01 September, 2014

31 Aug 2014 - Hurry up and waiting on that Scroll...

First off, to my former co-worker that got into KPSA, good luck on the start buddy!

I got my official letter from Northeastern University earlier this month as expect. Still no word from the Army, however. According to my recruiter, my packet has already been approved by the Department of the Army for the program and my name has been sent up the chain for scroll approval, a process by which no one has any real idea works. Having been scrolled in before when I commissioned into the Air Force Reserves, I know that the wait feels longer than forever. 

Basically, your packet is sent to the board for your branch for review. If you're approved by your branch it's supposed to be pretty much automatic that you're in because if you're going to get rejected, it's at the branch level. Your packet then gets sent to the Secretary of Defense for scroll approval. My assumption was that company grade officers O-1 to O-3 only required SECDEF approval which was usually automatic. I was told, however, that a law passed a few years back requiring Senate approval for all officers entering AD; Senate approval used to be be required only for field and flag officers. My guess is that it's supposed to be a formality so that the Senate can have more oversight over military spending. 

The important part, however, is that the Senate has the ability to line out specifics from the scroll. So basically, I can still be rejected if I pissed off a Senator or two who still have the ability to line out my name on the scroll. It just takes a long time because of the bureaucracy. That and since it's the end of the fiscal year, my guess is I won't be finding out until October when I get to commission in. 


01 August, 2014

01 August 2014 - One down, one to go.

I'm on vacation in Kauai right now and work doesn't seem to understand that. Neither do the roosters. I've been getting called every day for overtime, so for the most part my phone's been off on radio silence.

I turned it on this AM and sifted through the junk pile up this morning to find this email. Got in. Now just waiting on the recruiters to call me back with good news.

09 July, 2014

09 July 2014 - USAGPAN Packets are in. Soon.



Late post: My packets are in for USAGPAN. I can finally breathe easy. The application process for USAGPAN is a two step process:

The first step is the apply for the contract school that USAGPAN runs its program through. In this case, it's Northeastern University. Application for the that is in and complete. I spoke with Ms. Litzinger from the anesthesia program there and confirmed my packet is completed and my letter of recommendation is in from the Phase II director from Madigan Army Hospital. I'm just awaiting review by their admissions panel sometime this month. Results should be in by the end of the month with resulting email notification of acceptance by end of August.

The second step is to apply for commission to the Army Nurse Corps. As stated previously, my situation is a little more sensitive than a regular Direct Accession since I'm transferring branches. My conditional release from the Air Force Reserve is only good for a set amount of time, my recruiters were working double time to get my packet in for boards before it expires. I had a little hiccup going through MEPS with my laser eye surgery documentation, but my waiver for that has finally been cleared. Yesterday I signed my digital signature to approve my packet to be sent to boards. Somewhere in the clouds my packet is sitting awaiting to be reviewed by a special committee for approval for commission. According to my recruiters, I should hear back by end of July or early August.

Its complicated, but I will need acceptance from both boards to be admitted into the program. I also found out from my recruiter that you only get two shots at applying; if I don't get in this time, I only get one more try. I guess that means I better vibe hard for that acceptance.

It's been a long process, but I'm glad I went through with it. At least now I can relax, finish up my biochemistry refresher, enjoy life again for a little bit. I go on a long awaited vacation in two weeks, should be back first week of August hopefully just in time to find out results. Can't wait to go from HUA to HOOAH.


16 May, 2014

15 May 2014 - USAGPAN Update

It's been a while since I've updated and I finally found a spare moment to do so. My time has mostly been occupied retaking biochemistry, working civilian and military, and reorganizing life "stuff."

I've been thinking more and more about the benefits of going the military route. I know military pay, even as an officer, is no where near what anesthetist make in the civilian world. But again, it's never been about the money. It's about job satisfaction and the DNP/DNAP.

As such, I've been in contact with an Army Health Care recruiter and have completed my application to Northeastern University.

