Archive for February, 2007
Resources For CRNA Board Prep
Posted by: | CommentsFor the senior class members that will be graduating soon, board preparation is on everyone’s mind or else it should be. I have been doing a little searching around the web for resources for the nurse anesthetist board candidate and found a couple of interesting web sites. Listing these sites does not confer endorsement by me or anyone here. However, I think that checking these things out could prove helpful to you. Not everyone learns, studies or needs the same things. These various resources offer a range of products and services that if they suit your style then will help you to reach your goal of getting that Pass letter in the mail.
The first place to start is to narrow down your reading material. The large text books like Barash and Miller are great for general study and case preparation during your clinical years. When it comes down to the wire and time is getting pinched look for other reading material to help you prepare for boards. I suggest a couple of books. The Basics of Anesthesia, 5th ed edited by Stoelting and Miller is a great start as well as Morgan and Mikhail. Anesthesia Review by Faust is really top notch as well as the question and answer books like Anesthesia Secrets. Two books that I feel really are essential are Anesthesia and Co-existing Diseases by Stoelting and Review of Medical Physiology by Ganong. What I suggest is to read these two texts again during the last 6 months of clinical rotations. There is an amazing amount of physiology on the board test as well as stuff found in the Co-existing book.
Other review material and courses are listed below that I have found.
Valley Anesthesia review is a long time standby for board prep offering both review courses and valuable study material. Highly recommended.
Core Concepts Anesthesia Review On line course. I just ran into these folks the other day and they seem legitimate. I poked around their web site and found some interesting stuff like the Question of the Day. Recommend checking their service out.
Prodigy Anesthesia Review is an interesting web site presence. Like the Core Concepts place, here you can find pracitce exams that look very close to the real thing. Check them out and let me know what you think.
CRNA Secrets is another one that I need info on. Please check it out and let me know what you think of this guy!
Good luck and keep me informed about your progress.
Jim’s Pediatric Sheet Update
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One of the pleasures that I have today is to work with really great people. One of those individuals is Jim Carey who just happens to be the Vice-President of the California Association of Nurse Anesthetists (CANA). Jim has revamped his pediatric reference sheet and I just put the new version up on the web site here under Clinical Documents. The new version of Jim Carey’s Pediatric Sheet in PDF format can be reached here for your downloading pleasure. This little sheet is very helpful as a reference and general guideline when considering pediatric anesthetic choices. It must be remembered that anesthesia is an every changing applied medical science and any reference sheet is just that – a reference and does not replace sound clinical judgment so user be forewarned.
I was in the local court house the other day fulfilling my Jury Duty summons. While passing through the check point the security guard commented on the book that I was carrying at the time, “Basics of Anesthesia” by Stoelting and Miller who are the editors of the current edition. The security guard perks up and asks me, “Could you do anesthesia after reading that book…….its like Betty Crocker right?” I had to laugh and answer that, “No it would take a lot more than just reading this little book to be able to do safe anesthesia.” So I guess the pediatric sheet is like that too. Having the sheet will help you out Students but will not replace studying the big texts, clinical mentor-ship and years of experience.
Thanks Jim for the update I will save a copy and put it in my little folder which I carry with me in to the OR. Small note: Jim recently sent me a couple of pictures from last Halloween and I have enclosed one of them for your amusement. Pardon me Jim it is just too good to pass up!
Anesthesia Question Of The Day
Posted by: | CommentsI just found a link to an on line review course that publishes on line an anesthesia Question Of The Day. The course at Core Concepts Anesthesia Review is something that I am going to check out in the near future.
Enjoy!
There, I Said It Tells All
Posted by: | CommentsThe longer I am exposed to the great anesthesia practitioners the more respect I have for what we do in the OR. I feel so privileged to be where I am today with the opportunity to do anesthesia and to teach – I am really blown away every day. One of my former clinical instructors and true mentors has confided in me concerns about what it takes to do well as an incoming anesthesia student and I wanted to share their concerns with you. If you want to know the truth it may hurt but it will set you free. Thank you so much “There, I Said It”. You rock TISI! For those of you that want to be CRNA’s take heed and follow the advice of a pro and you will be well prepared for clinical residency.
Why I think year ICU experience isn’t enough by “There, I Said It”.
I am a Nurse Anesthetist and a Clinical Instructor of Anesthesiology at a large metropolitan teaching institution.
