Shanimal

I'm not surprised you've resorted to personal attacks. I'll keep an eye out for your own thread about sexual harassment of male nurses. Have a nice day.

Yeah, and good for her. You say this as if it's a bad thing. Except that's NOT what this post was about, so stop trying to minimize what happened to the OP like it's not a big deal just because stuff like this happens to men too. Of course it happens to men too and that's never OK. But this post was about her own personal experience. If you feel victimized as a male nurse, then by all means start your own thread. Certainly sexual harassment of male nurses is worthy of a discussion all on its own. I assure you that I will be there to support it, but not when you come on here trying to invalidate someone else's experience.

Need a few more details on this one. You mention your "first degree"--was this in nursing or something else? How long ago was it? How does your GPA since your first degree measure up? What is your science GPA and what sciences have you taken? Have you reached out to the anesthesia programs you're interested in and asked for advice specific to your situation? If so, what were you told? (And if you haven't, at some point you should.) Having a low GPA from a first degree isn't an automatic disqualifier necessarily (I speak from experience), but there are a lot of factors--as indicated above--into how much that matters and the strategies needed to compensate for it.

DNAP vs. DNP in anesthesia degrees creates a lot of confusion. Both are terminal degrees for CRNAs, and soon having one or the other will be the entry-to-practice requirement. The actual difference between the two degrees is that the DNAP is typically awarded through a School of Medicine, School of Allied Health, or some such while the DNP is awarded through a School of Nursing. A side-by-side comparison of the DNAP vs. DNP in anesthesia curriculum though is quite comparable.

Incorrect. Both the DNP and DNAP are considered terminal degrees. Having one vs. the other as a CRNA does not affect one's prospects for teaching in a nurse anesthesia program. Both would be doctorally-prepared CRNAs. Also incorrect. There are post-graduate degree programs and post-graduate certificate programs to enter into other advanced practice nursing specialties. The length of these programs vary, but having a DNAP vs. DNP degree has no effect on this that I'm aware of, nor should it. That would be silly. The length of a post-graduate program is independent of whether one enters it having a DNP in anesthesia vs. a DNAP. Same as answer #1. See answers #2 and #3.

I'm going through school now as a mom to toddlers. The amount of free time you have at any given point depends on how the program is structured. In my first two semesters I was able to continue working and still had a reasonable amount of time to spend with family. Now that I'm in my third semester, working is out of the question. Aside from class time, I'm easily averaging 45-55 hours every week in just studying. Every weekday I leave my house while the rest of my family is still sleeping, and by the time I get home it's already time to put the kids to bed. On weekends I spend most of my time at the library studying to be away from distractions. I haven't even started clinicals yet (I'm in a front-loaded program, so our clinicals don't start until next semester). We start with two clinical days a week, which gradually increases to five days a week before we graduate. Some programs require that students rotate through distant clinical sites, often for weeks or more at a time. So it depends on how much "free time" to spend with your family you consider to be sufficient, because added up these things don't leave much left over. When it comes to family time, what I lack in quantity I try to make up for in quality. But none of this is easy, especially the times when the kids cry when they see me leave for the day or whenever I miss one of their milestones. I went into this willing to make those sacrifices if that's what it took, but I could never fault those who decide that having to make those sacrifices isn't the right choice for them or their family. Good luck in whatever you decide.

I have nothing helpful to offer other than to say, "Good luck with med school."

I once worked in a facility like this. When I attempted, along with my nursing and physician colleagues, to provide evidence to administration why severe nursing staff shortages were unsafe in emergency and critical care settings, our concerns were brushed off (though not without a smile and thanks for our input LOL). It's a cynical thing to say, but there's some truth to it--money talks. The hospital execs didn't start to listen until they were forced to pay out tons of money for travel nurses and "consultants" to come in and make the same recommendations we did from the get go (figure that!). So you can certainly try the same route we did--do a lit review with recommendations for staffing, and have the backing of other nurses and physicians. But there's no guarantee they'll listen. I suspect more than likely the problem will continue to get worse before it ever gets better, so you have to decide if it's worth sticking around to find out. Good luck!

The climate of medicine is certainly NOT more liberal. As noted above, intolerance is a completely different issue. The more recent cases that I believe you're referring to (i.e., a medical professional is prosecuted for refusing to provide care in abortion cases) have more to do with a provider refusing to provide care for emergent cases (and NOT elective ones) when there is an obligation to provide care and no other providers are available to do so. I see no reason why you would be "forced" to provide anesthetic care for elective abortions and sterilizations during school--you will not be the only provider present. Also understand that the vast majority of elective abortions are performed with local anesthesia or with moderate sedation, which typically do not require an anesthesia provider. But if it's something that concerns you, then why not ask about it during your school interview? Good luck.

