In 2014, Mason McDowell, DNAP, CRNA quit his job, sold most of what he owned and moved with his wife and two young daughters to Chad, Africa for a long-term commitment to provide anesthesia and education.  Here is a glimpse of their story.

Part 1 overviews Dr McDowell’s experience and challenges providing anesthesia and living in Chad.

In Part 2, Dr McDowell offers advice for CRNAs/SRNAs who are looking to travel internationally to provide anesthesia in developing nations.

The McDowell family’s time in Chad was interrupted abruptly by a deteriorating political situation making it unsafe for them to stay.  They lived in Bere, Chad for nearly two years before being forced to leave and return to the United States.  Since that time, Dr McDowell has traveled to Nepal and Sierra Leone to provide short term anesthesia services.  In this podcast I talk with him about the challenges of providing anesthesia in underdeveloped settings.  From the bugs at night in the desert heat to draw-over vaporizers and the heart wrenching stories of not having enough resources to provide care, Dr McDowell conveys what it was like for his family to live and work in Chad and what we can do as SRNAs, CRNAs and anesthesia providers to help serve underdeveloped nations.

This is really an amazing story that I’m honored to share.  You can read more about Dr McDowell’s time in Chad at his blog: Why We Should Go.  Dig deep, read the stories.  They’re amazing.

http://whyweshouldgo.blogspot.com

Dr Mason McDowell lives in Western North Carolina and serves as faculty with Western Carolina University’s (WCU) Graduate Nurse Anesthesia Program.  Before moving to Chad, he served as the Assistant Director of the Graduate Nurse Anesthesia Program at WCU.  He is the co-author of the chapter on Hepatobillary and Gastrointestinal Disturbances and Anesthesia in Nagelhout’s Nurse Anesthesia.

Resources:

Unites States Department of State page on Chad:

https://travel.state.gov/content/passports/en/country/chad.html

Corbett, S., Fikkert, B.  (2012) When helping hurts: how to alleviate poverty without hurting the poor… and yourself.  Chicago, IL: Moody Publishers.

In 2014, Mason McDowell, DNAP, CRNA quit his job, sold most of what he owned and moved with his wife and two young daughters to Chad, Africa for a long-term commitment to provide anesthesia and education.  Here is a glimpse of their story.

Part 1 overviews Dr McDowell’s experience and challenges providing anesthesia and living in Chad.

In Part 2, Dr McDowell offers advice for CRNAs/SRNAs who are looking to travel internationally to provide anesthesia in developing nations.

The McDowell family’s time in Chad was interrupted abruptly by a deteriorating political situation making it unsafe for them to stay.  They lived in Bere, Chad for nearly two years before being forced to leave and return to the United States.  Since that time, Dr McDowell has traveled to Nepal and Sierra Leone to provide short term anesthesia services.  In this podcast I talk with him about the challenges of providing anesthesia in underdeveloped settings.  From the bugs at night in the desert heat to draw-over vaporizers and the heart wrenching stories of not having enough resources to provide care, Dr McDowell conveys what it was like for his family to live and work in Chad and what we can do as SRNAs, CRNAs and anesthesia providers to help serve underdeveloped nations.

This is really an amazing story that I’m honored to share.  You can read more about Dr McDowell’s time in Chad at his blog, Why We Should Go.  Dig deep, read the stories.  They’re amazing.

http://whyweshouldgo.blogspot.com

Dr Mason McDowell lives in Western North Carolina and serves as faculty with Western Carolina University’s (WCU) Graduate Nurse Anesthesia Program.  Before moving to Chad, he served as the Assistant Director of the Graduate Nurse Anesthesia Program at WCU.  He is the co-author of the chapter on Hepatobillary and Gastrointestinal Disturbances and Anesthesia in Nagelhout’s Nurse Anesthesia.

 

Resources:

Unites States Department of State page on Chad:

https://travel.state.gov/content/passports/en/country/chad.html

Corbett, S., Fikkert, B.  (2012) When helping hurts: how to alleviate poverty without hurting the poor… and yourself.  Chicago, IL: Moody Publishers.