I have been a clinical instructor for some years, and have seen many students come and go. We have so many applicants to our program, and each time the interviewing process becomes more and more difficult, as each applicant appears to be cream of the crop. The difficult decisions as to who will be accepted into the program come from a comprehensive process that involves input from many individuals of varying levels of practice; from student nurse anesthetists to department chairs.
According to the AANA, requirements for admission to an accredited program of nurse anesthesia include a minimum of 1 year of acute care experience, such as in ICU or ER. Herein lies my beef. Applicants or students who think 1 year of acute care experience is enough to perform at an acceptable level, in my view, are sorely mistaken. I feel this requirement should be changed. Can one truly master the art of ICU or ER nursing in 1 year?? Is a year enough time to glean an adequate level of skills or experience in adult critical care or ER nursing? After one year, can you throw up epi, levophed, dobutamine, dopamine, nitro, etc. and truly be comfortable with what you are doing?? Do you think you’ll be able to insert a swan and know what in the hell you’re doing? How much code experience occurs over 1 year? Is a year time enough to mature the development of interpersonal relationships with other members of the health care team much less the patient? Ask yourself these questions and I bet your answer will be no, no and no!
The students who have slithered through the interview process with what looks good on paper but have never been realized in practice have a hell of a time in residency. The clinical instructor has to work overtime to protect the patient from the student. I daresay there are those individuals that just have met the minimal requirements and are truly stellar students. However, these are few and far between.
I suggest the minimal requirement in an acute care setting be increased to at least 3 years. Applicants, if you barely have the minimal requirements for admission, ask yourself if you truly have enough experience to entertain delivering anesthesia care to an elderly individual with an aortic aneurysm, a child with epiglottitis, or an individual with multiple gunshot wounds to the chest and abdomen.
Signed,
There, I Said It
Get To Work Old Man!
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Well – it’s been several months now since passing boards and vacation time is over. Since November 1st 2006 the gainful employment thing has been happening in full stride. I could not be happier as a nurse anesthetist! All of the hard work and struggle is worth it more than double. There was a running joke about the last year of clinical rotations that goes something like this. “If you can make it through this gauntlet still standing you are a winner.” Let me explain.
Most graduate education is difficult. I should know, this last effort was a second post graduate degree. However, in nurse anesthesia education the stakes are higher and many people feel its their duty and privilege to make life difficult for the prospective candidate for the Certifying Nurse Anesthesia exam. The gauntlet that the student runs is like a small alley way lined on both sides with angry frustrated preceptors that are wielding long bamboo sticks. Any unworthy student trying to run down the alley is beaten from both sides as they try to make it through. You think I am kidding – well maybe the allusion is too graphic but the idea still holds. In the words of one old timer mentor, “Yup, we love to cull the herd!” So its taken me a little time to recuperate from the last two years of very hard work getting through clinical residency. All of the bruises are healed but the scares still remain.
Now I am one! One what you ask. Well now I am one of the mentors and the bamboo is put away. You’re laughing I am hoping, yes? Actually I have been very fortunate and have been appointed to a faculty position at a leading Medical School that houses a nurse anesthesia program. Just little over six months ago I was a student and now I hold a faculty position with my own students to ed-u-ma-cate. I am humbled by the position I am in and having the time of my life. Love it! The perspective from the other side is of course different but I try to hold on to the kindness for others that suffering produces.
One of the questions that was asked of me during my interview process for the faculty position at the University of Southern California was how I would deal with a difficult student one who is not progressing or one that is not safe clinically. To be honest I do not feel that I am ready to deal with this case scenario and told them so. I can handle the new student and the ones that are a quick study. Maybe next year I will have a bit more experience to handle the difficult student. Just as an aside I do have many years of as a preceptor in another capacity so teaching and mentoring is not new for me.
So whats it like to be in practice now as a nurse anesthetist. Wonderful – I love my job and what I do. In our practice setting we work in a team collaborative practice with anesthesiology. The joint practice is great when the Staff are good. Every day is another learning experience which I can talk about in the future. For now I just wanted to touch bases with you and let you know that the NurseAnesthetist.org web site is still going strong. I will be recruiting new writers in the months to come and adding links that should prove helpful to the prospective CRNA or clinical resource for the practicing nurse anesthetist.
Your feedback is always encouraged so let me know what your ideas or concerns are. Thanks for reading.
