Category: Wellness

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Wellness

#107 – No Peace in Quiet with Keli Rueth, DNP, CRNA

What’s up yall this is Jon Lowrance and this is episode 107 – No Peace In Quiet with Keli Rueth.

I’m pumped to bring you this conversation with Keli where we discuss her first published novel, No Peace In Quiet.  

This episode was so much fun to record and I think you’re really going to enjoy it.  It’s a story that is worth sharing on an anesthesia podcast because it’s a story about how we as anesthesia providers explore the rest of our lives…  how we can step out from our clinical roles as anesthesia providers to express our creativity and joy in a different way than being mixologists and potion makers in the OR.  

In this episode, Keli and I talk through her process and approach to finding her passion for writing and how she has snuck that in to the nooks and crannies of her life between working as a mother, full time CRNA and professor of anesthesiology at the University of New England.  

Keli Rueth is the pen name of Dr Keli Scrapchansky, who, by the way, was one of my favorite people on planet earth even before I knew she was a novelist.  Keli started her career at Maine Medical Center just a few months before my wife, Kristin, and I did back 2015.  She graduated with her Master’s in Anesthesia from Old Dominion University in 2014 and went on to complete her Doctor of Nursing Practice at the University of North Florida.  Keli is one of those people who shows up anywhere with a smile on her face and brightens up the room she walks into.  It’s incredibly difficult to get through a conversation of any length with her without laughing about whatever topic is on the table.  She’s an easy conversationalist, a masterful clinician and educator and now, a published novelist.  

No Peace In Quiet is Keli Rueth’s first novel in a trilogy, the next volume of which has a planned release for later this summer.  I thoroughly enjoyed reading No Peace In Quiet and literally couldn’t stop turning the pages as the story developed and unfolded in the small town and surrounding mountains of Quiet, North Carolina.

You can check out Keli’s book at kelirueth.com.

And with that, let’s get to the show!

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Anesthesia Education Preparing for Grad School/Residency Wellness

#106 – What we know about anesthesia school formatting – Cassie Capps

What’s up yall! I am back after a few months off from the podcast. This is episode 106 – following up: what we know about anesthesia school formatting with Cassie Capps.

This is a follow up show to the episode that Cassie brought to us back in December on the effects of anesthesia school didactic formatting on resident wellbeing… whether in-person, online, synchronous or asynchronous styles have any effect on your wellbeing as a trainee.

Before we get to this show, I’ve got a couple updates for you… our crew at Maine Medical Center has been on a bit of tour this spring attending conferences, job fairs and universities telling the story about our team and why we may be where you want to invest your career as an anesthesia provider. Cat Godfrey & April Bourgoin were just down at AANA’s Mid Year Assembly in Washington D.C. and then Cat made her way on to University of North Carolina at Greensboro to chat with the residents at Terry Wick’s program. She followed up dropping in on UNC-G with a virtual lunch & learn session with Mary Baldwin University’s anesthesia program over in Virginia. And then, Kristin and I just returned last week from Florida International University’s job fair down in Miami. We were so happy to know that even the locals thought it was super hot cause oooooooo….eeeeeeee… it was swimmy humid and all kinda hot down in the Sunshine State. We were stoked to meet a bunch of FIU anesthesia residents and tell yall about our absolutely gorgeous summers and four season climate up in Maine and how we’re probably where you want to start your career if you’re looking for a top notch level 1 trauma center to be at where you’re treated with respect, well-supported and want to join a thriving team that has a ton of fun working together. Just saying.

Part of my intention with Anesthesia Guidebook is to help CRNAs make a successful transition to practice and if you’re looking to do high acuity work in a busy tertiary medical center surrounded by an amazing team and in a phenomenal location, drop me a line and we can chat. I’d love to tell you more about our crew and see if we’re a good fit for where you’re headed.

In other news, this fall I’m teaching at Encore Symposium’s Autumn in Bar Harbor and Acadia National Park conference. If you’re looking for a spot to come knock out some continuing education this year, Encore is headed back to Bar Harbor, Maine, which is just outside of Acadia National Park, from October 14-17. If you’ve never been to Acadia, or Bar Harbor or Maine… this is your chance. Come check it out. Acadia in October is simply stunning… a national park, on an island, in Maine. With your anesthesia friends! You’ll be hard pressed to find a cooler spot to come get your learn on. Hope to see you there!

All right… with that, let’s get to this show. Cassie Capps is back. We first heard from Cassie in late December 2024 on episode 99 of Anesthesia Guidebook and now she’s back to walk us through the impact of anesthesia school didactic formatting on resident wellbeing. Thank to everyone who took Cassie’s survey and provided your insights… the data was actually a bit surprising so let me re-introduce Cassie to you and then she’s gonna get right to it.

This podcast was part of Cassie Capps’ Doctor of Nursing Practice in anesthesiology program at the University of Arizona. Prior to anesthesia training, Cassie was a CVICU Registered Nurse for 8 years and worked in the cath lab for 5 years before that. Prior to nursing school, Cassie completed a Master’s degree in music with a focus on Piano Performance & Pedagogy. Cassie continued to teach piano on the side while completing her doctorate in anesthesiology at the University of Arizona.

Her unique experience with anesthesia school included moving through her program as a single mom of an 11 year old daughter. She also continues to play a big role in the lives of her two former stepdaughters, who are now young adults. 

This podcast is coming out in May of 2024 and with that, let’s get to the show!

References

Alajmi, B., & Alasousi, H. (2019). Understanding and motivating academic library employees: theoretical implications. Library management, 40(3/4), 203-214. https://doi.org/10.1108/LM-10-2017-0111

Baqutayan, S. M. S. (2015). Stress and Coping Mechanisms: A Historical Overview. Mediterranean Journal of Social Sciences; Vol 6, No 2 S1 (2015): March 2015. https://www.mcser.org/journal/index.php/mjss/article/view/5927/5699

Berry, G. R., & Hughes, H. (2020). Integrating Work-Life Balance with 24/7 Information and Communication Technologies: The Experience of Adult Students With Online Learning. The American journal of distance education, 34(2), 91-105. https://doi.org/10.1080/08923647.2020.1701301

Botha, E., Gwin, T., & Purpora, C. (2015). The effectiveness of mindfulness based programs in reducing stress experienced by nurses in adult hospital settings: a systematic review of quantitative evidence protocol. JBI database of systematic reviews and implementation reports, 13(10), 21-29. https://doi.org/10.11124/jbisrir-2015-2380

Centers for Disease Control and Prevention. (2022). Poor nutrition. https://www.cdc.gov/chronicdisease/resources/publications/factsheets/nutrition.htm

Columbia University. (2022). How sleep deprivation impacts mental health. https://www.columbiapsychiatry.org/news/how-sleep-deprivation-affects-your-mental-health

Conner, M. (2015). Self-Efficacy, Stress, and Social Support in Retention of Student Registered Nurse Anesthetists [Article]. AANA Journal, 83(2), 133-138. http://ezproxy.library.arizona.edu/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=asn&AN=102321364&site=ehost-live

Council on Accreditation of Nurse Anesthesia Educational Programs (COA). (2020, 3/22/21). FAQ’s and statement regarding meeting clinical requirements. https://www.coacrna.org/coa-statement-regarding-coronavirus-disease-2019-covid-19/

Council on Accreditation of Nurse Anesthesia Educational Programs (COA). (2022). List of accredited educational programs. https://www.coacrna.org/wp-content/uploads/2022/07/List-of-Accredited-Educational-Programs-July-18-2022-1.pdf

Day, C. M. F., Lakatos, K. M., Dalley, C. B., Eshkevari, L., & O’Guin, C. (2022). The Experience of Burnout in the SRNA Population and Association With Situational and Demographic Factors. AANA Journal, 90(6), 447-453. 

Desmet, P., & Fokkinga, S. (2020). Beyond maslow’s pyramid: Introducing a typology of thirteen fundamental needs for human-centered design. Multimodal technologies and interaction, 4(3), 1-22. https://doi.org/10.3390/mti4030038

Freitas, F. A., & Leonard, L. J. (2011). Maslow’s hierarchy of needs and student academic success. Teaching and learning in nursing, 6(1), 9-13. https://doi.org/10.1016/j.teln.2010.07.004

Griffin, A., Yancey, V., & Dudley, M. (2017). Wellness and thriving in a student registered nurse anesthetist population. AANA Journal, 85(5), 325-330. 

Hale, A. J., Ricotta, D. N., Freed, J., Smith, C. C., & Huang, G. C. (2019). Adapting Maslow’s Hierarchy of Needs as a Framework for Resident Wellness. Teaching and Learning in Medicine, 31(1), 109-118. https://doi.org/10.1080/10401334.2018.1456928

Harwood, K. J., McDonald, P. L., Butler, J. T., Drago, D., & Schlumpf, K. S. (2018). Comparing student outcomes in traditional vs intensive, online graduate programs in health professional education. BMC medical education, 18(1), 240-240. https://doi.org/10.1186/s12909-018-1343-7

Hoffman, H. J., & Elmi, A. F. (2020). Comparing Student Performance in a Graduate-Level Introductory Biostatistics Course Using an Online versus a Traditional in-Person Learning Environment. Journal of statistics and data science education, ahead-of-print(ahead-of-print), 1-10. https://doi.org/10.1080/10691898.2020.1841592

Imus, F. S., & Burns, S. (2015). What to Consider Before Beginning Graduate Education: A Pilot Study. AANA J, 83(5), 345-350. https://www.ncbi.nlm.nih.gov/pubmed/26638456

Imus, F. S., Burns, S., & Weglarz, D. M. (2017). Self-efficacy and graduate education in a nurse Anesthesia program: A pilot study. AANA Journal, 85(3), 205-216. 

Institute for Healthcare Improvement. (2023). How to improve. https://www.ihi.org/resources/Pages/HowtoImprove/ScienceofImprovementHowtoImprove.aspx

Kondo, M. C., Jacoby, S. F., & South, E. C. (2018). Does spending time outdoors reduce stress? A review of real-time stress response to outdoor environments. Health & place, 51, 136-150. https://doi.org/10.1016/j.healthplace.2018.03.001

Lowrance, J. (2023). Anesthesia Guidebook. https://anesthesiaguidebook.com

Malek-Ismail, J. (2021). Thriving in the First Semester of Graduate School: A Process of Rebalancing and Self-Determination. The American journal of occupational therapy, 75(S2), 7512520410-7512520410p7512520411. https://doi.org/10.5014/ajot.2021.75S2-RP410

Maslow, A. H. (1943). A theory of human motivation. Psychological Review, 50(4), 370-396. 

Mesisca, J., & Mainwaring, J. (2021). Stress, Anxiety, and Well-being in Nurse Anesthesia Doctoral Students. AANA J,89(5), 396-402. https://www.ncbi.nlm.nih.gov/pubmed/34586993

Montag, C., Sindermann, C., Lester, D., & Davis, K. L. (2020). Linking individual differences in satisfaction with each of Maslow’s needs to the Big Five personality traits and Panksepp’s primary emotional systems. Heliyon, 6(7), e04325-e04325. https://doi.org/10.1016/j.heliyon.2020.e04325

National Center for Education Statistics. (2021). Table 9. Unduplicated headcount enrollment at Title IV institutions, by control of institution, student level, level of institution, and distance education status of student: United States, 2020–21. In: U.S. Department of Education.

Osaili, T. M., Ismail, L. C., ElMehdi, H. M., Al-Nabulsi, A. A., Taybeh, A. O., Saleh, S. T., Kassem, H., Alkhalidy, H., Ali, H. I., Al Dhaheri, A. S., & Stojanovska, L. (2023). Comparison of students’ perceptions of online and hybrid learning modalities during the covid-19 pandemic: The case of the University of Sharjah. PLoS One, 18(3), e0283513. https://doi.org/10.1371/journal.pone.0283513

Palmer, L., amp, J. M., Ren, D., & Henker, R. (2014). Comparison of Nurse Anesthesia Student 12 Lead EKG Knowledge, Interpretation Skill, Satisfaction and Attitude: Traditional Instruction vs. Asynchronous Online Video Lecture. Journal of Online Learning and Teaching, 10(3), 420-n/a. https://ezproxy.library.arizona.edu/login?url=https://www.proquest.com/scholarly-journals/comparison-nurse-anesthesia-student-12-lead-ekg/docview/1650489030/se-2?accountid=8360

Papaleontiou–Louca, E., Esmailnia, S., & Thoma, N. (2022). A Critical Review of Maslow’s Theory of Spirituality. Journal of Spirituality in Mental Health, 24(4), 327-343. https://doi.org/10.1080/19349637.2021.1932694

Pecka, S. L., Kotcherlakota, S., & Berger, A. M. (2014). Community of inquiry model: Advancing distance learning in nurse anesthesia education. AANA Journal, 82(3), 212-218. 

Polit, D., & Beck, C. (2020). Nursing Research. Philadelphia, UNITED STATES Wolters Kluwer Health. 

Pressman, S. D., Gallagher, M. W., & Lopez, S. J. (2013). Is the Emotion-Health Connection a “First-World Problem”? Psychological science, 24(4), 544-549. https://doi.org/10.1177/0956797612457382

Wilson, J. T., Gibbons, S. W., & Wofford, K. (2015). Process Improvement: Addressing Attrition from the Uniformed Services University of the Health Sciences Nurse Anesthesia Program. AANA J, 83(5), 351-356. https://www.ncbi.nlm.nih.gov/pubmed/26638457

Worthen, M., & Cash, E. (2022). Stress Management. StatPearls [Internet], Jan. 2022. https://www.ncbi.nlm.nih.gov/books/NBK513300/

Yaribeygi, H., Panahi, Y., Sahraei, H., Johnston, T. P., & Sahebkar, A. (2017). The impact of stress on body function: A review. Excli j, 16, 1057-1072. https://doi.org/10.17179/excli2017-480

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Anesthesia Education Personal Finances Preparing for Grad School/Residency Wellness

#102 – Marriage + Anesthesia School with Brad & Madisson Marcum

Brad & Madisson Marcum join me to talk about the dynamics of being married and going to anesthesia school together. They met in nursing school, had divergent paths professionally for a bit, with Brad starting nurse practitioner school and Madisson considering anesthesia school. They ended up sharing the same goal of becoming CRNAs and we talk through their approach to applying together, getting into the University of Evansville together and working through the program alongside one another.

In episode 15, I talked with Jenny & Robert Montague about what it’s like for the significant others of anesthesia residents. Jenny has her Master of Science in Nutrition and works as a Registered Dietitian and supported Robert and their 2 kids while he attended the University of New England’s anesthesia program.

In epsisode 50, I caught up with Lein & Nate Woodin to talk specifically on parenting in anesthesia school. Nate is a family therapist and supported Lein and their 2 kids while she went through the University of New England’s anesthesia program.

In this episode, Brad & Madisson Marcum talk about what it’s like to both get into and work through anesthesia school together. We’re planning for this to be the first in a series of conversations with them as they progress through their program. They’re just finishing their first year of training and have yet to start clinicals. I plan to touch base with them down to the road to see how that phase of the program goes.

Folks are often making difficult decisions around when to do anesthesia school. For a couple in my program, the husband went through school 2 years ahead of his wife, who was in my class, and they overlapped for just one semester. A local couple here in Portland stacked their programs end to end with one of them fully completing the program and a semester after that, the other starting anesthesia school. That stretched their anesthesia training experience to a full six years as a couple.

My hope is that this conversation with Brad & Madisson helps you and your partner think through the considerations around what you want to do or how it’s going for you if you’re currently in a program.

Brad hails from Salem, Illinois and spent 5 years as a critical care Registered Nurse in the cardio thoracic & transplant ICUs at Mayo Clinic prior to starting anesthesia school in the University of Evansville’s DNAP program. His clinical interests are regional anesthesia and opioid sparring anesthetic techniques with an emphasis on pharmacology and pharmacogenetics.

Madisson is from Effingham, Illinois and also spent 5 years as a critical care Registered Nurse in the trauma surgical ICU at Mayo Clinic in Rochester prior to anesthesia training. Her clinical interests are regional anesthesia and difficult airway management.

