Hi everyone,
It’s been a while since I blogged but it has been even
longer since graduation. Today it’s a year mark since graduation and it has
been a great one. There have been so many things I learned and improved. I agree
completely with what my preceptors told me during clinicals that “real learning
begins when you are on your own”. That leads me to the topic for today,
independence in the profession of Nurse Anesthesia.
If you are just considering applying for CRNA School, you
might think topic about jobs is a little too far for your interest. However, I
think the biggest shock for me not knowing much about the profession was
realizing that there is such a vast range of independence allowed in this
profession based on where you work. I am not talking about doing certain types
of cases but the scope of practice you will be “allowed” as a Nurse
Anesthetist. It may be a little difficult to grasp since as RNs we are all
expected to be efficient in everything (and often more) than our defined scope
of practice. The scope of practice for Nurse Anesthetists has unfortunately been
distorted by American Society of Anesthesiologists (ASA). So for us this means that even though skills
such as placing central lines, administering neuraxial anesthesia or regional
analgesia are under our scope of practice, we have to sort through multiples
jobs to find a place that “allows” us practice with such independence. I have
realized that the real depressing issue is that we have allowed that to happen.
I consider myself lucky to have attended a school that had clinical
sites all over the nation. This allowed me to experience vast array of settings
that CRNAs practice in today. These included completely supervised CRNAs
practices, MDA/CRNA groups without supervision and CRNA only practices. I get
goose bumps thinking about places like a clinical site that I attended where
CRNAs are highly supervised by MDAs and often treated as second class to
anesthesiologists. That is mostly not the norm and I have seen practices where
the relationship is harmonious. My goal with this is to have you consider that
if you are looking forward to a completely independent unsupervised CRNA career,
you might have to sacrifice a few “must haves” on your list until we have a
stronger professional organization that restricts these limitations. These may
include you having to move into a rural area, work in setting where you have to
take significant call days, and possibly lesser pay. So, before you make that
decision of attending a school, be sure you know what clinical experience they offer.
In addition, have a clear insight of the things that are important to you in
your CRNA career. I HIGHLY recommend focusing your clinical time to prepare yourselves
for an independent practice. It might even be worthwhile to make those tough
sacrifices to better yourself as an independent practitioner during the early
years of your career. Before I get off
the soap box, I do want to mention that I work in a rural area in a CRNA/MDA
model with 100% independence and practice every skill I learned during school
and I wouldn’t give up this freedom for anything.
5 comments :
thanks for your time and info, i am currently a 2nd years srna at downstate university in ny and love it , thanks for the real world experience. what state do you work in by the way , i am looking to work somewhere i can work autonomously and develop my skills.
I work in a rural area in Arizona. I do have full autonomy which I won't do without. It's the best way to improve your skills but be sure to have a strong base. Thanks for visiting the blog! Good luck!
Your blog was interesting! Did you work in a bigger hospital before going into a rural one? Do you feel it is beneficial to start in a larger hospital under an MD and then to one where you are independent? Or, do you feel your skills as a new graduate is suffice to work solo in a smaller hospital?
Sorry it took me a while to reply to your questions. I never worked at a big hospital as a CRNA. If you pick your school right, you should be confident enough to practice independently. Remember, we are CRNAs not AAs. I honestly don't see a benefit or harm of them being around. Certainly, experience matters but you can learn the same from senior CRNAs and MDs. Just my opinion. I be writing a post about that shortly.
Sorry for late reply. Thanks for responding I have since graduated and have been doing Locum work recently. I love it. There’s something to learn everyday. Thanks for your blog it helped me a lot just reading what your were going thru also. I have also written a book that’s shares my experiences as well going thru the crna journey. https://amzn.com/B01MG4XD9J If u are interested thanks again
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