The USAGPAN application is pretty long and drawn out. I'd be going in as Direct Accession from the USAF Reserves which in itself makes the application process sensitive. I'll follow up in more detail on the application process in a follow up post, but here's the important parts:


  • Since I'm a Reservist, obtain a DD Form 368 release signed from your unit commander. This gets turned into the recruiter and starts the application process. 
  • Apply directly to the contract school that USAGPAN is working through for the CRNA Program. Right now its through Northeastern University in Boston. 
  • Concurrent application for Direct Accession into the Army Nurse Corps. 




22 March, 2014

22 March 2014 - Decisions, decisions.

I spoke to some Army recruiters. Here's my current options:

Option 1: Attend the program at USF and use the Army HPSP; this would basically entitle me to Full tuition coverage and a living stipend of about $2100/month. I would be losing rank; I'd be an O-1 and in the IRR during this time. The AD service obligation starts after I finish the program. 

Option 2: Apply for USAGPAN. Tuition and materials are covered and I would be on AD during the time I'm in school, so I'm receiving a salary and the time in school counts towards retirement. Service obligation starts after completion of CRNA school. I'm not sure if I'd be losing rank though. 

Option 3: Go the Reserve route and only receive a stipend of about $2100 a month. Tuition, living expenses, etc is out of pocket, there's no salary during school. During school I'd be in IRR status, losing rank to O-1. 

Decisions, decisions. 

13 March, 2014

13 March 2014 - The Sting of Rejection and the Great Gamble

Recap up to this point:

  • I didn't get into KPSA. I felt like I did well on the interview, but for some reason or another, I was turned down. I'm not too bummed out about it; I was told that being rejected the first round is normal, just go to the follow up counseling session, follow their advice, try again next year.
  • I got into USF's CRNA program.This would require me relocating to Tampa Bay, FL to attend their program this coming Fall. 
  • I was invited to an interview at Barry University. I didn't attend the interview session. 
  • I am currently in contacts with Army recruiters and working on my packet for accession into USAGPAN. 

The benefits of waiting another year (with assumption I get into KPSA or USAGPAN):
- I can pay off more loans and save up some extra cash.
- I wouldn't be in as much debt at time of graduation.
- I can put on Captain before I transfer from the USAF Reserves.

The gamble: If I turn down USF, I give up a secure seat with a chance of not getting into another program next year.

The worse case scenario if I do attend USF is that I quit my job here in Southern California, sell my car, and move across the country. By my estimates, I'll most likely graduate around $130-$150k in debt, that's not to include loans I still have existing from my undergraduate. The plan would be to move to wherever would hire me straight after graduation and start working to pay off loans as quickly as possible before attempting to move back to California. (A quick scan of gaswork.com and you'll see that there's few positions available in California, not to mention the higher cost of living means slower loan pay offs.)


According to rumor mills, however, the anesthesia nursing field is on its way to becoming over-saturated. (More information on that here.) Best case scenario is that the over-saturation is a regional phenomenon, which would mean I'd have to move out of state to find work. Given incentives to work in rural areas and the lower costs of living, moving to the middle of nowhere would seem like the most logical choice. The regional over-saturation could possibly mean I don't get to declare myself a California resident again for half a decade or more, although I'm not really sure if that's a bad thing.

The advantage of attending this year is based on security and opportunity cost. Again, I'd be turning down a sure seat without the guarantee of a seat for next year. I'd also be losing out on one year of practice and income. I don't believe in putting all my eggs in one basket but I've always told people to have back up plans for your back up plans. I guess we'll see what happens.

15 February, 2014

15 February 2014 - Post KPSA Interview: How it went down.

This past Thrusday I had my panel interview with KPSA. I think it was a rather nice experience despite all the stressing I've been going through up until this point. Regardless, I'm glad it's over. For the skinny and debrief skip to the bottom, for the detailed synopsis, read on.

A couple months back I got the invitation for the panel interview at KPSA. Unfortunately, it fell right in the middle of a military tour I'd be doing at the Navy Medical Center in San Diego. I called Sandra Hinkson over at KPSA to see if I could reschedule, but unfortunately, interviews were fixed due to the logistical issue of getting the panel together. So it was basically figure out a way to skip duty for a day and scoot my way back up to Pasadena for the interview. Fortunately, the department head on my assigned unit was understanding of my Reserve/civilian status and made accommodations for my schedule.

