J.L.Seagal

How many attempts would you make at an intubation using a MAC or Miller blade before going to other interventions in order to establish a definitive airway? Is there a specific protocol for this or does it generally depend on the one doing the case?

"I suspect the ASA would raise the roof were we to actually start a movement to change the titles. How dare we presume to take the title "anesthesiologist," and all that implies, from MD's? "--by Kevin M. I once shadowed a CRNA who was written up because she allowed her patient to call her an anesthesiologist. Actually the CRNA corrected the patient and explained her title to the patient, but the pt. continued to call her an anesthesiologist(while winking at the CRNA at the same time). Well, the situation was misinterpreted by an MDA resident who reported the incident to his superiors...who in turn hit the roof. Soon after, a memo was circulated to remind all providers that the title of "anesthesiologist" was the exclusive domain of MDAs, etc, etc.... Apparently, this issue of titles is not new, nor do I believe that MDAs would give up their title of anesthesiologist for "anesthesia provider." Nice concept, though Kevin!

Great post ether! Thanks for sharing your experience.

Virginia Commonwealth University beginning August 2004!!!!!!

Just finished getting bids for moving to Virginia. My aunt and uncle moved their family from Conneticut to CA using Bekins. Good friends of mine moved from New Jersey using Bekins and loved them. I got a pretty good quote from Bekins. I'm a little leery of using a small outfit on a cross country move, so even though Bekins wasn't the cheapest (nor were they the most expensive), I've decided to go with Bekins for my move. Hope your seach for a moving company goes well!

Suzanne and Yoga...I was wondering if you could elaborate more on blindly nasally intubating someone who is awake. Instinctively, this sounds like a very uncomfortable procedure to me. Would you give some kind of sedation before performing this procedure? What drug would be optimal for a procedure that requires the pt's cooperation? How do you talk a pt. through a procedure like this? Just HOW do you talk a pt. into "inhaling" an ET tube????? Wouldn't this at least trigger a gag reflex? I'm not sure what the incidence of getting the tube into the esophagus vs. the trachea is, but how in the heck do you talk the patient into giving the procedure another shot when the tube just went down the wrong way? Although I have shadowed CRNAs before applying to school (and I realize I have A LOT to learn), I have never seen this procedure performed nor did the subject come up. I am intrigued by this and would love to hear your explanations and opinions on this procedure. Thanks!

All bickering aside, let's look at the practical side. Can MDA's supervise 4 ORs efficiently without trusting the CRNAs in them are doing their best? MDA's must be able to trust the CRNA's ability for critical thinking and that they will call for assistance when needed. CRNAs must be able to realize his/her limits in both knowledge and clinical expertise. Gaspassah, I tend to agree with you that in the field of nurse anesthesia, a solid foundation in the sciences/pharmacology over nursing theory would be extremely helpful in closing the gap of misunderstanding between CRNAs and MDAs--we can at least all begin to speak the same language during consultations over difficult cases. Let us discuss instead who is the most important person in OR--THE PATIENT. CRNAs and MDAs must be able to leave their egos at the OR door, share each other's knowledg and concentrate on doing their best, as a team, for that patient. In the end, everyone will win!

During holiday breaks, and breaks between semesters, would you recommend working some extra shifts in a hospital...especially if you're wanting to establish state residency status?

During holiday breaks, and breaks between semesters, would you recommend working some extra shifts in a hospital...especially if you're wanting to establish state residency status?

Sherpa...your post was great! I had a similiar experience during my interview at VCU. In my case, I woke up sick that morning and considered cancelling the morning interview and rescheduling for the next day. As fate would have it, I could not get a live person on the phone (too early in the morning for that) so I decided to take a chance and go to the interview anyway. I was breaking out in a cold sweat that morning...but so were the other candidates. And yes, I got asked the clinical questions too (ie. naming a vasoactive drug and discussing dosages, indications, contraindications, etc....then going on the the next drug). I managed to answer the questions in between bouts of nausea. Needless to say, I managed to finish my interviews and went back to my hotel room in a daze. I spiked a temp that night and developed severe joint pains. I honestly had no idea how I did on my interviews. I am happy to report that I was accepted to VCU's program for this fall. So don't lose hope Vinny! Stay positive and remember that there are many people out there who had similiar experiences to yours. Good Luck!

I was wondering if any CRNAs out there can tell me if any of them were able to pay off the debt incurred during school within the first year of employment. I was told this could be done, but is there a former SRNA out there who actually accomplished this????

Commuting time from Elk Grove is a real nightmare...especially if your job is located in downtown Sacramento. I would suggest coming to Sacramento and trying out a rush hour commute to and from Elk Grove. It gets old really fast! I have friends who bought homes in Elk Grove, they sold their homes and moved to West Sacramento. Downtown Sacramento is only 7 miles away from there and their commute went from 1 hour down to 15 minutes!

The best strategy that has worked for me has been to "kill them with kindness." It's hard to be petty and jealous to someone who is kind to you.