They are focusing their doctoral project on the functionality and effectiveness of virtual reality training in anesthesia programs and plan to utilize Peter Stallo’s SIMVANA VR platform for research. You may remember my conversation with Peter in episode 96 on SIMVANA and virtual reality in anesthesia education. It’s a fascinating discussion on what will likely become a central element to anesthesia education in years to come.

Long term, Brad & Madisson intend to become involved in medial mission trips and create a pediatric charity foundation to provide basic necessities to children in need in their local area following anesthesia school.

Brad and Madisson Marcum

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Anesthesia Education Preparing for Grad School/Residency Wellness

#99 – The Effects of Anesthesia School Didactic Formatting on Resident Wellbeing – Cassie Capps

Cassie Capps, BSN, SRNA joins me to talk about the effects of didactic formatting in anesthesia training on resident wellbeing including stress, anxiety, confidence and academic performance. Her specific focus is on the mix of online versus in-person course work for nurse anesthesia trainees.

Cassie overviews what the literature says about this topic and is looking for YOU to join her efforts by completing a very quick survey about your experience at the end of this podcast.

The survey HAS CLOSED.

Cassie is completing her Doctor of Nursing Practice in anesthesiology at the University of Arizona and this study is part of her doctoral work. Prior to anesthesia training, Cassie was a CVICU Registered Nurse for 8 years and worked in the cath lab for 5 years before that. Prior to nursing school, Cassie completed a Master’s degree in music with a focus on Piano Performance & Pedagogy. She continues to teach piano on the side while completing her doctorate in anesthesiology at the University of Arizona.

Her unique experience with anesthesia school included moving through her program as a single mom of an 11 year old daughter. She also continues to play a big role in the lives of her two former stepdaughters who are now young adults.

This podcast is coming out on December 26, 2023. I hope you’ve had an amazing year and am thrilled to bring this episode to you. Please take a moment and complete the survey and help Cassie get some solid data for her project. Stay tuned because I plan to reconnect with Cassie in a couple of months after she’s crunched the numbers and see what she’s learned.

REFERENCES

Alajmi, B., & Alasousi, H. (2019). Understanding and motivating academic library employees: theoretical implications. Library management, 40(3/4), 203-214. https://doi.org/10.1108/LM-10-2017-0111

Baqutayan, S. M. S. (2015). Stress and Coping Mechanisms: A Historical Overview. Mediterranean Journal of Social Sciences; Vol 6, No 2 S1 (2015): March 2015. https://www.mcser.org/journal/index.php/mjss/article/view/5927/5699

Berry, G. R., & Hughes, H. (2020). Integrating Work-Life Balance with 24/7 Information and Communication Technologies: The Experience of Adult Students With Online Learning. The American journal of distance education, 34(2), 91-105. https://doi.org/10.1080/08923647.2020.1701301

Botha, E., Gwin, T., & Purpora, C. (2015). The effectiveness of mindfulness based programs in reducing stress experienced by nurses in adult hospital settings: a systematic review of quantitative evidence protocol. JBI database of systematic reviews and implementation reports, 13(10), 21-29. https://doi.org/10.11124/jbisrir-2015-2380

Centers for Disease Control and Prevention. (2022). Poor nutrition. https://www.cdc.gov/chronicdisease/resources/publications/factsheets/nutrition.htm

Columbia University. (2022). How sleep deprivation impacts mental health. https://www.columbiapsychiatry.org/news/how-sleep-deprivation-affects-your-mental-health

Conner, M. (2015). Self-Efficacy, Stress, and Social Support in Retention of Student Registered Nurse Anesthetists [Article]. AANA Journal, 83(2), 133-138. http://ezproxy.library.arizona.edu/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=asn&AN=102321364&site=ehost-live

Council on Accreditation of Nurse Anesthesia Educational Programs (COA). (2020, 3/22/21). FAQ’s and statement regarding meeting clinical requirements. https://www.coacrna.org/coa-statement-regarding-coronavirus-disease-2019-covid-19/

Council on Accreditation of Nurse Anesthesia Educational Programs (COA). (2022). List of accredited educational programs. https://www.coacrna.org/wp-content/uploads/2022/07/List-of-Accredited-Educational-Programs-July-18-2022-1.pdf

Day, C. M. F., Lakatos, K. M., Dalley, C. B., Eshkevari, L., & O’Guin, C. (2022). The Experience of Burnout in the SRNA Population and Association With Situational and Demographic Factors. AANA Journal, 90(6), 447-453. 

Desmet, P., & Fokkinga, S. (2020). Beyond maslow’s pyramid: Introducing a typology of thirteen fundamental needs for human-centered design. Multimodal technologies and interaction, 4(3), 1-22. https://doi.org/10.3390/mti4030038

Freitas, F. A., & Leonard, L. J. (2011). Maslow’s hierarchy of needs and student academic success. Teaching and learning in nursing, 6(1), 9-13. https://doi.org/10.1016/j.teln.2010.07.004

Griffin, A., Yancey, V., & Dudley, M. (2017). Wellness and thriving in a student registered nurse anesthetist population. AANA Journal, 85(5), 325-330. 

Hale, A. J., Ricotta, D. N., Freed, J., Smith, C. C., & Huang, G. C. (2019). Adapting Maslow’s Hierarchy of Needs as a Framework for Resident Wellness. Teaching and Learning in Medicine, 31(1), 109-118. https://doi.org/10.1080/10401334.2018.1456928

Harwood, K. J., McDonald, P. L., Butler, J. T., Drago, D., & Schlumpf, K. S. (2018). Comparing student outcomes in traditional vs intensive, online graduate programs in health professional education. BMC medical education, 18(1), 240-240. https://doi.org/10.1186/s12909-018-1343-7

Hoffman, H. J., & Elmi, A. F. (2020). Comparing Student Performance in a Graduate-Level Introductory Biostatistics Course Using an Online versus a Traditional in-Person Learning Environment. Journal of statistics and data science education, ahead-of-print(ahead-of-print), 1-10. https://doi.org/10.1080/10691898.2020.1841592

Imus, F. S., & Burns, S. (2015). What to Consider Before Beginning Graduate Education: A Pilot Study. AANA J, 83(5), 345-350. https://www.ncbi.nlm.nih.gov/pubmed/26638456

Imus, F. S., Burns, S., & Weglarz, D. M. (2017). Self-efficacy and graduate education in a nurse Anesthesia program: A pilot study. AANA Journal, 85(3), 205-216. 

Institute for Healthcare Improvement. (2023). How to improve. https://www.ihi.org/resources/Pages/HowtoImprove/ScienceofImprovementHowtoImprove.aspx

Kondo, M. C., Jacoby, S. F., & South, E. C. (2018). Does spending time outdoors reduce stress? A review of real-time stress response to outdoor environments. Health & place, 51, 136-150. https://doi.org/10.1016/j.healthplace.2018.03.001

Lowrance, J. (2023). Anesthesia Guidebook. https://anesthesiaguidebook.com

Malek-Ismail, J. (2021). Thriving in the First Semester of Graduate School: A Process of Rebalancing and Self-Determination. The American journal of occupational therapy, 75(S2), 7512520410-7512520410p7512520411. https://doi.org/10.5014/ajot.2021.75S2-RP410

Maslow, A. H. (1943). A theory of human motivation. Psychological Review, 50(4), 370-396. 

Mesisca, J., & Mainwaring, J. (2021). Stress, Anxiety, and Well-being in Nurse Anesthesia Doctoral Students. AANA J,89(5), 396-402. https://www.ncbi.nlm.nih.gov/pubmed/34586993

Montag, C., Sindermann, C., Lester, D., & Davis, K. L. (2020). Linking individual differences in satisfaction with each of Maslow’s needs to the Big Five personality traits and Panksepp’s primary emotional systems. Heliyon, 6(7), e04325-e04325. https://doi.org/10.1016/j.heliyon.2020.e04325

National Center for Education Statistics. (2021). Table 9. Unduplicated headcount enrollment at Title IV institutions, by control of institution, student level, level of institution, and distance education status of student: United States, 2020–21. In: U.S. Department of Education.

Osaili, T. M., Ismail, L. C., ElMehdi, H. M., Al-Nabulsi, A. A., Taybeh, A. O., Saleh, S. T., Kassem, H., Alkhalidy, H., Ali, H. I., Al Dhaheri, A. S., & Stojanovska, L. (2023). Comparison of students’ perceptions of online and hybrid learning modalities during the covid-19 pandemic: The case of the University of Sharjah. PLoS One, 18(3), e0283513. https://doi.org/10.1371/journal.pone.0283513

Palmer, L., amp, J. M., Ren, D., & Henker, R. (2014). Comparison of Nurse Anesthesia Student 12 Lead EKG Knowledge, Interpretation Skill, Satisfaction and Attitude: Traditional Instruction vs. Asynchronous Online Video Lecture. Journal of Online Learning and Teaching, 10(3), 420-n/a. https://ezproxy.library.arizona.edu/login?url=https://www.proquest.com/scholarly-journals/comparison-nurse-anesthesia-student-12-lead-ekg/docview/1650489030/se-2?accountid=8360

Papaleontiou–Louca, E., Esmailnia, S., & Thoma, N. (2022). A Critical Review of Maslow’s Theory of Spirituality. Journal of Spirituality in Mental Health, 24(4), 327-343. https://doi.org/10.1080/19349637.2021.1932694

Pecka, S. L., Kotcherlakota, S., & Berger, A. M. (2014). Community of inquiry model: Advancing distance learning in nurse anesthesia education. AANA Journal, 82(3), 212-218. 

Polit, D., & Beck, C. (2020). Nursing Research. Philadelphia, UNITED STATES Wolters Kluwer Health. 

Pressman, S. D., Gallagher, M. W., & Lopez, S. J. (2013). Is the Emotion-Health Connection a “First-World Problem”? Psychological science, 24(4), 544-549. https://doi.org/10.1177/0956797612457382

Wilson, J. T., Gibbons, S. W., & Wofford, K. (2015). Process Improvement: Addressing Attrition from the Uniformed Services University of the Health Sciences Nurse Anesthesia Program. AANA J, 83(5), 351-356. https://www.ncbi.nlm.nih.gov/pubmed/26638457

Worthen, M., & Cash, E. (2022). Stress Management. StatPearls [Internet], Jan. 2022. https://www.ncbi.nlm.nih.gov/books/NBK513300/

Yaribeygi, H., Panahi, Y., Sahraei, H., Johnston, T. P., & Sahebkar, A. (2017). The impact of stress on body function: A review. Excli j, 16, 1057-1072. https://doi.org/10.17179/excli2017-480

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Wellness

#94 – Shorts – Cue Ball

All right what’s up folks this is Jon Lowrance and it’s May 16, 2023.

This is episode 94 – and I’m calling it “shorts: cue ball.” 

And I don’t mean shorts like the things you wear but shorts like, this will be brief and there will be more episodes like this to come… you know, shorts.

But first… updates!  

Maine Medical Center will the at the AANA Annual Congress in Seattle this August. We’ll have a table in the exhibition hall and a couple of our CRNAs will be there to tell yall about our sweet gig and you can ask questions and see if where we’re headed is similar to where you want to head. Maybe you can join us. And we’ll join you. And we’ll move in the same direction. If you want practice a wide range of case types as part of a clinically excellent and supportive team while living in a super cool town that’s just big enough but doesn’t come with the downsides of huge metro areas, come check us out!

In other news, this fall I’m back on the teaching circuit… well, circuit might be a little generous – I’m teaching at 1 conference this year which is the New England at the Cliff House 2023 Encore Symposium in Cape Neddick, Maine.  The dates are October 16 – 19.  You can check out the other folks who will be presenting at the conference and register at Encore’s website, which is e-s-crnas.com.  Look for “New England at the Cliff House 2023 Encore Symposium” and again the dates are October 16-19.  This conference usually sells out by July.  Part of the reason is the location… the Cliff House is an iconic resort built in 1872 on a 70-foot cliff overlooking the Atlantic Ocean.  So if a fresh cool ocean air, granite cliffs and near by sandy beaches are your thing, this might be a great get-away to come get your learn on.  If you come, we’ll get the chance to talk about practical pharmacology for anesthesia providers, leadership in emergencies, best practices in neuromuscular blockage, monitoring & reversal, ERAS, airway management & a run down on what’s new in anesthesia… so much!  It’s going to be fantastic.  Encore Symposiums – October 16 – 19 – Cliff House.  I hope to see you there!   

All right, with that let me tell you about Neil deGrasse Tyson, the famed astrophysicist, and his take on cue balls. This will blow your mind…

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Anesthesia Education Business/Finances Wellness

#91 – Vantage Point for January 2023

What up yall. This is Jon Lowrance. I’m still here. 😂 We’re still here. This is the first episode of 2023 and the first episode on Anesthesia Guidebook since October – October!

I’m so glad to get back to the podcast and bring you this update. This is a re-cap of the last few months of my world. It’s also a reminder of what Anesthesia Guidebook is about and a look forward into 2023.

I’ve got some very exiting news to share… my wife is pregnant with our second baby boy, due in March, and I’ve also transitioned in my role at Maine Medical Center from the SRNA Clinical Coordinator and into the role of chief CRNA.

In this episode, I talk about that transition and a bit about the philosophy of organizational leadership that I have found to be most compelling that’s shaping my approach to supporting my team and will undoubtedly continue to influence the podcast.

Thank you to everyone who reached out in the last couple of months! Your check-in’s, DMs, podcast reviews and emails have been encouraging and much appreciated! I’m honored to share this space with you and to be part of your runs, Peloton rides, commutes, baby naps and all the other times you tune into Anesthesia Guidebook to stay sharp and get your learn on.

I want to share the link for the group that I have the opportunity to support as chief CRNA here: Maine Medical Center. Search for the CRNA positions in Portland, Maine. Come work with us… I hope to share more about our team and the why behind what we do a little later in the year. It’s a special place with an amazing team. Reach out and we can talk about it.

That said, I will always work to maintain a professional degree of separation between my place of employment and this podcast in terms of the information and opinions I share.  My views and opinions – and those of my guests – do not necessarily represent those of any of our employers.  With any medical education content, you should always consult with other healthcare experts, medical texts and peer-reviewed journals before acting upon anything you hear in a podcast or social media post. 

Take care and welcome to 2023! 

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Anesthesia Education Anesthesia Equipment and Technology Business/Finances Case Studies Clinical Tips Leadership in Emergencies Preparing for Grad School/Residency Wellness

#89 – Distraction in the OR with Heather Turcotte, DO

What’s up y’all this is Jon Lowrance and this is episode 89 – Distraction in the OR with Heather Turcotte, DO. Y’all, I am so stoked to bring you this conversation… I caught up with Dr Turcotte earlier this summer as she was finishing her residency in anesthesia and I’m pumped to finally get this out to you in early September of 2022. This topic was the focus of her residency project and senior grand rounds presentation and it definitely created a stir in our group as CRNAs, physicians, residents & SRNAs grappled with how to appropriately use cell phones and other technology in their practices.

Since it’s late summer, early fall… I gotta give a shout out to all the residents & SRNAs out there who graduated this summer. It’s always fun to see yall wrap up clinicals & residency projects and transition into your new jobs or fellowships.

I love getting texts & photos from SRNAs of their board results with the word PASS printed in the middle of the page… It’s such an incredible moment that makes all of the hard work worth it. So thanks to all of you who have reached out by email, text & social media recently with your passing boards photos, positive reviews & ratings of the podcasts and questions. This podcast puts me in touch with so many amazing people… I’ve recently heard from experienced providers to newly minted CRNAs on the day they pass boards, to brand new CA1’s to ICU nurses who found the podcast and are on the path to becoming anesthesia providers. Wherever you are in your own journey, my hope is that Anesthesia Guidebook will be a go-to guide for you as you seek to get your learn on and master your craft.

Heather Turcotte, DO joins me in this is fascinating conversation that weaves through the considerations around using cell phones in the OR, checking email/internet, music that’s playing, conversations, door swings and other forms of distraction in the operating room.