So after my 12 hour shift on Wednesday, I drove back to home to Long Beach. Tired from the drive, I did little prepping for the interview. I figured everything I needed to know I already did and had already figured this would be more of a personality and behavioral interview. The next morning I woke up, had breakfast that my girlfriend prepared for me and drove up to Pasadena, knocked out my interview, and then came back to San Diego for my shift on Friday morning. It's been a busy week needless to say.

Anyways, here's how it went down:

I would break the interview process down into three parts. There was an initial introduction, the panel interview itself, and a teamwork/scenario workshop.

My interview was scheduled at 1400. On the invitation there was a note to come in 30 minutes earlier than your scheduled interview time. When I checked in at 1320, I told the guard I was a little early, but he noted I was right on time, stating that I was scheduled to check in at 1330 and logged in my time in the book. Basically, if you come early, you're really on time, and if you come on time, you're late.

The first part of the interview is the introduction. After checking in, you go into a room and sit down with Sandra Hinkson and a few other candidates. This is your "staging" room. Sandra introduces you to the other students and you have time to talk and get to know everyone. The conversations we had had nothing to do with the interview process or anything CRNA related and were definitely not of professional in nature. We actually talked about some rather potentially offensive topics: the shitty parking situation, gay marriage, animal abuse, euthanasia, incest, alcoholism, politics, and the Olympics. Sandra is quite straight forward, cusses a lot, and I found it quite amusing. She also gives you some papers with FAQs and instructions for the interview process. I think the point of this was to serve three purposes: to help you calm your nerves, to observe your ability to interact with other candidates, and to see how you really are in an informal setting. I have a feeling that although Sandra was just an administrative assistant, she has a large say in who gets picked.

When its your turn, Dr. Boytim comes and pulls you into another the room for the panel interview. He gives you a quick briefing, tells you that panel members have your packet and have reviewed your resume and that the panel consisted of faculty and current and former students. He tells you they ask 6-8 questions which, for the most part, were pertinent to your resume and it should last about 10-15 minutes. He tells you to be youself and to answer the questions. The interview is basically self guided.

As you enter the room and take your seat; the seating arrangement in the room makes the interview a little bit more intimidating. The room is situated as a horseshoe with you in the middle. On one side of the room are Dr. Boytim, Dr. Nagelhout and another senior faculty member; everyone else is on the otherside; nobody is really directly in front of you, which makes addressing the entire audience at the same time awkward.

As you answer your question, you'll notice that only half the room is paying attention. Everyone else is doing something; staring down, talking amongst themselves, or just blanking staring at you. Based on my previous interview, I figured most of them just are skimming your resume and reading your mission statement. The only people that seem to be paying attention and initially asking questions are Dr. Boytim and Dr. Nagelhout; but remember to try to make eye contact and address everyone.

Here's a few questions they asked me and how I answered them.
1) Tell us about yourself. - I basically outlined my resume quickly, told them my ICU and work experience, my educational background, certifications, and current goals.

2) What do you think makes a good team. - I cited my experience from the Air Force; a good team has a good leader to direct the team towards a common goal, to provide an environment that fosters growth of team members through education, providing resources, and allows for opportunity to debrief and allow feedback to improve performance.

3) What kind of ICU did you work in, did you deal with ventilators/weaning/drips/etc.? - I quickly discussed my experience in KP WLA's and Centinela's ICU and the types of disease processes we treated.

4) Please clarify "focused-introvert" in regards to your mission statement. - I stated that I have an introverted personality type; while I work well as a team and can be sociable, I do best when I am left to think on my own. I also stated that while I am able to grasp a general idea or goal, I tend to have an easier time in situations require tactile skills and compartmentalized focus. I also made it clear that while I am by no means OCD or type A, but I have a high level of attention to detail and efficiency. I provided examples of having meticulous line hygiene contributed to my ability to work quickly and how attention to small details, such as having positive pressure valves on your drips and swiping a stick of antiperspirant across my forward before the interview contributed to better outcome.

