23 May, 2018

23 May 2018 - Home Stretch

It's the home stretch now. It's been a long journey: 3 states, 5 out-rotations (and a day doing canine anesthesia), 1,000+ cases, and a doctoral project later we finally attended graduation from NEU earlier this month. After finishing up clinicals, we'll soon get some time dedicated to sitting down and reviewing for boards. Looking over test material it's amazing to see how much I've forgotten from Phase 1.

For review materials I've purchased a couple of review apps, a subscription to APEX earlier in Phase 2, as well as attended Valley Review. The apps were cheap question and answer banks and were worth the $50 or so I spent on them. As for Valley Review vs. APEX, I can't really endorse any one of these over another; they both have their strengths and weaknesses and is probably best discusses in another post. The short of it is that APEX is probably a more detailed and up to date but the attempt at creating third-order questions makes the rationales given seen like a stretch. Valley Review is bit dated but the questions and information are a bit more straight forward and seem well vetted. Also, people that learn better from a lecture would probably benefit from the 3-day review session. For those that don't want to spend the money, sitting down with Barash, Morgan & Mikhail, or even Nagelhout and outlining the chapters is probably just as well.

In typical Army manner, however, even though I'm studying for boards, I'm also starting to get things together to out-process and PCS to my Phase 3 duty station. There's always multiple things to do. At least I'll get some time to go visit California for a bit between stations. Will update again soon.

16 July, 2016

4 July 2016 - Start of Phase 2

It's been a while since I've updated this blog. It's been hectic moving again half way across the country but I've arrived at my next duty station in North Carolina and will be starting Phase 2 soon while finishing up some in-processing.

Apparently, each Phase 2 site is run slightly differently. We pretty much hit the ground and are now scrambling to figure out where we are at. There hasn't been much sleep and its been a bit overwhelming. The staff and faculty are supportive and do understand the struggle, however. We're given plenty of time to settle in and overall my family and I are happy where we're at.

I feel like I've already forgotten most of what I learned in Phase 1, or if I do remember, it's wrong, not practical, or not congruent with practice where we're at. Phase 1 was definitely one of the most challenging academic experiences in my life and built a great knowledge foundation. Phase 2 is a completely different workflow. I figure, however, that it's one of those "if I can do it, anyone can do it" type of things. As has been said by many before me: I'm not the smartest person but I'm willing to work hard and sleep less.

02 August, 2015

2 AUG 2015 - The fire hose is on.

It's been a while since my last post. Here's a quick catch up since then:

1) Finished BOLC. Basic officer leadership course for the Army. Not bad at a all. You get a 2.5 month crash course on what it's like to be an Army officer. There's resources for BOLC all over the place so I won't go into too much detail other than to address a few main points.

The basic officer leadership course does three things: gives you a basic introduction to Army life so you don't look foolish when you forget to tuck your shirt in or forget to return a salute to a private. You'll also learn how to shoot firearms, learn the command structure, and where to go for resources you will need for your future career as an Army officer. You'll also get a chance to taste Texas cuisine and most importantly, NETWORK with other officers.

2) I've moved my family out here from California. I do question the strain on my family though. I won't go too far into detail with this.

3) The program has started and the fire hose as been turned on; The program directors literally equate it to drinking out of a fire hose which is started it at a trickle and as you're slowly gulping it down is turned on full blast. But the first rule of USAGPAN is that you DO NOT TALK (BAD) ABOUT USAGPAN.

And really I can't. It's a great program, The staff are phenomenal and the support system backing you is tremendous. There are resources for you everywhere in this program not just academically but socially and financially. The instructors have so far been amazing and everyday my mind is blown by how much more information they can pump into my head. I'm surprised by how often I get that "Hmm..." and "Ahh ha..." moment where you realized you probably could've killed a few of your patients a few times over. Thankfully, the human body is an amazing and resilient machine.

More to come...


28 February, 2015

28 February 2015 - Goodbye SoCal, Hello Texas.


It's finally happening. I've said my farewells, made peace with the fact that I was moving out of California, where I've lived my entire life, and made the drive out to San Antonio. The drive was pleasant; I wish I had more time to actually enjoy the scenery and explore a little bit.

I arrived to Fort Sam Houston to check in per orders; of course, there were still a few hiccups. I was supposed to get the ball rolling in terms of reporting in to my command, getting checked into temporary living quarters, oathing to Army, getting all my paperwork filed so I could get a new ID card, find housing, and start getting my pay and keep my family insured. Unfortunately, I checked in with my command, but the person I was supposed to see was gone for the day. It's probably just my case since the transition between branches has been so chaotic. So basically I'm here in the hotel until I can check in on Monday. Suck embraced. 

Lighter note, I did make a few stops on the way out to take pictures.