Dr Turcotte was born and raised in the great state of Maine. She earned a doctorate in physical therapy and practiced as a physical therapist for 4 years before going back to medical school in 2014 at the University of New England. Dr Turcotte finished her residency in anesthesiology at Maine Medical Center in 2022 and entered into private practice. Outside of medicine, she enjoys spending time with her husband and 3 kids, who are 9, 6, and 1 years old at the time of this recording, going to the beach, and drinking lots of coffee!

In this conversation, Dr Turcotte brings this discussion to life with a case study where an anesthesia provider settled out of court in a dispute on negligence in a case where the patient experienced hypotension and a PEA arrest, survived the case but died a few days later. The anesthesia provider had used their cell phone and anesthesia station computer to check email and online news stories. Interestingly, an expert anesthesia witness testified that the actions of the anesthesia provider in managing the patient were flawless. But just because the provider had used their cell phone & surfed the internet on the work computer, the legal team advised they settle to avoid a jury verdict on the case.

Cell phone use, open internet access including email, music playing the OR and so many other forms of distraction are common elements in operating rooms across the United States. Some institutions create policies that limit cell phone use in the OR. Others have policies that are more vague while others have no formal policies around cell phone use in the OR. There’s legitimate considerations for each of these… On one hand, how does a hospital enforce a policy that is very strict? Does creating a policy set that institution up for compliance issues or litigation? On the other hand, how can hospitals help engineer safe and reliable environments for providers to work in? As technology continues to become more and more central t0 the work we do, the issues of attention span, distraction, user experience of technology and systems engineering to create & maintain safe environments will remain important factors for each provider, group and institution to consider.

References

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Anesthesia Education Business/Finances Personal Finances Wellness

#81 – How to Navigate the Business of Anesthesia with Tracy Young, MSNA, CRNA, MBA

I caught up with Tracy Young, CRNA, MBA & CEO of YPS Anesthesia Services in Houston back in November 2019 to talk about the business of anesthesia.

Tracy is one of the most sought-after experts on the business of anesthesia not just at CRNA conferences but throughout the healthcare management & business industry.

In this episode we discuss a broad range of topics including anesthesia billing & staffing models, trends in reimbursement, differences between W2 & 1099 work, advice for establishing your first anesthesia staffing contract, how to succeed both in your career as an anesthesia clinician and how to transition into the business of anesthesia, how to maintain balance & wellbeing over the course of your career and other key insights.

Tracy covers the origin and mission of his business, YPS Anesthesia Services, which at the time of this interview (8 December 2019) supports over 450 anesthesia providers to staff over 60 endoscopy & ambulatory surgery centers and hospitals across seven states in the United States.

Tracy Young, CRNA, MBA, CEO of YPS Anesthesia Services

Tracy Young earned his Master of Science in Anesthesia (MSNA) from Texas Wesleyan University in 2000, found YPS Anesthesia Services in 2003 and went on to earn a Master in Business Administration (MBA) from George Washington University in 2008.

Leading YPS Anesthesia Services for nearly 20 years has provided Tracy a wealth of first hand experience in the anesthesia and healthcare business world. He enjoys giving back to the anesthesia community through teaching on business related issues for SRNAs at several anesthesia programs and for CRNAs through private conferences across the United States. Tracy also enjoys developing venture capital opportunities with both businesses in and out of healthcare. Tracy has been a long-time active member of the Louisiana State Association of Nurse Anesthetists, serving 2-terms as the president of the association.

All of this experience, coupled with Tracy’s easy-going Louisiana style, makes him one of the most sought-after expert presenters on the business of anesthesia. His presentations on business related topics are really some of the best I’ve heard. The power behind his talks comes from his deep personal knowledge coupled with an ability to communicate the relevance of business topics to practicing clinicians, both those working in employed W2 settings and those working in 1099 practices. But it’s not just this deep knowledge and keen teaching ability that Tracy brings to his talks. Perhaps the most powerful aspect of his ability to communicate is his character & integrity and emphasis on professionalism as a key to success in business.

Tracy often talks about the 3 A’s of Anesthesia.

The Three A’s of Anesthesia:

Amicable + Affable + Available

He encourages providers to understand that you’re in the service industry and your clients are diverse: it’s not just the patients, but the surgeons, the OR nurses & techs, the hospital administration and other staff. You’re in a service-oriented industry and embracing a positive attitude (being amicable & affable) while being available and supporting the delivery of efficient, high quality anesthesia care are critical aspects of developing a successful anesthesia practice or business.

I’m so glad you’ve found this podcast… it’s just an amazing conversation and I think you’re really going to enjoy it.

If you want to hear more from Tracy Young, I’ve linked in the show notes to another interview he did on the business of anesthesia with podcast host Jason Duprat of the Healthcare Entrepreneur Academy.

I should also mention, if it’s not obvious already, that Tracy is always recruiting physician anesthesiologists & CRNAs to join one of his many clinical sites or expand into new contracts. So if you’re looking for a great team to join with competitive benefits & compensation and flexible work schedules, be sure to drop them a line on their website at YPSAnesthesia.com.

Quotable moments:

“Some days you’re the bug & some days you’re the windshield.” – Tracy Young

“Trust takes a long time to build – 6 months, a year, multiple years to build that trust – but it only takes 5 seconds to loose that trust by one bad decision.” – Tracy Young

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#80 – How to do 1099 Anesthesia Work with Sandry Gaillard, MSN, CRNA

What’s up yall, this is Jon Lowrance with Anesthesia Guidebook. This is episode 80 – how to do 1099 anesthesia work with Sandry Gaillard, MSN, CRNA. This is the second episode in a short series on the business of anesthesia. I’m gonna do a little run of interviews and topics on the business of anesthesia in the next few weeks. In the last episode you heard from Navin Goyal, MD & Saket Agrawal, CEO, both with OFFOR Health on how physician anesthesiologists can expand their careers beyond their clinical practice. In upcoming shows you’ll hear from Tracy Young of YPS Anesthesia in an episode covering lots of topics on the business of anesthesia and another episode with Randy Moore & Desirée Chappell of NorthStar Anesthesia on change management & leadership in anesthesia.

These conversations are incredibly valuable for anyone in anesthesia even if you have no interest in running your own business or becoming a practice manager or leader. These podcasts are relevant for every staff CRNA, physician anesthesiologist & anesthesia resident because they help you understand the contexts that we all work in. A mentor shared with me that there’s four pillars of anesthesia: your clinical practice, which everyone has at least initially in your career, education & research, advocacy work & the business of anesthesia. While you might anchor yourself solely in your clinical practice as your primary or even only professional interest, it’s helpful to have a basic understanding of the other domains – education & research, advocacy & policy and the business of healthcare – so that you can be a more informed provider and adept at navigating your career.

This episode was first released on 14 February 2015. At the time, Sandry Gaillard, MSN, CRNA was working as an independent CRNA in a 1099 practice in rural Western North Carolina.

This episode was released as part of the initial launch of From the Head of the Bed, the podcast that preceded Anesthesia Guidebook. It’s an interview between Kristin Lowrance (formerly Kristin Andrejco) who at the time was a SRNA at Western Carolina University. Kristin and I both worked with Sandry while we were SRNAs at WCU and Kristin invited her on the show to talk about the basic difference between working as a W2 employee and 1099 contractor, as well as some of the unique characteristics of working in a small, rural independent CRNA practice.

Sandry clearly outlines the key differences between working as a W2 employee and working as a 1099 independent contractor. Her and Kristin discuss the financial & business considerations including filing taxes, hiring an attorney & accountant, setting up a business structure and insurance considerations. They also discuss the personal leap it takes to transition from working as a W2 employee to 1099 work where you have to learn to manage you finances & certain aspects of your career in much greater detail. Sandry shares her story of making this transition and gives some wonderful encouragement for others who might be considering making the switch.

Beyond discussing the financial & business considerations of working as a 1099 independent contractor, they discuss the unique characteristics of working in a small, rural CRNA-only practice.

It’s important to recognize that you can work as a 1099 “independent contractor” while still working in a group or with an anesthesia care team or with a larger company, whether that is a larger CRNA-only or physician-only group or an anesthesia care team model that includes both CRNAs & physicians. Filing taxes as a 1099 doesn’t mean you work in a CRNA-only or physician-only group. It’s simply a different business structure for your professional life and means you’re not a W2 employee. Working as a 1099 contractor brings certain tax benefits – as well as additional financial responsibilities – that W2 employees don’t have.

The bottom line is there are lots of opportunities for setting your work life up depending on what your interests and goals are. Many people prefer the relative ease of working in a W2 setting where an employer offers a benefits & compensation package including health insurance, retirement and professional liability insurance as well as a lot of other administrative support. Others prefer the flexibility and tax advantages of working in a 1099 setting. Layered on top of each of these fundamentally different financial & tax arrangements is the decision around whether you work as an independent provider or as part of an anesthesia care team or group.

This episode unpacks all of these considerations and is a great place to start if you’re wondering about what kinds of career opportunities or business structures are available for CRNAs and physician anesthesiologists.

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#79 – The Future of Healthcare with Navin Goyal, MD & Saket Agrawal, CEO with OFFOR Health

What’s up yall this is Jon Lowrance with Anesthesia Guidebook.  I’m really excited to bring you this episode on the future of healthcare with Dr Navin Goyal and Saket Agrawal of OFFOR Health.

This is episode 79 of anesthesia guidebook and it’s coming out on June 24, 2022.

This is one of the most interesting conversations I’ve had with contributors to this show.  Navin & Saket are here to discuss what the future looks like – or what it could look like – for physicians in healthcare.  They hit on something that’s not talked about very much in medical school or residency programs or every around the OR amongst your colleagues, which is “what more can you do” as a physician anesthesiologist?  What else is out there?  Graduating from medical school and completing your residency is really just the beginning – or as Navin puts it – fills one particular bucket in your career.  But there are other possibilities out there and now more than ever, he and Saket want to share with you how physicians can engage in new ventures and roles both in the healthcare sector and beyond as a way to leverage the value you bring as a highly trained clinician.

They unpack this story and create this invitation to look beyond your clinical practice through sharing the story of OFFOR Health and the path they’ve been on as business partners. 

So let me tell you a little about each of them and then we’ll get to it…

Navin Goyal, MD

Navin Goyal, MD is a physician anesthesiologist and a co-founder of SmileMD, a mobile anesthesiology startup that is aiming to change the accessibility of anesthesia to small practices. He is also a co-founder of Loud Capital, a venture capital firm that provides financial support to early-stage startups as well as value-added services such as business development and guidance in scaling sales operations.

Navin received his MD from the University of Cincinnati College of Medicine and trained in anesthesiology at the University of Chicago Medical Center.

Saket Agrawal 

Saket is the CEO of OFFOR Health, a company that brings access to specialists closer to home by partnering with local dentists and medical offices to deliver specialized care. Saket became CEO of OFFOR Health in 2016 after working for years in the technology space in Silicon Valley. 

Sakate graduated from The Ohio State University with training in computer science and engineering, earned his MBA in North Carolina, and worked in tech in San Francisco for nearly 10 years before SmileMD’s mission drew him back to Columbus.

So one of the contextual frameworks we worked off of in planning this discussion was physician anesthesiologist burnout.  Navin is going to share with you his own story of being over a decade into his clinical practice at a large academic medical center when he began to feel bored with the daily grind and started wondering what else was out there.  We talked before we recorded this about the MedScape 2022 Physician Burnout & Depression survey.  Now this is a survey I’ve been following for several years and sharing in my own talks at anesthesia conferences on wellness.  Each year, Medscape surveys around 13-15,000 physicians across 29 specialities and reports data on burnout, what contributes to burnout and how to mitigate it.  In their 2022 survey, they reported that 47% of physicians reported feeling burnt out last year.  

We certainly know the pandemic has created an incredible degree of stress on everyone’s lives – not just healthcare providers – and has served as a huge lever or catalyst for individuals across sectors to re-evaluate what they’re doing and why.  Physician anesthesiologists, along with CRNAs & other healthcare providers, are right in the middle of this cultural upheaval.  

And that’s another reason why I’m so pumped to bring you this talk.  Navin & Saket talk about what motivated them to create OFFOR Health and provide novel solutions – not only for patients in need – but for providers who are looking to shake things up in their own professional lives. 

You may remember back in episode 26 I spoke with Paul Samuels, a pediatric physician anesthesiologist about mobile pediatric dental anesthesia.  In that episode, he unpacked the nitty gritty of what SmileMD is all about – which an OFFOR Health company – along with the specific anesthesia considerations for practicing in mobile, pediatric dental settings.  Be sure to check that episode out if you want to hear a little more on SmileMD.

Stay tuned for lots of amazing things coming your way on the podcast… I’ve got several more shows on the business of anesthesia headed your way in the coming weeks along with one on the McLott Mix for opioid free anesthesia with Mr Jason McLott himself and ton of more content in the editing phase right now.  

As always, I’m stoked to hear from you.  Thank you so much for those of you who have reached out through email, Facebook, Instagram, Twitter – or even in person for all the SRNAs at the University of New England here in Portland, Maine.  

And with that, let’s get to the show!

Resources:

OFFOR Health

SmileMD

Anesthesia Guidebook episode on SmileMD: #26 – Mobile, pediatric dental anesthesia with Paul Samuels, MD

Physician Underdog, a book by Navin Goyal, MD

Beyond Physician – a professional development platform for physicians

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Anesthesia Education Clinical Tips Personal Finances Preparing for Grad School/Residency Wellness

#78 – Thrive in Training: how to transition to practice

This episode covers advice for the last six months of anesthesia training, transitioning out of training and into the first six months of your anesthesia practice.

The year encompassing your last six months of training through boards and your first six months of practice is epic!  

There’s a huge learning curve you encounter during your first six months of anesthesia practice following the “completion of training.” Finishing training is a bit of a misnomer given that the best providers keep training… keep practicing and developing towards true expertise and mastering their craft.

This was the first solo episode I produced on From the Head of the Bed, meaning just me and the mic. I originally published this on February 1, 2016, about 8 months after I completed anesthesia training and passed boards. At the time, I wanted to do a show on transitioning to practice before the lessons of that time faded from my immediate memory.

I think there’s three big aspects of the last six months of anesthesia training: completing your research/thesis/DNP or residency project, securing a job and passing boards. For CRNAs, we must pass boards before we begin work. For physician residents, you may start working as a board-eligible physician anesthesiologist and work towards completing boards after you make that transition to practice.

I speak a bit about wrapping up training in this episode from the experience side of things… your co-residents will likely scatter to take jobs all across the nation after training. Try to connect with them in the final months and thank your program faculty. They pour a ton of effort into developing you as a provider and launching you into the world. A little gratitude goes a long way towards helping them know their work is appreciated.

The first six months of your practice brings a massive learning curve as you’re finally charged with putting all of the pieces together on your own. This is an important time where you must answer the following questions concerning your actual practice:

  1. Why do I do what I do?
  2. Why do I not do what I don’t do?

Sounds simple enough, but you must clarify your decision making around clinical judgments and interventions finally for yourself and not because your program faculty or preceptors prefer you to do or not do something. My encouragement is that you frame your decision making on the latest evidence for best practices and not simply because you taught one way to do things. You must continue to evolve your practice after graduation.

I hope you enjoy this show. As always, drop your comments or questions on the website, social media or in an email to me. If you haven’t already, please take 3-5 minutes and drop a review on Apple podcasts. You rating, but especially your written review, helps push the podcast out to more people and helps those individuals trust the show.

I mentioned this article in the podcast:

Assante, J., Collins, S., & Hewer, I. (2015). Infection Associated With Single-Dose Dexamethasone for Prevention of Postoperative Nausea and Vomiting: A Literature Review. AANA Journal, 83(4), 281-288.

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#73 – Midlife Van Life: reinventing work-life balance with Kyle & Jen Steen

This show is so much fun and launching this now coincides with the launch date of my friends’ journey, which you’ll hear all about in this episode.  

