brownie1129

I started out as a new grad ADN in Surgical/Trauma ICU of a regional level 1 trauma center. CVRU did not hire new grads as a policy. After one year, I transferred to CVICU and worked for 8 months before being accepted to 3 CRNA programs (I am in the Active Duty Army Program). SICU did get lots of complicated traumas and more variety than CVRU so I was grateful for the experience in addition to lots of long term patients CVRU gave me more experience with Swans, IABP's, and numerous Vasoactive IV meds that I never used in SICU. So my advice is (especially if you already have tech experience in an SICU) is to take the job in CVICU. You will get better experience that will be more pertinent to your future career as a CRNA. It will be a huge help in your interviews as well. So in summary, CVICU is, IMO, a better choice concerning your long term goals. SICU will give you lots of different experience if that is what you want. Plus you may be able to float over to SICU for a change of pace. Hope this helps. Brownie

This helped me: Positive charges are oriented toward the outer surface of the membrane and negative charges are oriented toward the inner surface of the membrane. The lipid bilayer acts as a barrier to diffusion of ions; nongated channels allow selective movement of ions. Unequal distribution of electrolytes across the cell membrane - Na+ and Cl− are at higher concentrations in the ECF. K+ and large anions (proteins, organic polyphosphate compounds, nucleic acids, etc.) are at higher concentration in the ICF. Membrane permeability (P) or conductance (g) - Even at very high membrane potentials there is virtually no ionic current flow through the lipid bilayer because of high resistance. Nongated channels permit some diffusion of Na+, K+, and Cl− (leak currents) through the resting membrane. The resting membrane is moderately permeable to K+ and only slightly permeable to Na+ and Cl−. Relative permeabilities - PK+ : PNa+ = 1.0:0.04, therefore the membrane is about 25× more permeable to K+ than to Na+. PK+ : PCl− = 1.0:0.45, therefore the membrane is about 2.2× more permeable to K+ than to Cl−. The cell membrane is impermeable to the large intracellular anions. Basis for unequal ion concentrations across the membrane - Most of the anions in the intracellular fluid are large, organic anions that cannot pass through the cell membrane. These anions attract cations into the cell. Since the resting cell membrane is mostly permeable to K+, K+ ions pair up with intracellular anions. K+ is the predominant intracellular cation, while Na+ is the predominant extracellular cation. Cl- can pass through the cell membrane but is mostly paired up aawith Na+ in the ECF. The Na+-K+ pump - An important function is to maintain cell volume. By maintaining a low intracellular Na+ concentration, the Na+-K+ pump helps to prevent swelling and lysis of cells. During hypoxia or when the Na+-K+ pump is severely inhibited, intracellular Na+ increases, more water enters the cell by osmosis, and the cell eventually ruptures. The Na+-K+ pump balances leak currents - At rest, the leakage of Na+ and K+ are exactly balanced by the Na+-K+ pump, therefore the concentration gradients for these ions are maintained. Because the pump moves 3 Na+ out of the cell for every 2 K+ it moves into the cell it causes a net transfer of positive charges out of the cell; this constitutes a pump current. Diffusion Potentials - The force that causes a substance to diffuse through a solution from an area of high concentration to an area of low concentration is a chemical force; this force moves particles down their concentration gradient. As a charged particle diffuses due to a chemical force, a separation of charge develops; the attraction of opposite charges is an electrical force that acts in opposition to a chemical force. Thus, when there is unequal distribution of an ion across a membrane and the membrane is permeable to the ion, passive diffusion of the ion produces an electrical potential across the membrane. Equilibrium potential (or Nernst potential) - The electrical driving force that is equal and opposite to the chemical driving force. Describes a point that is reached at which the driving force of the chemical gradient for ion is exactly counteracted by the electrical attraction of the excess anions on the inside of the membrane and the electrical repulsion of the excess cations on the outside of the membrane; this is the electrochemical equilibrium. NOTE: The Nernst equation assumes that the membrane is freely permeable to the ion in question. In other words, the equation only holds true under conditions when the membrane is substantially permeable to the subject ion. Nernst equation can be thought of as a tool that converts the energy in the form of a concentration gradient into electrical units of potential difference (mV). Significance of Nernst potentials - For a given ion, the Nernst potential is the potential at which there is no net flux of that ion across the membrane. The greater the difference between the membrane potential and the Nernst potential of an ion(Em - Ex), the greater the driving force for movement of that ion across the membrane. If a membrane becomes more permeable to a particular ion, the resulting ionic current will cause the membrane potential to change in the direction of the Nernst potential of that ion. When a membrane is permeable to more than one ion species, each ion tends to force the membrane potential toward its own Nernst Potential. Only ions to which the membrane is permeable and who's chemical gradients are actively maintained can influence the ER. The more permeable the membrane is to a given ion, the more influence that ion will have on the membrane potential. K+ more permeable than Cl- which is more permeable to Na+. Movement of Cl− ions tends toward an equilibrium across the membrane, so the Nernst potential for Cl− is equal to the resting potential and there is no net diffusion of Cl− at rest. Gibbs Donnan: This situation is called a Gibbs-Donnan equilibrium a. The diffusible cation concentration, [K+], will be higher on the side of the impermeant anion, A- (Intracellular) b. The diffusible anion concentration [Cl-], will be lower on the side of the impermeant anion, A- (Intracellular) c. More water moves into the side of the impermeant anion than would be predicted on the basis of the [A-] alone PM me with your personal email and I will send you some files that may be more helpful. Brownie