Agreed. Or they work in toxic environments they either can't or won't leave.

In the ERs I worked in, yes this was a policy. When there were emergencies in which every second counted however, not everyone who needed to be at the bedside could be properly masked up in time. This was acceptable as long as it was documented in the chart along with the reason for the protocol deviation. The person placing the line was expected to be gowned, but no one else. Strangely the ICUs in these facilities mandated caps too, but not the ERs. Eyewear was also required in OR settings, but not anywhere else that I've worked.

To sit for the CCRN exam, you need to have spent 1750 hours providing direct care of acutely ill/critically ill patients within the past two years, and at least 875 of those hours accrued need to be within the most recent year. What that means is that if you've worked 1750 hours over the past year, then you've met that requirement. Most full-time ICU RNs should be at or near those hours within one calendar year (36 hours x 52 weeks = 1872 hours). As far as studying strategies go, first take a look at the CCRN exam blueprint and notice which topic areas have the highest percentage of questions. I personally then used Barron's CCRN Exam guide, focusing on the topics that are heavily tested as well as the topics I didn't feel as comfortable in. From there I used the computer question bank from Dennison's Pass CCRN, taking tests over and over, reading rationales to questions I missed, then re-focusing on areas I didn't perform as well in. There are a ton of in-person and online CCRN prep courses if you choose to go that route, but that choice should be based on your own individual learning style and preferences--they're certainly not a requirement to be successful.

Just my opinion, but I don't think the co-presence of an anesthesia residency and a nurse anesthesia program at the same institution is necessarily a bad thing, as long as the nurse anesthesia students don't have to compete against residents for the clinical experience they need. I consider myself fortunate to be in a program that, while part of a university that also has a residency program, ensures we have more than enough cases to get the wide range of skills and experiences we need, whether it's in the university medical center, in the surrounding areas, or in areas much further away if we choose to.

You might also want to consider researching the graduate degree programs you would potentially apply to later on. Most program websites will include fairly detailed information on what is required for admission, including any undergraduate degree accreditation requirements. If it's not explicitly stated there, a quick email to the program's admission department should clear up any uncertainty. Good luck in your search.

^Haha sorry for the multiple edits in my above post. Not sure if it was something with this site, my connection, or whatever else, but my comment kept posting before I had a chance to look it over and make sure it was saying what I was intending it to say LOL

Ah, OK, thanks for the link. From your initial post I thought you were implying that Johns Hopkins currently has an entry-to-practice nurse anesthesia program. Now that I see the job posting, my impression is that JH may be hiring for a program director to assist with the initial accreditation process and development of an entry-to-practice nurse anesthesia program, because at this time JH is not COA-accredited, nor does it appear to have a pending application for COA accreditation. Even in the case that JH eventually does develop its own program, I'm not sure that it's necessarily a bad thing to be in the same city as UMD's program since Baltimore is a fairly large city and there are so many potential clinical sites in the surrounding areas. Personally I wouldn't take issue with JH having its own program as long as it does the following: 1) produces nurse anesthetists with a wide range of clinical experiences in different practice environments, 2) ensures that nurse anesthesia students do not have to compete with residents to get the clinical experience they need, and 3) the nurse anesthetists they produce graduate with the ability to safely and confidently practice without a physician anesthesiologist's supervision, regardless of what practice environment they choose to work in after graduation and boards.

I think you've been misinformed or simply misunderstood something you've heard. Johns Hopkins does indeed have DNP programs, but not an entry-to-practice nurse anesthesia program. Their hospital is a clinical site for nurse anesthesia students for multiple schools though. Perhaps their hiring notice for a CRNA director is referring to a position that involves overseeing the clinical training of those students at their site, which is different from a CRNA program director. Do you have a link you could share?

Whether that matters or not depends on two things. First, some ADN to MSN programs award a BSN along the way, others do not. Second, some DNP programs require a BSN, although most recognize MSNs for entry. In other words, the scenario the other nurse warned you about is possible, but can only happen if your ADN to MSN program does not award a BSN along the way AND whatever DNP program you apply to later REQUIRES a BSN (without MSN substitution). Back when I was looking into ADN-BSN programs, I was considering an ADN bridge program that awarded an MSN but not a BSN. Ultimately I didn't choose that program because I knew I was later going to apply to doctoral program in nurse anesthesia, and most (though not all) of them specifically require a BSN for entry. Mine was one of the more rare circumstances where it mattered. I think the prudent thing to do is to check to see if your ADN to MSN program awards a BSN, and if doesn't, to check whether the DNP programs you're considering later on accept MSNs instead before you start worrying too much about it.

