Categories
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

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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

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

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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 improvehttps://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 Guidebookhttps://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

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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

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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. 2022https://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

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

#77 – Thrive in Training: how to land your first job in anesthesia with Jon Bradstreet, MSN, CRNA

In this episode, I talk with Jon Bradstreet, MSN, CRNA who at the time of this recording was the chief CRNA/Director of CRNA Services at Maine Medical Center, Maine’s only level 1 trauma center. Jon was the chief CRNA who gave me my first job in anesthesia. At the time he hired my wife and I, in June of 2015, there were around 50 CRNAs in our group. Seven years later, our group has more than doubled in size with just over 100 CRNAs. Jon has overseen that growth and the development of an incredibly healthy culture within the anesthesia team at Maine Medical Center. We originally recorded this interview in December of 2015.

In this episode we talk about how to prepare for the job hunt as a SRNA… everything from what to look for in a job and how to weigh various pros & cons, how to prepare your resume or CV and how to ace the interview & follow up communications with a prospective employer. You’ve worked incredibly hard during anesthesia school to develop the skills & knowledge to become a competent provider; following through with a similar degree of proactive ownership to land your first job is key to making a successful transition into working as an anesthesia provider. This episode will tell how to do just that.

Key topics:

  • CV Preparation – what works and what’s fluff on your CV
  • When to and how to contact prospective employers
  • Tips for interviews including:
    • What chief CRNAs are looking for in your interview
    • Questions you should be asking in your interview
    • Things to consider doing and avoid doing in an interview
    • When to follow up on an interview
  • Tips for promoting yourself as a CRNA
  • Advice for how to prioritize important aspects of jobs including location, practice type, group culture, compensation packages and more
  • Advice for CRNA couples who are in the job hunt together

Parting words from Jon Bradstreet, MSN, CRNA:

“Have fun… we have a great profession and we have a great lifestyle.  We’re very lucky to do what we do for a living.  Always keep that in mind – how fortunate we are in this profession.  And then finally I think I would say listen to your gut.  It’s taken you very far in life already… don’t repress what it’s telling you as you’re in that interview.”

Categories
Anesthesia Education Clinical Tips Preparing for Grad School/Residency

#75 – Thrive in Training: communicating with preceptors

In this episode, the founders of From the Head of the Bed… Jon Lowrance, Kristin (Andrejco) Lowrance, Brad Morgan & Cassidy Padgett, talk about how to communicate with preceptors as anesthesia trainees.

This conversation was recorded as one of the original podcasts released at the launch of From the Head of the Bed, the podcast the proceeded Anesthesia Guidebook, back on March 10, 2015. Over 7 years later, it’s getting a re-release here as part of the Thrive in Training series and the tips shared are just as relevant as ever.

All four of these folks were third-year SRNAs at the time of this recording and offer tips for anesthesia trainees hitting the clinical environment for how to communicate with preceptors. How well you get along with the folks you work with in the OR will either make or break your day – as an anesthesia trainee and as a licensed anesthesia provider. It takes a hefty dose of emotional intelligence to navigate the relationships found in the OR. This is one of the things that many anesthesia trainees find surprising: just how hard they have to work to understand the people they work with, what relationships are already at play in the OR between OR RNs, surgeons, CSTs & anesthesia providers and how to create positive working relationships with preceptors.

It’s rare that anesthesia training programs – for CRNA or physician anesthesiologists – provide education on how to become a clinical anesthesia educator or preceptor. Those skills are usually left up to anesthesia providers to figure out on the job. Given that, many anesthesia providers don’t approach their roles as preceptors and clinical educators with deliberate and highly functional skills and techniques. They just do their job as anesthesia providers and expect anesthesia trainees to figure the job out as they work together through the day. Given this context, it’s critical for anesthesia trainees to understand how to communicate with preceptors in order to create positive working relationships.

