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Don't give up; I got my BSRN, went to crna school and my "terminal" degree" was in aero engineering"..not the usual track for a nurse...then med school after working for a while.......don't let anyone label you are a nurse, pre-crna, doctor or anything else..if you want to persue a professional pathway, find a mentor and do it. at 57, I have degrees and professional certifications, but haven't decided exactly what i want to "specialize" in//best of luck and don't let anyone tell you "no, you can't"

I forgot one thing in my previous reply: have you considered a NP program? A good NP can really help people and it's a good job. PS: my primary care provider is a NP and she's the best...I have my choice of many physicians and I choose a NP. Best of luck

As a physician who has been involved in many colonoscopy exams (my own included-I probably have colon cancer)...I doubt that anyone on these boards gives 2 ***** about my opinion, but here it is: please get a colonoscopy..it's not that bad.....I'm an internal med doc who has done many of these exams......laugh your ass off; at my skinny butt undergoing a colonoscopy-my doc provided pics........I'm a board-certified internist (whoopee) and I hope that every patient gets scoped ay age 50 or earlier with a history......

adios to you and please go with God.......I wish you the best, but working as a nurse in anesthesia is not for everyone.

Once again, CRNA are totally interested in "solo practice" and economic issues........I see a total abscence of concern for patient safety........I would not let an unsupervised CRNA "practice" on my patient. and that's from a former CRNA.........you don't know (or seem to care) what you don't know............that's why I never admit that I'm (or was) a nurse.............best wishes and be careful; patients lives are at stake...........

What an absolutely awful experience. Patients deserve an anesthesia provider and proper drugs (ie: propofol) for these procedures. I have many years of experience doing endo sedation and have NEVER had a patient "moaning or struggling" durinf an endoscopic procedure. Never. Propofol as a single agent given by an anesthediologist; maybe with some fentanyl, never with amnestics like midazolam unless the patient wants amnesia and a hangover. We use anesthesiologists for every case and NEVER have problems. Some nurses (including crna) can and do give CS, but the results often are poor. I want a patient to be willing to return for future procedures....my 2 cents worth

totally correct about reversal of these agents. Personally I believe that patients are much better off having an anesthesia provider administer their sedation (especially for endo); better drugs and no artificial limits on doseage......i just finished a protracted conversation with a patient who had an absolutely awful CS experience with her colonoscopy and she was quite reluctant to undergo another.. the nurses in the GI lab had used midazolam/fentanyl appropriately and she still had lots of pain and an incomplete exam. trying to reassure her that I could do better with propofol pretty much fell on deaf ears, once a patient has a bad sedation experience, it's hard to "reverse" that. it's impossible to predict how much (mg) of a sedation drug that an individual patient will require..this patient was a healthy 50 year-old with essentially no medical issues undergoing repeat screening colonoscopy. still she required 190mg of propfol and lots of reassurance; but she ended up having a totally comfortable experience with no complications. I have often wondered: for endo procedures (especially colonoscopy), would it be advantageous to have anesthesia do ALL of these cases rather than the GI nurses administering midazolam/fentanyl? With anesthesia administered propofol, the patientwould be almost assured of a totally comfortable procedure, emerge clear-headed and be safely discharged quickly. With difficult to sedate patients, midazolam/fentanyl can resuly in an oversedated patient rquiring 1:! nursing care in recovery, which must slow things down considerably. I'm not an expert on this, but I just had a colonoscopy and watched a fair number of patients go thru this process and it looked inefficient; the GI nurses have more important things to do than administer CS with yesterday's drugs. For my own exam, I chose no sedation and the GI nurse talked me thru the procedure and it was a breeze; she was a gem. I must admit that an unsedated colonoscopy is not for everyone.

