Friday, November 9, 2012

Assertive APN

Yup- it was as bad as I thought!

Parts of it were actually worse.

At one point I found myself squatting in an alcove in the back of a secluded hallway thinking "What in the world am I doing here!?"

If you haven't read my last blog post, you have no idea what I'm talking about.  And the above sentence may just sound downright creepy!

So to fill you in- I'm talking about taking the PICU APN out of the PICU and plopping her into the great abyss known as the OR.

The OR could not be any different than the PICU.

And it certainly isn't for me!

I went there for airway management skills, and left with more frustration than knowledge.

We have 3 floors of ORs...3 FLOORS! And each floor has about 20 ORs.  So that's a whole lotta OR rooms that I have to troll myself into and try and convince the anesthesiologists to teach me airway skills!

Oh it was lovely fun.  Creeping outside each OR room, waiting for someone to show up.  And then it was the same speech- "I'm an APN from the PICU and I'm here to learn airway management."

This speech got me tons of different comments ranging from:

"I'm an anesthesia resident, and you cannot take procedures from me...I need this experience"

"Umm, this room is already a bit crowded...maybe you can find another OR" (stated by an anesthesiologist in a room with 5 other people...very standard for the LARGE ORs!)

I got a TON of "I already have a resident with me...go find another room without one."

And then there was the "Oh, I would LOVE to teach you, but I just don't have any interesting cases today.  Are you here next week?"

Gee, thanks guys!

I will say the most helpful and amazing 4 people I met all week were as follows:  3 were CRNAs (or APNs that are anesthesiologists), and an anesthesiologist that also worked in the PICU with me for the last 8 years!

Gotta love that the APNs stick together!  One even said, "I can't believe you have to go room to room, hoping someone will take you can be brutal among anesthesiologists!"  Umm, definitely agreed!

So I'm done with the OR!  I want to learn airway management...its crucial in the PICU...but I don't want to do it this way!

I told our scheduler that the best way to get these skills would be to pair up with one of the CRNAs who will gladly take us under their wing, teach us, and give us the hands on experience that we need! And 2 of the CRNAs that I met said they would be more than happy to be the contact person!

So while this brilliant idea may not apply to me, at least it will help out our new hires from now on!

Its funny that all the APNs before me went through this, and have nothing positive to say about it.  And all of our attendings in the PICU have had to do this in the past year to keep up their airway management skills. And of ALL the attendings that went through, ALL of them have said "Ugh, that was the worst week ever!  I could barely get my hands on a patient!"

If anesthesiologists aren't letting PICU attendings intubate the kids, there is NO way they will be letting brand new APNs!

So this APN isn't going to be another one of the above...another APN that goes through, hating the experience and then letting others after them have to endure the same thing!

It is my newfound PICU mission to help the APNs that we have starting in January...and all the ones after that get their airway skills without wanting to gouge their eyes out!

You can now call me Assertive APN.  I may be new, but I get things done.

All in the name of the PICU.  Booyah!


  1. Good for you!Too many just accept bad work practices and cultures and don't speak up.

  2. It is hard for the husband to hear these stories. I have told Dana to possibly rephrase the question and see what the results will be since it doesn't hurt to try...

    "I'm an APN from the PICU and I'm here to learn airway management. What, you don't want to help me? Are you sure? Okay, how about I introduce you to my 6' 220 lb husband?"

    - The Husband