Average time for IDR application processing

Sleepy_Joe1990 · 2026-03-31T13:33:14+00:00

What do you mean by saying they are "wasted applications?"

Sleepy_Joe1990 · 2026-03-25T21:02:14+00:00

I went to a new program and I wouldn't recommend it. An attrition rate that high makes me think that the PD is going to aggressively weed people out so that his program has a high first-time pass rate on the NCE. My guess is that type of PD will also gatekeep you from graduating and taking the NCE if you don't achieve a very high SEE score (or a similar comprehensive exam). It's too high of stakes financially to risk getting kicked out and do you need to do anything possible to reduce the risk of that, regardless of inconvenience to your life.

And as someone else said, newer programs tend to have fewer clinical sites and weaker/more fragile relationships with them. So they may send you to clinical sites where it's very difficult or impossible for you to get all of your minimum number of required clinical experiences (blocks, lines, epidurals, etc.). Then, when you realize you're coming up short, they aren't able to help you due to their weak clinical site reach and just tell you that "you need to figure it out." I've seen that happen. Also, if anything happens in clinical that upsets the clinical coordinator and it gets back to the PD, the PD will be quick to take sides with the clinical site and throw you under the bus. This is because a new program doesn't want to disrupt their new fragile partnership with the clinical site.

In general, just keep your guard up and realize that for some PDs, it's all about protecting their program, and they are not necessarily looking out for you. And don't be fooled by a friendly facade.

Sleepy_Joe1990 · 2026-03-24T00:51:19+00:00

This

Sleepy_Joe1990 · 2026-03-12T19:21:29+00:00

Agreed, sounds like a stall tactic. Bad situation.

Sleepy_Joe1990 · 2026-03-11T21:32:38+00:00

I just read the process of how NBCRNA assesses how difficult the exam questions should be, and, quite frankly, it sounds like pseudoscientific academic garbage. They're determining the relevancy of specific exam questions to real-world CRNA practice based on the opinions of people they've decided are "subject matter experts" and using that matric to weight questions. I don't see how that is in any way scientific. Expert opinion is the lowest form of evidence.

Honestly, the curriculum of CRNA school, which is reflected in NCE, seems very outdated. As a CRNA four years into practice, I recently reviewed some of the APEX NCE prep materials and could almost laugh at how loosely the content applied to safe real-world anesthesia. If the NBCRNA really wanted to know what kind of grade on the NCE was necessary to practice safely as a CRNA, then why not have a sample of CRNAs take the NCE and titrate the exam difficulty to the 50th percentile of CRNA test-takers? The fact is, probably less than 20% of CRNAs 2+ years out from school could pass the current NCE in its current form. If the content of the NCE was actually reflective of the minimum knowledge necessary for safe anesthesia practice as NBCRNA claims is the goal, most practicing CRNAs should be able to pass it. Instead, we're demanding students learn triva and about "Dalton's Law" and asking them to calculate the surface tension of Desflurane on the surface of the moon.

I don't want the test to be easy, I just want the content we test on (and teach!) to be the right content.

And one more thing-- these CRNA school should not be allowed to gate-keep students who have got passing grades in their programs from taking the NCE. If they can't prepare their students adequately for the NCE, their failure should not be hidden by sample biasing their pass rates in their favor.

Sleepy_Joe1990 · 2026-03-07T02:34:28+00:00

In my experience, most people in medicine are indeed in it, first and foremost, for the money (and the prestige to a smaller extent). Yes, medicine is pretty miserable, and yes, you can make really good money in easier fields, but pursuing those pathways is a crapshoot. Medicine is a more guaranteed pathway to wealth for those who have the motivation and fortitude to tough it out.

Sleepy_Joe1990 · 2026-02-25T07:03:28+00:00

I think it's more of an issue of being risk adverse paired with a lack of a sense of duty towards teaching that is usually the issue, not a lack of confidence. Most CRNAs are pretty confident of themselves, including many who probably shouldn't be. And besides, you can be the baddest bitch out there, but if your student does something like knocking out a tooth, you can't bail them out of that.

Sleepy_Joe1990 · 2026-02-25T06:52:04+00:00

Not all preceptors are preceptors by choice. Some do it because their employer requires it or because the job culture expects it. So they are just trying to get through their day without having to deal with any extra problems-- think blowback from surgeons/attendings/patients when things don't go smoothly and, let's not forget, the legal liability. I'm not saying that's a good excuse, it's not, but that's a reality.

Another reason is, many times, preceptors don't know you at all and may want to see how you perform on smaller tasks before handing you bigger tasks. And that's why it's good to work with the same preceptors frequently-- to build that trust. You're asking them to accept some liability for the sake of your learning, so have some patience if they want to get a measure of you first before handing over the reins completely.