First stop, Davis-Monthan AFB and the Pima County Air Museum. I had a chance to stop by and take a tour of the boneyard. That place is massive, I've never seen so many fighters before. Definitely a must see for jet fighter junkies. Did you know they restored a mothballed B-52 from junk to fully functional in about 2 months and flew it out of there a week ago? That's nuts. Those things are older than I am and they still fly. They also had a bunch of A-10's parted out. Beastly planes they are. 


The drive from Arizona to New Mexico wasn't too bad. That is until I decided to divert from my originally planned route and went into the back country. I drove for about maybe 4-5 hours without reception hoping my GPS wouldn't lose signal, no phone reception the entire time. Stopped a few times in some one road towns and to take pictures of these giant satellites in the Plains of St. Agustin:

Cue X-Files theme. The truth is out there...

Of course, I made some contact with aliens and spent the night in Roswell:


The rest of the drive into through New Mexico into west Texas was pretty uneventful. The weather was getting gloomy and everything just felt run down and gloomy. I don't think I'd personally be able to live out in rural America. But the New Mexico sunsets sure are beautiful. The juxtaposition of the lonely road on to the landscape and the open skies is really something else. I could really disappear out here one day if I wanted to.


All that driving by yourself really messes with your head. You really start to feel lonely and insignificant. But that's why you go to have a good foundation at home, right? I'm going to miss my friends in California, but I'll see you guys later!










11 February, 2015

11 Feb 2015 - Orders are in, getting ready for the move.

As always, life as been pretty hectic so I'll do a quick update.

1) Everything that has happened up until this point has been nerve racking; transferring branches of service is not easy. It's been back and forth about who "owns" me, the Air Force Reserves or the Army. There's been paper work mix ups regarding who had authority to sign what which was easy to clear up. I've already signed my contract with the Army, but I guess it was an "illegal" contract since AFRC hasn't released me. Then AFRC didn't want to release me until I had orders from the Army, but the Army didn't want to give me orders until AFRC released me. Then AFRC didn't want to release me until I had an oath of commission into the Army, but technically I'm already oathed in as a military officer of the United States. Not a problem though. The Army will oath me in again when I go to BOLC. So basically I'm currently in a grey area where I belong in two branches.

2) The good news is that on 29 Jan 2015, I finally got the call from my recruiters saying my orders are in and I've been approved to attend BOLC with a report date at the end of February. I guess one month notice is gracious enough for the military and I've already turned in my two notice at my civilian employer. I'm in the middle of packing up my apartment right now and planning a small road trip while driving out to Texas later this month.

3) The great thing about USAGPAN that has impressed me so far is the guidance and the organization. What's really helped so far is the fact that they actually had a current student contact me as a sponsor/mentor. It's great to have a resource to answer your questions not only about the program itself but about life in general, such as moving, living arrangements, tips about BOLC, and other logistics. The other thing I find interesting is that the community is tiny; I've already made contact with a couple of future classmates online through various forums and boards.

 

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.

18 December, 2013

18 December 2013 - Congratulations, you've been selected...

I've been awake for approximately 24 whole hours as I write this. I've been awake since yesterday morning, did a full 12 hour shift, then proceeded to teach a CPR class right after work. I was driving home when I saw an email with this attachment:




Despite my lack of enthusiasm on the outside, I was pretty ecstatic to see that email. Unfortunately, the date which I am scheduled happens to fall right in the middle of my Air Force Reserve Annual Tour, meaning I'll technically be orders. So as I was figuring out exactly how'd be able to be in two places at once, I got this second email:


Needless to say, I'm kind of confused. One email that gave me a congratulations and an interview date and another that says I got rejected, try again later. I don't know how to express all these feels. Anyways, I gave them a call, hopefully I hear back soon so I can plan accordingly. 

Either way, earlier this week, I got this email from U of South Florida:



Despite Kaiser being my first choice, I believe that only fools put all their eggs in one basket. Planning for success involves making contingency plans, so I guess come January I'll be flying out to Tampa for an interview. 



26 November, 2013

26 November 2013 - KPSAN responds.

Got this from KPSAN in the self addressed envelope today; that was much quicker than anticipated. I also dropped off an additional reference letter from a CRNA I shadowed for a few hours who happens to be a KPSA alumni. Will follow up with that to make sure it's in my file this week.


I've also sent out the rest of my application packets to National University, Barry U, and the U of South Florida. Now its basically time to sit and wait until I hear back. And so my watch begins. 

04 November, 2013

The future is here: Robotic anesthesiologists/anesthetists?