5) We see that you started your master's program. Did they make you declare a focus of study and why did you decide CRNA over NP? - I figured that they would ask me this question. I stated that one of my goals was to continue my education and no matter that I'd be going on to graduate school, so I started my graduate program at CSULB to start some core courses. I stated that I declared Adult Geriatric NP as my area of focus and discussed my shadow experience with both NPs and CRNAs. I expanded on how I didn't think being a clinician/diagnostician was a fit for my personality. I discussed how I enjoyed the fast paced work flow and procedural aspects of being a CRNA.

7) Tell us about your shadowing experience. - I briefly discussed shadowing a day with a former KPSA alumni that recent graduated. I also mentioned shadowing with another CRNA that graduated from an east coast program who let me get a little more hands on.

8) Did you do any precepting on your ICU? - I mentioned one of the candidates from the week before that happened to be my coworker.

9) You've been working for a few years and have been making good money; do you believe you are ready for this program? How is your support system? - I discussed how I've been paying off credit cards and student loans to prepare for full time graduate school. I told them I was prepared to revert back to my cup ramen and PB&J diet. I also mentioned that although I applied at other schools, one of the reasons KPSA is my number one choice because my primary support system is in Southern California.

10) Please expand on your use of the term "reduction of daily fecal matter load" in your mission statement. - One of the interviewers stated that in his 25 years of reading mission statements he's never had anybody use the term "fecal matter" in their mission statements. I just smiled and reverted back to my goals; I stated that one of the main reasons I wanted to pursue higher education was so that I could get away from bedside before 1) I hurt back back, and 2) so I could reduce the amount of fecal matter I deal with on a daily basis, literally and figuratively. At this point most of the room started chuckling. I don't know if this is good or bad.

11) Do you have any questions for us? - I avoided asking questions that were on already answered on the FAQs. I basically asked for feedback in regards to how the interview went and if there was anything I can address in regards to my resume and qualifications that I may have been of concern. They said that I did pretty well and that there weren't any pertinent issues they were concerned about.

They ended up asking a lot more questions than I thought they'd ask. After the interview, I asked Dr. Boytim in the hall how he thought it went. He said he thought I did well and answered all the questions appropriately. After the panel interview you and another candidate proceed to another room. In the room, Dr. Elisha, Dr. Heiner, and some current students present you a scenario.

It's a pretty simple scenario, much easier than the scenario I had to deal with at the USF interview but I think they just want to get a feel of how you problem solve with your peers. I believe the other candidate and I did a pretty good job, we bounced ideas off each other and discussed how we would intervene, what diagnostics we would need, and what we thought the diagnosis was. We came to a conclusion and presented how we would manage the situation. I think we did so fairly well.

The second part of the scenario had to do with how well you dealt with criticism and the question went along the lines of 'you overhead other nurses stating that you were incompetent and that your care would lead the patient's dismise, how do you deal with that situation?' My partner stated that she would complete the patient care and since she obviously knew she wasn't incompetent, she would approach the other nurses and the manager and see how she would deal with the situation. I took a more conservative approach and stated that after stabilizing the patient, I wouldn't necessarily confront the other nurses nor would I take it to heart. I would approach my manager and without stating names say that I overheard other nurses saying that my care was incompetent and if there was any performance feedback she could offer. I saw the faculty members taking notes and took that as a good sign.

After the scenario portion we were told we were free to go. I still, however, wanted to pick Sandra's brain for a minute, since she said she would answer any questions we would have after the interview. I went back to the room and sat down and asked her in a straight forward manner: "So how do they really pick who gets in?"After a brief discussion about how the admission process was an art form of behavioral and personality analysis mixed with science. I asked her if there was a point in reapplying if I didn't get in this year and she said yes of course. After our discussion, I told her that if I didn't see her in August, I'd see her same time next year. She told me that if she didn't see me in August, she'd track me down herself. I left with a smile. :)

TL;DR:

It went well, I left feeling good about how the interview went. Now it's just a waiting game to hear back.