Yikes. I just looked at the course description. There's no WAY I'd pay that kind of money for what it offers. Especially because it doesn't count towards any degree requirement. It's advertised as something to help prepare potential applicants for entry into a nurse anesthesia program or to help someone determine whether a career in nurse anesthesia would be a good fit. These are my opinions of course, but I'm sure many others will agree. The absolute BEST prep I had for anesthesia school was having solid work experience in a high-acuity ICU (and in my case, an ER too). The other stuff the course says it offers--a review of intro level chemistry, physics, pharmacology, physiology, and math--can be easily gleaned from FREE resources. Heck, for that kind of money just take a couple of graduate-level science courses that will offer you more prep than intro level stuff. If a potential applicant is just trying to figure out if a career in nurse anesthesia would be a good fit or not, then SHADOW, and do so in different practice settings. Show up at state AANA meetings and network--these events are often free. When I see a course like this that costs as much as it does, I can't help but suspect the worst of intentions--intentions that do NOT favor students.

I've never heard of any blanket protocol that recommends holding tube feedings during dialysis in ICU settings (and I'm here in the US), nor can I identify generalized recommendations for such in the literature. An exception for this would be if the patient has a femoral dialysis catheter access that requires patient positioning to be more supine, but the rationale for this is related to aspiration and not postprandial hypotension. Postprandial hypotension is a more patient-specific concern, and I see no reason for universal application to all patients. If we did this for every potential thing that could go wrong in patient care, we wouldn't be performing any healthcare interventions at all. This underscores the importance of bedside nurses that are competent and vigilant with strong assessment skills. You mention routine feeding of patients during dialysis is common Europe and Asia, but not in Canada and the US. Where are you finding this information?

Hard to know based on this information alone, but things that I would immediately suspect: the patient fluid removal rate has been on the low side for an extended period of time and/or the patient is hypercoagulable for whatever reason. Having a filter clot that often warrants a discussion with the nephrologist. Where I worked the CRRT orders were often adjusted to increase goal patient fluid removal (if tolerated and appropriate for the patient's need) and/or added anticoagulation, which was usually regionalized to the circuit using titrated sodium citrate paired with calcium gluconate replacement through the patient's IV access. Hope that helps some.

Dude, I actually said nothing of the sort. Like Jules extrapolated the findings of the research he/she posted links to, you're extrapolating waaaaaaay beyond anything I posted. On the contrary, I enjoy having very collaborative relationships with the physicians I work with in which there is a mutual understanding that our different educational, training, and professional experiences each provide value to patient care. In the world of anesthesia (since this is the CRNA forum after all, and I have no interest in discussing other APRN roles), there are certainly differences in how we become anesthesia providers, but both physician anesthesiologists and CRNAs provide anesthesia the exact same way with no difference in outcomes based on provider type. Period. You seem to want to keep discussing NPs, so I suggest you troll their forum instead. You sound like a med student trying to protect your future turf. As for me, I think this thread has been hijacked quite enough, so I'm out. Peace.

I'm sorry, but I didn't bother going past the first link. An abstract about patient referrals is supposed to be high-quality evidence that supports physician-led care has better outcomes than APRN-led care? It's not even measuring the same thing. You've extrapolated that study far beyond what it was intended to measure, and I suspect you've done the same for the other studies you posted links to as well. You seem to be disparaging your own education quite a bit in this thread, and I think I'm starting to see why.

OK, but neither of you answered my question. Can you provide links to the high-quality research you're referring to that disputes anything I said? I'm seriously not trying to be facetious. I'd like to educate myself.

Interesting opinion. Would you be able to link to some research that supports this? I ask this because the only well-validated research I've found consistently indicates that the quality of patient outcomes is independent of provider type. I think we all know that there are terrible providers out there, but there doesn't seem to be any correlation in what letters come after their name. Not trying to bash physicians at all or say that there is no need for them, because I know that they have a valuable role in healthcare. Also not trying to say that all APNs out there are stellar, because I'm pretty sure we all know that's not true either. But if research indicates that patient outcomes are the same whether it's from an APN or a physician, then why should it even matter who's education is more rigorous?