TNCC - Trauma Nursing Core Course. Required for all new ANC Nurses. http://www.ena.org/catn_enpc_tncc/tncc/ You will do it at a local hospital downtown over the weekend, which is why it is better if you already have it when you get here for OBC. Ol' sandman was enjoying some quality time with family that weekend while I was in class! No need to do PALS/ACLS unless you want to. Nurse track/OBC does not require it and you will redo it anyway towards the end of phase I so you are current throughout phase II. All incoming students will be assigned sponsors (current phase I students) prior to your arrival to ease your transition. Brownie

Typical day/week in the program: OBC: This program is elvolving constantly so even though I just finished 2 cycles ago, my information may not be accurate. You will inprocess for a couple of weeks. PT is 3 days per week at 0530 with ability groups after the first PT test. If you fail your diagnostic you will PT 5 days per week. You will spend 4+ weeks in the field M-F and home on weekends...This was set to change to straight field time. Our field schedule had something to do with avialable manpower and transportation. FTX is at Camp Bullis 1/2 hour from Ft. Sam Houston. Just go to your happy place and you will get through it with no problems. After that the rest of the time is M-F in the classroom. There are a few formations and your level of BS is directly proportional to the class attitude and performance. Ours had lots of prior service folks so we played the game and did not really get messed with too much. Weekends / evenings off. One inspection of Class A's, Dress Blue's. Rest of the time is ACU's. Buy your uniforms before you get here as clothing and sales is frequently short items you may need. 2 week nurse track is at the end of OBC where you will get CPR/TNCC if you don't already have these. IF you already have these and they are good for at least a year, then you will most likely have extra time off those days. Back to camp Bullis for a couple of days for another FTX. USAGPNA: Class scheduled M-F 0830-1630. Some days lets out earlier which gives you extra study time. Weekends off. Class is ACU/BDU. No formations. Assigned seating, assigned laptop, LAN connection at every desk. PT on your own with schedule turned in once per month. If you fail they threaten to make you do PT with the AIT soldiers in the company every day until you pass. No one has had to do that yet. Simulation time is generally scheduled 2 times per month before and after class with open time available for extra practice prn. Hope this helps. Brownie

We just took our final in stats yesterday. My advice is learn the principles, names of tests and application of same, and interpretation of results of the tests, but don't worry at all about learning the formulas unless you just want to know them. We use a program called SPSS which does all the math/formulas for you. This knowledge will carry over to the Research class as there is a lot of overlap with stats. As for a normal life, if you are good with time management you will be fine.

Dude.... Obviously the free time is not that reduced or you would not be surfing allnurses and posting your stinky opinion. Brownie "ENJOY YOUR FAMILY WHIILE YOU CAN. Once school starts your free time is GREATLY reduced."

I was invited for an interview to both schools last year. I ended up in the Army program in Texas at Ft. Sam Houston. I am in my 3rd month of school right now. So...for Mercer I can't be much help other than what my app looked like as I did not actually go to the interview. Basic stats were 9 years EMT including 5 years as an Army medic, 18 months Surgical/Truama ICU and CVICU RN experience, GPA 3.9, GRE 1100, ADN-BSN completed just before the interview. No CCRN, no Sigma Theta Tau. Invited for interviews at UNCC, MUSC, Mercer, MCG...Accepted to UNCC, MUSC, Army, turned down MCG, Mercer. UNCC was my first choice (after the Army). The interview process is a panel model with 8 interviewers taking turns asking questions. Questions ranged from personal preparation for school to clinical knowledge. I asked and was told that SRNA's at UNCC would be taught central line placement on dummies but never get to do one on a real patient. Regional block experience seemed limited and required distant site rotations clearly spelled out on their website. Core classes are taken at the hospital/school site, but the others such as stats, research, etc...were taken at the main campus across town. Too much of a commute for me. Seemed like you would be sharing cases with MDA's at the hospital there in Charlotte. My 2 cents. Be yourself at the interview. Easier said than done. If you can crack a joke and get them laughing it might help. They (UNCC) asked me how I was going to pay for the program so I told them I was playing the powerball and had a real good feeling about the numbers that day. Got a little chuckle. When asked how many schools I had applied to, I did not lie (they can see from your GRE report anyway) and I did not tell them that I only had eyes for their program. I stated " I want to be a CRNA. I have applied to 5 schools and have already been accepted to the Army program. If I am not accepted here, I will be wearing green in the fall. I will attend school this year whether you accept me or not". I can't be sure, but felt like they liked the honesty. I got in anyway. Hope this helps and does not come off too bragadocious. When I was going through the process I just wanted straight answers, and numbers not vague humility. If I can do anything to help anyone who reads this, let me know and I will be glad to do what I can. In addition if anyone is interested in the active duty or reserve army program, let me know that also. It is great getting paid to attend the #2 program in the country with autonomy second to none. Best of luck. Brownie

