The End of an Era

It's hard to believe this journey has come to an end...and I made it out alive!



Graduation was quite honestly one of the best nights of my life, it's even up there with the day I got married....seriously, those two days are neck and neck at the top. If you've graduated from anesthesia school, you know what I mean!

UTC Anesthesia Class of 2011!

And oh, did we celebrate!

And then what?! Well, going from getting up at the crack of dawn every morning and spending 50 + hours in the OR every week to sitting at home studying was definitely an adjustment. But wow, did the house stay clean. I'm talking eat your dinner off the bathroom floor clean...OK I might not take it that far with a man living in the house.

I studied for 6 weeks. Now, I am not going to blow rainbows up anyone's behind and say I studied for 8 hours a day, everyday and even on the weekends. There's just no way. If you can study like that, more power to ya! I studied on average 4-5 hours a day, MAX. And for the first four weeks, none on the weekends. I went through Valley (which I highly recommend!) in the first four weeks and then studied the stuff I had trouble with for the last two weeks. I also focused most of my time in Memory Master from Valley in the last two weeks. I didn't purchase Prodigy but I did spend a little time in Core Concepts taking the practice exams.



I took my boards on Thursday September 22 at noon. I'm not usually a nervous test-taker but this was no ordinary test. I went to bed early the night before and tossed and turned all night. After siging over the naming rights to my first-born child to the NBCRNA, I was allowed to enter the testing room. I spent 5-10 minutes (I think I got sucked into a black time hole for some of that) staring at the screen before entering my answer for the 100th question. Then, BOOM. I was done. (Some of you may not know that the minumum number of questions on the certification exam is 100 and the max is 170....you can get any number of questions in between, but once the computer determines that you have passed or failed, it shuts down the test)



And then, the survey....really?


"How friendly was the staff at the testing center...blah blah blah" Ummm, couldn't we do this some other time? I have a lot riding on these results. Survey complete, I step out into the waiting room and the "all-knowing results-holding" guy says, "Wait, I need to print this on different paper". Cue panic attack. Slowly lower self to chair before passing out.





"This is torture, you know" I said to Mr. all-knowing, results-holding guy. "What?" He replied, "You don't know?" and hands me my results....






PASS














Oh Holy mother of God! I don't care what sort of fancy paper you want to print it on...this is good enough for me.













So, I managed to keep myself semi-composed while Mr. Letmeprintthisonfancypaper guy did his thing and handed me my results all official like. I RAN out to my car and pumped up the jam all the way home. Wow. I still get excited thinking about that day. And....I think it's now in the running for best day ever, right up there with graduation and getting married.





Daniel and I left that next day and headed to Orlando, FL to stay with his dad for two nights before making the drive to Miami on Sunday for a 7 day cruise through the Caribbean. We visited Half Moon Cay, Bahamas; St. Thomas in the USVI; San Juan, Puerto Rico; and Grand Turk. It was FABulous! I even got some of my tan back :)
























Now it is time to wait on the AL BON to process paperwork and send my license in the mail. Let the waiting begin :)

It's Been Quite Awhile~

Wow how time flies! I haven't been on top of the blog in the past few months, obviously!

Graduation is in 59 days. We were officially done with class at the end of April and are clinical only til August 11th. The learning curve has been steep and not even the peak of a plataeu is in sight! Now that I am doing more and more cases by myself, it validates all that I have learned in the past two years. It amazes me to know that I have done almost 1,000 cases in the past year and a half. It will probably take four or more years out of school to do that many cases again!

I just paid for my board exam today, so I guess I need to get serious about studying soon! I plan to get my provisional (temporary) license once I graduate (AL is one of the states that allow this) and work 1-2 days a week while studying for boards. Gotta start making up for these more than 2 years of unemployment! I will then take (and PASS) boards in September and hopefully a cruise to somewhere tropical won't be too far following.

The stress of anesthesia school doens't disappear, just changes. Now it's on to dealing with finding a job; paying for, studying for, and passing boards; filling out all the paperwork required for graduation/credentialing, etc.

Our anesthesia program hooding ceremony will be Friday night August 12th and our par-tay is scheduled for Saturday the 13th. It will be here before we know it!

Holly Daze

So the class of 2011 took our last final of the semester today. Exciting stuff since we only have one more class to go in spring and then it's only clinicals through August 11-- our last official clinical day. Graduation has been changed to Saturday August 13 at 10am. Our private anesthesia hooding will most likely be the Friday night prior and the big blowout Saturday night. We've already started planning the big event and hope to have it at the Loose Cannon art gallery downtown with DJ "Taz", a friend of Daniel's that also DJ'd our wedding.

The ACE (Anesthesia Consultants Exchange) annual Christmas party was this past Saturday night at the Sheraton downtown and here are some pictures. We had a blast!