 

I talk with Denham Ward, MD, PhD on the topic of expertise in anesthesia.  Dr Ward is currently the director of the Academy at Maine Medical Center Institute for Teaching Excellence and a Professor of Anesthesiology at Tufts University School of Medicine.  He is Emeritus Professor and Chair of Anesthesiology and Emeritus Professor of Biomedical Engineering at the University of Rochester.

This podcast focuses on the idea of developing and maintaining expertise over a career in anesthesia.  Highlights range from defining expertise, specialization in anesthesia, types of problem solving and clinical decision making and how to teach and coach the development of expertise in trainees as well as experienced clinicians.

“The difference between medicine and music is… musicians practice, practice, practice and then they go to Carnegie Hall for one evening…  We’re essentially at Carnegie Hall every day.”  Denham Ward, MD, PhD

References:

Ericsson, K. A. (2015). Acquisition and Maintenance of Medical Expertise: A Perspective From the Expert – Performance Approach With Deliberate Practice. Academic Medicine, 90(11), 1471. doi:10.1097/ACM.0000000000000939

Gawande, A. (2011). Personal best. The New Yorker, (30). 44.  Retrieved from http://www.newyorker.com/magazine/2011/10/03/personal-best.

Kahneman, D. (2011). Thinking, fast and slow. New York: Farrar, Straus and Giroux.

Moulton, C. E., Regehr, G., Mylopoulos, M., & MacRae, H. M. (2007). Slowing down when you should: a new model of expert judgment. Academic Medicine: Journal Of The Association Of American Medical Colleges, 82(10 Suppl), S109-S116.

 

 

Jon provides a quick update on the publication of the article “Social media in nurse anesthesia – a model for a reproducible podcast” published in the February 2017 edition of the AANA Journal.  This article provides the literature review associated with and production overview of the creation of “From the Head of the Bed… a podcast for the anesthesia community.”  The article was authored by the founders of From the Head of the Bed:  Kristin Andrejco, Jon Lowrance, Brad Morgan, Cassidy Padgett and by Shawn Collins.

 

References:

Andrejco, K. (2017). Social Media in Nurse Anesthesia: A Model of a Reproducible Educational Podcast. AANA Journal, 85(1), 10-16.

Biddle, C. (2017). Increasing the Online Presence of the AANA Journal. AANA Journal, 85(1), 6-7.

 

In this show I talk about hardship in anesthesia school. Yep. It is for you, actually.  It’s for you if you’re struggling.  Or even if you’re not – cause your classmate or colleague might be.

This podcast is about the hardships we face in anesthesia school and how we can find help, cope and pull through to a brighter future.  It’s about knowing you’re not alone.  It’s about learning how to deal with the pain and the challenges and how to find help.

To develop this show, I asked for help from my friends, colleagues and from the anesthesia social media world.  Many of you replied with your stories and advice.  I pulled together what I’ve heard and a little of what I went through personally and put it here, for you, for each of us.

I want you to know this:

If you’re struggling with suicidal ideation or drug abuse there is help available.

You are important.  You are not alone.  Your life is important and people care about you.

Please seek help and support.  Please tell someone what you’re facing.   Please call one of the numbers below and reach out to a friend, family member or colleague.

Help is available.  You are not alone.  People care about you.

American Foundation for Suicide Prevention Hotline 1-800-273-8255

National Suicide Prevention Lifeline   1-800-273-8255  

AANA Peer Assistance Hotline 1-800-654-5167

National Helpline 1-800-662-4357

 

Anesthetists in Recovery

Overview of Anesthetists in Recovery (AIR) and Partners of Anesthetists in Recovery (PAIR):

Bertrand, Anita.  (2013).  Saving Lives: AIR/PAIR.  AANA NewsBulletin.  Retrieved from:

http://www.aana.com/resources2/health-wellness/Documents/nb_pan_0513.pdf

 

This episode covers advice for the last six months of anesthesia school, transitioning out of school and into the first six months of your CRNA practice!

The year encompassing your last six months of anesthesia school through your first six months of practice is a big one!  There’s such a learning curve you will encounter from studying for boards to landing your first anesthesia job through your first several months of practice.  It’s an amazing time and well worth all the hard work and effort!

