Interview questions for Advanced Practice Nursing.

Interview questions for Advanced Practice Nursing..

Interview questions for Advanced Practice Nursing.

 

 

First of all, I would like to express my thanks for being willing to participate in this process as I work towards becoming a Nurse Practitioner. Your feedback is a valuable part of my education, and I would like to thank you for your assistance on this part of my journey.

Please feel free to add additional comments, discuss other topics in addition to your responses to the required elements below.

 

Thank you again!

 

Zelda

What is the reason that you chose your specific APN specialty?

 

I chose to become a CRNA because I saw it as the most advanced nursing practice that I could see myself doing. I wanted to do clinical work and not management. I enjoy the bedside aspect of ICU nursing and anesthesia encompasses that as well as more independence.

 

Please provide a description of: a) the type of setting where you work (i.e. community hospital, major medical center, private primary care practice, clinic for the underserved, etc.), and (b) a “typical” day as you render care.

 

I work in a 500 bed pediatric and adult level 1 trauma center. I care for patients in both the adult hospital as well as the children’s hospital. I care for patients getting all types of surgery except cardiac and liver transplant. I do both inpatient and outpatient OR settings. My typical day begins the day before doing chart reviews of my cases for the next day and writing preop notes. I also develop my anesthesia plan for the patient based on the case and the patient.

 

The next day I come in and set up my anesthesia work area, discuss the anesthesia plan with my staff anesthesiologist and do a preop assessment for my patient. In these few moments before going to the OR with the patient my job is to put them at ease and get them to trust me with their life in the OR. The OR RN and I take the patient back to the OR, I determine if any pre medication for anxiety or pain is needed and administer it if so. After the OR timeout typically the MD anesthesiologist pushes induction drugs. I mask ventilate the patient, place any airway device needed for the case, assess its positioning and secure the device. From this point generally I administer medications as needed for pain, nausea, muscle relaxation and reversal. I am responsible for monitoring and maintaining the patients vital signs. At the end of the case, the MD is required (for billing) to be present for emergence from anesthesia and extubation. Typically I am responsible for actually stopping the anesthesia, removing the airway device and assessing airway patency after removal. The surgery resident and I then transport the patient to the PACU and give bedside report to the PACU RN.

 

 

 

What is your level of satisfaction with your role in general, and specifically within the system where you are currently employed?

 

As a CRNA, when we graduate most of us must decide whether we want to practice independently, do our own regional anesthesia but not care for very sick patients on a regular basis or practice at a large center where we likely will not do our own regional anesthesia and be medically directed but then care for sicker patients. The smaller facilities generally come with higher pay, but more call. The larger centers, especially those with residents come with a more restrictive practice, usually less pay but a much more favorable schedule and far less call.

 

When I finished school I was older than most new CRNA’s, I have children and my choice was to have a better schedule. I would love to practice independently but at this point in my life the schedule is more important. I also have a love for pediatric anesthesia and while you may care for some healthy kids getting basic procedures in smaller places, you will not care for the types of patients that I do at a large children’s hospital. The children’s hospital keeps my satisfied with my current position. The perfect CRNA position currently does not exist where I could do my current job with independent practice.

 

 

 

What type of APN certification do you hold? Identify the accurate name of the certifying body with which you are certified.

 

I am a CRNA. We are certified by the NBCRNA (National Board of Certification and Recertification of Nurse Anesthetists)

 

 

Do you have prescriptive authority and do you prescribe controlled substances? If you do prescribe controlled substances, from which schedules of controlled substances are you allowed to prescribe?

 

I do have prescriptive authority. In my current position I do not prescribe outside the OR. Legally I can prescribe controlled substances schedule 2 and all other legal schedules.

 

 

Must you practice according to an agreement with a physician? If so, is the relationship supervisory or collaborative?(Please share as much information re: this as you are able.)

 

In my current position I am required to practice with an agreement with an MD. This is a supervisory relationship as our OR cases are billed as medically directed. This is the most restrictive type of anesthesia billing and practice for a CRNA. It is typical of all large medical centers throughout the country.

 

In the state of WI however, APRN’s are not required by the practice acts to have practice agreements. APRN’s can practice indecently and because we are a medicare opt out state we can also bill independently.

 

Are you credentialed and privileged by a hospital or health system? If your answer is “Yes”, please explain what the credentialing and privileging process entails in your organization (i.e., are the documents reviewed by only the human resources department, the nursing department, or the medical staff office, or perhaps all of these, etc.).

 

I am credentialed by a hospital. The credentialing process is actually fairly easy and efficient. We have to be credentialed every 3 years. I am sent a packet of forms to fill out about 2 months ahead of time and just have to fill it out and turn in to our HR contact. The finalized credentials are reviewed by the hospital credentialing committee and the hospital medical staff affairs office.

 

 

 

 

Do you specifically belong to a professional organization (s) that specifically addresses APN issues? If so, which one (s)? If not, why not?

 

I am a member of the AANA (American Association of Nurse Anesthetists). This is our voice for legislative actions. Currently they are addressing a few things, first the AANA recently approved “nurse anesthesiologist” as a descriptor for us. The American Society of Anesthesiologists (ASA) is currently fighting this with bills in several states to stop this. They also are constantly lobbying for our ability to practice independently in all states. Another large practice issue for us to try to prevent licensure of anesthesiologist’s assistants (AA) from getting practice authority in any more states. The ASA is consistently fighting to try to make our CRNA practice level the same as the AA level of practice. AA’s can not practice independently ever and this is what the ASA would like for us as well. Many of our issues are the same as any other APN, sadly the AANA and other APN organizations do not work together very well. If they would all work together we may have more success.

 

 

What is your understanding about the DNP degree (Please explain what you know about the degree itself), and whether you have this degree already or intend to pursue it? Can you please also tell me your feelings ( Positive or negative) about the DNP and why you feel this way.

 

The DNP is a clinical doctorate degree. It is 1 of 2 end degrees for an APN (PHD being the other). The DNP is more focused on clinical practice than research. I plan to get my DNP (or DNAP) at some point. I think that requiring a more advanced degree to practice is not a bad thing. If we are going to make the case that we are as good as an MD, adding more education can not hurt that argument.

 

 

 

 

Please feel free to add any additional information re: your specific field that you may feel may be beneficial for my learning process.

 

CRNA’s as a group had a falling out with other APN’s and RN’s in the past. This is why many CRNA programs are not housed in schools of nursing. Consequently many CRNA’s do not have a traditional MSN or DNP. Many of us have Masters or doctorate of nurse anesthesia practice, some even have a masters in biology or just anesthesia. Some nursing schools do house CRNA programs but most do not.

 

 

 

 

 

 

 

If at all possible, please return the responses to me by sometime Saturday, Feb,8,2020.

 

Sorry, I know its a little late, I was on call this weekend

 

Many thanks!

 

Zelda Skaife MSN/RN

The post Interview questions for Advanced Practice Nursing. appeared first on Infinite Essays.

Source link

Interview questions for Advanced Practice Nursing.

Thanks for installing the Bottom of every post plugin by Corey Salzano. Contact me if you need custom WordPress plugins or website design.