That’s not to say that the onus is just on anesthesia trainees for creating their own positive educational experiences. Certainly, clinical faculty and anesthesia training programs should bear the primary responsibility for creating effective educational environments for their trainees. But given that the quality of educational settings for anesthesia trainees can vary greatly, along with the clinical teaching skills of faculty, it can only help if you as an anesthesia trainee show up with some knowledge of how to communicate with your preceptors. So that’s what we talk about in this podcast.

We hit on the following topics:

  • Importance of communication skills in the perioperative environment
  • How to prepare for clinicals
  • Tips for making pre-clinical phone calls to preceptors
  • The use of cell phones/electronic devices in the OR
  • Common questions preceptors ask students
  • How your communication skills should evolve during training
  • Importance of being teachable, flexible, humble and thankful

In the podcast, we talk about the “smooth & in” video. Unfortunately, I can’t find it and the prior link has been removed. It was a classic. If someone can find it, let me know.

Categories
Anesthesia Education Clinical Tips Preparing for Grad School/Residency

#74 – Thrive in Training: how to crush clinical

This episode offers a run down on how to prepare for the clinical phase of anesthesia training. We touch on practical tips like which apps are helpful, what gear to utilize & how to acclimate to the clinical environment as well as meta issues like developing emotional intelligence and the right kind of attitude to create success in your journey.

I also highlight a bunch of other shows on Anesthesia Guidebook that are not part of this series that you may find helpful.

Outside of the Thrive in Training series, we’ve got lots of content on pharmacology and much more to come.  But to prepare for clinical, don’t miss the shows on the top drawer run down (episodes 17, 18 & 19), which for years were the number 1 requested content and remain some of the most listened to episodes.  Other shows on pharmacology include run downs on dexmedetomidine, succinylcholine, buprenorphine, the pharmacokinetics & pharmacodynamics of volatile anesthetics, local anesthetics and ondansetron for preventing spinal induced hypotension.  We’ve got an episode on a multi-modal, opioid sparing approach to total knee replacement surgery, one that overviews regional anesthesia, one on opioid free anesthesia and one on the anesthesia implications for patients who use cannabis.  

Other content that you’ll find helpful are 2 shows for anesthesia trainees who are going through the process with your families:  episode 15 is specifically about your significant others and anesthesia school with Jenny & Robert Montague.  Rob is now one of my CRNA colleagues here in Portland, Maine and his wife, Jenny, is a Registered Dietician.  They have 2 young kids and talk about the experience of doing anesthesia school as a family.  The other episode is number 50 – parenting during anesthesia training with Lein & Nate Woodin.  Lein was actually in Robert’s class at the University of New England and her husband, Nate, is a licensed child therapist.  They’re an amazing couple, also with 2 young kids, and we focus in specifically on the changing dynamics of parenting during anesthesia training.  Nate brings a wealth of experience to the conversation as a child therapist and husband of an SRNA.  

A couple other episodes you’ll want to go back to check out that would fit perfectly in the Thrive in Training series:  

Episode 10 is 10-quick tips on mastering airway management, episode 24 is with Jason Bolt and we talk about avoiding landmines as an anesthesia trainee in how you represent yourself on social media.  Episodes 31-37 all deal with learning anesthesia & the path to expertise; so we hit on deliberate practice, understanding cognitive state of flow in balancing challenge with skill and the power of the invisible can-of-calm.  We also hit on asynchronous learning, emotional intelligence of SRNAs and the transition, this year, of entry-to-practice training for CRNAs becoming a doctorate degree, when, for the last 30 years or so, it’s been a master’s degree.  

Then there’s a 10-episode run on provider wellness from episodes 51 through 60 that touch on everything from how to pay your debt off, to dealing with the pandemic to how to weather the storms and setbacks you’ll have in anesthesia training.  The top show in that run for anesthesia trainees, if you want to go back and just pick out one, is episode 54: hardship in anesthesia school.  This continues to be one of the most-listened to episodes from all of Anesthesia Guidebook and zeroes in on the best advice and stories I have for you if you find yourself up against a wall or being beat down by god-knows what on your path to becoming an anesthesia provider.  