Kyle & Jen Steen have been friends of mine for the last 7 years.  Kyle’s been a CRNA for 13 years, Jen is a fashion designer and farm-to-table chef.  The short story is they built out a custom Sprinter van into a tiny home on wheels, sold pretty much everything they own, including their house, and hit the road this week on a mid-career van life adventure with no end date on the calendar.  Kyle is 41, Jen is 39.  They’re in the middle of their careers.  

Kyle Steen, MSN, CRNA, van builder, adventurer, husband to chef & creator Jen Steen.

In this episode we talk about the why behind their decision and the how – both financially and specifically: like what kind of van they built, how they paired down 25 years of accumulated stuff to the absolute bare necessities and what they hope to do while they’re on the road.

This is a long-form interview.  We take our time over the next hour to talk through their decision & dream.  I can remember talking with Kyle & Jen when they first hatched this plan and I’ve watched them pull this dream together over the last couple of years.  We did this interview from their van on the day before their epic road trip kicks off this week.  You can see photos of the van in the show notes to this episode, on Anesthesia Guidebook’s Instagram page or in the biggest and best way by following Kyle & Jen on Instagram @FrankvannSteen. 

It’s not every day you see a highly intelligent, socially well-connected couple quit their high income day jobs and hit the road full time in a tiny home van.  We talk in this episode about the American Dream and the accumulation of wealth, status & possessions.  What I love about Kyle & Jen’s story is that they kept seeing people embrace the mantra of delayed gratification all the way up to retirement and then hit walls:  walls like ailing health, limited physical ability, cancer, strokes or just the fear of change that security & stability can subtly bring to one’s life… and they didn’t want that.  They didn’t want to just keep contributing to retirement accounts and doing the same thing every day while the best years of their life passed them by.  So they’re doing something different.  They’re taking a break from their careers to travel & create an adventure and a life worth living.


I think it’s so interesting because many people who go into anesthesia get very used to the income and routine of their careers.  Kyle & Jen’s decision drops the gauntlet for the rest of us to re-evaluate our lives and the why behind our lifestyles.  Where do you really derive your sense of enjoyment from?  If money wasn’t an issue, what would you do with your time?  Are you able to get to the point, even for a short period of time like a month, 3 months or a year, where your financial situation would allow you to chase that dream? To do that thing that may right now already be fading from the front of your mind under the scrutiny of Common Sense, your Practicality or sense of “but what would people think?”  

And maybe it’s not about finding a bunch of days all strung together but the ability to drop down a day or two per week.  We work on average four 10-hour shifts at our hospital.  My wife just dropped a day and now only works three 10-hour shifts a week.  That extra day off each week has made a huge impact on her well being and satisfaction, especially because it gives her more time to spend with our little 9-month old munchkin.  We also both take around 10 weeks off a year.  We could certainly work more and make more money, but we value the time more than the money we would make.

I came across this idea years ago that “what’s not important will continue on without you.”  

Kyle’s decision to step away from full time anesthesia work to adventure with Jen came at the same time that a couple of our other CRNAs, physician anesthesiologists and even our lead administrative specialist, retired after long, long careers at one institution.  Those people will be missed and there was a lot of legitimate nostalgia shared when looking back over their careers.  But the patients keep coming, the department has hired replacement staff and the healthcare machine churns on.  

I’ve always been wary of the sense that CRNAs and physician anesthesiologists are just cogs in a giant healthcare wheel.  It can be de-personalizing, anonymizing and demoralizing.  When you think about the statement “what’s not important will continue on without you,” it’s a reminder that we have to actively build for purpose in our careers… 

Research shows* that if you can arrange for 20% of your time at work to be geared towards something you truly are intrinsically motivated for, it’s protective against burnout.

(*Swensen, S. J., & Shanafelt, T. (2017). An Organizational Framework to Reduce Professional Burnout and Bring Back Joy in Practice. The Joint Commission Journal on Quality and Patient Safety, 43(6), 308-313.)  

I wanted to share Kyle & Jen’s story with you as an opportunity for you to re-evaluate where you’re at, where you’re headed and whether you need to make changes so you can take a step in the direction of being more fully alive.  LOTS of people go into anesthesia because it’s an amazing field and a fascinating type of hands-on, brainy kind of work that can be very rewarding and a service to others, but also, because the income allows us to pursue other things in our lives.  This podcast is an invitation for you to re-calibrate your story.  I hope you enjoy it and what it does to you as much as I have! 

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Anesthesia Education Preparing for Grad School/Residency Wellness

#72 – Thrive in Training: finding balance with Temima Luchansky & Maya Kelkar

In this episode, I’m joined by Temima Luchansky & Maya Kelkar, the 2 current SRNA reps to the AANA Health & Wellness Committee, to talk about how to find balance in anesthesia training.

Now if that immediately sounds impossible to you, then you’re listening to the right podcast.  We’re going to talk about a very concrete way of looking at your life and specific tips for how to manage the incredible challenges we face as anesthesia trainees.  

Balance can be an elusive concept to understand and an even more elusive state of being to achieve. Thankfully, the National Wellness Institute provides a simple framework to help us better understand what finding balance looks like in real life. It’s called the Six Dimensions of Wellness.  You can think of it like this:  there are six domains in each of our lives: social, emotional, occupational, physical, spiritual and intellectual.  Temima & Maya share insights for what each of these domains means to them as anesthesia trainees, the specific challenges they face in each domain and specific tips for how to thrive in each of these domains.

Finding balance happens when we work towards putting equal energy & focus into each domain. In the US, especially for Finding balance happens when we work towards putting equal energy & focus into each dimension of our lives.  For anesthesia and other healthcare trainees, a disproportionate amount of energy is usually placed on developing the occupational domain as we work through school and towards passing boards. Now, there’s times in our lives when we are intentionally out of balance: when we charge in one domain harder than in the others. And that can be ok for a period of time.  It can resulted in a concentrated period of extreme growth and development.  But for the long term, understanding what each of these domains can look like in your life and working to put equal energy into each of them can help build real wellness, resiliency and a very tangible & practical sense of balance in our lives.  

I’m so grateful that Temima & Maya took time out of their busy lives to join me to discuss the Six Dimensions of Wellness in this podcast. Both of these women are SRNA representatives to the national AANA Health & Wellness Committee. Temima became interested in volunteering on this committee after listening to a prior podcast on Anesthesia Guidebook with other SRNA reps to the Health & Wellness Committee.  And Maya came up with the idea for doing a deep dive on this specific topic after listening to a talk I gave at last year’s Idaho State Association of Nurse Anesthetists virtual conference on provider wellness.  Both of these individuals have powerful voices and are on a mission to help other SRNAs thrive in their training.  I think you’re really going to enjoy hearing from them, which is why I couldn’t find any way to trim this show down from around an hour & twenty minutes… it’s a long podcast but we talk through so much and they give wonderful, practical examples of how to work towards a healthy state of balance & wellness during your anesthesia training.  So break up the show over a few commutes or work outs and let us know what you think on Instagram, Facebook, Twitter or as comments on the website.  Speaking of the internet webs… the show notes of this episode has links to journal articles and a quick PDF run down on the Six Dimensions of Wellness from the National Wellness Institute.  We also link to the American Association of Nurse Anesthesiology’s website for Student Wellness which hosts a ton of resources for SRNAs who are actively trying to make it all work during training.  The AANA has put in a huge amount of effort on fostering proactive wellness initiatives for SRNAs & CRNAs in the last few years and I know these are having far reaching impacts in the anesthesia community.

Which reminds me, Temima & Maya will be hosting a live Zoom session for SRNAs they’re calling SRNA Shared Experiences through the AANA.  These are free, live Zoom sessions with a focus on peer-to-peer support in a judgment free zone.  Participants talk about the SRNA experience and how to be successful and well in anesthesia training.  The next session is in 2 days… Monday, March 21.  They run every other month, so if you miss Monday’s SRNA Shared Experience, you can circle back in May to hear from and talk with SRNAs around the nation in these free peer-to-peer support sessions.  

So a bit on Temima & Maya and then we’re on to the show… 

Temim Luchansky was born & bred in Baltimore, Maryland. She worked in Baltimore at a medical ICU for 2 years and then did 2.5 years of travel nursing in several hospitals throughout New York City in a mix of ICUs including CICU, SICU, CTICU, getting a variety of experience before CRNA school. She’s currently in the inaugural DNP Nurse Anesthesia class at Johns Hopkins University with an anticipated graduate date of 2023.

Maya Kelkar is a 2nd year nurse anesthesia student in the Gonzaga University/Providence Sacred Heart Medical Center Nurse Anesthesia Program. She’s from Atlanta, Georgia and her nursing background is in the pediatric ICU at Children’s Healthcare of Atlanta. The PICU is where she became passionate about healthcare provider wellness, after seeing high levels of burnout and compassion fatigue among her colleagues, and she was involved in wellness initiatives in her unit and for the hospital. She continues to promote wellness among anesthesia providers as one of the student representatives to the AANA Health & Wellness Committee. She also remembers citing From the Head of the Bed in her grad school interview and is THRILLED to be on the podcast.

Resources

AANA SRNA Wellness website

Wondering When to Ask for Help? Check this out from AANA…

Check out #54 – Hardship in Anesthesia School where I talk about my own path in anesthesia training and offer insights for how to keep moving even when the path gets incredibly difficult.

NWI-Six-Dimensions-ToolDownload
Stress-Anxiety-and-Well-being-in-Nurse-Anesthesia-Doctoral-StudentsDownload

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Anesthesia Education Anesthesia Equipment and Technology Human Physiology and Pathophysiology Preparing for Grad School/Residency Wellness

#71 – Thrive in Training: destroying didactics with Jenny Finnell, MSN, CRNA

Jenny Finnell, MSN, CRNA joins me to talk about how anesthesia trainees can master the didactic phase of their training. We cover lots of tips in this show: everything from how to make challenging content stick to how to get organized, which apps & resources are helpful and how to maintain mental wellbeing during anesthesia training.

This episode will help you dial in your plan for success in didactics. Our goal is for you to thrive and not just survive in school. The volume of information you have to master is immense and the learning curve is incredibly steep, especially when you begin to integrate clinical training into your journey. Creating early success in didactics is key to progressing in anesthesia school.

There’s 3 domains of knowledge in any kind of training:

  • the know-what
  • the know-why and 
  • the know-how.

The know-what is the core information, principles & facts.  

The know-why is understanding the situationally-specific rationales for actions & processes.

And the know-how is where we learn to put the know-what & the know-why into practice: it’s the experiential, practical application of knowledge. 

The didactic portion of training is where we pick up most of the know-what.  What you need to know is learned by studying, being taught, reading, watching video & listening to lectures & podcasts.  It’s here where we also learn a lot of the know-why: the rationales behind why we do things the way we do them in anesthesia.  You’re only able to develop the art of anesthesia if you have a solid foundation in the science of anesthesia.  Learning the know-how: the actual mechanics and flow of putting everything together, the timing & art of anesthesia is learned best by doing… especially when that experiential education is under the guidance of a skilled preceptor, clinical coach or mentor.  

Jenny Finnell, MSN, CRNA runs the CRNA School Prep Academy, which is a mentoring and professional coaching community designed for those who want to pursue a career as a CRNA.  Her team offers a blog, podcast and public & private forums as well as individualized coaching for every phase of preparing for anesthesia training.  She’s active on Facebook & Instagram if you want to see what the CRNA School Prep Academy is all about or you can certainly cruise over to her website at CRNAschoolprepacademy.com. 

Resources:

The CRNA School Prep Academy Ultimate Resource Guide:

…this is Jenny Finnell’s Six-Page Free Resource Guide. In it, she lists the best podcasts, YouTube channels, apps, websites, books related to anesthesia, studying/learning, grad school interviews and professional resources.

Chipas, A., & McKenna, D. (2011). Stress and burnout in nurse anesthesia. AANA journal, 79(2).

Vargo Anesthesia Mega App. This is an incredibly thorough app covering run downs on surgeries, pathological conditions, pharmacology and detailed weight-based guides to pediatric anesthesia. While you have to pay for this app, the cost is definitely worth what you get.

Master Anesthesia app in App Store: check out the story from app creator Matthew Willis in Episode 38 of Anesthesia Guidebook. This app is FREE and growing in its scope of surgeries & medications but rolled out with a phenomenal calculator for quickly seeing max doses of multiple local anesthetics.

Writing in the Sciences: FREE course on professional/scientific writing from Stanford University. Take this course to improve your professional writing.

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Anesthesia Education Preparing for Grad School/Residency Wellness

#70 – Thrive in Training – Growth Mindset with Jenny Finnell, MSN, CRNA

Jenny Finnell, MSN, CRNA, the creator behind the CRNA School Prep Academy joins us today to talk about growth mindset.

Learning to develop a growth mindset is key to pushing beyond where you’re at currently to where you want to go.

Carol Dweck is a psychologist and the Lewis and Virginia Eaton Professor of Psychology at Stanford University. Her research found that people generally work from two mindsets: a fixed mindset or a growth mindset. Dweck argues that intelligence is not fixed trait but something that can be developed and expanded with the right kind of training, effort and encouragement. Your IQ and certainly your SAT/ACT/GRE scores and even GPA are not the final word on your capacity, intelligence or potential. They’re merely snapshots of your performance at particular points in time on particular assessments. The way you see intelligence, challenges, obstacles, the success of others, the value of effort and your potential all relate to which mindset you work from. Her book, Mindset: the new psychology of success, is a worthy read for any one looking to master their craft and/or help others along the way. Whether you’re on the path to becoming an expert clinician, want to train the next generation of providers or even parent more effectively, Dweck’s work will show you the path.

Two Mindsets Chart.  (2016).  GLT Carol Dweck: Two Mindsets Chart and Compelling Questions.  Guidline Leaders and Teams.  Retrieved from https://guidingleadersandteams.com/resources-glt/carol-dweck-two-mindsets-chart-and-compelling-questions-glt/.  Screen shot by author.

Dweck, C. S. (2008). Mindset: The new psychology of success. Random House Digital, Inc..  Retreived from https://www.penguinrandomhouse.com/books/44330/mindset-by-carol-s-dweck-phd/9780345472328/.

Jenny Finnell, MSN, CRNA runs the CRNA School Prep Academy, which is a mentoring and professional coaching community designed for those who want to pursue a career as a CRNA.  Her team offers a blog, podcast and public & private forums as well as individualized coaching for every phase of preparing for anesthesia training.  She’s active on Facebook & Instagram if you want to see what the CRNA School Prep Academy is all about or you can certainly cruise over to her website at CRNAschoolprepacademy.com.  We’ll talk a little bit more about what she’s been up to with her company at the end of this show but first…

I’m so glad Jenny joined me to talk about growth mindset.  Learning to develop a growth mindset is key to pushing beyond where you’re at currently to where you want to go.  Whether you’re an experienced anesthesia provider, a current anesthesia resident or someone who’s on the path towards anesthesia training, understanding how to embrace a growth mindset and move beyond the limitations and shackles of a fixed mindset will help you actually thrive on the journey.  If you don’t just want to survive anesthesia training – or worse, not even make it, but you actually want to thrive, you need to understand how to develop a growth mindset. 

Resources:

Dweck, C. S. (2008). Mindset: The new psychology of success. Random House Digital, Inc..  Retreived from https://www.penguinrandomhouse.com/books/44330/mindset-by-carol-s-dweck-phd/9780345472328/

Jenny Finnell’s podcast: Growth Mindset & Why This Single Thing Can Allow Your Journey To Be Easier

Grant, A.  (2018, December 8).  What straight-A students get wrong.  The New York Times.  Retrieved from https://www.nytimes.com/2018/12/08/opinion/college-gpa-career-success.html

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Anesthesia Education Preparing for Grad School/Residency Wellness

#69 – Thrive in Training: how to start strong

The key to thriving in training is setting a trajectory in life based on your deep interest, learning to embrace deliberate practice in your craft, remembering your why and locking on to the hope that comes with knowing your goal is worth the work you will put in.

This series is designed to help physician and nurse anesthesia residents succeed in anesthesia training.