Check out the podcast and please feel free to offer your own insights/advice in the comments section.

Topics covered:

* Wrapping up anesthesia school:  your project/thesis, landing a job and tips for boards

* Transitioning out of school – it goes by fast!

* The first six months of practice:  tips for your practice, your ability to influence others and finances!

I mentioned this article in the podcast:

Assante, J., Collins, S., & Hewer, I. (2015). Infection Associated With Single-Dose Dexamethasone for Prevention of Postoperative Nausea and Vomiting: A Literature Review. AANA Journal, 83(4), 281-288.

Cherie Burke, DNP, CRNA discusses the concept of positive deviance in healthcare.  Highlights include how to effect change as healthcare providers and the power of focusing quality improvement proactively on what goes right in an organization verses reacting to errors and negative outcomes.  Dr Burke is a practicing CRNA with nearly 30 years of clinical and teaching experience.  She holds a Doctorate of Nursing Practice from LaSalle University with her doctoral research focusing on patient safety.

 

Topics Discussed:

* Positive deviance as a methodology of outcome analysis

* Positive deviance as a professional behavior of healthcare providers

* How to harness the power of positive deviance in anesthesia practice and education

* The limitations and risks of positive deviance as a research tool and professional practice

 

Highlights:

“Positive deviance is really about… taking those things that people are doing right and sharing them with everyone so that everyone is doing things to improve our patient’s care, our patient’s outcome.”  Dr Cherie Burke

“We have to really encourage innovation.  We’re at a tipping point in healthcare.  We’re going to have to do major, major innovation to be successful and to survive in the healthcare arena…  Nurse anesthetists are going to have to be creative.  We’re going to have to figure out how can we continue doing high quality care with excellent outcomes, safety [and] efficiency.”  Dr Cherie Burke

 

Resources: 

Bradley, E. H., Curry, L. A., Ramanadhan, S., Rowe, L., Nembhard, I. M., & Krumholz, H. M. (2009). Research in action: using positive deviance to improve quality of health care. Implementation Science, 41-11. doi:10.1186/1748-5908-4-25\

Ford, K. (2013). Survey of Syringe and Needle Safety Among Student Registered Nurse Anesthetists: Are We Making Any Progress?. AANA Journal, 81(1), 37-42.

Gary, J. C. (2013). Exploring the concept and use of positive deviance in nursing. The American Journal Of Nursing, 113(8), 26. doi:10.1097/01.NAJ.0000432960.95762.5f

Lawton R., Taylor, N., Clay-Williams, R., & Braithwaite, J. (2014). Positive deviance: a different approach to achieving patient safety.  BMJ, 0:1–4. doi:10.1136/bmjqs-2014-003115

Prielipp, R. C., Magro, M., Morell, R. C., & Brull, S. J. (2010). THE OPEN MIND. The Normalization of Deviance: Do We (Un)Knowingly Accept Doing the Wrong Thing?. AANA Journal, 78(4), 284-287. doi:10.1213/ANE.0b013e3181d5adc5

Rosenberg, T. (2013, February 27).  When deviants do good.  The New York Times, Retrieved from http://opinionator.blogs.nytimes.com/2013/02/27/when-deviants-do-good/?_r=0

I sat down with Jon Bradstreet, MSN, CRNA to chat about how SRNAs and CRNAs can prepare for the job market.  Jon Bradstreet, MSN, CRNA is the Chief CRNA and Director of CRNA Services of Maine’s largest CRNA group and only level one trauma center, Maine Medical Center, in Portland, Maine.  In this episode we cover everything from Curriculum Vitae’s (CVs) to tips for interviews and the job hunt.  If you’re an SRNA wrapping up your anesthesia training or a CRNA considering a job move – check it out!

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.”

Links:

Maine Medical Center

 

Jon caught up with Dr Juan Quintana, president of the American Association of Nurse Anesthetists, and Kristie Hoch, president of the Maine Association of Nurse Anesthetists, to chat about the value of being a member of the American Association of Nurse Anesthetists (AANA).  Membership in the AANA is open to Certified Registered Nurse Anesthetists (CRNAs) and Student Registered Nurse Anesthetists (SRNAs).

