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Sarah, Congratulations on starting your journey to become a nurse. Almost all of the CRNA programs in the area have the same admission requirements as these are dictated by both our professional accrediting body and our universities. At a minimum, you will need a 3.0 or better GPA with a strong GPA in the sciences. Once you become an RN, you will need at least 1 year of critical care experience. This is best accomplished by working in a large urban medical center where you would care for the very sickest of patients while learning to manage vasoactive infusions, both noninvasive and invasive monitoring modalities, and ventilators. As you mention, you will also need a "good" score on the GRE. To give you some perspective, the "average" student that we admitted last year had a 3.5 overall GPA, with a 3.4 GPA in sciences. GRE scores in the top 30% and 3.5 years of ICU experience. If you would like to talk further, or come up and take a tour, feel free to message me. Good luck with your BSN! Franklin McShane, DNP, CRNA, APNP Program Director, Nurse Anesthesia Program Rosalind Franklin University of Medicine and Science

Having taught in the Army CRNA program - I'll try to answer your question. The Army program is a 2 phase program; Phase I is all didactic and at the Academy of Health Sciences at Ft Sam Houston in San Antonio TX, Phase II is all clinical and at one of 6 clinical sites - of which Madigan is one. Each clinical site takes students based on their ability to provide clinical experience - so the bigger hospitals take more students. I think that Madigan takes 8 students a year (don't quote me on this but I should be in the ballpark). The selection process for who goes where for phase 2 is usually left to the students - everyone works it out. So to answer your question - there is no guarantee that you will get Madigan as a Phase II site. The other thing to keep in mind - it is an unwritten rule that you cannot stay at your Phase II site after you graduate (there are some exceptions - but they are very rare). So even if you get Madigan for Phase II you will (most likely) not be able to stay there after graduation. It might be better to do Phase II somewhere else and then try to get to Madigan for Phase III (after graduation). Hope that helps. Franklin

There are several research articles on this very issue, unfortunately I don't have the citations for you. I am sure you could easily find them by doing a pubmed search. Most of these articles say that the "magic" number is between 50 - 80 repititions of whatever you are trying to master. Good luck! Franklin

The real question is what you want to do after becoming a CRNA. If you want to be a clinician, then the degree doesn't matter - the certification matters. If you want to teach, do research, etc. then the degree matters. It also matters where you want to pursue these endeavors. If you want to teach in a program housed in a school of nursing then you should get a MSN. The question may be moot soon - programs housed in schools of nursing will have to go the the doctorate for entry into practice in 2015-ish. Franklin

Very breifly and in a nutshell, the answer to your question is...it depends....upon the type of anesthesia machine you are using. The textbook answer is that most machines have a minimum O2 flow of 200ml/min (even with the flow meters all the way off). This flow starts as soon as you turn the machine on. This is a safety mechanism so that you cannot deliver a hypoxic mixture at very low flows. However, some of the older narcomed machines will allow you to "turn off" all flow through the circuit. I would assume that you are delivering a general anesthetic, so if you have no flow through the circuit then you have no flow through the vaporizer and therefore have no anesthesia (unless you are doing TIVA and just using the ventilator on the machine). All the new machines have this safety mechanism, so the answer to your question is that there is always some flow through the circuit. The other part of yor question is what "drives" the machine. Newer machines use medical air to drive the ventilators. Older machines used O2 to drive the ventilator. The drive gas is different from the gas delivered to the patient. Hope that helps.

I am an Army Reserve CRNA and have "mobilized" once already in support of GWOT (the global war on terrorism). Here is the story, the 90 day rule applys to certain critical specialties - one of which is CRNAs. The rule is 90 days "boots on ground". This means that you will serve for 90 days once you get to where you are going. I served at William Beaumont Army Medical Center in El Paso TX - so my inprocessing and outprocessing only took a week each. I have friends that ended up in Iraq and Afganistan and thier inprocessing and outprocessing took substantially longer. The OPTEMPO (operations tempo - meaning the requirements for mobilization) is higher now than ever before. If you are in the reserves, you should plan on mobilizing twice in a 4 year period (you have a stabilization period of twice the length of you mobilization), at least. This is predicated on the assumption that the OPTEMPO stays as high as it is. It is our fervent hope that the OPTEMPO wil dramatically decrease with time and as the situation in Iraq and the rest of the world calms down (and the water in the gulf coast recedes!). I truely value the time I have spent in the Army (19 years) - both active duty and reserves. It is an honor and privledge to care for the best patients in the world! The soldiers and family members of our armed forces. The experiece you will get is second to none. I think that the Army reserve has a lot to offer and you shouldn't necessary predicate your decision to join based soley on the "chances" of mobilizing. I hope this helps and good luck with your decision. Franklin

This has caused me to question my own practice and we are in discussion amoung our group and with the OB dept. I usually let the father/significant other participate by sitting in front of and "holding" the mother during placement of the intrathecal/epidural. The advantage of this is twofold: (1) they can't see what you are doing, and (2) they are sitting so if they do go to ground they don't have as far to travel. I have had several "fathers" go to ground just seeing me open the tray, let alone placing the needle. It may be that this occurance will change the way we practice OB anesthesia from a risk management standpoint.

CSE for L+D - I don't use this technique for a primip. The analgesia you get with the intrathecal administration of a low dose local anestheic and opioid is phenomenal. They get almost total pain relief. That's a good thing you say. Yes it is, until the intrathecal starts to wear off after several hours. Then when you dose the epidural - the analgesia is not as complete. The patients are not as happy and end up complaining for the rest of the labor. For a primip I use striaght epidural. For multips I use CSE. Both provide excellant analgesia, and patients are very happy with your services. Just my personal take on the matter.

I am a CRNA in a small community hospital in rural Wisconsin, and we do about 65% of ALL cases with a block of some sort. Regional experience in your practice setting is much like regional experience in your program. There are places that do it and there are places that don't. I personally really believe in the superiority of regional anesthesia - that is why I practice where I do. If you want to do regional when you graduate, you will have to find a place that does a lot of regional and is willing to train. Unless you are in the military schools - there are very few schools that have a great regional experience. The important thing to remember is that there are places where CRNAs do lots of regional - you just have to look for them. Good Luck.

You ask a very vague question which is difficult to answer. I spent 14 years active Army and last 5 in Army Reserves. The first question you need to ask yourself is what you want ot do? The follow on to this is how will the Army Reserves will help you achieve that goal. The reserves offer some exceptional programs for sure, but Army life is not for everyone. If you join the reserves, be prepared for mobilizations and time away from family and freinds. So you need to decide the risk/benefit ratio for your goals. I think the reserves offer opportunities that you won't find anywhere else, as long as they are opportunities you are looking for. Hope that helps a little. Franklin