Topics covered include:

  • developing a growth mindset
  • dialing in didactics
  • crushing clinicals
  • developing time management
  • avoiding landmines and overcoming set backs
  • dealing with hardship in anesthesia training
  • financial management
  • preparing for and acing exams and boards
  • tips for the job hunt
  • transitioning to practice and through the first six months after training

I originally released this on February 21, 2015 on From the Head of the Bed (the predecessor podcast to Anesthesia Guidebook). I talk with Mason McDowell, DNAP, CRNA and Kara Michalov, MSN, CRNA on their top tips for success in anesthesia school. This is a bit of a 10,000-foot overview of how to thrive in anesthesia school. In later episodes in this series, we’ll dive into many of these topics in more detail. In this episode, we discuss:

  • how to start strong
  • should you work or moonlight during training?
  • advice for starting clinical
  • how to socializing (or not) in the OR as a resident
  • how to recover from novice mistakes and keep going
  • goal setting with preceptors
  • project/thesis identification & tips
  • advice on studying for boards

At the time of this interview, Mason McDowell, DNAP, CRNA was the Associate Professor and former Assistant Director of the Nurse Anesthesia Program at Western Carolina University.   His Doctorate of Nurse Anesthesia Practice (DNAP) from Texas Wesleyan University included research focused on perioperative patient management and cardiac risk assessment.  He is the co-author of the Hepatobiliary and Gastrointestinal Disturbances and Anesthesia chapter in Nagelhout’s Nurse Anesthesia.  A few weeks after this interview in 2015, Mason moved with his wife and two daughters to Bere, Chad to provide anesthesia. You can hear more about his story in episode 61 & 62 of Anesthesia Guidebook. You can also read about his experiences in Chad at http://www.whyweshouldgo.blogspot.com. 

At the time of this interview, Kara Michalov, MSN, CRNA was a CRNA in Asheville, North Carolina. Kara and Mason are co-authors of Intravenous Acetaminophen and Intravenous Ketorolac for Management of Pediatric Surgical Pain: A Literature Review, which was published in the February 2014 edition of the AANA Journal (Vol. 82, No.1).

A remarkable note on her paper:  her and her primary co-author, Kit Baley, submitted their paper for publication and received no request for corrections from their peer reviewers.  This is an incredible accomplishment as they essentially wrote a perfect paper on this topic prior to submitting it for publication.  Nice job, Kara & Kit! 

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Anesthesia Education Preparing for Grad School/Residency Wellness

#68 – Thrive in Training: how to prepare for anesthesia school

The Thrive in Training series is designed to help physician and nurse anesthesia residents succeed in anesthesia training.

The key to thriving in training is setting your trajectory in life based on your deep interest, learning to embrace deliberate practice in your craft, remembering your why and locking on to the hope that comes with knowing your goal is worth the work you will put in.

Topics covered include:

  • developing a growth mindset
  • dialing in didactics
  • crushing clinicals
  • developing time management
  • avoiding landmines and overcoming set backs
  • dealing with hardship in anesthesia training
  • financial management
  • preparing for and acing exams and boards
  • tips for the job hunt
  • transitioning to practice and through the first six months after training

In this episode, the second in the series, I talk with Mason McDowell, DNAP, CRNA and Kara Michalov, MSN, CRNA about the following:

– advice for how to prepare for nurse anesthesia school
– advice for students with families, significant others & pets
– what to study (or not) ahead of time
– how to prepare for the Big Interview to get into school

I released this episode originally on February 21, 2015 on the podcast From the Head of the Bed. Today, exactly 7 years later, it’s coming back to Anesthesia Guidebook as part of the Thrive in Training series with a fresh introduction. I also summarize tips for preparing for anesthesia school at the end of the show. What Mason & Kara share remains relevant and they offer keen insights from their personal experience. You’ll definitely enjoy this conversation!

At the time of this interview, Mason McDowell, DNAP, CRNA was the Associate Professor and former Assistant Director of the Nurse Anesthesia Program at Western Carolina University.   His Doctorate of Nurse Anesthesia Practice (DNAP) from Texas Wesleyan University included research focused on perioperative patient management and cardiac risk assessment.  He is the co-author of the Hepatobiliary and Gastrointestinal Disturbances and Anesthesia chapter in Nagelhout’s Nurse Anesthesia 5th Edition.  A few weeks after this interview in 2015, Mason moved with his wife and two daughters to Bere, Chad to provide anesthesia. You can hear more about his story in episode 61 & 62 of Anesthesia Guidebook. You can also read about his experiences in Chad at http://www.whyweshouldgo.blogspot.com.

At the time of this interview, Kara Michalov, MSN, CRNA was a CRNA in Asheville, North Carolina. Kara and Mason are co-authors of Intravenous Acetaminophen and Intravenous Ketorolac for Management of Pediatric Surgical Pain: A Literature Review, which was published in the February 2014 edition of the AANA Journal (Vol. 82, No.1).

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Anesthesia Education Clinical Tips Personal Finances Preparing for Grad School/Residency Wellness

#67 – How to Thrive in Training

This is the first episode in a series that will focus on helping anesthesia residents thrive in training. This is designed for physician and nurse anesthesia trainees and will unpack crucial beta for helping you dial your game in during anesthesia training.

In this first episode I discuss finding your why behind going to anesthesia school. Your why is what will propel you through the tough times in training and help you find the motivation to excel.

Angela Duckworth is a psychologist and researcher who, in her bestselling book titled Grit – the power of passion and perseverance, says that grit is what separates those who succeed from those who fail when facing extreme challenge.

Your why will help you develop the level of grit that you need to get through the challenges of anesthesia training.  

Grit is what you have when your passion fuels a perseverance that propels you through obstacles to achieve your goals.

Duckworth says there’s four components of developing grit: interested, practice, purpose and hope.

Do you have an authentic interest in the work anesthesia providers do? Are you stoked about the field of anesthesia and have an accurate mental representation of what it’s actually about?

You will need to develop deliberate practice in order to master the craft of anesthesia and become competent in the core skills/knowledge base. If you’re unwilling to do this, anesthesia training will quickly seem overwhelming and you probably won’t make it. But deliberate practice is the key to unlocking true skill development and expertise and will make the road ahead achievable.

You must know your purpose – or your why – behind going to anesthesia school. This episode is all about finding that. It will be the reason you come back to when the road gets tough and you have to find the motivation to push through the challenges, set backs and hurdles that will inevitably come your way.

And lastly, hope is what you will have in your back pocket when you believe that the journey is worth all the hard work you put in. Hope comes when you believe that the juice is worth the squeeze, that the payoff is worth the effort.

Interest. Practice. Purpose. Hope. When you understand and foster each of these in your journey, you will develop a grittiness that will see you through the steepest of climbs and most difficult days.

Stay tuned for the upcoming series where you’ll hear from CRNAs, professors and SRNAs alike on the following topics:

  • developing a growth mindset
  • dialing in didactics
  • crushing clinicals
  • developing time management
  • avoiding landmines and overcoming set backs
  • dealing with hardship in anesthesia training
  • financial management
  • preparing for and acing exams and boards
  • tips for the job hunt
  • transitioning to practice and through the first six months after training

This series is an active work in progress so if there’s something you want to hear about, be sure to reach out and let me know!

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Anesthesia Education Business/Finances Preparing for Grad School/Residency Wellness

#59 – How to Achieve Your Goals

This is episode 59 – How To Achieve Your Goals.  This is one of my favorite episodes and the content here is something that I come back to again and again.  I’ve listened to it probably 5 or 6 times since I first released it and every time I come back to this, I leave with refreshed clarity around what’s important and a renewed sense of how to move forward.

This episode was first released in January 2020 on From the Head of the Bed – the podcast that was the podcast before Anesthesia Guidebook.  You know, the thing we did before we did this thing.  Cause there’s always a thing before the thing.  Or the thing behind the thing.  There’s evolutions to what we do.  Chapters.  Seasons.  Change and growth and movement.  I talked about that a bit on the last episode about the rhythms in your life…

This episode is a follow up to that.  The last episode was really about how to rest and carve out time to restore your energy and clear you mind.  This one is about how to set a trajectory in your life and do the work to achieve your goals.  

Transcript: #59 How to Achieve Your GoalsDownload

References

Ericsson, A., & Pool, R. (2016). Peak: Secrets from the new science of expertise. Houghton Mifflin Harcourt.

Dweck, C. S. (2008). Mindset: The new psychology of success. Random House Digital, Inc.. 

Dalio, R. (2018). Principles. Simon and Schuster. 

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Anesthesia Education Preparing for Grad School/Residency Wellness

#58 – How to Recharge & Create Rhythm in Your Life

When’s the last time you put your cell phone down and did something relaxing or to recharge your energy?

When’s the last time you felt relaxed and refreshed?

Can you imagine feeling refreshed & relaxed, clear-minded and rested on a regular basis? Tanked up? Ready to charge?

Finding rhythm and downtime to recharge seems wildly counterproductive at first and like a luxury serious people can’t afford (or successful people… or people who are on the path to become successful).

That’s what this podcast is about. This is about how to recharge yourself and be well. You can find space for this even during anesthesia training. It’s actually crucial that you do so. It will help you perform at your top level and crush school & clinical.

You can find space for this even if you lead a busy life with kids & jobs and a never-done to-do list. It’s actually crucial that you do so.

Brené Brown talks about in her research on vulnerability and shame, she “discovered” that people who rated their lives high on markers of life satisfaction and well-being all consistently engaged in unstructured time designed to rejuvenate themselves. It turns out she wasn’t the first person to realize this. Other researchers and sociologists have studied this and call it “play.” That’s right. Like playtime. Time set aside to do things for fun. Things that fill your cup, restore your energy and help you whether the demands of the rest of your life. That’s what this podcast is about.

I originally put out what you’re about to hear in February of 2019 on the podcast From the Head of the Bed. In the show I mention taking van trips and that references the Sprinter van that my wife and I built out a few years ago as a camper van. You can hear more about that and how one SRNA converted an old ambulance into his home on wheels for grad school in episode #6 of Anesthesia Guidebook, titled Van Life in Anesthesia School with Marcus House.

AANA Ask For Help website

AANA Student Wellness website

References:

  1. Tarantur, N., Deshur, M. (2018).  Anesthesia professional burnout – a clear and present danger.  APSF Newsletter. 33(2), 43-44.
  2. Chipas, A., & McKenna, D. (2011). Stress and burnout in nurse anesthesia. AANA journal, 79(2). 
  3. Chipas, A, Cordrey, D., Floyd D., Grubbs, L., Miller S., & Tyre B. (2012). Stress: perceptions, manifestations, and coping mechanisms of student registered nurse anesthetists. AANA journal, 80(4), S49. 
  4. De Oliveira, G. S., Chang, R., Fitzgerald, P. C., Almeida, M. D., Castro-Alves, L. S., Ahmad, S., & McCarthy, R. J. (2013). The prevalence of burnout and depression and their association with adherence to safety and practice standards: a survey of United States anesthesiology trainees. Anesthesia & Analgesia, 117(1), 182-193.  
  5. Raj, K. S. (2016). Well-being in residency: a systematic review. Journal of graduate medical education, 8(5), 674-684.  
  6. Hettler, B. (1976). Six dimensions of wellness model. National Wellness Institute. Retrieved from https://cdn.ymaws.com/www.nationalwellness.org/resource/resmgr/tools/SixDimensionsFactSheet_Tool.pdf.  Screenshot by author.
  7. Dweck, C. S. (2008). Mindset: The new psychology of success. Random House Digital, Inc..  Retreived from https://www.penguinrandomhouse.com/books/44330/mindset-by-carol-s-dweck-phd/9780345472328/. 
  8. Grant, A.  (2018, December 8).  What straight-A students get wrong.  The New York Times.  Retrieved from https://www.nytimes.com/2018/12/08/opinion/college-gpa-career-success.html

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Anesthesia Education Clinical Tips Preparing for Grad School/Residency Wellness

#57 – Incivility in the Workplace – Joshua Lea, DNP, MBA, CRNA & Kelly Gallant, PhD, CRNA

Josh Lea, DNP, MBA, CRNA and Kelly Gallant, PhD, MSN, CRNA join me to discuss workplace incivility in anesthesia training. We discuss the role of precepting SRNAs and anesthesia residents, root causes and implications of incivility and processes for improving healthy work environments. 

Josh Lea, DNP, MBA, CRNA is a professor of anesthesia at Northeastern University’s Nurse Anesthesia Program and staff CRNA at Massachusetts General Hospital in Boston.  He serves on the board of the Anesthesia Patient Safety Foundation and focuses on burnout & creating healthy work environments as his area of research and publication. He has spoken extensively on the topics both nationally and internationally through his work with the Anesthesia Patient Safety Foundation and as a member of the American Association of Nurse Anesthetists (AANA) Health and Wellness Committee. 

Kelly Gallant, PhD, SRNA completed her anesthesia training at Northeastern University in Boston. She received her Bachelor’s degree from Northeastern in 2010 and spent 8 years working in the surgical intensive care unit as a Registered Nurse while researching pediatric pulmonary hypertension and caregiver reactions as part of her PhD, which she completed at Northeastern in 2017. Kelly then returned to school to study anesthesia completing her Master of Science at Northeastern in May 2020. Kelly was the fiscal year 2019 SRNA Representative to the AANA Health & Wellness Committee. and also contributed to episode #52 – SRNA Wellness in COVID-19 of Anesthesia Guidebook.

References:

Elmblad, R., Kodjebacheva, G., & Lebeck, L. (2014). Workplace Incivility Affecting CRNAs: A Study of Prevalence, Severity, and Consequences With Proposed Interventions. AANA Journal, 82(6), 437–445.

Katz, D., Blasius, K., Isaak, R., Lipps, J., Kushelev, M., Goldberg, A., Fastman, J., Marsh, B., & DeMaria, S. (2019). Exposure to incivility hinders clinical performance in a simulated operative crisis. BMJ Quality & Safety, 28(9), 750–757.

Neft, M., Hartgkidek, A., & Lea, J. (2017). Wellness milestone: The road to wellness: Paving the way toward a healthy work environment. AANA NewsBulletin.

Mahoney, C. B., Lea, J., Schumann, P., & Jillson, I. (2020). Turnover, burnout, and job satisfaction of certified registered nurse anesthetists in the United States: Role of job characteristics and personality. AANA Journal, 88(1), 39-48.

Mahoney, C. B., Lea, J., Jillson, I., & Meeusen, V. (2014). Turnover of nurse anesthetists: The similarities and differences between countries. BioMed Central Ltd. 14(2).

Other Resources:

Do you want to learn from APSF about patient safety? Easy. Just subscribe to the APSF Newsletter for FREE and connect with APSF on Twitter, Facebook, and LinkedIn.

AANA Promoting a Culture of Safety and Healthy Work Environment: Practice Considerations PDF

AANA Webpage on Bullying, Disruptive Behavior and Workplace Incivility

AANA SRNA Wellness

Need Help? Not sure? Check out AANA Ask For Help website.


AANA Nurse Anesthesia Leadership Survival Guide PDF

Do you have more questions about workplace incivility? Feel free and contact Joshua Lea, DNP, MBA, CRNA at lea.joshua@gmail.com, Kelly Gallant, PhD, MSN, CRNA at gallant.k@husky.neu.edu or wellness@aana.com.  For concerns related to alcohol or other drugs, call the AANA Helpline at 1-800-654-5167 for 24/7 live confidential help.

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Wellness

#56 – Guided Relaxation with Matt Zinder, MS, CRNA, CH

In this podcast, Matt Zinder, MS, CRNA, CH walks us through a fifteen-minute guided relaxation session that is sure to leave you feeling refreshed and renewed. You should try this at home, on your lunch break or to help you go to sleep at night.  Get to a place where you can close your eyes and tune out distractions.  Hopefully, you’ll find yourself relaxed and refreshed, ready to move forward with renewed energy or simply fast asleep.

Matthew Zinder, MS, CRNA, CH has worked in some level of healthcare for close to 25 years, starting as an EMT in a volunteer fire station. Matthew owns and operates the Maryland-based mobile anesthesia practice Zinder Anesthesia, LLC, that has been in business since 1984. It consists of 20 practitioners and covers 50 locations throughout the state of Maryland.