no education is BS....................crna usually undergo 2 years of additional nursing-school "anesthesia" training and are possibly qualified (with supervision) to administer anesthesia...............I was/am a crna who went to med school and became anesthesiologist (MD)..I don't give a tinker's damn about being called "doctor"........as a physician, I realize that anesthesia is beyond the skill set of a nurse (crna or otherwise)........been there, done that.........after med school, I realized that crna practice should be and MUST be supervised by an anesthesiologist.......................solo crna who are "militant" shame on you....you are nurses and you should be concerned that your patients get the best care....................a "solo" crna is like a student pilot flying an airliner

once again, patient safety is thrown to the wind by nurses who want to act as solo anesthesia providers.......sort of makes one ashamed of ever being a nurse..................stop looking at your own economic interests and focus on patient safety

patients DESERVE an anestesiologist, not a nurse managing their anesthesia. I was a CRNA before going to med school..............give it a rest......it's not about money, it's about patient safety....................solo CRNA practice isn't safe, we all know that.....

Your have a lack of respect for anesthesiologists; I'm glad that your posts speak for themselves. "Blowing smoke"? I doubt it; I have seen both side quite clearly and I do not attack anesthesia nurses....FYI, almost every nursing field overlaps my own; I'm just not as insecure as you seem to be. Please notice that I state my opinion and do not "trash" anyone...Yep, as a nurse I had a few times where I performed the anesthetic for a doc and they were grateful.....Same as a physician, just much safer practice. You disrespect speaks volumes about your own insecurity; I'm comfortable with my profession and my candle doesn't burn any brighter if I try to blow another person's candle out. I would never call a CRNA anything but a "real" nurse..in fact they are, at the core, nurses and that's nothing to be ashamed of. Please keep posting; you are proving my points quite eloquently.

Everyone is entitled to an opinion, but I see a lot CRNA bashing anesthesiologists just as much or more than I see anesthesiologists bashing CRNA. Been in both sets of shoes. My issue is with unsupervised CRNA practice; I don't think that it's safe. Patients should be told in advance if their anesthesia will be done by an unsupervised nurse and this should be part of informed consent. If a patient wants to accept having an unsupervised CRNA perform his/her anesthesia, that's a personal choice, albeit a bad one IMHO. best wishes to all.. Colonel. D. (wtbcrna-just had to throw that in there even though I'm retired)

Out of curiosity, what are you basing your opinoins of crna's on? I worked as a CRNA before attending med school.

You probably had a doc who took his/her time to do the colonoscopy properly and you must have an easy colon to navigate. Colonoscopies are done in most of the world (not the US) without sedation. Here in the US, sedation is the standard of care. Being a control freak, I chose an unsedated colonoscopy dspite the fact that my CRNA friends (yes, anesthesia docs have them) offered to stand by with propofol and fentanyl if needed. The drug-free exam was quite tolerable and it was nice to drive myself home. The GI doc who did the procedure was great, but she convinced me to get my next colonoscopy with drugs for several reasons: 1. it's easier for the colonoscopist to examine the colon of a sedated patient; believe it or not most endo docs don't like to cause pain and when they do an unsedated exam, they tend to rush...even when the patient lays there and suffers in silence (like I did). 2. with proper sedation, most patients won't remember the exam, if propofol was used they almost always have a great experience and most who get versed/fentanyl also have a good expeience. I personally hatet he idea of procedural amnesia, but now I realize that having a colonoscopy isn't about some esoteric patient preference, it's about allowing the GI doc to do a slow, careful examination of the colon (5 1/2 feet or more) without rushing. if the patient is proprly sedated, the GI doc can do his/her job. Off my soapbox. I just had a colonoscopy and need to repeat because of biopsy issues. The endo doc suggests sedation, which I again refused, but then I changed my mind. With propofol, it's possible to get safe, profound sedation during the exam with a safe airway and an almost immediate recovery (I have done this about a thousand times with my patients). And yes, a CRNA will be doing my colonoscopy sedation on 1-10-11; this is an appropriate role for the CRNA and I'm glad that Sue will be doing my case. Can a patient refuse sedation? Absolutely, I did for my first colonoscopy and for an ulnar nerve trans.......probably a bad idea.