Dr Juan Quintana, CRNA, DNP, MHS, leads a CRNA-only anesthesia practice in Texas and well as an anesthesia billing firm.  His expertise lies in the areas of anesthesia practice models, economics, billing and reimbursement.  According to his website, “Dr Quintana became the first CRNA to serve on the Medicare Evidence Development and Coverage Advisory Council (MEDCAC), an independent body that provides the Medicare agency guidance and expert advice on the science and technology affecting healthcare delivery.”  He currently is serving as the president of the American Association of Nurse Anesthetists.

Kristie Hoch, APRN, CRNA, MSN, works in CRNA-only settings and Anesthesia Care Team practices in Maine.  She serves as the chairwoman of a group of CRNA chiefs in her organization in addition to serving as the CRNA recruiter for her company.  Kristie recently served on the Program Committee for the AANA, which is the committee that plans the Association’s Annual Congress and is currently on the AANA’s Communications Committee.  She is wrapping up her term as president of the Maine Association of Nurse Anesthetists where she has been very active in promoting CRNA services across the state.  During her term as president, MeANA was awarded the Best Public Relations Effort by Small State Association honor from the AANA.

Highlights:

“The future for CRNA’s is brilliant; absolutely brilliant.  Everything is designed right now to move CRNA practice into the forefront…  If you’re in CRNA practice, if you’re a student thinking about going into CRNA practice, you’ve made an excellent choice.”  Juan Quintana

“There’s not a question in terms of the anesthesia that I provide because it’s always going to be what I would give my mom.  So it’s going to be the absolute best.”  Juan Quintana

“The AANA supports your right to practice.  Over forty-four thousand CRNAs across the country have a much stronger voice than you alone would have.”  Kristie Hoch

Resources:

American Association of Nurse Anesthetists

Maine Association of Nurse Anesthetists

The Future of Anesthesia Care Today

 

Dr Shawn Collins, DNP, PhD, CRNA discusses his research on Emotional Intelligence of Student Registered Nurse Anesthetists (SRNAs).  Highlights include the relevance of emotional intelligence to the practice of anesthesia, models of emotional intelligence and ways that emotional intelligence can be developed as a skill.

Dr Shawn Collins currently serves as the Director of the Graduate Nurse Anesthesia Program and the Interim Associate Dean of the College of Health and Human Sciences at Western Carolina University (WCU).  Dr Collins completed his anesthesia training at the Erlanger Medical Center at the University of Tennessee – Chattanooga and went on to obtain his Doctorate of Nursing Practice from Rush University before obtaining his PhD in Leadership from Andrews University.  He maintains his clinical practice at several CRNA-only clinical sites in both North Carolina and Iowa.  At WCU, he was integral in the development of the WCU Doctor of Nursing Practice Program and served as its first director.  He is currently developing WCU’s DNP program for entry-level education for CRNAs.

Podcast highlights:

* Overview of Dr Collins’ article:  Emotional Intelligence as a Noncognitive Factor in Student Registered Nurse Anesthetists

* Discuss models and theories of emotional intelligence

* Discuss the significance of emotional intelligence in the practice of anesthesia for SRNAs & CRNAs

* Discuss how emotional intelligence is a skill that can be developed

* Discuss the positive correlation of emotional intelligence to scores on the NBCRNA’s National Certification Exam

Resources:

Collins S. Emotional Intelligence as a Noncognitive Factor in Student Registered Nurse Anesthetists. AANA Journal [serial online]. December 2013;81(6):465-472. Available from: Academic Search Complete, Ipswich, MA. Accessed September 19, 2015.

Collins S, Andrejco K. A longitudinal study of emotional intelligence in graduate nurse anesthesia students. Asia Pac J Oncol Nurs [serial online] 2015 [cited 2015 Sep 19];2:56-62. Available from: http://www.apjon.org/text.asp?2015/2/2/56/157566

(We’d like to highlight that podcast producer, Kristin Andrejco, was a co-author, along with Dr Collins, of the above study published in the Asia Pacific Journal of Oncology Nursing.)