Matthew speaks at many professional conferences, both nationally and internationally, involving topics such as stress management, business of anesthesia, hypnosis, and the practice of anesthesia. Matthew also has an active hypnotherapy practice that caters mainly to healthcare providers. He is the founder and director of Maryland Emergency Response, a disaster relief 501(c)(3) non-profit organization that works to aid victims following natural and/or man-made disasters. Matthew is currently the District IV director for the Maryland Association of Nurse Anesthetists.

Check out episode #55 – How to Be Well During the Pandemic where Matt and I talk about the stress management and mindfulness for healthcare providers in more detail. Be well!

Meditation apps:

10% Happier – healthcare providers get a free 6 month membership in light of the pandemic. 10% Happier has guided meditation and stress management content. Email care@tenpercent.com, let them know you’re a healthcare provider and they will give you instructions for accessing the content.

Insight Timer – 35,000 free guided meditations.

Books (for your self-quarantined downtime):

Why We Sleep by Matthew Walker, PhD

10% Happier by Dan Harris

Meditation for Fidgety Skeptics by Dan Harris

The Biology of Belief by Bruce Lipton

Why Zebras Don’t Get Ulcers by Robert Sapolsky

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Wellness

#55 – How to Be Well During the Pandemic – Matt Zinder

#60 – Peace of Mind During COVID19 Pandemic with Matt Zinder, MS, CRNA, CH
Why Zebras Don’t Get Ulcers, by Robert Sapolsky is a book explaining the physiology of chronic stress and techniques for managing it. Sapolsky is a professor of biology and neurology at Stanford University. Matt Zinder recommends this book, saying, “It’s the seminal text on stress. This author describes to minute detail what stress is, what stress does to the body and ends with some techniques for managing stress.” Image retrieved from https://animals.desktopnexus.com/wallpaper/2068315/.

This podcast was originally published on From the Head of the Bed on March 17, 2020. That was during the early stages of the COVID-19 pandemic. Now, in December 2021, as the pandemic has stretched out nearly 2 years, we’re revisiting Matt Zinder’s advice on how to be well and cope with the stress and change that the pandemic has brought.

Matt walks us through several techniques for stress management and mindfulness in this podcast. This episode, and the one to follow, where Matt actually guides us through a 10-minute spoken meditation, are just as helpful if not more so now as they were nearly 2 years ago. Just this week, my local health system in Maine has been hit harder with COVID-19 patients than at any time in the pandemic. Our local level-1 trauma center is completely full with patients. We’ve suspended all surgical cases with the exception of true emergencies. Just today, we stood up an emergency ICU/IMC unit in one of our PACUs to help alleviate the strain on our regular ICU staff and build capacity.

After each wave that comes & goes in the pandemic, another one seems to follow. This has resulted in fatigue, stress, burnout and frustration in many healthcare workers. Tens of thousands of healthcare works have either left their jobs or hit the travel circuit. The reasons they are motivated to quit or take travel assignments are complex and multifactorial. However, this phenomenon in the middle of the pandemic has exacerbated the staffing crisis and strained health systems to levels not seen in modern times. Responding to COVID-19 and its variants with vaccines, boosters and other therapies is crucial but only one part of addressing the broader healthcare crisis in the US. Systemic change is needed. Research shows that about 80% of individual burnout can be attributed to factors that need to be addressed at the organizational or system level. While it’s important to recognize that and put energy and attention into creating more functional organizations and healthcare systems, this podcast is about what we can do as individuals to bolster our resiliency during the pandemic.

Matthew Zinder, MS, CRNA, CH has worked in some level of healthcare for close to 25 years, starting as an EMT in a volunteer fire station. Matthew owns and operates the Maryland-based mobile anesthesia practice Zinder Anesthesia, LLC, that has been in business since 1984. It consists of 20 practitioners and covers 50 locations throughout the state of Maryland.

Matthew speaks at many professional conferences, both nationally and internationally, involving topics such as stress management, business of anesthesia, hypnosis, and the practice of anesthesia. Matthew also has an active hypnotherapy practice that caters mainly to healthcare providers. He is the founder and director of Maryland Emergency Response, a disaster relief 501(c)(3) non-profit organization that works to aid victims following natural and/or man-made disasters. Matthew has also served as the director for the Maryland Association of Nurse Anesthetists.

Matt Zinder has made his email address public for questions, comments or speaking engagements: zinderllc@gmail.com  

Meditation apps:

10% Happier – healthcare providers get a free 6 month membership in light of the pandemic. 10% Happier has guided meditation and stress management content. Email care@tenpercent.com, let them know you’re a healthcare provider and they will give you instructions for accessing the content.

Insight Timer – 35,000 free guided meditations.

Books (for your self-quarantined downtime):

Why We Sleep by Matthew Walker, PhD

10% Happier by Dan Harris

Meditation for Fidgety Skeptics by Dan Harris

The Biology of Belief by Bruce Lipton

Why Zebras Don’t Get Ulcers by Robert Sapolsky

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Anesthesia Education Clinical Tips Preparing for Grad School/Residency Wellness

#54 – Hardship in Anesthesia School

This episode speaks to why anesthesia school/residency is hard and what we as SRNAs, residents, program faculty, preceptors, CRNAs and physician anesthesiologists can do about it.

Anesthesia training is hard because life is hard and doesn’t stop just because you enroll in an incredibly difficult program.

Anesthesia school is also hard because anesthesia school is just really hard.

Whether you’re a physician resident or SRNA, you have to learn to take an incredible degree of ownership for your actions and couple a voluminous depth of information with rapid, correct and highly skilled actions under time pressure in the clinical setting.

 That’s anesthesia training!

Do you need help working through the challenges of anesthesia school? Not sure if you need help? Check out the AANA’s website Ask For Help to find links to resources and context that clearly shows that SRNAs and providers alike are not alone when they face stress, burnout, frustration and challenges where professional help can be, well, helpful. You can also check out the AANA SRNA Wellness website for more content on finding a path towards peace of mind and wellness.

Below are crucial numbers to know in order to get help or support those who are in crisis. Also, the full transcript to this podcast is in PDF format so you read on the go. And the link to Jocko Willink’s video “Jocko Motivation ‘GOOD’.” Be sure to watch that every morning you wake up during anesthesia training!!

The Crisis Text Line is 741741… you can text anything to that number and a trained crisis volunteer will be on the other line: 24/7/365 for free! You can text if you’re a friend, preceptor or program faculty. You can text if you’re the one in crisis and need to talk (text) with someone to find the motivation to stay stay safe and get help.

Hardship in Anesthesia School transcript PDFDownload

BOOKS FOR YOU:

Trevor Noah’s Born a Crime

David Goggins’ Can’t Hurt Me

Laura Hillenbrand’s Unbroken

Jocko Willink’s Extreme Ownership

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Anesthesia Education Preparing for Grad School/Residency Wellness

#53 – Overcoming Setbacks in Anesthesia Training

I originally released this podcast on April 4, 2020 to offer advice & encouragement to SRNAs who had been furloughed from clinical due to the COVID-19 pandemic. While elements of this show speak specifically to that context, the themes ring true for overcoming any set back during anesthesia school.

At the time, our level 1 trauma center, along with hospitals across the nation, clamped down on all non-essential staff, removing medical students, nursing students, SRNAs and others from the clinical environment in order to reduce their risk of exposure to COVID-19 and reduce transmission rates in general. This was an unprecedented moment for SRNAs across the nation. Adrienne Chavez and Kelly Gallant and I talked about that on the last episode of Anesthesia Guidebook. They were SRNA representatives to the AANA Health & Wellness Committee at the time and shared their stories of what they were facing and how they were keeping their focus on moving forward as the pandemic spread worldwide.

With anesthesia school, you gotta believe that the juice is worth the squeeze and keep your eyes on the finish line while finding ways to cope and be successful along the way. So again, while this show was originally focused on how SRNAs can deal with the set back of being furloughed from clinical because of the pandemic, the themes and advice I share is applicable to almost any set back you may be facing. So with that in mind, let’s get right to the show!

References:

Edmond Eger NYTimes Tribute:

Grady, D.  (20 September 2017).  Dr. Edmond Eger II, 86, Dies: Found Way to Make Anesthesia Safer.  The New York Times.  Retrieved from https://www.nytimes.com/2017/09/20/obituaries/dr-edmond-eger-ii-86-dies-found-way-to-make-anesthesia-safer.html.Audio Player

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Anesthesia Education Preparing for Grad School/Residency Wellness

#52 – SRNA Wellness in COVID-19 with Adrienne Chavez & Kelly Gallant

This podcast was originally posted on April 13, 2020, in the early stages of the COVID-19 pandemic. At the time of this podcast both Kelly Gallant and Adrienne Chavez were SRNAs completing their anesthesia training. They have both completed their training and passed boards as CRNAs. This show continues to have value for SRNAs & anesthesia residents as the themes we discuss around wellness & resiliency remain as relevant as ever.

At the time of this recording, Kelly and Adrienne were the immediate past and current SRNA Representatives to the American Association of Nurse Anesthestists’s Health and Wellness Committee, with Kelly serving in 2019 and Adrienne in 2020. I caught up with them to discuss how SRNAs were facing the challenges and concerns of the COVID-19 pandemic as well as resources that Kelly and Adrienne created, along with the rest of the Health & Wellness Committee, that are available on aana.com.

Kelly Gallant, PhD, SRNA is wrapping up her training this spring at Northeastern University in Boston. She received her Bachelor’s degree from Northeastern in 2010 and spent 8 years working in the surgical intensive care unit as a Registered Nurse while researching pediatric pulmonary hypertension and caregiver reactions as part of her PhD, which she completed at Northeastern in 2017. Kelly then returned to school to study anesthesia and will graduate from Northeastern’s Nurse Anesthesia program with her Master of Science in May 2020. Kelly was the fiscal year 2019 SRNA Representative to the AANA Health & Wellness Committee.

Adrienne Chavez, BSN, SRNA is currently training at the University of Maryland. Adrienne received two Bachelor’s of Science degrees from the University of Maryland, one in psychology and the other in nursing. She is currently enrolled in the University of Maryland’s Doctor of Nursing Practice program with an anticipated graduation date of May 2021. Most recently she worked at the National Institutes of Health as a critical care Registered Nurse. She is the fiscal year 2020 SRNA Representative to the AANA Health & Wellness Committee.

Resources from the AANA Health & Wellness Committee:

aana.com/covid19 – AANA developed this great resource which has answers to questions SRNAs and CRNAs are asking. The website is constantly updated to include the latest news & information relevant to the current pandemic with topics including clinical practice, critical care management, COVID-19 employment issues, the SRNA experience and more.

AANA COVID19 Well-being. This site includes CRNA-produced content on wellness related to the current pandemic, including other  podcasts and Aly McLean, CRNA’s “Mindfulness while wearing an N95 mask” video, which is also linked here.

aana.com/thrive
The THRIVE initiative provides resources for the general public and AANA members in regards to career transitions related to the CRNA role. RNs looking to become nurse anesthesia students, new graduate CRNAs looking for their first job, transitioning in mid- to late-career, and retirement are all covered with a multitude of resources. 

AANA COVID19 Infographic:  https://www.aana.com/docs/default-source/marketing-aana-com-web-documents-(all)/2020_ppr02_flyer_corona_wellbeing_v6.pdf?sfvrsn=e6e394ca_4

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Preparing for Grad School/Residency Wellness

#51 – Provider Wellness with Christine Hein, MD

This is one of my favorite podcasts that I’v recorded. If you’ve had the privilege of working with or getting to know Dr Christine Hein, MD, – or once you listen to this podcast – you’ll know why!

Christine Hein, MD is an emergency medicine physician and the Chief Wellness Officer at Maine Medical Center, Maine’s only level 1 trauma center and academic teaching hospital.

We recorded this episode in August of 2017 when Dr Hein was developing the Provider Well-being and Peer Support program at MMC. Since that time, the well-being program has grown substantially with continued support from the medical center and numerous volunteers. Maine Medical Center made a substantial statement of supporting provider wellness by establishing the Chief Wellness Officer position and Dr Hein was selected to serve as the first Chief Wellness Officer.

She’s in the trenches as an emergency medicine physician and actively engaged in resident education. She’s an absolute master at all things related to provider wellness, a wife and mother of 5 kids and an elite distance runner. She has somehow found a way in her professional life to maintain a since of joy & optimism that is truly authentic and infectious. It’s like she walks around just spilling joy everywhere; she’s like an overflowing glass of water just sloshing a refreshing positive vibe wherever she goes, leaving the rest of us better off for having interacted with her. Yet that vibe is not some shallow surface level corporate smile campaign. With Christine, it’s actually rooted deep in a career as an emergency medicine provider and as a proficient healthcare leader & administrator. She’s someone who’s been in the arena, with her face mared by dust & sweat & blood*, to borrow from Theodore Roosevelt’s speech. And it’s from her personal story as an emergency medicine physician and from some dark places in her personal life – which she talks about in this episode – that she’s developed this deep desire to improve the lives of other healthcare providers around her through her work on provider wellness.

So all that comes through in this episode. That’s who were talking to today. You’re going to love it. And not only that, but we also had the immense pleasure of being joined for this discussion by Dr Hein’s daughter, Ms Abby Irish. This is the first time that a guest has brought one of their children along to a podcast recording and that, again, speaks to how important this topic is to Dr Hein and one of the reasons why I love this episode. At the time of this recording Abby was an 8th grader who was interested in becoming a physician. She had just finished surgery summer camp in Boston and talks about her experience at the start of the show.

We run the gamut of provider wellness in this conversation. We discuss burnout, wellness, resiliency, organizational drivers of burnout and ways hospitals, med schools & anesthesia programs can build structural components to eliminate burnout and foster well-being. We talk about peer support & how that’s different than professional counseling. We touch on substance abuse, suicide and the stigma of mental health concerns and getting help & support. We share personal stories from our careers and those of others that bring these concepts to life and give them real traction. As healthcare providers, we spend an incredible amount of time, energy and money becoming highly qualified in our fields yet rarely create space for deliberately developing a sense of well-being in our professional and personal lives. We should remember that as health is more than the absence of disease, joy in work is more than the absence of burnout. We owe it to ourselves, our colleagues and our patients to be whole people, grounded in a deep sense of well-being. This show explains why doing that matters and gives actionable steps we can take to minimize burnout and foster joy in our work.

One more thing before I introduce you to Dr Hein and Abby: we discuss a shocking statistic that 300-400 physicians commit suicide each year in the United States. That’s 1 to 2 medical school classes of physicians each year. It’s remarkable. I had a classmate in anesthesia school who took her own life and last year a SRNA reached out to talk after her roommate and classmate took her life just months before the end of their program. Research shows that upwards of 21% of SRNAs experience suicidal ideation during their training. If that’s you, or someone you know, I want you to know that you’re not alone and there’s a wealth of resources created by people who understand what you’re going through and who care deeply about your wellbeing and safety. I’ve got links in the show notes to people you can call or even text. The Crisis Text Line is 741741. You can text any message to the number 741741 and a trained volunteer will respond to you anytime of day or night. It’s a free service. That number is 741-741. Put it in your phone. Post it in your break rooms & locker rooms. And don’t hesitate to text the number. Help is available – just a text message away.

And with that, let’s get to the show…

Quotes:

“As health is more than the absence of disease, joy in work is more than the absence of burnout.” – Jon Lowrance

“300-400 physicians each year in the United States commit suicide… essentially two medical school classes of physicians each year.”  Christine Hein, MD

“I think that it has professionally been probably the most satisfying experience of my career – to be involved in [Provider Wellness].”  Christine Hein, MD

“[Resilience is] the capability of a strained body to recover its size and shape after deformation caused especially by compressive forces.”  Christine Hein, MD

Dr Hein completed Dr Hein completed medical school at Dartmouth in 2001 followed by her residency in emergency medicine at Maine Medical Center where she was Chief Resident in her final year. At the time of this recording, she served as the Associate Medical Director for the Department of Emergency Medicine and the Director of Provider Well-being and Peer Support at Maine Medical Center as well as the Director of Emergency Medicine for MaineHealth.  She is an Associate Professor of Emergency Medicine at Tufts University School of Medicine and is well-respected as a medical educator, receiving in 2009 the American College of Emergency Physicians National Teacher of the Year award.  Her research interests include burnout, resiliency, critical care and women’s issues in medicine.  Outside of work, Dr Hein is married, has five children and is an avid marathoner, completing over 23 marathons including posting highly competitive times in the Boston Marathon.

