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

My program director did not repeat anything he heard someone else say. It was his program (that he was the director of at the time) that educated this particular AA/CRNA. I know several AAs socially. Have not worked with one. And no one spoon feeds me anything. And the length of time you and georgia_aa have been providing anesthesia has nothing to do with your knowledge of how CRNAs are educated.

First of all, don't be rude. My program director, who has been the director for 10+ years, provided me with this information. He is a well-respected member in the nurse anesthesia profession, and I have no reason to disbelieve anything he has told me. Furthermore, this particular individual was already an RN, and chose to do AA school immediately after gradution from nursing school. After completion of AA school, she worked for a while, and then went on to CRNA school for the increased work opportunities in other states. I am curious - how is it that YOU would be the expert on what other AAs do with their careers?

This choice was available to me. I chose CRNA. The program I attended educated a former AA to be a CRNA, and from what I was told, that particular individual was blown away at the depth and breadth of information she was taught in CRNA school that she was not taught in AA school.

FYI: The original poster is talking about CRNA boards, NOT RN boards. And yes, I do know someone who had the minimum number of questions, and still failed, but she didn't study except a few weeks (as in, two) before the exam. No one was really surprised.

Sevoflurane can cause emergence delirium. In most cases, kids wake up screaming and crying. Sometimes its pain, sometimes its emotional distress, and sometimes its none of the above or a combination of the two. Sounds like the anesthesia/PACU team tried to take care of the child's pain first, and then the emotional needs. What traumatized you? The child's reaction? Any PACU nurse who has recovered kids would be able to tell you that they typically wake up this way.

Accidentally dislodging a central line during transfer is something that unfortunately can happen if you are not careful. While I understand that when someone is reprimanding you, it may seem that they are yelling, I don't think this falls under the category of verbal harassment. As for the locker room talk, well, perhaps they dismissed you from the clinical site for professionalism issues. I would imagine discussing your supervisor in the locker room where others can hear would get you in trouble regardless of where you worked. As far as breaking teeth...unfortunately that happens occasionally too. Whether it's due to learning, or difficult airway, or poor dentition, it happens. One of the hazards of anesthesia. I don't mean any disrespect, but if that's all it took for you to quit, then I think you would have had a hard time in anesthesia as a career. It's a stressful environment, and stressful things happen. You can't be so defensive. Sorry to be so blunt about your situation, but that my opinion.

45,000 (that includes 6,000 from undergrad)

Any drugs that we need quickly, we usually have out already (we get it out in preparation for the case). We have a pyxis in several of our fast-turnover rooms, and it is very helpful.

The CRNA boards don't even compare to the NCLEX. It's all more advanced anatomy, physiology, physics, pharmacology, etc than NCLEX. The two can't really even be compared. Yes, if you fail you can retake it. I am not sure what the passing rate is.

Please don't spread incorrect information. This is not true. Some facilities choose to have a team approach to anesthesia, where the MD and CRNA are together for induction. Some facilities do not. In fact, many hospitals are CRNA only facilities. Secondly, CRNAs do not have to follow anyone's orders, regardless of the practice environment. As you claim to be a former SRNA from your previous posts, you should know this.