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nomadcrna DNP, CRNA, NP

Anesthesia, Pain, Emergency Medicine

Nurse Anesthesiologist/Family Nurse Practitioner/Emergency Nurse Practitioner

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nomadcrna has 42 years experience as a DNP, CRNA, NP and specializes in Anesthesia, Pain, Emergency Medicine.


nomadcrna's Latest Activity

  1. nomadcrna

    The economics of PA vs. NP

    Your comments are telling. You "HAD to work alone out of school"? You were graduated without knowing how to do central lines and spinals? Seriously? A spinal is such a basic part of our practice that I fail to see how your program to fail you so hard. I assume you also did not do PNBs as well. Your retort is pretty much word salad. It makes little sense. My "ego" has nothing to do with my post. My anesthesia care is absolutely no different than an MD anesthesiologist. My ER care of patients is no different than an FP physician. In fact, I find it much better due to also being a Nurse Anesthesiologist (CRNA).
  2. nomadcrna

    The economics of PA vs. NP

    Nice insult. This is where the problem lays. Calling us "midlevel".
  3. nomadcrna

    NBCRNA and the AANA... WOW!

    You do realize that NPs have a choice with credentialing bodies? Competition is good.
  4. nomadcrna

    Dislike ER nursing, FNP still good choice?

    BTW, not all PCP clinics get stable walk in. Many rural clinics get fractures, I&Ds, wounds etc. Don't project your small part of the world to FNPs all over.
  5. nomadcrna

    Dislike ER nursing, FNP still good choice?

    You treat patients based on "guidelines and protocols"? We are professionals and should be treating patients based on current evidence. You are a provider not a technician.
  6. nomadcrna

    What Kind of NP to become?

    FNPs can work inpatient. In fact, many rural ERs are solo FNP. No physician etc. There is even a board certification for FNPs that grants the ENP (Emergency Nurse practitioner). Some states and many educators are confused about the consensus model. It is slowly changing but if you are interested, read up on the AAENP and ENP websites. The board certifications are through ANCC and AANP-CP
  7. nomadcrna

    APRN required to have First assist

    Sam, You get get education and training above your basic education as long has it's in the population/role. So FNPs in the ER are fine. Many rural ERs are staff by solo FNPs. NOTE: Many states don't need a collaborating physician. Here in Montana we are totally independent. There are even board certifications for FNPs to become ENPs. Look at ANCC and AANP-CP or AAENP. The same with first assisting. Done by NPs all over especially in rural areas. Remember, just because your hospital/state does it one way does not mean all states do it that way.
  8. nomadcrna

    Hospitalist --- FNP or AGACNP?

    FNPs admit and manage patients all over rural america. If you remember, there is a Emergency Nurse Practitioner board certification through both ANCC and AANP (AAENP). FNPs are the only ones allowed to take the AANP version. Many rural ERs are staffed solo by FNPs who admit and manage as well. Much depends on your state laws, of course. Thankfully, hopefully, we are moving away from set roles. I think it's ridiculous that a ACNP is not allowed to do peds or some states want to keep FNPs in the clinic. This type of thinking only hurts the profession.
  9. nomadcrna

    New NP, contract job ending and pregnant? Take RN job?

    Now that you are a NP, you are judge at a different standard. You will always be judged as a NP not as a RN. Working as an RN is not a good idea.
  10. nomadcrna

    Experienced CRNA...ask me anything

    We don't use EEG during anesthesia. Some will use a BIS monitor but the literature says that it is pretty much useless.
  11. nomadcrna

    Should I inform current employer of APRN license?

    You are now judged at a different standard. No longer as an RN but as a nurse practitioner.
  12. nomadcrna

    Experienced CRNA...ask me anything

    I do work in both roles. Each role also utilizes the other. For instance in the ER, I'm great with trauma and airway management due to my years as a CRNA. I'm much better at medically managing a patient in the peri-operative period due to my NP. I provide solo anesthesia coverage in a small CAH. I'm the only anesthesia provider. I cover OR, Ob and ER for critical care, trauma etc. I usually take 8-10 weeks off a year. Some of this time, I cover the ER at two neighboring rural hospitals that utilize NPs as the sole provider. Staying up to date is easy. The CME can usually be used for both. My typical week depends. If I'm covering anesthesia, I'm on 24/7 call. We have visiting surgeons that come certain days of the month. We do pediatric dental cases every Monday. Scopes every other week. Occasional pain management consults such as ESIs and such. I cover OB for epidurals and c-sections. I cover the ER for trauma, codes, airway management. i also do quite a few peripheral nerve blocks for fracture reductions, dislocations etc. We have FP clinic providers at the hospital I cover anesthesia at. A couple of them are not as strong in ER medicine and I'm happy to help. Chest tubes, FAST exams etc. if I cover ER. I will do either 24 or 48 hours of coverage. Usually see 15/day so it's not overly busy. Occasional trauma or other more serious condition that gets shipped out.
  13. nomadcrna

    Experienced CRNA...ask me anything

    I was a CRNA for 18 years and went back for my FNP. A few years later I also got my ENP. Having a general medical knowledge will absolutely help your anesthesia practice. You will have a much greater knowledge of disease processes and treatments.
  14. nomadcrna

    Any Thoughts on why Orthopedics Hire PA more than APN

    LOL, I'm done. But you keep trying to put words in my mouth. You may gain a greater understanding when you get more experience.
  15. nomadcrna

    Any Thoughts on why Orthopedics Hire PA more than APN

    Do you really think 6 or 8 weeks is enough to learn to be a first assist? LOL NPs are not required to do a FA program for billing and payment. You really can't think that because YOUR hospital and area do it one way mean that it's done that way all over the country? Are you an NP? Have you worked anywhere else besides your hospital system? If you did, you would see many different approaches. There is a big difference between an NP who already knows how to suture, does minor surgical procedures and can treat disease processes and and RN. Very easy to OJT a NP and nothing wrong with it.
  16. nomadcrna

    Any Thoughts on why Orthopedics Hire PA more than APN

    Lots of NPs first assist in the OR. PAs are not trained either but receive OJT. A nice benefit of an NP is that in many states they are indepedent.