*”It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.” – Theodore Roosevelt

Resources:

AANA Health & Wellness and Peer Assistance Website

Attending:  medicine, mindfulness and humanity Ronald Epstein, MD

TEDTalk:  Everything you think you know about addiction is wrong by Johann Hari

Epstein, R. M., & Krasner, M. S. (2013). Physician resilience: what it means, why it matters, and how to promote it. Academic Medicine, 88(3), 301-303.Raj, K. S. (2016). Well-being in residency: a systematic review. Journal of graduate medical education, 8(5), 674-684.

Swensen, S. J., & Shanafelt, T. (2017). An Organizational Framework to Reduce Professional Burnout and Bring Back Joy in Practice. The Joint Commission Journal on Quality and Patient Safety, 43(6), 308-313.

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Anesthesia Education Business/Finances Preparing for Grad School/Residency Wellness

#50 – Parenting during Anesthesia Training with Lien & Nate Woodin

I’m joined today by Nate & Lien Woodin who are married and the parents of two boys – aged 6 & 9 as this show comes out on the first of October 2021.

If you’re a critical care nurse, medical student, resident or SRNA – or a spouse or partner to one of these folks – and you’re wondering how to hold it together as a parent & partner during anesthesia training or even if it’s possible for you to go back to anesthesia school – this podcast is for you! 

We don’t hit a list of bullet points on this one.  There’s no simple how-to here.  Instead, we walk through Lien & Nate’s story and in it you’ll find some incredible insights of how they prepared for anesthesia school, parented during anesthesia school and stuck together as a couple all the way through.  

Lien just wrapped up her Master’s of Nursing in Anesthesia at the University of New England a couple of weeks ago and decided to go back to school after working as a nurse for 20 years – 17 of which were as a critical care nurse in a cardiothoracic intensive care unit.  Nate is a Licensed Marriage and Family Therapist who focuses his practice on child & adolescent therapy.  He completed his Bachelor of Arts in Psychology at the University of New Hampshire in 2000 and his Master’s of Arts in Marital & Family Therapy from the University of San Diego in 2007.  He completed a post-master’s Certificate of Studies in Play Therapy in 2009 from the University of California, San Diego.  

Lien worked as a critical care Registered Nurse at Maine Medical Center and came back to train for a couple of months with the anesthesia team at Maine Med, where I work as the SRNA Clinical Coordinator.  We got to spend a few days in the OR together and that’s where I first heard snippets of her story.  When she talked about how hard it was to make the decision to go back to school after working as an ICU nurse for 20 years, how her & Nate have a son with PANDAS which encompasses a set of neuropsychiatric disorders and how Nate is a child & family therapist who Lien always bragged about as being such a huge support to her as a SRNA and their boys, I knew I wanted to get them on the podcast and hear more about their story.  And it’s a remarkable story.  I think you’ll really enjoy hearing it.  

A couple other things before we get to the show… 

Lien was in the same class as Robert Montague.  You may remember Robert and his wife Jenny from episode 15 titled “Significant Others and Anesthesia School.”  That episode came out in December of 2020.  Robert also just successfully passed boards and became a CRNA along with Lien.  He and Jenny are doing well and are also enjoying life after anesthesia school.  I think both this and that podcast would be key shows to listen to if you’re considering going back to anesthesia school as parents – or if you’re in an anesthesia program or residency now and need a little encouragement to keep going and find ways to make it work.  They’re great shows for you and your partners.

There’s never really a good time to go to anesthesia school and having a significant other and kids can make the process very challenging.  And while both of these families have found ways to thrive during their programs, others are frankly not.  For, I think the first time ever on the podcast, in this episode, I talk a little about my own path in anesthesia school which involved going through a divorce in the fist six months as well as meeting my wife in the program who I now share a life with along with our 3-month old son and how helpful marriage therapy has been for both of us.

I know other SRNAs who are either in or have gone through extremely challenging family situations including the loss of a child, or a partner, severe illnesses, trauma & surgery, ugly divorces, restraining orders, physical & emotional abuse and more.  For those of you out there who are struggling I want you to know that you’re not alone and that help is available.  The AANA has a wealth of resources available that I’ll link to in the show notes.  There’s also a free 24-hour Crisis Text Line if you need support right now… you can text anything to the number 741741 and a trained counselor will reach out with support over text.   You can also find support at your university or hospital through wellness committees and student or employee health services… there are usually always free, confidential counseling & therapy resources available.  Don’t struggle alone.  Reach out to one of these resources.  Get help.  It’s a very human thing to do.  

And hopefully you’ll find a little hope & encouragement through Lien & Nate’s story…

Resources:

AANA SRNA Wellness

Crisis Text Line text “hello” or “help” or whatever to 741741 and a trained counselor will respond. It’s free and it’s over text.

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Anesthesia Education Business/Finances Personal Finances Wellness

#39 – The 5 Keys to Achieving Financial Independence with Shane Garner, MS, CRNA, NSPM-C

In this episode you’re going to hear from Shane Garner, MS, CRNA, NSPM-C on the 5 Keys for Achieving Financial Independence.  This show was originally released in April of 2020 on From the Head of the Bed and I’m pulling it forward to Anesthesia Guidebook on August 30, 2021.  

I’m pumped Shane brought this intel to the podcast… anesthesia providers are high income earners but it’s rare to see any formal training on financial literacy as part of core medical & nursing education or during anesthesia training programs.  CRNAs & physician anesthesiologists get out and make great money but often fail to apply basic financial principals like living below your means, becoming debt free and saving & investing for the future.  It sounds like boring stuff but these are some of the keys that will create freedom and peace of mind for your future.  If you apply a fraction of what you’ll hear in the next 30 minutes, you’ll set yourself on a trajectory you can truly be stoked about and you’ll thank yourself down the road.  You owe it to your future self to check this episode out and apply what you hear.

The 5 Keys to Financial Independence are 1. Set goals to live below your means. 2. Pay yourself first. 3. Avoid debt. 4. Invest in low cost index funds. 5. Educate yourself.

Shane Garner is a CRNA who works in Ripon, Wisconsin and is passionate about teaching anesthesia providers on personal finance as well as regional anesthesia.  He has a Bachelor of Science in Nursing from the University of Minnesota and graduated from Rosalind Franklin University with his Master of Science in Nurse Anesthesia in 2012.  He went on to complete a fellowship in Advanced Pain Management at the University of South Florida before becoming board certified in Nonsurgical Pain Management through the NBCRNA. Shane is an adjunct faculty member at the University of Alabama at Birmingham’s nurse anesthesia program and regularly instructs with Twin Oaks Anesthesia & Cornerstone Anesthesia Conferences.  

Shane Garner, MS, CRNA, NSPM-C

Resources

The White Coat Investor

The Bogleheads‘ Guide to Investing (book)

The Simple Path to Wealth (book)

The Millionaire Next Door (book)

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Anesthesia Education Business/Finances Clinical Tips Leadership in Emergencies Preparing for Grad School/Residency Wellness

#37 – Emotional Intelligence of SRNAs with Shawn Collins, DNP, PhD, CRNA

This episode is coming out on August 21, 2021 but it FIRST came out way back on September 19, 2015.  

The show is on emotional intelligence of SRNAs with Dr Shawn Collins, DNP, PhD, CRNA.

At the time of the interview, Dr Shawn Collins was the nurse anesthesia program director and the interim dean of the College of Health & Human Sciences at Western Carolina University (WCU).  I was super early in developing the podcast From the Head of the Bed and was actually still a SRNA at WCU even though the show was published after I graduated.  In the show, Dr Collins will walk us through what emotional intelligence is and how, if harnessed, can impact your work as an anesthesia trainee and provider.  

I think emotional intelligence is central to human behavior, relationships and success in whatever you’re doing… it’s about how we relate to one another.  I love how Dr Collins talks about getting a bird’s eye view of any situation you’re in and reading the emotional state of the other people around you.  Exercising emotional intelligence is often about learning how to walk through your life with this third-person view point of the situations you’re in.  It’s about understanding where other people are at, where they’re coming from, what their biases & goals might be and adapting your interaction with them to get you both – or a whole team of people – moving in the direction you want.  It’s thinking about: who is this person, where are they coming from, what might their hopes, dreams, fears or concerns be right now, how do they perceive me, who do they think I am – who am I FOR REAL – where am I headed, what are my goals and how can I tailor my interaction with this individual, in the context of all this, to get us both moving where we need to go.  This is every day stuff for anesthesia providers.  Emotional intelligence, when harnessed, will make your interactions with patients so much better and more meaningful.  It’ll help you deal with surgeons, OR nurses, CSTs, hospital administrators, preceptors, your boss, your trainees & students with greater skill & efficacy.  Emotional intelligence is like a key that unlocks an incredibly powerful, supercharged tool in relationships and it will help create success for you in whatever stage of your career or, for that matter you marriage or dating relationships or business partnerships, that you’re in.  

Dr Collins completed his master’s in anesthesia at Erlanger Medical Center at the University of Tennessee Chattanooga, his doctor of nursing practice degree at Rush and his PhD in leadership at Andrew’s University.  

Dr Collins is currently the associate dean for academic affairs and graduate studies for Loma Linda University’s School of Nursing, where he supports 2 master’s programs, a PhD program and 8 clinical doctorates. 

He was the program director when I attended WCU and was instrumental in helping my classmates and I launch the podcast From the Head of the Bed, serving as our project chair and one of the co-authors of the paper we published on social media in nurse anesthesia education in the AANA Journal.  Without him giving us a huge GREEN LIGHT and a lot of support & guidance along the way, From the Head of the Bed, and therefore this podcast would not exist… 

And with that, let’s get to the show…. 

Resources

Collins S. Emotional Intelligence as a Noncognitive Factor in Student Registered Nurse Anesthetists. AANA Journal [serial online]. December 2013;81(6):465-472. Available from: Academic Search Complete, Ipswich, MA. Accessed September 19, 2015.

Collins S, Andrejco K. A longitudinal study of emotional intelligence in graduate nurse anesthesia students. Asia Pac J Oncol Nurs [serial online] 2015 [cited 2015 Sep 19];2:56-62. Available from: http://www.apjon.org/text.asp?2015/2/2/56/157566

Kristin Andrejco was a co-author, along with Dr Collins, of the above study published in the Asia Pacific Journal of Oncology Nursing. She helped create From the Head of the Bed and still exerts a bit of influence on Anesthesia Guidebook under her new name.

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Anesthesia Education Clinical Tips Leadership in Emergencies Preparing for Grad School/Residency Wellness

#32 – Harnessing the power of deliberate practice

This podcast discusses deliberate practice, a concept developed by renowned cognitive psychologist Anders Ericsson, PhD. Deliberate practice is the kind of practice that top performers employ in order to reach the very highest levels of excellence across domains. Ericsson studied countless musicians, athletes, dancers, chess players, medical professionals and others to uncover the secrets and power of deliberate practice.

Malcolm Gladwell popularized some of Ericsson’s work in his 2008 book, Outliers, as the 10,000-hour rule to expertise, stating that on average, it takes about 10,000 hours to develop as an expert. But it’s not as easy as that. It’s not that simple. It’s not just about being on the job for 10,000 hours. And you know what I’m talking about. You’ve worked with people who are very experienced yet not the best – not even great – perhaps even mediocre, at their jobs. What Ericsson saw is that it takes top performers around 10,000 hours of deliberate practice – a concentrated, effortful, focused kind of practice, with feedback from a coach, to achieve the top level in any field.

Check out the podcast and links in the show notes for a quick break down and some examples of how to harness deliberate practice to improve your anesthesia career.

Resources:

Ericsson, K. A. (2008). Deliberate practice and acquisition of expert performance: a general overview. Academic emergency medicine, 15(11), 988-994.

Ericsson, K. A. (2004). Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Academic medicine, 79(10), S70-S81.

Ericsson, K. A. (2015). Acquisition and Maintenance of Medical Expertise: A Perspective From the Expert – Performance Approach With Deliberate Practice. Academic Medicine, 90(11), 1471. doi:10.1097/ACM.0000000000000939

Ericsson, A., & Pool, R. (2016). Peak: Secrets from the new science of expertise. Houghton Mifflin Harcourt.

Weinger, M. B., Banerjee, A., Burden, A. R., McIvor, W. R., Boulet, J., Cooper, J. B., … & Torsher, L. (2017). Simulation-based assessment of the management of critical events by board-certified anesthesiologists. Anesthesiology: The Journal of the American Society of Anesthesiologists, 127(3), 475-489.  

Young, J. 5 May 2020. Researcher Behind ‘10,000-Hour Rule’ Says Good Teaching Matters, Not Just Practice. (podcast). EdSurg Podcast.  Retrieved from https://www.edsurge.com/news/2020-05-05-researcher-behind-10-000-hour-rule-says-good-teaching-matters-not-just-practice. 

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Anesthesia Education Business/Finances Personal Finances Preparing for Grad School/Residency Wellness

#30 – The mid-to-late career phase with Cindy Farina, DNP, CRNA

In this episode Dr Cynthia Farina and I talk about the mid-to-late phase of your career as a CRNA.  Every stage of your career has unique challenges & opportunities. There’s so much attention focused on getting into CRNA school, the SRNA/resident/training phase and becoming a new CRNA… this conversation is for the part of your career farther down the road.

Dr Farina is a CRNA from Michigan whom, at the time of this recording (December 2019), served as the chair of the American Association of Nurse Anesthetists’ (AANA) Health and Wellness Committee and the Michigan Association of Nurse Anesthetists Wellness Committee.

Dr Farina completed her Bachelor of Science in Nursing at the University of Michigan, Ann Arbor and then her Master of Science in Nursing in the anesthesia track from Oakland University in 1996.  She then returned to the University of Michigan to complete her Doctor of Nursing Practice degree.

Cindy practiced full-time at a large suburban teaching hospital, where she also served as a clinical and didactic instructor in the Oakland University-Beaumont Graduate Program of Nurse Anesthesia. 

Cindy has a strong interest in creating and sharing educational material on personal and workplace wellness for CRNAs and SRNAs. In her most recent work, she has explored the topic of career phases and transitions for nurse anesthetists.

You may contact Cynthia Farina, DNP, CRNA, CNE at: cindy.farina@icloud.com or via her LinkedIn profile at www.linkedin.com/in/cynthiafarina

AANA Thrive: Resources for Career Stages

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Business/Finances Clinical Tips Personal Finances Preparing for Grad School/Residency Wellness

#29 – On Retirement with Eric Carlson, CRNA

I caught back up with Eric Carlson, CRNA to discuss his recent retirement and advice he has for anesthesia providers still in the thick of it. Eric was interviewed by Kristin Lowrance, MSN, CRNA way back in 2015 for our podcast “From the Head of the Bed.” We just re-released that podcast as #28 – Can’t Intubate, Can’t Oxygenate (CICO) during stat C-section: a case study with Eric Carlson, CRNA on Anesthesia Guidebook. If you haven’t listened to it, it’s a harrowing story of how he managed this incredibly difficult airway and situation.  

I wanted to catch back up with Eric following his retirement and today you’ll hear us reflect back on that podcast he & Kristin did several years ago.  I was surprised by what he had to say about it.  