National Nurse Anesthestists Week

National Nurse Anesthestists Week is coming up January 23-29, 2011.

Borrowed from the AANA website:


Anesthesia Q&A

Q: Is anesthesia safe?

A: According to a 1999 report released by the Institute of Medicine, anesthesia today is nearly 50 times safer than it was in the early 1980s. New monitoring technologies and drugs, increased education, and more extensive professional standards have made the administration of anesthesia one of the safest aspects of a surgical or obstetrical procedure.

Q: Who administers anesthesia?

A: In the majority of cases, anesthesia is administered by a Certified Registered Nurse Anesthetist (CRNA). CRNAs work with your surgeon, dentist or podiatrist, and may work with an anesthesiologist. CRNAs are advanced practice nurses with specialized graduate-level education in anesthesiology. For nearly 150 years, nurse anesthetists have been administering anesthesia in all types of surgical cases, using all anesthetic techniques and practicing in every setting in which anesthesia is administered.

Q: Will the nurse anesthetist stay with me throughout my surgery?

A: The nurse anesthetist stays with you for the entire procedure, constantly monitoring every important function of your body and individually modifying your anesthetic to ensure your maximum safety and comfort.

Q: Are there different types of anesthesia?

A: There are three basic types of anesthesia: General anesthesia produces a loss of sensation throughout the entire body; regional anesthesia produces a loss of sensation to a specific region of the body; and local anesthesia produces a loss of sensation to a small, specific area of the body.

Q: What determines which type of anesthesia is best for me?

A: The anesthesia chosen for you is based on factors such as your physical condition, the nature of the surgery, and your reactions to medications.

Q: Do different types of patients require different types of anesthesia?

A: Many factors go into determining the best anesthetic and administration technique for each person. Pregnant patients, children, older adults and patients with hereditary disorders such as diabetes or sickle cell anemia all require special consideration. Even lifestyle choices such as the use of complementary and alternative medicines, tobacco or alcohol can influence the anesthesia selection process.



Q: Why haven’t I heard about CRNAs? Are you a new profession?

A: Nurse anesthesia was established in the late 1800s as the first clinical nursing specialty in response to the growing need surgeons had for anesthetists. Nurse anesthetists, pioneers in anesthesia, have been administering anesthesia for nearly 150 years and have played significant roles in developing the practice.

Q: What is the difference between a CRNA and anesthesiologist?

A: The most substantial difference between CRNAs and anesthesiologists is that prior to anesthesia education, anesthesiologists receive medical education while CRNAs receive nursing education. However, the anesthesia part of the education is very similar for both providers. They are both educated to use the same anesthesia process in the provision of anesthesia and related services, and both adhere to the same standards of patient care.

Q: Tell me what to expect when I go for my anesthesia?

A: During the procedure, anesthesia allows you to be free of pain. All anesthesia care is provided with the highest degree of professionalism, including constant monitoring of every important body function. In addition to the nurse anesthetist’s role in the procedure itself, they also make many preparations for the patient before surgery. So it is important that the patient take an active role in these preparations by communicating and cooperating with their nurse anesthetist and surgeon. For example, frank and open discussion with the nurse anesthetist is key in the selection of the best anesthetic. In particular, the patient must speak freely and follow instructions closely regarding the intake of medications, food, or beverages before anesthesia. Such substances can react negatively with anesthetic drugs and chemicals.

Q: What educational qualifications must all CRNAs have?

A: As advanced practice nurses, CRNAs receive their specialty anesthesia education in more than 100 accredited graduate programs offering a master's degree. Admission requirements include a BSN or other appropriate baccalaureate degree, RN license, and a minimum of one year of acute care nursing experience. The anesthesia curriculum covers advanced anatomy, physiology, and pathophysiology; biochemistry and physics related to anesthesia; advanced pharmacology; and principles of anesthesia practice, plus hours of hands-on experience in a wide variety of cases and techniques. Upon graduation from an accredited program of nurse anesthesia education, the individual must successfully pass a national certification exam to hold the CRNA credential. Thereafter, the CRNA is committed to lifelong learning, with one requirement being 40 CE hours every two years for recertification.

From the commencement of the professional education in nursing, a minimum of seven years of education and training is involved in the preparation of a CRNA. The bottom line is you don’t have to be a physician to administer anesthesia.

Q: Where can consumers get more information about anesthesia?

A: Consumers are encouraged to call the American Association of Nurse Anesthetists at (847) 692-7050, or visit the AANA websites at www.aana.com and www.AnesthesiaPatientSafety.com.

Bad First Impression

I try to keep most of my posts positive and avoid the "politics" of being in anesthesia school. After a recent discussion with a classmate of mine, I felt compelled to share an excerpt from John Marble, CRNA's book entitled What I Was Not Necessarily Taught in Anesthesia School.