Earlier this year Johnson & Johnson released what they call a Computer Assisted Personal Sedation System (CAPS) codenamed Sedasys. This automated system does real time monitoring of your vital signs and provides procedural sedation during colonoscopies by administering and titrating our favorite hypnotic/amnestic agent, propofol. But since propofol is also used for the induction and maintenance of general anesthesia, who's not to say that it might progress to that, especially for low risk procedures?

Some anesthesiologists are already concerned with anesthesia specialization going to nurses, which is all well and fine. Ultimately, the goal for anesthesiologists and anesthetists is the same; providing safe, high quality anesthesia services with an aim for the best possible patient outcome. However, with health care reform on the horizon, we're also looking more and more into cost savings. But to machines? Sure it'll take out the human error factor, but machines fail too. One thing for sure though, it'll reduce the human touch of anesthesia care.

I, for one, welcome our future robotic overlords. As long it's not the one putting the scope in my butt. Just kidding, I'm still on the fence about this one.

More information here: http://www.sedasys.com/
FDA link can be found here.



03 November, 2013

First packet away!

Application, check. Transcripts, check. Reference forms, check. Miscellaneous documents, check. 

I originally intended to turn in my packet with 4 references including one from an alumni, but I've decided to keep to 3 and turn in my packet early. KPSAN application packet all compiled and to mailed tomorrow. Wish me luck!

27 October, 2013

Eric's Notes on Nursing

Nursing now days has so many formal rules. Here's a list of thoughts and informal rules of thumbs that I've picked up in my short time as an ICU nurse:


  1. A good nurse lacks shame, an ego, and a conscience but has heart, soul, and the determination to never stop smiling. Even during codes. 
  2. There's nothing to be nervous about; you're not the one that's gonna die.
  3. You have to laugh at inappropriate things. 
  4. Be and island of calm in a sea of chaos. 
  5. Primum non nocere. Do no harm. Addendum: Primum non nocere sans documentum. Do no harm without proper documentation.
  6. The IV access catheter is quite possible the most important invention ever created for the medical profession. Without an IV access, I am useless. 
  7. Revatio rhymes with fellatio. 
  8. All the crap learned in nursing school about patient advocacy and doing "what's right" and "by the book": out the window. Patient advocacy is all good, but protect your job and license first. 
  9. Work when you're sick. Call in sick when you're not. 
  10. Scrubs: Pockets are your friend. The more the better. ADDENDUM: As my experience in ICU progresses, I find that I have a need for fewer and fewer pockets, because I carry fewer things. And probably because I'm tired of finding crumpled up alcohol wipes in the dryer. 
  11. Invest in comfortable shoes, even if they're ugly. You'll be standing on them for 12+ hours.
  12. You should chart and document like how girls should pick clothes: just enough to cover your ass; sometimes less is more. 
  13. Turn on the lights in the patients room or you might miss something on your assessment. Turn off your lights in your patients rooms so they go to sleep and stop bugging you. 
  14. Learn to prioritize: take things one step at a time, accomplish the small and simple tasks first and get them out of the way. It leaves you time to tackle the bigger issues, like the drsg change on the sacrum of your 600 lbs patient.
  15. There's always going to be that lingering thought that you forgot administer this, fax or document that, or call so and so for whatever reason. You are human and can only do so much; endose that shit to the next shift. Leave work at work; when you get home, the scrubs come off. 
  16. A good nurse takes good care of their patients. A great nurse takes good care of their patients but does great documenting. 
  17. Nursing will never be easy or stress-free; you will never be comfortable in your element. If you ever get to that point, you're not doing it right. 
  18. Reorientate and negotiation doesn't work. Restrain your patients for, you know, their safety. Addendum: It's ok for med-surg patients to walk around. 
  19. If 90 year old dementia grandma says she's going to buy you a pie, sometimes she's serious.
  20. Best idea over: Obesity differential. You should get an extra dime an hour for every 10 lbs over ideal body weight if your patient is morbidly obese, and an extra quarter an hour more if they're immobile. 
  21. Adventitious heart and lung sounds? No symptoms, no problems.
  22. Got gas? Best place to release is to go crop dust in your comatose, intubated, C-diff+ patient's room.
  23. The worst part about C-diff isn't the smell or the isolation procedures. It's getting bleach on your scrubs. 
  24. The speed at which ER brings your admission is direct proportional to how stable the patient is. Severe sepsis with a suspected ruptured AAA on 3 vasopressors? Patient rolls through door while you're on the phone for report. Suicidal patient that just needs ICU for 1:1? Arrives at change of shift. 
  25. You wouldn't donate blood if you knew some of the patients who would be receiving it. 
  26. Your gut instincts is just as important as your physical assessment skills. 
  27. If you work night shift, which inevitably you will, your phone's "do not disturb" mode is your best friend. Your manager WILL call you at 3PM after you just finally fell asleep to ask you to come in early to do overtime.