Theme of the interview:

The words that kept reverberating in my head that the alumni I shadowed with kept mentioning was, "Just be yourself." and I used that as the common theme for how I approached the interview. I tried not to overly prepare or sound too rehearsed.

I think the whole point of the interview was to figure out a few things; how dedicated you are and how well you'd get along with other students in the program. To this, you have to answer the following questions: do you know what you want, why do you want it, and how you prepared for it. You'd have to so while being personable and "real."

27 January, 2014

27 Jan 2014 - To those who wait...


It's a good Monday.

I was at drill this weekend, so I was catching up on errands this morning. I woke up, checked reddit, checked my stocks and did some buying. Forced myself to go for a mile and a half run (my time is terribly embarassing, too much so to mention here. My goal is to cut off about a minute and a half by the end of February). I dropped off my laundry, went to the post office, and stopped by a sushi place for lunch.

And while I was eating, also had time to pull out my cell phone to check my email. And then I saw this:



Yeeeeeaaaa buddddddy!

Anyways, time to go to bed. I work tonight. :D

27 January 2014 - Interview Prepping 101

My interview with University of South Florida is this Friday. Have I been prepping? Yes and no.
An email sent a little while said that there would be a CCRN style test focusing on the cardiac system. If I can recall my CCRN scores, the cardiovascular system was one of my weaker subjects. I'm a tactile learner and best retain knowledge when I'm about to incorporate theory with practice. Unfortunately, I've only touched a PA catheter once in my 3 years of nursing and rarely do I deal with inotropic agents. I've played with dobutamine a handful of times and Primacor once. But these are things you can study for and apply later.

I think my weak spot is the actual inteview itself. A quick google search for "CRNA interview questions" brings up a list of questions to which I've been studying off of. Most of these questions seem to revolve around why you want to be a CRNA and why do you qualify or have what it takes to become a CRNA. More on this later.

19 Jan - An interview in review.

I meant to write this sooner while things were still fresh on my mind but I've been fairly busy with life "stuff."

On 17 Jan 2014 I had my interview at the University of South Florida's CRNA program. I flew out a day before, got a rental car, drove around downtown and walked around a little bit, looking around like a good scout. Initial impressions of the downtown area were the follow: clean, fresh, quiet. When I got the CAMLS building is right in the downtown area about a 10 minute walk from where my hotel room was. It was built recently and is very modern.



The interview can be broken down into a few parts: initial introduction, interview with faculty, interview with students, a tour of the facility, and a CCRN style exam.

So how'd it go? Introduction was fine. I suited up, walked into the building, and introduced myself. I met one of the current students and another guy that was there for the interview. We made small chit chat and the student aid spoke highly of the school.

The faculty interview I feel went well. They asked basic questions; introduce myself, why I wanted to be a CRNA, leadership and employment history. We also discussed some fairly general physiology, anatomy, and pharmacology questions. There was also a scenario given on paper that was pretty straight forward, I think I talked myself through it fairly well. Most of the questions asked covered cardiology. Needless to say, there were some things I was unsure of and I let them know it but they didn't offer much feedback. Overall, I was told I was a strong candidate and I would be hearing back in a week or two.

The interview with the students was more like a question and answer session, more so on my side. They asked me a few questions, the same personality questions asked during the faculty interview. After that I had the opportunity to ask questions, the down and dirty of the CRNA program. There was limited time to talk to the other applicants, but between the little time I did get and the feel that I got from the current students, I felt a little more comfortable with my qualifications.

The CCRN test was typical. Some of the questions were worded funny, but like the actual CCRN test, if you take your time and think through it, you'll do fine. I think I did ok; most of the questions I answered easily and I know which questions I missed. This is usually typical of how I take tests.

The way they set up there interview was a little different from the interview I had at Midwestern University last year. I actually felt ok about this interview. I didn't leave with a bad feeling.

And of course, I wander around at night randomly. Here's a couple of night shots.



As beautiful as Tampa is and despite my love/hate relationship with it, there's really no place like Los Angeles.