Some of you who are currently in school or even if you've been a practicing CRNA for years, you can probably relate:

"..you too may be misjudged by an instructor. Though you may have remarkable cognitive and/or clinical ability, you will be asked to function in an environment that you've never seen how to act within. No one cares that you may have been the best ICU nurse on a thirty bed unit. What they do care about is whether or not you are going to display the need to be prompted in order to sense something that you've never been exposed to; whether ot not it's interpreting something you've never seen, doing something you've never done, or recognizing a number that you have no idea what it means."

"..You'll be judged primarily from the start on something that you're assured to initially fail at due to a lack of being properly prepared by both the facility in which you used to work and a comprehensive, but nonspecific didactic course load. Consequently and sadly, some will jump on the 'nostalgia bandwagon' with a chain-smoking classmate while reminiscing just outside the cafeteria doors about how they and their classmates were 'never' like that, and would have been kicked out of school on the very first day if they ever were; all while secretly knowing that you are within earshot, but acting as if they don't."

"Just remember that they were once there too and were probably worse than you. This is their payback for having to endure the same confidence teardown that they are currently giving you and your classmates. You'll have more time to win them over. Just don't hug them before you leave when your time at their institution is up, or your clothes will end up smelling like an ash tray."

For more information on John's book visit: http://www.whatiwasnottaught.com/book.html

Interview Tips

Although interviews for UTC's class of 2013 took place this past Thursday and Friday, I have had several people in the past ask for advice on the interview process. This post is my personal experience only and may not be all-inclusive. First, a list of the personality traits of a good SRNA:

1. Don't be too quiet (you will be labeled as "passive" or "apathetic")
2. Don't be too loud (you will be labeled as "pompous" or "too aggressive")
3. You must be just the right amount of obsessive-compulsive
4. You must be adaptable to change
5. You must have tough skin
6. You need to be able to master organization and time-management skills

I realize many of the above qualities are contradictory, but so has been my experience in anesthesia school. As the saying goes, "you can't make everybody happy" and never has there been a more approppriate place/time. It took me 18 months to figure this out.

UTC/Erlanger interviews have historically been conducted in front of a panel including the following people: the head of the anesthesiology department at Erlanger, chief CRNA, assistant chief CRNA, UTC's nurse anesthesia program director, and both assistant directors.

Interviews typically start with "Tell me a little about yourself". This is a great time to talk about your career/educational experience, when you first learned about nurse anesthesia, why you want to be a nurse anethetist and maybe throw in some hobbies/interests. (I would keep the personal stuff to a minimum though).

It would be a good idea to have a patient to present as sometimes they might ask "Tell me about a typical patient you took care of in the unit you worked in". Or be prepared to answer "Tell me about a conflict you experienced at work and how you resolved it".

The most important piece of advice I can give regarding UTC's interview process is: DO NOT bring up a subject that you cannot elaborate on or discuss in detail (ie, clotting cascade, DIC, etc). Once you start discussing a clinical issue, you will usually be led down the rabbit hole until they know you don't know the answer to their question. It is OK to say "I don't know". It is even better to say "I don't know, that is something I would have to look up." The panel wants to know you aren't going to BS your way through a problem or refuse to admit you need help. This is also a tactic to see how well you perform under stress.

UTC's interviews are 99% clinically based while UAB's interviews are 99% personal questions. (At least this was my experience). Hope this helps! Feel free to elaborate in the comment section if you have anything to add.

I see the light....at the END of the tunnel!

Less than 10 months until graduation. August 14, 2011 for those of you who forgot :) We are halfway through this semester and it's amazing to me that we only have one more class left in the program. (Our last summer is clinicals only.)

I'm in OB this week and I'm finally getting some epidural and spinal experience. I will be the first to admit, sticking needles in people's backs never appealed to me, but as I gain more confidence, it's definitely growing on me. I actually did 3 epidurals today without any assistance but I must've been due up for a little dose of humility because the next two required a LOT of assistance from my CRNA. Screwing up epidurals is alot different than missing an intubation or having a slow wake-up in a general anesthestic because the patient and often times, their family, are alert, awake, and very much so paying attention to what you are doing/saying, etc. Our class is very fortunate to have a GREAT CRNA at the OB specialty site we work. He allows us to focus on the technicality of epidurals and spinals instead of paperwork, and other site-specific concerns.

Interviews for the class of 2013 are next Thursday and Friday, Oct. 28th and 29th. Good luck to everyone! We are ecstatic to see another group of fresh faces milling about.







I also realize that it has been awhile since I posted any pictures on the blog....BORING! Here are some pictures from this past weekend when we attended the Tennessee Association of Nurse Anesthetists Conference in Murfreesboro. Enjoy!