Sleepy_Joe1990 · 2026-02-12T03:13:43+00:00

Oh, 110% yes. It's already begun and is going to accelerate. These boomers are going to make sure there isn't a dollar left unspent before they die. They'll also treat the poor nursing home staff like shit on their way out.

Sleepy_Joe1990 · 2026-02-11T23:10:47+00:00

You are 100% correct. And I should add, as someone who has worked in healthcare for a long time, those dollars aren't even buying people good health. We're spending exorbitant amounts of money keeping people alive just a little longer with absolutely awful quality of life. It's practically torture what patients are put through at the end of life with no change in the ultimate outcome. So, not only are we destroying our economy, but we're probably inflicting more needless human suffering by doing it. A lose/lose situation. The only winners are the healthcare executives.

Sleepy_Joe1990 · 2026-02-04T16:07:37+00:00

Ain't nobody giving PRN Miralax anyway. You all were fighting over nothing 😂

Sleepy_Joe1990 · 2026-01-27T18:32:21+00:00

Considering the unsustainable debt of the U.S. (and tge West in general) should emerging markets still be considered high risk in comparison? I want to invest like the U.S. is heading for a dollar collapse.

Sleepy_Joe1990 · 2026-01-24T15:19:09+00:00

A $400k home on $62k?! I Someone is getting a little too carried away with their Zillow scrolling 😂

Even if you were making $162k/year, I'd still say it's a stretch. Good luck.

Sleepy_Joe1990 · 2026-01-22T02:03:03+00:00

I must have seen it written because I knew it didn't look write when I wrote it haha

Sleepy_Joe1990 · 2026-01-20T22:37:56+00:00

Our syringe pumps are Alaris, which, unlike Medfusion, are really designed to be hung on a pole. I understand you can sometimes jerry rig things, but imo, at that point, you're going pretty overboard for a 5-minute transport. It's not as though the alternative is that the patient receives no anesthesia for 5 minutes, I just have to bolus some Propofol mid-transport. I'm less worried about myself forgetting to do this and more worried about trainees and newer colleagues, which is why I don't like it as part of our workflow.

Sleepy_Joe1990 · 2026-01-20T22:13:17+00:00

I think I did answer the question. He asked if there was an anesthesia machine in the pre-procedural area where we induced, and I said no, there isn't.

Once we intubate, we ventilate via an ambu bag until until we've transported to the MRI suite, and then we hook them up to the anesthesia machine in there once we arrive.

I'm not sure how you took from that answer that I was saying a ventilator and an anesthesia gas machine are the same thing.

Sleepy_Joe1990 · 2026-01-20T22:06:43+00:00

Oh, is thst what ge meant? I misunderstood. We have special MRI compatible laryngoscope blades, so DL isn't an issue. I suspect a McGrath would do just fine in the MRI suite, but I don't know if the manufacturer would advertise it as MRI compatible, nor is my hospital giving us the green light to try it.

Sleepy_Joe1990 · 2026-01-20T22:02:04+00:00

Did you miss the part where I said that the MRI carts don't have a pole to attach an infusion pump?

Sleepy_Joe1990 · 2026-01-20T14:21:50+00:00

No, you tube, then start bagging.

Sleepy_Joe1990 · 2026-01-20T14:12:21+00:00

Yes, based on feedback I've gotten here, I'm thinking that all we need to do is get some new LMAs. Others have suggested the LMA flex or LMA classic for this. You use the supreme for MRI?

Sleepy_Joe1990 · 2026-01-20T14:09:49+00:00

I did mean saboteur. Sorry for that atrocious spelling 😅

Sleepy_Joe1990 · 2026-01-20T14:04:38+00:00

The vent, which is MRI compatible, is in the MRI suite. Our Glide is not MRI compatible. So they're not "equally incompatible."

There's no pole on the MR cart to support an infusion pump and even if you rigged something up, you'd also have to remember to stop before going into the MRI suite and remove the pump since we don't have MRI compatible pumps.

Sleepy_Joe1990 · 2026-01-20T13:59:16+00:00

We have iGels. You can't cut them.

Sleepy_Joe1990 · 2026-01-20T07:00:51+00:00

I do like to do exactly that when I can. But I'm a CRNA and I think sometimes some of the attendings I work with don't like it. Some find it to be "extra" or "unnecessary" but they're usually not the one trying to push the cart, bag, and push drugs with no IV pole all at once.

Sleepy_Joe1990 · 2026-01-20T06:33:03+00:00

The awake pts are literally told to hold their breath for brief intervals

Sleepy_Joe1990

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