With all due respect, if a patient wants an unsupervised nurse (solo CRNA) performing his/her anesthesia, that's their choice; I just want to make sure that the patient understands who their anesthesia provider actually is. You are entitled to your own opinion. To be meaningful, supervision means anesthesiologist, nurses supervising other nurses flys in the face of safety as well as the ACT model. Comparing the depth, scope and tenor of an anesthesiologist's education to that of a CRNA is quite ridiculous......Been there, done that (both). I haven't seen anyone who went to med school try to compete with anyone who went to CRNA school and the reference to wars, weapons etc goes over my head entirely. And for your information, this IS my turf too.

wow, I have never asked anyone to "carry my water"........your comments and disrespect(?) speak volumes about this issue.......a "loosing battle"? I have no battles to fight and neither do most in the anesthesiology profession..........safe practice means an anesthesiologist managing each and every case; CRNA have a role and I respect that (I worked in that role).....your comments reinforce my opinion that unsupervised CRNA practice is unsafe.......

Thabks for the replies; I tried to comment from a unique perspective, but it seems that this was a waste of time. Many patients want to know who is managing their anesthesia; and I'm often the one to answer the question. Docs, hospital administrators, people "in the know" want an anesthesiologist........I guess that my posting on a nursing board was a waste of time......I thought that the CRNA here would respond with a better response .. yep, I was wrong again (must be the nurse in me)..........STILL: BEST WISHES FOR ALL OF YOU FOR THE HOLIDAYS,

wtb: yes I did work in an independent environment as a CRNA and was trained to do so. I felt increasingly uncomfortable doing so as my education progressed. This is my opinion only and I mean no disrespect to CRNA...I do not believe that "solo" CRNA practice is safe or desireable; again that is my opinion only. I try not to make abrasive comments about the capabilities (and limitations) of CRNA, but when I read that some CRNA claim professional parity with anesthesiologists I feel the need to give my opinion. One advantage of sitting on the fence watching both side of the debate is that I can take the high ground (advocate patient safety) rather than trying to protect some professional "turf" (CRNA or anesthesiologist). Interestingly enough, I do not see the "anesthesiologist being replaced by CRNA" issue anywhere except online. Best wishes for the holidays.

Having worked on both sides of this equation gives me a unique viewpoint. Surgeons do surgery and I haven't met one who knew beans about anesthesia. CRNA are useful providers, when properly supervised by an anesthesiologist they provide an invaluable service. Trying to "prove" which side is right (anesthesiologist supervised CRNA vs solo CRNA) is a waste of time; it's an opinion and it's a decision that should be left up to the patient.

Then you don't even understand the act model. CRNA are nurses, anesthesiologists are physicians. A few misguided CRNA seem to think that they can "work solo"...they can't and it's dangerous; some do in some areas and they "get away with it" (just like most drunk drivers "get away with it". "supervision of a medicare formality"? Any CRNA who thinks that they are in any way, shape or form "equal" to an anesthesiologist is experienceing a dangerous delusion.

I know that the post is ancient, but a bubble gum enema is quite real and use to soften impactions. It consists of Colace Liquid (not the syrup) which often comes in a dropper bottle for peds. Its a red liquid thats given orally. Its harmess DSS. For a bubble gum enema, you mix a quantity (say 30ml in an empty fleet enema bottle and add an equal amount of oil (I think that it was mineral oil) and shake. This results in an pink emulsion that looks like bubble gum and is administeredas a retention enema. This is a hold-ever from the old days when formularies weren't enforced. I recall it because I saw it done as a student for a peds parient who was impacted and who was to receive a dose of barbiturate rectally.

More and more patients are declining sedation for endoscopy and that's their absolute right. The endoscopist can refuse to do the exam unsdated, but he/she had better have a good reason for doing so..not just the usual "it's going to hurt".....If you absolutely don't want sedation, don't sign the sedation consent or cross out references to sedation in the general procedural consent.

