Senior in a Cardiac Rotation

[bwt02]

Just wanted to hear from other SRNA's as to how your heart rotation went. I am at a private heart hospital that does about 3 hearts a day and lots of vascular. It is all MDA staff. Only 1 week into the rotation, but we are treated as task masters (intubate, make this gtt, make that gtt). Basically not managing the patient. It is only a 4 week rotation and I really just want to get through it.

[MaleAPRN]

I'm sorry to hear that. As seniors in heart rooms, we are expected to do as much as possible during the entire case. CRNAs supervise, MDA is there for induction, TEE placement, coming off CPB. That's it. As seniors, we are in charge of the case, CRNA will sit behind us and will help with charting, etc. It all depends on the CRNA and their complete trust on us seniors. We do about 2-3 hearts a day.

[EmeraldNYL, BSN, RN]

I am doing my rotation at a small community hospital that does about 1 heart a day. There are 2 cardiac surgeons, one excellent and the other not so good. The one surgeon likes to do a lot of off-pump cases so I get experience with that. I have done about 8 hearts so far and will be at this hospital for several more months so I will at least double my number. Sometimes I am with both a CRNA and an MDA, and sometimes just an MDA. They let me do the lines and help me manage the case except when we are coming off bypass the one MDA likes to push me out of the way. Some docs it seems just can't sit back and let you do things for yourself, while other docs are cool and just help you if you need it. Overall I feel I'm getting a decent experience.

[JJRN]

I am on my heart rotation right now and it is great. They do 2-3 hearts a day (on and off pump), but as of lately it has been three. Only paired with MDA, and the whole experience has been very autonomous. They come in for induction, to peek at TEE, and for coming off pump (but to guide...not hip check)...otherwise the show is yours. We are expected to do it all and to know what we are doing. It is a great experience so far...it will be hard going to back to primary site and being told what to do again, but it will be nice not to wake up at 0340.

While we are talking about hearts, I wanted to ask everyone what there practice is for how they administer Amicar...bolus or gtt? I have seen different things and wanted to figure out the norm.

[jewelcutt]

Absolutely loved my cardiac rotation. We do about 5-6 hearts a day, got other experience also(thoracic aneurysms, ASD/VSD, ventricular remodeling procedures, crashes). Basically the CRNA supervises (sits in back) and helps out at busy times, MDA comes in for induction, TEE, and coming off pump. But we manage the case and coming off pump. I'm sorry to hear about your rotation, perhaps you could request to do hearts at other places. They're basically all the same, just a different setup at different hospitals.

[MaleAPRN]

The way I give Amicar is per surgeon's preference: A bolus over half an hour started once the surgeon walks in the room. Then a drip to last till transfer to CVICU.

[miloisstinky]

BWT,

i think its luck of the draw...i had the same experience in my cardiac rotation, i was basically the go-fer and the robot. I still learned a lot, but had no autonomy at all, even had to "ask" before i gave a freakin dose of a narcotic!!! And God forbid i even touch the TEE!