Here’s the NRS Video Dream where Ben Marr imagines what life would be like if he was good at paddling. It’s amazing! (This is what it’s like to be a novice in the OR, watching the expert providers all around you… you just WANNA BE GOOD!)

Categories
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.

Categories
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!

Categories
Anesthesia Education Business/Finances

#66 – The CPC Assessment (Exam) Overview

This is run down specifically on NBCRNA’s Continued Professional Certification (CPC) Program Assessment (or Exam) for CRNAs.

Episode 64 was a 10-minute run down on the whole CPC Program – a quick overview. In episode 65, I did a whole hour-long deep dive on the program, including the CPC Assessment. This episode cuts out all the other content on the CPC Program and just focuses on the exam. This is the element of the CPC Program that causes the most anxiety for CRNAs so it’s worth doing a whole show on. I talk about the background of the exam, the layout & nature of the exam, the decision about taking in person at a Pearson Testing Center or at home on your own computer and tips for preparing (or not) for the exam.

In April of 2019, I interviewed John Preston, DNSc, CRNA, FNAP, APRN and Lisa Kamen, CAE of the NBCRNA on the CPC Program for the podcast From the Head of the Bed. At the time, Dr Preston was the Chief Credentialing Officer at NBCRNA; he is now the CEO of NBCRNA. Lisa Kamen is an association manager who supports the work of NBCRNA as a full time staff member. Several elements of the CPC Program have changed since 2019 so the last 3 episodes on Anesthesia Guidebook are all new.

Drop me an email or comment on Instagram/Facebook if you’ve got questions on the exam after listening to these 3 episodes. Links below for content from NBCRNA to help you naviaged the CPC Program along with the powerpoint outline I’ve used to present on the CPC Program at state & national conferences for CRNAs.

The CPC Program at a glance.

Check your progress in the CPC Program here: NCBRNA Website

More on the CPC Program:

NBCRNA CPC Program

Categories
Anesthesia Education Business/Finances

#65 – 1-hour CPC Program Overview

This is an all-new 1-hour overview of the NBCRNA’s Continued Professional Certification (CPC) Program for CRNAs.

In April of 2019, I interviewed John Preston, DNSc, CRNA, FNAP, APRN and Lisa Kamen, CAE of the NBCRNA on the CPC Program for the podcast From the Head of the Bed. At the time, Dr Preston was the Chief Credentialing Officer at NBCRNA; he is now the CEO of NBCRNA. Lisa Kamen is an association manager who supports the work of NBCRNA as a full time staff member. Instead of brining that episode forward to Anesthesia Guidebook, I’ve decided to complete re-write this update because the CPC Program has evolved even since 2019.

Episode 64 of Anesthesia Guidebook includes a brief 10-minute run down on the CPC Program that you can share with friends who just want a quick overview. I recorded the 1-hour run down first and then realized that there’s probably some CRNAs out there who just want a quick overview, so I hammered episode 64 int0 just over 10-minutes.

The CPC Program at a glance.

Check your progress in the CPC Program here: NCBRNA Website

More on the CPC Program:

NBCRNA CPC Program

Categories
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

Categories
Clinical Tips Opioid Free Anesthesia Outpatient Anesthesia Pharmacology Preparing for Grad School/Residency Regional Anesthesia

#41 – Regional Anesthesia with Shane Garner, MS, CRNA, NSPM-C

This episode was originally released in April of 2020 on From the Head of the Bed… a podcast for the anesthesia community and is being re-released on 5 September 2021 on Anesthesia Guidebook.

In this episode, I speak with Shane Garner, MS, CRNA, NSPM-C about an introduction & overview of regional anesthesia. We discuss:

  • opioid-free anesthesia
  • how to gain experience in regional anesthesia as a SRNA or CRNA
  • fellowships in pain management available to CRNAs
  • the Non-Surgical Pain Management (NSPM) board examination
  • how to start a block program and gain surgeon buy-in
  • Exparel (bupivacaine liposome injectable suspension)
  • when to use regional anesthesia catheters and more!
Shane Garner, MS, CRNA, NSPM-C

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.