Congrats to both of you. I am in the program with Sandman right now. We are through our first 3 months of phase I right now. I second his sentiment that we will be glad to see you guys show up as that means we will be moving on to phase II. I was a civilian applicant. I did have 5 years prior service as an enlisted Army medic, then broke service for 5 years to attend nursing school and get my ICU experience. My advice is to take one thing at a time. You have to get through OBC before you get to CRNA school. You will have lots of field time as the OBC program evolves to better prepare new officers to enter a field environment (middle east deployments). As for Academic pre-prep. I did not do any, but finished my BSN just 8 months before going to OBC. Be in good physical shape just because it will make your life a lot easier through both programs. The pre-course prep material on the http://www.dns.amedd.army.mil/crna/PreCourseMaterialPages%2002%20Jan%202002/PrecourseMaterial.htm website are pretty good. The chemistry math was a good refresher for me. Good luck with your prep. Bottom line, focus on one target at a time...you will be here before you know it. PM me (or Sandman) if you need any specific information regarding what you've heard compared to the way it really is.

I say yes it will be harder and take longer. There are waivers for almost everything in the Army, including the 2 years time on station requirement, but that does not mean the command will give you one. You are taking a gamble of having to wait longer to get in. Here is a scenario that happened to me as an enlisted Army medic. I wanted to apply to a program. I was sent to Europe with a requirement to complete 5/6 of a 3 year tour before being able to rotate back stateside. When I got back stateside, I had missed the application deadline and now had an additional 1 year time on station requirement. This can turn into an ongoing cycle depending on your situation. If enter as a nurse you will attend OBC for 10-12 weeks, then go on to your assignment. You may get sent to a unit and be deployed. When you return you may be reassigned incurring another 2 year time on station requirement. See where this is going? This is obviously worst case scenario, but is a reality for many aspiring applicants. As long as you are willing to lose the gamble, and know that you will probably get in eventually, go for it. If however, you're goal is to get into school asap, then my advice is to apply now as a civilian. If it does not work out, you can then enter as a nurse (Making sure you are given the 8A critical Additional Skill Identifier ASI upon entry), but if you go the other way, you may have to wait longer than you would have to otherwise. If you are qualified, you will get in eventually either way.

1 year Surgical / Trauma ICU, 8 months Cardiovascular Recovery. Total time as an RN 1 year 8 months.

I am also a civilian applicant (with prior enlisted service) starting the June class. Your local healthcare recruiter wants you to sign up as a nurse.period. They have pressure on them for numbers which is what you are right now. Decide what you want to do and stick to your guns. The guidelines clearly state what is the recruiters job and what is yours. Now realize that you may have to do everything with your boot in the recruiters backside. Use LTC Richardson and Fisher as much as they are willing to help you and ensure you have items in on time to give them as much reaction time as possible to be able to help you. It can be done.

Sounds like some good motivation for me not to flunk out, quit, or otherwise fail to complete the rigorous Army program. I was an active duty army medic in the past and saw this same thing in my enlisted training. Soldiers unable to meet the standard were re-assigned to different specialties based on the needs of the Army (One guy went from medic trainee to Quatermaster another Infantry). At least, if this happens, I would remain an officer and an RN. Good advice to consider all the angles before making a committment.

You can apply as a civilian to the active duty program. If accepted you will transition onto active duty to attend school. The training is conducted by the Army but the degree is issued by University of Texas Health Science Center at Houston. Phase I is at Fort Sam Houston, San Antonio TX for 1 year and then phase II is at one of 8 different training sites around the country. After you finish school you will owe 4.5years active duty. You will have full pay and allowances while attending school. There is another program for the reserves called STRAP program where you can attend any school to which you are accepted. I don't know all the in's and out's , but you can do a search on the CRNA threads or the Military Nursing forum for info on this program. Here is a link to the Army website with the active duty program application guide: http://www.dns.amedd.army.mil/crna/Application_Information/application_info_for_civilians_and_reservists.htm Here is a link to a thread on this website where the benefits are discussed: https://allnurses.com/forums/f16/requested-reposting-information-concerning-us-army-graduate-program-anest-nsg-84110.html PM me if you have any specific questions after reviewing the links above. Brownie

I've had a great 2 weeks! Have applied to 5 programs. I've been invited to interviews scheduled in January for UNCC (Charlotte, NC), and MUSC (Charleston, SC). 2 schools in GA are still pending. I have also been accepted into the US Army Graduate Program for Anesthesia Nursing. After all the hard work of studying for and taking the GRE and the application process x 5 it is nice to be rewarded. Any advice on interviewing at the above schools would be appreciated. Merry Christmas Brownie

I'm In....