Guest Speaker Adam Farber Nurse Anesthetist (CRNA) 9/15/17
Introductions all around the room
Born and raised in bakersfield
Went to community college for 7 years left with 180 units
Trying to decide between health care and education
Ultimately decided to go to nursing school
On the first day he felt is was difficult and wanted to quit
Decided to stick it out
The next day he met a nurse anesthetist Decided this was what he wanted to do.
Then mapped out a plan
Got a bachelor's degreed and was working at the same time.
Got accepted at USC
Moved up to Sacramento and got at Davis
Do not work for an anesthesiologist, but work with a care team and with an anesthesiologist
Facts: providing anaesthesia for over 150 years
Approx 43 million anesthetics a year
There are a lot in the military
CRNA practice all over,
ANesthesia is without sensation with or without the loss of consciousness.
There are many different types of anesthesia
You need to know a little about everything.
Changes across the lifespan
Up every day at 4:30
By for the most important part in anesthesia controlling airway. If I can’t breathe for you there is only one outcome and its not good
Everybody gets an IV. Makes it important to know pharmacology.
Patient meetup, anesthesia plan, review history. Coming up with a safe plan to make it through the procedure.
Intra-operative is not the exciting part.
Excitement in NOT a good thing.
The patient is now also in the hands of the surgeon.
Emergence The part where all the anesthetics that went in are now being removed and starting the wake up process.
Have to be a registered nurse to be an anesthetist
You need 1 year of critical care experience usually 2 or more is wanted.
Find a program. There are 5 programs in California
Application process and testing
There are multiple tests
Anesthesia school- different from medical school
Modeled off of residency
Classes, Clinical- spend up to 6 days in the hospital. Take in 24 hour calls. (in house)
Averaged 3 hours a night of sleep for 2 years.
Average starting pay is ~150
Work schedule now is 4 10hour (currently working nightl)
Anxiety in the program. Daily. Still have it. People's lives are in your hand. You have to separate yourself from it. There are things you just can’t control. As long as you do the best you can do, you can’t do much more than that.
Bad outcomes are reviewed by a big panel.
Death is very rare from too much anesthesia. Complications usually arise from something else.
When first got into nursing worked 3 12’s. Got 4 days off a week. Could work MTW then have off Th F Sa Su M T W Th and then work F Sa Su. Had a week off without taking vacation time
There is traveling nursing where you work in a location for 6 week and then travel around to different locations for 6 weeks at a time
When you are doing this like this(AMSA) for medical school, you have to do something that sets you apart from all the other people.
Did research on a procedure call Family process during cardiac arrest.
Worked in a general ICU and a trauma ICU. Also sat on committees.
Do stuff now to set yourself apart from all the others, because you are competing against all the other, even those that are in this room.
Look at places where people don’t want to live. Those places usually need people to work there. LIke rural areas
At the end of November, Have been at davis for 3 years.
If your are not passionate about it you won’t do it. It’s easy to work in a job that you are passionate about.
After a snowboarding accident, met male nurses and decided that’s what he wanted to do.
Nurses eat their own young. As a new grad people will do everything they can to make you miserable. It can be kind of brutal. Having thick skin is important.
Re took both anatomy and physiology. It’s all memorization. Also took chemistry.
Now have advanced degrees in them.
Pre-op and post-op, most of the interactions are with the family. Still get a lot of interactions with patients.
There are good surgeries and bad surgeries. Like a kidney transplant. Being able to calm tem down, talking them through and getting them through surgery.
Family members are not allowed in until the patient is awake.
Scrub nurse is the one handing over the tools and is scrubbed in.
Circulator is the one that typically goes and gets things, extra pair of hand Not scrubbed in, so they can go in and out of the room.
Procedures without anesthesia. Like hypnosis. Huge fan of whatever works. Ignorance is bliss. Can have surgeries with going unconscious. Acupuncture is great for after surgery care.
GPA, going into nursing school. Probably around a 3.5, dont really remember. After meeting the nurse anesthetist never got less than an A.
The bachelor's degree is becoming the standard. Places are starting to not hire unless you have a bachelor's degree. Sad.
Go where you get in. But you have to be really careful, Be aware of the cost. Some of it is not worth it. It you don’t take the opportunity you lose out on 1 year of pay.
Difference between working in a clinic and an OR. One you work with an anesthesiologist and the other you work on your own. Both are good. The pay is a little bit different and it's a bit more stress. With the OR there is a second pair of eyes. The biggest difference is the size of the cases. And the procedures.
The difference between an nurse anesthetist and an anesthesiologist. One is a doctor that went to medical school and the other went to nursing school. Anesthesiologist might have more training time in specific areas.
At Davis tend to work with an anesthesiologist and the Anesthesiologist will also have a resident.
Surgeons typically do long cases and are sometimes in surgery for 18 to 20 hours. Most surgers do not go 9 10 or 20 hours most surgeries go 2 or 3 hours.
Anesthesiologists and nurse anesthetists have relief and can take brakes.
Lot of opportunities in nursing.
The person that assists the surgeon. PA and nurse first assist.
PA may get to do portions of the surgery. Nurse first assist might be the one closing.
Stanford has a combined NP/PA program.
Parents were a big help/support.
Anesthesia is not physically involved. Sitting down 80% of the day. It’s just not physically intensive. Just don’t see myself doing a desk job.
Did 6 different community colleges and 10 different universities.
I could get a job a community college teaching nursing. There are so many different possibilities.
If you get burned out, there are many different things that can be done.
Have 4 associate degrees, a couple of certificates, bachelors in nursing, bachelor in science, Masters of science and nursing.
If you decide you want to go this route. Not all colleges have the same program. Masters of science or a masters of nursing.
Had a very bad first experience. There are no books on the experience. Until you're doing it, It can’t be put into words. The best thing to do is to shadowing. “Millers basic of Anesthesia”