Welcome to My CRNA Life – a resource site for anesthesia professionals. This site collects all of the best resources from across the web and curates them in one convenient place. Bookmark for future reference and share with a fellow CRNA.

Launched Sept 2020

FEATURED PROVIDER

 

Barbara Evans, CRNA, MSN, APRN

This cardiac CRNA is a wealth of information! From former state association President to preceptor extraordinaire, there is so much to be gained from this interview.

Click HERE to read the interview!

I can be reached at bevans21@comcast.net

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My CRNA Life

About Me

How long have you been practicing?

I have been practicing as a CRNA for 11 years. I was a critical care nurse for 20 years before graduating anesthesia school. CRNA school was always on my radar but I waited for the right time in my life to apply. I am so glad I did— I have absolutely no regrets!

Do you work in a care team model or as an independent practitioner?

I work in a care team model presently. I like the fact that 2 brains are critically thinking about the patient. I am interested in pursing independent practice in the future.

Why did you choose to pursue nurse anesthesia?

Nurse anesthesia was always intriguing as an RN. I worked in postoperative care in a CVICU and a PACU most of my RN career and met many CRNAs who seemed to love their job. I shadowed a couple times and loved the autonomy and critical thinking. I wanted to further my education and chose CRNA over any other APRN career because of the acute hands-on care.

What first attracted you to cardiac anesthesia?

I have always found the heart to be the most complex part of the body. How the heart functions and responds with the right treatment is amazing and satisfying. I enjoy the challenge of caring for one of the sickest patient populations and utilizing critical thinking to deliver effective, safe care. All the hemodynamic information from echos, swans, a-lines, EKGs, labs are pieces of a puzzle. When the pieces are put together with the correct treatments, the bigger picture is a stable patient (hopefully).

What are some of the differences unique to hearts versus the main OR?

Caring for heart patients is very unique. Every patient that enters the cardiac OR has significant coronary, vascular, or valvular disease severe enough to warrant heart surgery. Small changes in hemodynamics can lead to serious consequences so vigilance with attention to detail is vital throughout the surgery. Vasopressors are very frequently utilized to keep adequate perfusion for before they go on bypass. After bypass, continued attention is mandated due to the systemic complications from inflammatory responses, the stunned myocardium, blood loss, and coagulopathies. Titrating multiple drug drips, correcting abnormal lab values, administering blood products are typical for maintaining hemodynamic stability of a cardiac patient. Some of the monitors that are different:

 

What skills have you developed by doing cardiac anesthesia?

I have developed the fun and awesome skills of inserting IVs, A-lines, IJ central lines, and swans routinely with the use of ultrasound for some A-lines and all central lines.

How can a SRNA best prepare for their cardiac rotation?

My suggestions for all SRNAs to prepare for their cardiac rotation is to read as much information about cardiac anesthesia and CABG/valve surgery as possible. Watch central line presentations and understand the anatomy of the neck. Practice suturing techniques (the central line). Watch Aline insertions presentation. Achieve an understanding of CPB and the cannulas that are placed during heart surgery—where the cannulas are placed and how blood flows on bypass. I strongly recommend to have a good knowledge about all vasopressors and inotropes and understand why one agent would be given over another. Also, read up on blood products—what to give for abnormal values.

Go to your rotation excited and ready to learn. Ask questions and be receptive to feedback.

One website I referred to as a student:

https://anesthesia.ucsf.edu/sites/anesthesia.ucsf.edu/files/wysiwyg/pdfs/CardiacAnesthesiaMadeRidiculouslySimple%20.pdf

What attracted you to become involved in your state association?

As a student, I was introduced to the state and national association by a couple of very involved CRNAs at my clinical site. They stressed the importance of being part of the professional association in order to keep the profession strong. Their commitment was infectious and I have been involved in some way since then.

What positions have you held in your state association?

I started on the nominating committee—great introduction to the state association operations. I then moved to upstate director, then vice president and eventually president elect. Last year, I was president of our state association. I have also been very active with the state committees (mainly Public Relations and Professional Development Committees) and enjoy the interaction with other CRNAs and SRNAs

What role does a state nurse anesthesia association play in the profession?

Our state association offers our CRNA members insight on government issues at the state and national level that can effect our practice. State associations are advocates for CRNAs and help protect CRNA practice from infringements on our scope of practice, reimbursement, and other regulatory matters.

State associations also offer educational opportunities. They serve as a resource for CRNAs, patient safety, and the public, and they are committed to bringing public awareness to the nurse anesthesia profession. I cannot stress enough how important it is to be involved and to support your state association.

What are the options available to CRNAs to become involved with their state association?

All state associations have various committees—Public Relations, Professional Development, Government Relations, Finance, Political Action Committee (PAC) to name a few. Any member is welcomed and encouraged to join any of the state level committees and share their ideas. This also gives a glimpse of how state associations function as a board. We highly encourage new members to apply for a committee or board position every year.

What are the biggest lessons you have learned over your career?

So many lessons—here are a few…

 

What advice do you have for SRNAs new to clinical?

 

What advice do you have for CRNAs who are new to practice?

 

Is there anything else you would like to share? 

It is a privilege to do this job. Patients put their lives in my hands— to gain their trust, ease their fears, and confidently deliver safe care is my reward everyday.