Resources:

University of South Florida Advanced Pain Management Fellowship

NBCRNA Non-Surgical Pain Management Board Exam

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

#36 – DNP: The Future of CRNA Education with Shawn Collins, DNP, PhD, CRNA

This episode originally appeared on the podcast From the Head of the Bed on August 6, 2015. It’s re-released here on August 17, 2021. Dr Shawn Collins, DNP, PhD, CRNA and I discuss the transition from Master’s level training for CRNAs to practice doctorates, most commonly the Doctor of Nursing Practice degree or DNP.  

Every CRNA program must transition to the doctorate level for new classes by January 1, 2022, with every SRNA graduating from doctorate level training by 2025.  Most of the 124 CRNA programs in the US have already transitioned to doctorate degrees, with some having done so more than a decade ago.  Dr Collins and I discuss why CRNA training transitioned from the master’s level to the doctoral level and what this means for education, clinical practice and business.  

Beginning the fall of 2019, the Council on Accreditation of Nurse Anesthesia Educational Programs, which sets the standards for university programs, began revising those standards based upon recommendations from a “Full Scope of Practice Competency Task Force.”  The COA updated several standards and requirements of CRNA doctorate programs including increasing the number of required anesthesia cases, mandating specific training in the use of point of care ultrasound for diagnosis and therapeutic interventions, 12-lead ECG interpretation, radiology & flouroscopy use, chest X-ray interpretation and more.  You can read about these changes and the specific requirements for CRNA doctoral programs at the COA’s website.

At the time of the interview, Dr Shawn Collins was the nurse anesthesia program director at Western Carolina University and the interim dean of the College of Health & Human Sciences.  

He was the program director when I attended WCU and was a huge source of encouragement and support to me personally as I ran the gauntlet of anesthesia training.  He was also 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. 

Dr Collins has obtained both his doctor of nursing practice degree and his PhD and compares these degrees, along with other types of doctoral programs, in this podcast.

He was instrumental in developing the DNP program at WCU, transitioning the master’s-level nurse anesthesia program to a practice doctorate.  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. 

Categories
Anesthesia Education Preparing for Grad School/Residency Wellness

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

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.

Categories
Anesthesia Education Personal Finances Preparing for Grad School/Residency

#6 – Van life in anesthesia school with Marcus House

Today I talk with Marcus House, BSN, SRNA about his decision to live in an ambulance during remote clinical rotations in anesthesia school. Marcus is currently working towards completing his Doctor of Nurse Anesthesia Practice at Missouri State University. He holds Bachelor of Science degrees in Education and Nursing, both from Southeast Missouri State University. Marcus worked for 7 years as a high school science teacher alongside his wife, Casey, also a high school teacher, before returning to nursing school. He spent 3 years working in a CVICU prior to pursuing his doctorate degree in anesthesia. He would like you to know that he “knows when to hold ’em, AND when to fold ’em, [he] once owned a Nintendo Power Glove and [he’s] comfortable being either ‘big spoon’ or ‘little spoon’.”

In all seriousness, choosing to go mobile for your housing arrangements during graduate school or residency, depending on your clinical rotations, may make a lot of sense. As Marcus points out in the podcast, he’s saving money compared to the cost of rent while enjoying a personalized home on wheels that will be his to keep after anesthesia school. With many graduate anesthesia programs sending their SRNAs wide and far for clinical rotations, it can be extremely challenging to find affordable housing on the fly in grad school while still maintaining rent or a mortgage at a home base.

You don’t have to look far on the internet webs to find a virtual plethora of blog sites, Instagram & Pinterest feeds and YouTube channels dedicated to #vanlife for ideas & guides on build outs.

I put a few photos of Marcus’ ambulance, Bernice, below and you’ll find several more at Anesthesia Guidebook’s Instagram page. I’ll also include some photos on Instagram from a Sprinter van build that my wife and I completed after we finished anesthesia school. While we were able to get through our program in traditional housing, we’ve thoroughly enjoyed having a van for weekend to multi-week road trip adventures after grad school.

