r/CRNA

Just kidding how does anyone get a license in this state 😭

This is the area for prospective/ aspiring SRNAs and for SRNAs to ask their questions about the education process or anything school related.

This includes the usual

"which ICU should I work in?" "Should I take additional classes? "How do I become a CRNA?" "My GPA is 2.8, is my GPA good enough?" "What should I use to prep for boards?" "Help with my DNP project" "It's been my pa$$ion to become a CRNA, how do I do it and what do CRNAs do?"

Etc.

This will refresh every Friday at noon central. If you post Friday morning, it might not be seen.

SRNA looking for thoughts on a case today.

Patient had no respiratory history, normal EF, and normal hemodynamics after induction. During robotic fundoplication, the patient became persistently tachycardic and hypotensive enough to require a vasopressor infusion. Towards end of case I was on around 70% FiO2 with 8 of PEEP. Sats were in low 90’s

At the end of the case, I noticed significant subcutaneous emphysema with periorbital swelling. That made me concerned that the earlier hemodynamic and respiratory changes may have been from a CO₂ capnothorax with tension physiology.

In PACU, the patient was still requiring 8 L O₂ and saturating around 90%, so I suggested a CXR. Patient was still tachy and hypotensive, and uncomfortable from all the gas.

Would you consider that overall picture concerning enough for capnothorax/tension physiology? Would you get a CXR or lung ultrasound postop with that persistent oxygen requirement?

CRNAs need to understand what is happening here.

People outside our profession are helping build a larger CRNA labor supply, and they have every financial incentive to do it.

USAP (already in anti-trust lawsuits) is helping fund, train, mentor, and recruit through Nova’s anesthesia education pipeline. NAPA, owned by private equity, is paying SRNAs while they are still in school and recruiting them directly into its groups. These companies are employers. Labor is one of their biggest costs.

They do not need to announce “we want to saturate CRNAs and lower wages.” If you are an anesthesia corporation, more graduates means more applicants, easier staffing, less dependence on travelers, and eventually less leverage for individual CRNAs.
That is the problem.

We are letting organizations whose economic interests are directly opposed to strong CRNA bargaining power help shape the size of our training pipeline.

The COA should be raising standards, limiting low-quality expansion, and aggressively protecting clinical training quality. And PE-backed anesthesia groups should have no role in driving how many CRNAs we produce.

If the profession waits until the labor market is flooded to care, the damage will already be done.

Private equity anesthesia groups should have far less influence over CRNA education.

If we wait until wages, leverage, and training quality deteriorate to care about this, we waited too long.

SRNA here. I've been pretty good with ultrasound A lines (I've done countless US IVs as a nurse) but less than 50% successful with the palpation based technique. Should I just stick to ultrasound and get really good at it or keep practicing palpation and be decent at both? Thanks!