All very interesting comments. Having worked anesthesia as both a nurse and as an anesthesiologist, I always assumed that patients naturally wanted to be (or think that they were) "out" for the procedure. Most GI docs use enough (often too much midazolam) to prevent much memory of the procedure; but a fair number of patients do not think that this amnesia is a good thing. I have done a surprizing number of cases where the patient requests nothing of just standby fentanyl; it's harder for the endoscopist because it slows them down but most of the pain associated with colonoscopy is due to anatomy partly, but mostly due to operator skill. A fairly large number of older patients have no ride home and it bothers me when they are given the choice: sedation with a ride home or no test for you. A third option is an unsedated exam and the can drive home or take public transportation. A fair number of colonoscopies are incomplete due to tortuous colons even when done under sedation; but at least it's a partial exam. I just had one unsedated and it wasn't too bad.

I had to respond to the "they hold your life in their hands" part. Yeah, CRNA's sure do, so do anesthesiologists, so do bus drivers, etc ANd if the anesthesiologist was nowhere to be found, shame on the hospital. If the CRNA can practice independently, why worry about where the anesthesiologist was? Maybe he should have been siting his own case; that's why I do NOT supervise CRNA's.

I became a CRNA then took the unusual path to med school and became an anesthesiologist. There is no comparison between the 2 programs; both are intense and require a lot of work and if you are trying to complete either primarily for financial reasons, don't. If you want to work in anesthesia with the minimum investment in time and cost, go the CRNA route. You can get a fair amount of "bang for your buck" as a CRNA. I did it for a while and liked it, but after med school I realized that there was a lot that I did not know and my CRNA training was not as adequate as I would have liked. At some institutions, the nurses (CRNA's) and the physicians (MDA's) seem to get along; I was a great CRNA but was treated as a "worker" not a collegue by the MDA's. And after med school, I understand that medical doctors will almost never give a non-physician much respect; lip-service perhaps, but that's it. Now with healthcare reform and opt-in/opt out, the fur is really going to start to fly as the MDA's fight to keep their turf (or as they say, to protect the patient). Personally, I was proud to be a CRNA and I'm proud to be an MDA. My husband makes plenty so money isn't an issue for us; neither was the many years that I spent persuing my medical degree being paid at low wages. One observation: as many CRNA's become "militant" and insist that they can practice independently, I believe that they will be given the right to do so (at least for a while, in every state). In the furture, patients will be totally informed who is doing their anesthesia (MDA or nurse) and I believe that the veil of "supervision" will essentially vanish. I joined an MDA-only practice and do not supervise CRNA's, even though I was once one. I do not trash CRNA's, but when a patient asks me who is the best qualified to perform his/her anesthesia, I have to be honest and say an MDA, 1:1 without supervising CRNA. In the short-term, I think that more and more institutions will staff with the the cheapest anesthesia providers that they can get, probably AA's or even someone less qualified. The problem with believing that you can provide the same anesthesia with 4 CRNA "supervised" by one MDA is that the CRNA can supposedly work independently. Then why have the MDA at all? 99% of anesthesia can be safely provided by a person with little formal training, so why pay a CRNA 1/3 to 1/2 of what a MDA makes if you can use even cheaper help? How about 4 semi-AA's supervised by a CRNA? The CRNA still has to work under the licence of a physician (surgeon), so this would be legal. All this to say, if you want to work in anesthesia, best of luck. I think that CRNA's and AA's (and a lot of us MDA's) are going to be taking HUGE pay cuts shortly, that is if we can find jobs. My neighbor is a BC/BS administrator who had surgery on both arms, identical surgery R&L. First case: CRNA only, billed for something like $400. Second case: CRNA and MDA, billed for almost double. Both cases went fine. She said that they pay the MDA and CRNA the same based on time and complexity. How long do you think that they will continue to pay double? And if you think that the CRNA's will displace the MDA, I doubt it. As soon as they figure out that you can get a doc for the price of a nurse, who do you think will be looking for a new job? No disrespect to CRNA's; I'm too old to fight this mess and will probably retire before the issue is settled. The future isn't rosy.