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Clinical Preparation · CRNA Notes: From the Classroom to Clinical

0:01
SPEAKER_00: Welcome to CRNA Notes from the Classroom to Clinical, the podcast dedicated to helping student-registered nurse anesthetists and new CRNAs navigate the journey from the classroom to clinical practice and beyond.
0:29
SPEAKER_00: Welcome back to CRNA Notes from the Classroom to Clinical.
0:34
SPEAKER_00: Today's episode is probably going to be super helpful for students in the clinical spaces.
0:39
SPEAKER_00: We're going to talk about preparing for clinical without burning out.
0:44
SPEAKER_00: So you want to build habits that make you a better sRNA without feeling the pressure of how can I keep up this pace with the things that I need to get done.
0:57
SPEAKER_00: So whether you're getting ready for your clinical experience or you're halfway through your program or you're anywhere within the program, one thing always remains true is that clinical preparation never ends.
1:10
SPEAKER_00: But here's the problem I see over and over as not only a program director, but also a practicing cRNA is that students often confuse preparation with perfection.
1:23
SPEAKER_00: So they think they have to know absolutely everything about every patient before they arrive.
1:29
SPEAKER_00: Now, with saying that, I don't mean, hey, don't know anything.
1:34
SPEAKER_00: But you should know a great deal.
1:37
SPEAKER_00: However, there's a lot of discussion that should be going on between you and your clinical preceptor during the day.
1:43
SPEAKER_00: So what students do is they stay awake until midnight.
1:54
SPEAKER_00: They skip meals, they don't exercise, they don't think, they don't do the things that they really like to do.
2:00
SPEAKER_00: And they feel very guilty when they're not studying.
2:03
SPEAKER_00: So eventually continuing at that pace, students get exhausted before the patient is even in the OR.
2:11
SPEAKER_00: So, how do we do that?
2:12
SPEAKER_00: Um, today I want to talk about preparing for clinical in a way that actually helps you become a better anesthesia provider and not just a very tired one.
2:22
SPEAKER_00: So we'll discuss the things that matter immensely when you're preparing for clinical, how to prepare efficiently, effectively, and how to hopefully avoid burnout while still being an outstanding student.
2:38
SPEAKER_00: So let's get started.
2:39
SPEAKER_00: One of the caveats that we get into is what does being prepared really mean?
2:46
SPEAKER_00: And so I think that one of the biggest misconceptions that I see is that SRNAs think being prepared means memorizing every single detail.
2:58
SPEAKER_00: And it doesn't.
3:00
SPEAKER_00: And you know, being prepared means that you have a framework of understanding.
3:04
SPEAKER_00: So you want to ask yourself a couple questions as you are going into your clinical day.
3:10
SPEAKER_00: Can I explain why this patient is having surgery?
3:13
SPEAKER_00: What I see when students get themselves into a TIF or when they get themselves into a place that of non-understanding is when their preceptor asks them, so why is this patient having this surgery?
3:26
SPEAKER_00: And they can't answer that.
3:27
SPEAKER_00: That's the basic understanding of why you're delivering anesthesia to the patient.
3:32
SPEAKER_00: You also need to ask yourself, do I understand this disease process?
3:37
SPEAKER_00: Um one of the things that I often talk about when I'm precepting students is think about the anesthetic implications of this surgical procedure and can you anticipate those?
3:52
SPEAKER_00: Um, do you know what complications you're watching for?
3:56
SPEAKER_00: Can you explain your plan?
3:58
SPEAKER_00: There's nothing that probably gets to a preceptor more is a copy and pasted anesthesia clinical management plan.
4:07
SPEAKER_00: Because when it's copied and pasted and you haven't invested time in reviewing, uh that's when the clinical preceptors are like, wait, do you really understand what's going on?
4:17
SPEAKER_00: Now, when I say that, if you've done the case before, sure, the case doesn't change, but your anesthetic implications based on your patient's comorbidity, those things might change.
4:30
SPEAKER_00: So that's preparation and explaining that plan, of course.
4:34
SPEAKER_00: But let me tell you a couple things that aren't on the list.
4:38
SPEAKER_00: Knowing every lab value that the patient had for the last 10 years.
4:41
SPEAKER_00: Those, that's not pertinent to the care of that patient.
4:44
SPEAKER_00: Um, memorizing every article that was ever written about this particular disease or surgical procedure, uh, reading all of these anesthesia textbooks in one night.