Don’t hesitate to reach out to Marcus via Facebook or email (Marcus.House1@gmail.com) (that’s Marcus-dot-house, the number one, at gmail.com) or drop a question/comment below, on Instagram or directly to me via email (jon@anesthesiaguidebook.com) if you want to talk about van life in anesthesia school in more detail.

Categories
Anesthesia Education Preparing for Grad School/Residency

#5 – The CRNA Chase with Kiki Mattress, MSNA, CRNA

Kiki Mattress, MSNA, CRNA runs the blog The CRNA Chase which seeks to “empower, inspire, and educate” people who are interested in becoming CRNAs.

In this episode, I talk with Kiki about her journey to become a CRNA and her passion for helping others understand and be successful on that same path.

“Don’t just talk about it, be about it!” Kiki Mattress, MSNA, CRNA on what it takes to become a CRNA.

Kiki’s professional career started after an Associate’s Degree in Engineering from Tri-County Technical College.  After working in engineering and deciding it wasn’t the path she wanted to continue on, Kiki returned to Tri-County for a diploma as a surgical technologist.  While she was working in the OR as a surgical tech she first met a CRNA who became a mentor to her and encouraged her to return to nursing and then anesthesia school.  Kiki took up that path with another Associate’s Degree in Nursing from Tri-County followed by her Bachelor of Science in Nursing from the University of South Carolina Upstate and then her Master of Science in Nurse Anesthesia from the University of New England.  Upon graduating from UNE, Kiki moved back to South Carolina where she works as an independently contracting CRNA. 

You don’t want to miss this episode and if you’re already a SRNA or CRNA, forward this show on to the people you know who are thinking about becoming CRNAs!

Resources:

The CRNA Chase Blog

Follow The CRNA Chase on Twitter

Connect with Kiki Mattress on LinkedIn

Itzkoff, D. (2020, September 16). Chris Rock Tried to Warn Us. The New York Times. Retrieved from https://www.nytimes.com

Categories
Anesthesia Education

#1 – Anesthesia Guidebook Origin Story

Welcome! You made it! This is episode 1: the origin story, the backdrop, the context to who we are, where we’re from and where we are headed. Check out the podcast in your favorite player or right here on the website to hear our story, which is all about YOUR STORY!

You’re on a path to becoming an expert anesthesia provider… we’re here to help guide you.

Everything we do is designed to help you master your craft. 

Anesthesia providers hold their patients’ lives in their hands during every case. You never know when you will face crashing hemodynamics, a lost airway or a life-threatening surgical problem… and each of these emergencies can be complicated by your patients’ pathophysiology, suboptimal systems of care that surround you and/or your individual preparedness for the moment.

Anesthesia Guidebook will help you deepen your practice so that you can come through for your patients when it counts.

If you’re just starting to explore the absolutely fascinating world of anesthesia, maybe as a critical care Registered Nurse, medical student, anesthesia resident or SRNA, we have stories, guides and resources specifically designed with you in mind.

Anesthesia Guidebook is also for those seasoned providers who are looking to level up, dig deeper, stay fresh and develop new skills. We’ll bring you the latest on evidence-based medicine and emerging trends & techniques in the anesthesia community, so you can stay sharp and give your patients and students your best.

Renowned psychologist and best selling author on human performance & expertise, Anders Ericsson, has said:

“Most professionals reach a stable, average level of performance within a relatively short time frame and maintain this mediocre status for the rest of their careers.” (Ericsson, 2004)

Ericsson’s words throw down the gauntlet for anesthesia providers. And the stakes couldn’t be higher. The most vulnerable times in our patients lives often begin when we say “hello.” We have an esteemed responsibility to meet the demand for clinical expertise & assure high functioning systems of care that our patients expect, deserve and entrust their lives to.

Anesthesia Guidebook will bring you compelling stories, e-books and other resources built around pathophysiology, pharmacology, airway management, human performance and team dynamics, all tailored to the high stakes environment you work in.  Your path to becoming an expert anesthesia provider – to mastering your craft – will be the focus of everything we do.

Sources:

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.