Gina Wald, DC BSN CCRN
Gina comes to nurse anesthesia practice prepared as a doctor of chiropractics. Her experience includes several years as an RN in a neuro/trauma ICU. Her insightful assessments and understanding of anatomy is enormous. Here are a few of her insights at the start of clinical anesthesia rotations.
Though I am not the blogging sort, I am supportive of this forum; I would have loved a resource such as this when I was investigating and applying to NA school. The webmaster has graciously invited me to “join the conversation”, so here I am…
We started our first rotation a month ago, after a meager but grueling semesters’ preparation. I will never forget the tension in our classroom the week before we were to be cast to the lions.
Even the loudmouths of the class (myself included) were scared into silence. We knew what to expect, and while all 16 of us started this journey anticipating, even desiring a life-altering residency experience, we were scared. It was a strange mix of “I can’t wait to get started” and “Wait, I’m not ready yet”.
I am in the “kindest” of first year rotations, a So. California Veteran’s Administration Hospital where the CRNAs and attendings are brilliant, eager to teach, and supportive of our endeavors. And still I am exhausted. I cannot find time to do it all. I feel strapped beyond belief. I want to read more, to know and contextualize more, to have time to reflect on all that I am learning and doing. But there is no time. I determined last week that I must stop working, as much as I love having a place to go where I actually have some competence. It’s time to leave the nest, and begin the plummet we all must take before feeling our wings.
Days in the OR are wonderful. We start morning conference at 7:00 am with the CRNAs and Attending anesthesiologists. We present our cases for the day, and take whatever beating is dealt out. They kindly remind us that while we have looked everything up in the books, we still don’t know much about anesthesia. It’s important not to take it personally, and I worry about those of us with too thin skin. (Dermal hypertrophy should be listed as a prerequisite for all NA programs). There is no coddling here, but I know they are grooming us. We have only 18 months to go from inept to competent. I love the regional anesthesia exposure we are getting at the VA. As a chiropractor, I know my hands are good, I know the anatomy intimately and can visualize the structures as I place my needle. This is fun for me. Intubation is another story, and while my first couple seemed easy enough, I have struggled since then, taking in everyone’s advice, trying to keep my frustration from invading my thoughts during induction. There is always something I forget to do in a case, and I wonder how long it will take me to “get it”.
I love what we are doing. I love watching the transformation take place in my classmates, and feel my own mind making a very clunky shift. The skills and knowledge I brought from my experience as a neurotrauma nurse serve me well, but the thought process in anesthesia is a different paradigm, one which is much more in line with my background. This is such an exciting time, and everything I was looking for. If only I could get some sleep. To be continued….
4 Responses
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Fascinating, cannot wait for the continuation!
james
Gina Wald, DC BSN CCRN,
Forgive me for striking out with this in this forum. I am FRUSTRATED and need to vent.
I am not the kindest of instructors nor am I an “attending” you are so elegant in praising. I am a CRNA with 27 yrs. of 60-100/hr/wk experience in “all” environs and I am very serious when I say I give 100% of all the anesthetics administered in my operatory.
I represent a small group of individuals(your soon to be peers) who did not decide at the age of 35 or older to pick up and learn anesthesia. Nice letters afters your name btw….they won’t help…sorry sarcasm is always a waste.
Just like thousands of other CRNA’S day in and day out, We accept, without any help from those who would see us fail and sadly wish harm upon our success the responsibility of assuming ultimate control of a HUMAN LIFE as I guide it through the torturous maze known as surgical anesthesia.
Oh , sure, any one can do it….pass gas? Whatever…let so and so do the case or whomever….but, it is He/She who assumes the responsibility of that life that has to be recognized as the Anesthetist. The one who gets the job done….gives the great care to the patients…puts the lines in…places the blocks..writes the orders…stays up all night…
However, respect or acknowledgment let alone monetary reimbursement for one’s achievements, are always more easily paid w/ insincere BS than real world dollars.
I know as as a SRNA, one needs to be guided encouraged and instructed…this is all well and good, however after the lessons are learned and the the task is undertaken, why is the anesthetic that is administered to my patients less valuable than the one administered by an MDA/DOA???
This is an area of great inequality. We and our patients are either being mistreated or mislead (highly unliklely) or we are being seriously discriminated agaisnt by the like of the AMA, ASA, USA….ect.
Listen kiddo, I’m not anti-anethesiologist….some, not all, of the best… are docs…but,many are CRNA’S in the O.R. alone QD w/o any help from ANYONE …. doing whatever comes down the pike and working ALONG SIDE(not with) Docs who make twice as much as we do..and we’re very sick and tired of the BS. So Take Care Who You Pick as Hero’s…..you’ll be one of us soon and crow tastes like…….
Some of my HERO’s are Doc’s….most are CRNA’S .
Jeff Leach CRNA Ohio
Jeff,
I find it curious that you assumed the preceptor of whom I spoke was a medical doctor. SJ is, in fact, a CRNA. If I did not directly state that, I suppose it was because I assumed that people would recognize that those teaching us best are usually CRNAs. As far as the remainder of your diatribe, I am sorry you feel so bitter about the percieved lack of respect for the profession you obviously trained for at a much younger age than I. I congratulate you on having the vision and exposure to find your given talents before the ripe age of 35 (I was 38 when I started anesthesia- but even you must admit we old dogs are still capable of learning something). I, for one have enormous respect for CRNAs and have never felt “less than” a medical doctor because of the initials after my name. “Nice letters afters your name btw….they won’t help…sorry sarcasm is always a waste” To set the record straight, Jeff, the letters after my name have helped me tremendously, as they represent over 12 years of education in such areas as anatomy, physiology, neuroscience, embryology, pathology, radiology, palpation, physical examination, diagnosis, and orthopedics, among others. I take that bag of skills to the OR each day, so while I may have had a later start at this anesthesia thing than someone like you, I am surviving. And grateful for mentors, CRNA mentors if I need be more explicit, who are helping me along a path I am quite excited to be travelling. I praise you and honor you for the work you do every day, and I thank you for your comment.
Gina Wald
Gina,
As I said,crow tastes like…. I humbly ask your forgiveness for my rude and inexcusable behavior. I have no excuse. I don’t like jerks like I was either.
You should be proud of all your accomplishments and I wish you nothing but happiness and success. I hope you have a wonderful carreer in anesthesia, I have. I am not a bitter old man, just old and really worked over yet still in love with this profession. Apologies also to all the wonderful docs I might have inadvertantly trashed. I claim temporary insanity. This can be a very
difficult position at times but it does not excuse abhorent behavior.
Best wishes for a good life.
Jeff Leach
PS sorry this reply took so long. I was hoping to write sooner.
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