Dita

pushing back starting a family... :) Does everybody have to procreate? Take the road less traveled. More people need to escape that mindset. Jim CRNA

Depends on what state or states you practice in. I live in Kansas City. Missouri is about double the cost of Kansas. I'm guessing anywhere from $2k - 6k. is the average. Of course tax deductible, if your 1099.Jim

Go to the AANA web site. AANA.com AANA is pretty much the only place to get liability insurance for CRNA's, wanting their own individual policy. CNA is the insurance co. my policy is thru via AANA. JIM

"My response was I would proceed as the Anesthesiologist wished and after the case inquire on why he changed the plan of care and try and learn from the experience." I agree with this answer. No CRNA program wants to deal with a student that thinks they know more than the CRNA/MDA. Experience counts. Plus the MDA/CRNA have to be somewhat comfortable or familiar with the anesthetic plan inorder for it to go as smooth as possible. I certainly would appreciate your intense preparation for the case. But I think they want to see that you are flexible, and are amenable to learning different anesthetic techniques. Jim CRNA

Just curious, do you get to place/insert the swan? Or does the MDA do that?Do you live close to Atlanta? Any spectacular job opportunities down that way? Jim, CRNA

We use versed and fentanyl for pre-op sedation. Up to 5mg of versed and 250 ug for fentanyl, depending on what the patient requires. It seems like the scopolamine/ morphine combination has been around for years and is tried and true. Some may argue that scopolamine has too many potential side effects. jim CRNA

I think I can understand where you are coming from. You want a direct link via anesthesia to the patient and family. So often while visiting the patient in preoperative holding area, I truly feel like an ancillary person while in the presence of the anesthesiologist. Rarely does the patient realize, I'm the person who will being doing the bulk, if not all of their anesthetic. I do on most occasions try to emphasize that I'm the nurse anesthetist. Not only for your own personal satisfaction, I believe that you will be helping the CRNA profession by expanding the ranks of CRNA only groups. Plus, I'm sure it will make you think and grow in new areas of anesthesia. Goodluck in your future endeavor. jim, CRNA

May I ask why you want to join a CRNA only group? thanks, jim, CRNA

Was this patient all ready intubated in ICU? Look at the half lives of versed and morphine, especially in drip form. The patient also has renal impairment. I wouldn't think a sedative hypnotic is necessary if the patient was all ready on a versed drip in the ICU. Yes, I think the patient could have been returned in a better fashion. If I remember correctly, the vital signs were still high normal in the OR. Only when the patient was brought back to the ICU did the vitals go up. Just moving a big person to the OR table to the patients bed can cause a sympathetic response. Most diabetics have autonomic dysfunction, so HR and BP can be very unpredictable. Maybe the anesthesia provider figured that the pt. all ready had a narcotic and hypnotic on board via the drips in ICU, and felt a muscle relaxant(no movement) and a volatile agent to keep them unconscious was all that was needed. A less is more approach, since the patient is not exactly doing very well. A nice bolus of fentanyl could have probably smoothed things out. jim, CRNA