Jessica Chang is a student in UM-Flint’s anesthesia program. You can also read more on her blog www.nursejess.com.
Is UM-Flint an integrated or front-loaded program? What are adva
ntages and disadvantages?
It is an integrated program where clinical begins in the first semester. The disadvantage is that majority of the material has not be presented in a didactic format. It is simply impossible to cover every topic in less than one month before going into the clinical phase. While some clinical instructors understand this, others do not. There are still high expectations that you know everything about each drug used. But you take it in stride, learn the material, and do better the next day.
The advantage is to begin developing fine and gross motor skills and routine necessary to be a safe practitioner. As one educator mentioned early on, there’s a two-year learning curve to intubate. When all of the didactic material is presented in a front loaded style, there is no context to use the information. In an integrated program, it is much easier to use the information in clinical the next day.
The expectation is that you will be an independent anesthesia provider before you graduate.
What does the typical week look like for a student registered nurse anesthetist (SRNA)?
First semester – there’s two days of class, two days of clinical, and one study day. The first month of ‘clinical’ is simulation lab. After that, you hit the ground running in clinical.
Second semester – there’s two days of class and three days of clinical.
Third-Sixth semester – there’s one day of class and four days of clinical. During the fourth-sixth semester, you will rotate through different clinical sites. On the weekends, the SRNA studies for the upcoming exam. Depending on the clinical site, the SRNA will also do clinical during afternoon, midnight, and weekend shifts.
What do you do during clinical?
The day before clinical, you are frequently assigned cases. You prepare for all of your cases by looking up each patient. What is the patient’s history (medical, surgical, medications, etc), lab and diagnostic results, and how does that affect your anesthetic plan. What happens during each case, what is your plan A, B, and C (general, regional, sedation, what drugs and doses and when you plan on giving them), what are potential complications and how to prevent them, detect them and treat them.
On the day of clinical, you arrive early to check out the anesthesia machine and set up at least the first case of the day. You will talk to and assess the patient, get consent, and provide anesthesia from the beginning to the end. You will monitor them throughout the entire case and ensure that you are providing the best possible care. After the anesthetic, finding out how the patient did under your care will help you get better at the next one.