heartICU

Actually, we are pretty aggressive at my facility with glucose levels, at least in the cardiac ORs. Most patients end up on an insulin drip, at least for a few hours, starting with blood sugars over 150. Studies show that tighter control leads to better outcomes, or so I was told when I did my cardiac rotation.

I am not sure patient acuity has much to do with new grads being hired directly into ICU or not. I think it's a matter of being a larger facility and having more resources available to train new graduates.

It is difficult. I have not been practicing anesthesia for long, but I have done two - a two-year-old while I was a student, and a patient in their mid-thirties. Let me tell you, it is a hard thing to turn off the ventilator, turn off the monitoring equipment, and walk out. But when I thought of the overall picture, and how those organs were helping other patients, it did help. It's an odd feeling, more than anything.

Stank hole? Nice. FYI - Everyone around the Cleveland area pays for parking, at least if you work downtown. And UH, down the street from CCF, also charges employees for parking. The wages are not that bad - they are market wages for Cleveland. Benefits are fine-very comparable with area hospitals. Yes, it IS a big hospital, and needs more nurses (what hospital doesn't?) I have worked there for seven years, and I enjoy it. I know people who came from other hospitals, and also those from CCF who went elsewhere, and they all say the same thing: the work is the same as at other places. Too many patients, that are too sick, and not enough nurses. I think the variety of practice options at CCF is a strong point, as well as the wide variety of shifts. In the past seven years that I have worked there, I have seen many positive changes, and I think they willl only get better as they attempt to innovate more to recruit and retain quality nurses. Just my opinion. PM me if you want more info.

These patients present very interesting dilemmas. We have a well-known bariatric surgeon (two actually) at our facility, and I was discussing the post-op and long-term outcomes with one of them. Interestingly, many of the patients develop drinking and/or drug problems later. These patients tend to have an addictive personality, and when food cannot be used as the addiciton of choice, they often change to something else - namely, drugs, alcohol, cigarettes. This is part of the reason that intensive therapy is often used in conjunction with the surgical procedure itself. MAny people think GBP is the be-all end-all for obesity, but it can bring a whole host of other problems too.

This is incorrect. CRNAs practice in every state.

You say M&M is higher when CRNAs provide anesthesia, yet you also say you respect our job and see a need for it. You respect poor patient outcomes? You are contradicting yourself. Please provide the reference for your above statement about outcome differences between providers. For every one you provide, I can counter it with one that says outcomes are no different.

Money isn't everything. I like anesthesia better than ICU nursing. Plain and simple.

FYI - CRNAs are licensed/certified in U.S. Practice overseas would most liekly be impossible, unless it were with the military, or part of a humanitarian mission. Someone correct me if I am wrong.

MS = Master of Science MSN = Master of Science in Nursing You don't really get a MSN in Nurse Anesthesia. It would be called a MSNA. You are an advanced practice nurse with a masters degree in nursing. No effect that I can tell on employment and salary.

First of all, CRNA is a certification, not a degree. There is a movement to get all masters' prepared nurses to the doctoral level (DNP) at some point in the future. However, a PhD is a RESEARCH degree, while the DNP is a CLINICAL degree.

Since you are going to the program I just graduated from, I can offer some advice. They will send you a booklist soon, if they haven't already. You do not need to buy every book on it - when you get it in the mail, let me know, and I will give you my advice on what to buy if you want to know. You do not need a PDA for your rotations unless that is something you would like to have for quick reference. You do need a computer (doesn't matter if its a desktop or laptop). You will need MS Office at bare minimum, but if you do not have this, do not buy it. CWRU provides a variety of software to its students, as part of your tuition. You will need a printer but doesn't have to be anything incredibly fancy. A recorder is not essential unless it's something you think you will learn best with. I had one for the beginning of my program, and did not feel that it was that helpful. But that is just me. Other things that you may need for your clinical rotations will depend on which clinical site you are at. (CCF, UH, Summa?) Let me know if I can help with any other info.

I graduated from Case in Dec, and they are a little slow on the paperwork. Don't worry - it will get there. The program directors will make sure you have everything you need.

Just curious - how do you know he was not under general anesthesia? Was this supposed to be done under local anesthesia? Was he provided any sedatives? Sometimes the meds we give to provide sedation can cause funny things to happen to the airway, like obstruction, etc. Like others said, the safest airway when administering anesthetics (sedatives or otherwise) is one with a cuffed ET tube. FYI - diabetics do have some degree of delayed gastric emptying, so the fact that he was NPO is nice, but his stomach may not be empty.

I am not an NP, but the school I graduated from does offer a specialty in cardiovascular nursing as part of their NP program. Check it out. http://fpb.cwru.edu/MSN/Cardio.shtm