2)Did 2 years of pre-med Chem first, so 6 hours physics, 8 hours general chem, 10 hours o-chem, calculus, zoology I and II, micro, a&p 1 and 2, english comp, psychology, sociology. Then decided to change to nursing, so I did my english lit, anthropology, music appreciation. I'm sure there are more classes that I'm forgetting, but you get the picture. Then nursing school. 3)Refer to question 1. Pick the classes that will satisfy the requirements for most schools as to most efficiently increase your chances of getting accepted. 4) Now. And by that I mean it depends on some factors. For example, my nursing school had no waiting list so I applied the semester before I would start (I applied during summer for that fall). I got accepted conditionally, assuming that I would complete my summer classes (which were pre-reqs).

Allowed to? You won't really have a lot of time to. Had former two roomies who were med kids and they spent most of their time either studying or complaining about how they should be studying. But yeah, in 7 years of school you can become a CRNA, in 8 years of school you become an MD/DO. The difference is that the MD/DO then has 3-5 years MINIMUM before they can even practice and make any money (those 3-5 they are salaried at around 50k a year...they don't make enough money to make the base payments on their student loans so most defer loan payments based on "financial hardship"). After that they will make 170-400k but they'll also have hundreds of thousands in debt. Really, it's all what you want to do. Of course an MD will be more profitable in the long run....but I don't want to be a doctor. I want to be a CRNA. In a time where healthcare costs are skyrocketing, CRNA's are cheaper than anesthesiologists. For me it makes sense to become a CRNA as they will become the more popular option, just as in the future FNP's will become nearly as popular (if not more) than GPs.

I work in an ICU and we check everyone who comes through the doors for MRSA with a nasal swab. In terms of checking healthcare workers....your hospital doesn't want to do that because honestly...they don't want to know.

Believe it or not, anything an RT can do an RN can do (and theoretically should be competent doing). Unfortunately since RT has become so prevalent our nursing schools have started to fail us in this training. But yeah, you don't NEED an RT anywhere, technically. But they are damned nice to have. I work in an ICU and some of the stuff they do in terms of calculations on the ventilator are so far above my head that it would make a very stressful couple months while I learned their job in addition to my own. I just learned about calculating RSBI's and it makes me feel like an enlightened nurse, but simultaneously highly ignorant that I didn't know it before...

Honestly, with preceptorship looming, it may be too late for you. Right now your goal should be finish school, pass NCLEX ASAP. Start applying to jobs as soon as you graduate and let them know your testing date for NCLEX. But it can not be denied, a tech position helps immensely in getting a job...especially in getting the job you want.

1) Think of the valves like doors. If you are opening a door, you have to push the door harder than the air pressure on the other side of the door (as well as harder than the resistance created by the door frame) to open it. If you don't push harder than those resistances, the door won't open. You have to overcome ventricular backpressure to allow the valves to open. This is the type of thing you won't see a whole lot of problems with...what you will see problems is when the valve itself has stenosis, which makes the valve really hard to push open (think of stenosis like the door example above, but instead of just opening the door, now the door is stuck and you have to push a lot harder to get the door to open). The other problem you will see with valves is when they let blood come backwards through them, called regurgitation (like a door that doesn't seal properly, allowing a draft to come through). 2) As with most things, nothing happens in a vacuum. When you build plaque in your arteries, you will build it in all of your arteries. Plaque is kind of like dropping sand into the ocean. The current of the ocean will push it around and around and it will eventually more or less settle, but not all in one place. We tend to notice occluded arteries in the heart more often because a heart attack is more serious than a little occlusion. The other reason that it seems to happen in the coronary arteries moreso than other arteries is because 1) Coronary arteries are under a lot less pressure than other arteries (coronary arteries perfuse the heart during diastole, when the heart is at rest, as opposed to every other artery which perfuses during systole) and 2) Coronary arteries are smaller, like the size of a small drinking straw vs. the size of your finger (like the femoral).

The more than 3L is not exactly true..I've taken care of COPD patients who are on continuous home O2 @ 4L who come in with a perfect gas. The amount of O2 they are on will vary per patient on how much CO2 they retain. On the other hand, yeah she needed BiPAP if you were having trouble maintaining sats and your respiratory therapist should have realized that. You can't keep COPD patients on NRB masks. If they need NRB for more than a couple hours to catch up, they need BiPAP.

The only real like "tip" type thing that I have to remember EKG changes is that you can look at the T-Wave as a tent for potassium. If you have a low K, you will have flattened out T-waves. If you have a high K, you will have tall-peaked T-waves. Other than that I just took a class or two on EKG interpretation and now just have the different rhythms memorized. I recommend you take a class.

The first response nailed it--bleeding at tumor sights is very common. Think of the cliche of the man who discovered he had lung cancer after coughing up blood. The same is true of the brain. A patient with a brain tumor will eventually bleed intracranially and the coumadin would basically ensure that it would be a fatal bleed.

I think the fact that this case is even going to court is proof that the DA has nothing better to do. He doesn't have a solid case. There is too much reasonable doubt (which is all you need to prevent a conviction) to protect this woman...a patient in renal failure has toxic levels of morphine? Morphine has 1 active metabolite that is excreted by the kidneys and has been shown to store in the body in toxic levels in persons with renal failure. The DA doesn't have a case, all they are doing is ruining one woman's career.

ICU you will definitely clean a lot of poop. Can't speak of ORs or ERs, but I am sure they are not entirely exempt either. Best advice? Work outpatient, like a clinic. Cardiac stress clinic, pain management clinic, etc. Or just get over it. Cleaning poop is a lot easier than actually having to critically think about stuff. You will do it with your children (should you have any) and they won't pay you $50k base salary + benefits to do it.