kkTrg-zlpmDYP_bho1NKLnEUrXg A Student CRNA Blog

Tuesday, April 5, 2016

CRNA Board Preparation

When you are in the CRNA program and the "finish line" appears closer than ever, another stress starts to creep on. BOARDS! All your mentors, family and professors can keep telling you that "you are going to do just fine" (and yes you will do fine) but it is difficult to stay calm. Good preparation and planning is the key to success. So how do you prepare? Here are some tips that helped me get through.

1) Timing
Getting your appointment for your exam is a difficult decision to make. "I didn't get time to study during clinicals", "I am not ready" etc are all the questions that may deter you from taking that step. Nevertheless, you NEED to do it. People tend to do better with deadlines and that little sense of nervousness will help you study better. If you go in without a set date for the exam you will more likely procrastinate (I did :) ). Also, regardless of the date you are taking the exam, there is always a topic that can be prepared better. That should not be the reason to delay your exam since we all have topic that are difficult to understand. So, make that appointment and don't change it because you feel unprepared. 

2) Studying 
It is ideal to study throughout the program however, we all know it is unrealistic. Some clinical sites have difficult rotations, exhaustion, and family matters can all play a role in limiting your study hours. It is important to set realistic study hour goals based on clinical sites. For example, 8 hour days may allow you 2 hours of studying whereas 12 hour clinical days allow you only 1. Use them appropriately. 

3) Topics
I know everyone's learning styles and habits are unique to themselves. So, know yourself. Don't follow the group. Choosing topic to study may work better if you have something to relate to. Discuss a topic with your clinical preceptor, relate it with your case, or study about your case a day prior. Studying and relating it to real-life situation is a great way to retain information. 

4) Review Course
There are so many review courses out there that may make it almost overwhelming to choose from. Every one of them have positives and negatives that again relate to your personal learning habits. I learn better from lectures and visual information so Valley review course worked better. However, if you are interested in how the boards are set-up, then Prodigy or Apex (or others) may be ideal. 

5) Relax
Most important one for the last. Relaxation and sleep are often forgotten as a CRNA student but are key to your success. I was so exhausted after two weeks of post graduation studying that I was having a great deal of trouble retaining information. You don't want to go in tired. Eat well before the exam and drink enough water. I had to change the environment I studied in to keep it stimulating. 

At the end, remember you made it through the difficult part that is the school and this is really the easiest portion of CRNA program. Feel free to comment or email any specific questions you may have. Wish you all good luck! 

Saturday, February 13, 2016


Hi all,
So the reason for this long delay in posting has been a number of reasons both personal and professional. I have been busy with family and my the new addition to my family, Sandy, my "rez" dog. I have been told that that is a sign that you are permanent resident of rural Indian reservation. In addition to her keeping me occupied, I have also done something I thought I would never do again.
Yes, I am back in school and this is definitely the last time! I am in my third DNP course but it is no where close to being as interesting and exciting as CRNA school. All these time consuming assignments and discussion questions and research are so draining!
So why did I do it?
I believe that CRNAs and other advanced practice nursing specialties are in a constant battle for recognition with our physician colleagues. In order for us to be able to stand up for our profession, we need to take an active part in how things get to be in the today's medical field through research. I honestly believe that it gives us a much detailed understanding of why we practice the way we do. Another way of us being able to direct the practice rather than being directed.
I also wanted to match up with the soon to be all doctorate level CRNA graduate in the near future. I have always been interested in teaching and since most CRNA programs require a doctorate degree, it made sense to just get it done.
It isn't easy but I am in it to get it done.
I am hoping to return to my usual post frequency but I apologize for the delay already if I get too tangled up with life.
Hope everyone is approaching their goals as planned.

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Monday, October 12, 2015

Independent CRNA Practice vs. Team Care Model Vs. Anesthesia Supervision

Your graduation is coming up in a few months and you are looking for your first job. A lot of questions are popping in your mind mainly to do with salary, schedule and location of your new job. All seems to be in place yet there is something you didn't think would be as important in making you happy in your new career. Working supervised or as an independent CRNA.
Now I am not here to put down one anesthesia work model for another so lets put egos aside and really think through this. People have different priorities be it family, money, social life or schedule. However, if we were to think of our profession alone, how should new graduates read that fine print in that job offer that is offering ridiculous amount of money but something just isn't right.
Working in a supervised CRNA practice can mean a lot of things. It can start anywhere from "we have anesthesiologist here as a consult or emergency supervision purposes" or "No, you as CRNAs are not allowed to push your own induction drugs". Motive behind why certain places enforce supervision to a certain degree are usually to do with how CRNAs are presented to the hospital board members by the leading anesthesia group members. These kinds of jobs are more prevalent in bigger cities ruled by anesthesia groups. So, what should you look for before accepting a job?
Working under Anesthesiologist Supervision (and Team Care Model)
  1. Experience matters. This is not only true working with an anesthesiologist but also a senior CRNA. There are so many different ways of doing anesthesia but in dire situations, it is always good to have someone with more experience than you. So, as a new graduate CRNA (or an anesthesiologist) Knowledge sharing is a plus and it can be a good thing to work with someone. However, there is a very fine line where this can halt learning and turn you into a charting monkey. You cannot learn by not doing. Practical experience can only be gained by actually performing. Looking at someone else doing a regional block or putting in a central line won't mean anything until you get hands-on experience with it. Here is what you should pay attention to. It is a positive sign if you hear that anesthesiologist and CRNAs work together without restrictions and practical, hands-on teaching is promoted for all anesthesia providers. And you might want to rethink about places where you as CRNA don't do push induction drugs, call anesthesiologist for extubation and you cannot do peripheral or neuraxial blocks.
  2. 2) Interpersonal Relationship- I have been through rotation where CRNAs are looked as second class citizens and treated with disrespect and constant abuse. It is important to know your limitations but equally important to know your value. If you are being trained to perform as an independent provider then you should protect that right and not disrespect yourself by working in such place. Ask the CRNAs or RNs about how anesthesiologists and CRNAs get along. Do you get lunch breaks when you have floats and how are people relieved at the end of the day. This is especially important as some places CRNAs will be the last ones to leave at the end of their day. Extremely important! Also, clarify on the things that you are and aren't allowed to do before starting.
CRNA-Only Practice
  1. Now unless you are the sole provider for a facility, the pluses and minuses mentioned above still apply. Some CRNA-only practices run really efficiently with a comfortable working environment. Yet you can experience mistreatment if your group is being run by a poor leader. So be cognicent of that.
  2. Are you a leader: Now we all think making it thru a CRNA school is difficult and you have to be assertive in order to make it. However, when you are really on your own its a different game. You have to be a good leader who can organize a group of people to safely provide care to patients. Surgeons can be tough to deal with but at times you will have to stand your ground and not get run over. This is especially true if you are in a private practice where every case that you cancel makes you look bad. And to make matters even worse, you work for the surgeon's patient so they can be very pushy to make you do something you don't feel like is the right thing to do. There is a fine line between keeping good relationships between your team members and being a safe anesthesia provider.
These are a few of the many pros and cons to working in team care model and CRNA-only practice. It is up to you to decide what you are comfortable with. Your schooling was supposed to make you be comfortable enough to practice independently as you are not Anesthesia Assistants (Aas). So, don't underestimate your skill level and be brave and open to learn everyday to improve yourself. Your career's future depends on you! I highly suggest against working in places where you are not valued and limited from fully practicing your scope.

P.S. Sorry about the looong delay in posts. Personal life has been challenging over the past four months and I just started the doctorate program!! Most on that later.

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