We also take a look back on Eric’s career… what influenced his decision to go into anesthesia, how to look for your first job in anesthesia and what influences where you work throughout your career.  Eric spent most of his career in a tertiary care facility with over 800 inpatient beds and 50 operating rooms.  We touch on how challenging it can be to keep pace with a very demanding practice setting and walk through an article by Judy Thompson published in the AANA Journal in late 2020 titled “the certified registered nurse anesthetist as a late career practitioner” that looks at whether anesthesia providers should have mandatory retirement ages or cognitive testing as part of recredentialing. The link to that article is here:

Thompson, Judy. (2020).  The certified registered nurse anesthetist as a late career practitioner.  AANA Journal. Retrieved from: https://www.aana.com/docs/default-source/aana-journal-web-documents-1/thompson-r.pdf?sfvrsn=ea716ae2_4 

We also talk about how Eric planned financially for retirement and tips for practicing anesthesia providers on how to get there.  You’ll hear him discuss the last case he ever did and what it’s been like to step over to the other side… beyond the OR and into retirement.

Eric served as a preceptor for Kristin and me during our anesthesia training at Western Carolina University and we were always impressed with the depth of his knowledge, the sense of being anchored & unflappable that comes from deep competence, his willingness to teach and kindness as a preceptor.  Eric is a remarkable human being and I think you’ll really enjoy hearing from him as we look back over his career and the advice he’d give to folks who are still in the thick of it.

This podcast is absolutely relevant for SRNAs or anesthesia residents.  It can be profoundly helpful to hear from someone who is way down the road when you’re just getting started.  It’s like seeking out the village elder when you’re preparing to begin your own journey & adventure.  Listen to his stories.  Hear this wisdom in his voice.  

The following interview was posted by the North Carolina Association of Nurse Anesthetists in an email on 15 May 2015 to members titled “Spotlight on CRNAs” where a North Carolina CRNA is introduced at greater depth to the membership.  Of note, Eric was interviewed by Dustin Degman, CRNA, who has also contributed to our podcast in the Combat Trauma Anesthesia series.  In the interview, Dustin talks with Eric about his experience with the difficult airway case that he speaks to in the show featured on this page.  This interview is posted with the permission of the NCANA.

Eric Carlson, CRNA

Interviewed by Dustin Degman, CRNA

You were recently on the podcast “From the Head of the Bed” where you explained a case that, I guess you could say, changed the way you practice today. You got to give your history, the beginning of the scenario, and there was a moment that you said “I had a difficult airway case”. I must tell you that I was completely locked-in at that moment. Nothing was going to distract me from listening to the next 25 minutes. What I want to ask is, what about that event changed you most, either as a person or in practice?

This is a challenging question to answer. I am sure the event changed me both as a person and a CRNA practitioner. At the time of the event, I was very early in my career and riding high in self confidence. The event changed my level of confidence and reinforced the significance of the risks we take as CRNAs performing our job every day. I had to actively work on rebuilding my confidence over the ensuing months, slowly, I was able to regain some of the loss, but for better or for worse, I probably did not get back to the level I had been. In the long run, I think it made me a better CRNA because I realized that bad things can occur in our line of work at any time and you always need to have a back-up plan in mind. Be prepared for the unexpected. As a person, the event may have made me a more humble individual and helped me realize that we are all susceptible to very challenging occurrences in our profession.

People, who know you, know that you are a wonderful provider. Your patients, colleagues, and the students really look up to you. Is there something you would like to share about being a great mentor?

I appreciate the feedback and compliment. I consider myself very fortunate to have made the decision to become a CRNA more than 30 years ago. We all have many forks in the road when we have to make a choice that could affect the rest of our lives. When I had been a nurse for five years, I began to consider what specialty I may want to pursue to fulfill my desire to have a career pathway I may enjoy for the long term versus bouncing from one subspecialty to another. As an ED nurse at a teaching hospital, I was exposed to CRNAs both directly helping out in difficult cases, and assisting/teaching new Anesthesiologist residents with different tasks in the ED. These episodes spurred my interest so I talked to the Chief CRNA and learned more about the profession. That conversation led to my decision to pursue becoming a CRNA versus my other consideration of becoming a flight nurse. To this day, it was one of the best decisions I ever made. I am very proud of my profession and can honestly say I still love my job after three decades. I still tell my students they have chosen one of the coolest careers they could ask for. I guess my enthusiasm spills over.

I find the NCANA to have some of the most motivated members I have ever met. I feel like they bring out the best in me and am so thankful for the work that they do for our profession. You have been involved with the board and different committees for the past 15 years. Why did you choose the government relations committee for this term?

I was involved with the NCANA in the early 2000s. I decided to take leave from the active involvement in order to devote time to my family and help my wife raise our two children. Now that my children are grown, I have the opportunity to participate in the NCANA once again. Overall, the NCANA is under appreciated by the majority of its members, the active members serving on the Board and Committees are doing a lot of work that most members are never aware of. These dedicated members are volunteering their time and efforts to help preserve our profession and our livelihoods. Major changes can take place in the laws and regulations that govern our profession. These changes could directly effect our day to day job description, if the NCANA is not keeping watch over the potential changes in the laws and regulations then who is? We could go to work one day and find that our scope of practice has been completely redefined and we would be at a loss to change it at that point. One role of the NCANA, and the primary role of the Government Relations Committee is to monitor and respond to activity of the North Carolina General Assembly, the Board of Nursing, and the Board of Medicine that may effect our profession. Being part of this committee has allowed me to learn more about the importance of its function.

Any sound advise you would like to pass on to students who are about to graduate and become members of the NCANA?

Yes, be proud of your accomplishments and your career choice! Be active in the NCANA, so you and others can continue to enjoy the many rewards of being a CRNA. Someone has to take the helm, if not you….then who?

In the past 30 years, you have witnessed significant changes. We now typically use the ultrasound for central line placement, new adjuncts in airway management, and a significant increase in monitoring, e.g. pulse oximetry. What was the biggest adjustment for you as a provider? And, was there anything that occurred during your practice where you said “This is really going to change the way we do anesthesia”?

When I first started anesthesia school, we had to fight for the one automated non-invasive blood pressure machine in the department. The practice of anesthesia was full of many risks at that time, and still is today. The primary change has been technology allowing us to identify a problem before it becomes a crisis. The first time I used a pulse oximeter, I was annoyed by the beeping. At the time, I had no idea how much technology would change the practice of anesthesia.

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Anesthesia Education Preparing for Grad School/Residency Wellness

#24 – Social media leverage & landmines with Jason Bolt, DNP, CRNA

Jason Bolt, DNP, CRNA is a social media influencer in the anesthesia community and can be found @bolt_crna.

Dr. Jason Bolt, DNP, CRNA is a YouTuber and social media influencer in the anesthesia community. He graduated from Union University with his doctorate in anesthesia in 2019 and now practices in a collaborative group in the Bay Area. He offers mentorship through his YouTube channel memberships and enjoys helping others reach their goals in nursing and in anesthesia. He volunteers as a member of the AANA Communications Committee and is active in advocating for CRNAs on a legislative level. He is better known online as Bolt CRNA and you can find him @bolt_CRNA on YouTube, Instagram, Tiktok and Facebook. 

We talk about the pitfalls and leverage points of social media for anesthesia learners and other healthcare learners including nursing & medical students.

10 tips for surviving anesthesia training and your social media life:

  1. Make your posts anonymous relative to your school & clinical sites. (Avoid posting your school or clinical site names… like HIPAA, but for your school & clinical sites.)
  2. Avoid posting protected patient health information. This is obvious… and all about HIPAA.
  3. Keep your posts POSITIVE about healthcare. Rep your career path and the path of others in healthcare in the best light possible. Your posts reflect you as a provider and the profession in general.
  4. Avoid posting anything that may offend someone else. This is a tough one… especially when folks like Joe Rogan score multi-million dollar contracts to speak their mind. But you’re not Joe Rogan. (#yourenotjoerogan) You’re a student/learner… the more you piss people off by your posts & opinions, the harder (not easier) your path may be.
  5. Post & surf on your own time. Social media & any electronic communication is time stamped and discoverable. Practice vigilance at work and your profile pic at home.
  6. Avoid the usual pitfalls of social media… politics, religion, racism, sexism, demeaning posts/tags/likes/shares, etc.
  7. For content producers: be authentic, be honest, be truthful and cite peer-reviewed, professional sources in your posts if you’re talking about medical information. Be legit. What you & others post is not “peer reviewed” or edited by experts, so be extremely careful if you’re producing medical education for the world.
  8. Understand that your preceptors, faculty, professors, attendings, employers, program directors and legal teams at institutions (if necessary) will check you out on social media… post only what you want your employer and your mother to see.
  9. Rep your style. Do you. Tell people who you are & the path you’re on… real life stories gain traction more than fabricated realities. Have fun, find the others, connect with people, network and believe in the open, beautiful, hopeful world that social media is great at promoting.
  10. Be well. Shun the unbelievers, haters, trolls & hateful people. Block ’em. Don’t even engage. Watch the Social Dilemma. And then limit your time on social media with alerts on your phone. Go live your real life and be well.
Jason Bolt, DNP, CRNA making it look easy. Follow him @bolt_CRNA. #boltCRNA

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Anesthesia Education Personal Finances Preparing for Grad School/Residency Wellness

#15 – Significant Others and Anesthesia School with Jen & Rob Montague

Jennifer & Robert Montague moved across the country from Montana to Maine with their young children for Rob to attend anesthesia school.

Today I’m joined by Jennifer & Robert Montague to talk about the experience of significant others in anesthesia school. Rob is currently a second-year SRNA at the University of New England and Jen, his wife, is a Master’s-prepared Registered Dietitian who has taken on the lioness’ share of providing child care and homeschooling responsibilities for their two children while Rob attends anesthesia school. Jen and Rob moved across the country from Montana to Maine for Rob to pursue a mid-life career change from working as an international mountaineering guide to becoming a CRNA.

This podcast is like something from Death, Sex & Money or Joe Rogan – it’s narrative, it’s a story and unfolds over the hour & half we talk.

You’ll love hearing Rob & Jen’s humor and love for one another and their kids… how resilient their children are and how they’ve made the move work financially & emotionally as individuals and a couple.

If you’re getting ready for anesthesia school, wondering if you can do it with your family and children and how it all works, we talk through all of that. Who better to learn from than a couple, with kids, who are going through not only anesthesia school but doing it all in the middle of a worldwide pandemic?

I’ve been looking forward to doing a show on this topic for a long time and I’m so grateful to bring you Jen & Rob’s story! So settle in to the conversation, break it up over a couple of commutes or an evening on the couch with your significant other and enjoy the story.

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Anesthesia Education Personal Finances Preparing for Grad School/Residency Wellness

#12 – Ten Things Every Anesthesia Provider Should Know

The following ten ideas have the power to change your attitude towards and even the trajectory of your professional career and life.  There’s three core domains to developing as an anesthesia provider:  your knowledge base, skill set and attitude.  Each are unique and require different kinds of effort or deliberate practice to grow & improve.  This guide is predominately about tweaking & improving the attitude you approach your career with.  If you’re gonna show up in your life, why not show up with a level of stoke that pulls you through the doldrums & pushes you towards where you want to be?  These ten ideas may help you do just that.

1.  What you do matters because you hold the lives of your patients in your hands.

2.  You’re only as good as the decisions you make today (sort of).

3.  You provide a service and you are replaceable. 

4.  You have an incredible capacity to develop your skills, knowledge, attitude and even intelligence.  

5.  We work in systems that are designed by people, and people work in relationships.  

6.  No one cares about your money, career, scope of practice, time off, goals, wellbeing and success more than you do.

7.  Embracing delayed gratification and understanding the power of compounding interest are critical to creating a brighter financial future for yourself.

8.  You have more power, influence and capacity than you think, and so does everyone else.  

9.  Location – Compensation – Autonomy.  You can pick 2.  

10.  Joy is more valuable than your income or job.

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Resources

Duckworth, A. (2016). Grit: The power of passion and perseverance (Vol. 124). New York, NY: Scribner. Retrieved from http://www.simonandschuster.com/books/Grit/Angela-Duckworth/9781501111105.

Dweck, C. S. (2008). Mindset: The new psychology of success. Random House Digital, Inc..  Retreived from https://www.penguinrandomhouse.com/books/44330/mindset-by-carol-s-dweck-phd/9780345472328/.

Ericsson, A., & Pool, R. (2016). Peak: Secrets from the new science of expertise. Houghton Mifflin Harcourt.  Retrieved from https://www.hmhbooks.com/shop/books/Peak/9780544947221.

Jebb, A. T., Tay, L., Diener, E., & Oishi, S. (2018). Happiness, income satiation and turning points around the world. Nature Human Behaviour, 2(1), 33-38.

Oliver, M. (2020). Devotions: The Selected Poems of Mary Oliver. Penguin Books.

The Notorious B.I.G. (1997). Mo money mo problems [Song]. On Life after death. Bad Boy Records; Arista.

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Anesthesia Education Clinical Tips Preparing for Grad School/Residency Wellness

#8 – How to master precepting with Will Cohen, MSN, CRNA

Today I’m joined by Will Cohen to talk about clinical precepting.  We discuss ways to create effective learning environments, how to expect excellence while being supportive and other tips for mastering the art of precepting.

Will created the Facebook page CRNA Preceptors and has become well known in the CRNA world for creating masterfully crafted deep dives on physiology & pharmacology to help CRNA preceptors train their resident SRNAs  

William Cohen is a CRNA who currently practices at two hospitals in the Kansas City metro area.  The first is the University of Kansas Health System which serves as the regional level 1 trauma & burn center.  The other is the Minimally Invasive Surgical Hospital, which focuses on bariatric and orthopedic surgeries and is staffed by a CRNA-only team proficient in multimodal, opioid sparing and ultrasound guided regional anesthesia techniques. 

Mr. Cohen graduated from the Our Lady of Lourdes Nurse Anesthesia Program with a Master’s degree, and had been in various clinical roles prior to entering the anesthesia environment.  He has provided patient care in the pre-hospital setting as an EMT and Paramedic in Ohio and New Jersey, as well as working as a trauma critical care nurse in Atlantic City. Throughout each phase of his career, William has always taken on preceptor roles and enjoys having learners in the clinical environment. 

William has a wide array of interests in healthcare, including precepting learners, human behavior during crisis and emergencies, airway management, opioid sparing anesthesia, and process improvement. Saving the best for last, William thrives on being a husband and father. His family loves to travel, as well as go mountain biking, skiing and experiencing whatever local foods and beers happen to be found along the way.

Chipas, A., Cordrey, D., Floyd, D., Grubbs, L., Miller, S., & Tyre, B. (2012). Stress: perceptions, manifestations, and coping mechanisms of student registered nurse anesthetists. AANA Journal, 80(4).

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Anesthesia Education Wellness

#4 – Front Line Heroes with M.J. Hiblen

Front Line Heroes by M.J. Hiblen

MJ Hiblen is an illustrator from Norwich, United Kingdom who’s first book of art titled, Front Line Heroes is available now from Eyewear Publishing. 

This book is incredibly powerful.  I’ve followed MJ’s work on Instagram since the early days of the COVID19 pandemic when he began drawing images depicting the coronavirus as a classic comic-book style menacing villain with healthcare workers squaring off as the front line heroes the world has come to know them as.  When I saw that this collection of art was coming together in a limited edition hardcover, I immediately put my order in.  The book went to print in August 2020 and over the last few weeks I’ve shared it with colleagues in my anesthesia department.  Their first glance at the artwork – during busy shifts at our level 1 trauma center – was often much like mine:  at first intrigued and then within pages, fighting back tears as we realize the beauty and power of what M.J. Hiblen has captured in his images.  His work is evocative & heart wrenching, at once it powerfully represents the human toll and suffering this virus has brought around the world while also casting healthcare workers as the defiant, battle-worn and ultimately triumphant care providers they are.

You owe it to yourself, after the year we’ve all experienced, to look M.J. Hiblen up on Instagram and get a copy of this book for yourself.  You can find it on Amazon or directly from the publisher at Eyewear Publishing.  Links to the book are in the show notes and if you hurry, you might still be able to get one only 1000 first edition hardcovers, signed by M.J. Hiblen.

Click here: M.J. Hiblen on Instagram

Order your copy of Front Line Heroes, art by M.J. Hiblen here.

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