4:56
SPEAKER_00: So I frequently tell our students, hey, marry yourself to one of our anesthesia textbooks, whether it's uh clinical anesthesia by Barish and Cullen, whether it's nurse anesthesia by Nagelhout.
5:10
SPEAKER_00: You know, you want to marry yourself to a book so that you have a resource that you can fall back on.
5:16
SPEAKER_00: When you have six and seven different books out, values sometimes change, maybe something's a little off with a mean pressure or with a dose.
5:27
SPEAKER_00: Um, you know, maybe instead of one to 1.5, it's 1.25 to 2, and then you're all confused.
5:35
SPEAKER_00: Um preparation is about clinical reasoning.
5:38
SPEAKER_00: How can we get students to have a high-level functioning um plan and implement that plan and being able to discuss that plan reasonably?
5:52
SPEAKER_00: As a preceptor, I really don't expect students to know every little detail down to the dotted I's and the cross T's.
6:01
SPEAKER_00: I expect them to think, and that's one of the things that I think is a lost art in precepting students.
6:09
SPEAKER_00: Let them talk through the thing.
6:12
SPEAKER_00: Um, the students who impress me the most aren't the ones who can recite some obscure fact, right?
6:20
SPEAKER_00: The ones that can come explain to me why they made a particular decision, those are the ones who are impressive.
6:27
SPEAKER_00: I've been known in the OR when I'm precepting students to say, hey, what are you gonna do?
6:32
SPEAKER_00: What's your plan?
6:33
SPEAKER_00: And they tell me their plan.
6:34
SPEAKER_00: And if their plan is reasonable, sure.
6:36
SPEAKER_00: Maybe it's not my plan, but that plan sounds good too.
6:40
SPEAKER_00: And so we can go with that.
6:42
SPEAKER_00: What dosing of medication are you giving?
6:44
SPEAKER_00: If it's within range, then that's fine.
6:47
SPEAKER_00: I've actually seen clinical preceptors, so let's take acetamenophen, for example, and we know the dosing for acetamenophen IV is 10 to 15 milligrams per kilogram.
7:00
SPEAKER_00: So they can use 10, 12.5, uh, or 15.
7:05
SPEAKER_00: And I have seen clinical preceptors tell a student, well, no, why would you use 10?
7:11
SPEAKER_00: Or why would you use 15?
7:13
SPEAKER_00: Well, that's within dosing range.
7:15
SPEAKER_00: And if is it unsafe?
7:16
SPEAKER_00: No.
7:17
SPEAKER_00: So let's just let the student go ahead and do that as long as we um, you know, are they they have a rationale and they know why they want to do something.
7:26
SPEAKER_00: Um, so when we look at clinical preparation, one of the things that students need to consider is the 80-20 rule.
7:39
SPEAKER_00: This happens in in uh didactic training too, but let's talk about what it means in clinical.
7:44
SPEAKER_00: Roughly 20% of your preparation gives you 80% of the benefit.
7:50
SPEAKER_00: So, what does that mean?
7:51
SPEAKER_00: There are a couple high-yield areas that students need to focus on when they're working on their anesthesia management plans.
7:59
SPEAKER_00: Your patient's history.
8:00
SPEAKER_00: You need to know the history of, you know, why is the patient here and why are we doing what we're doing?
8:06
SPEAKER_00: What is the patient's airway assessment?
8:08
SPEAKER_00: Don't assume everyone is a malinpotty one or two because that's what's going to burn you.
8:12
SPEAKER_00: Uh, what medical conditions does the patient have that's going to affect your anesthetic?
8:18
SPEAKER_00: Um, current medications.
8:20
SPEAKER_00: We all need to know what medications our patients are on because that might affect our anesthetic, or our anesthetic might affect the patient's medications, right?
8:31
SPEAKER_00: We want to look at what is the planned procedure.
8:34
SPEAKER_00: How are we positioning this patient?
8:36
SPEAKER_00: So making sure that if they're in anything other than supine, that you have all the devices that you need in order to put to position them the way that you need to.
8:47
SPEAKER_00: What's the expected blood loss?
8:49
SPEAKER_00: Just because the expected blood loss is 500, maybe you get 150.
8:54
SPEAKER_00: Just because the expected blood loss is 150, maybe you get 500.
8:58
SPEAKER_00: But you want to know what's expected so that you know when you're out of the norm, I guess.
9:03
SPEAKER_00: Um, monitoring, of course, that that says its own thing.
9:07
SPEAKER_00: Pain management.
9:09
SPEAKER_00: Um, what are our emergence considerations?
9:12
SPEAKER_00: We all know that emergence starts with your assessment.
9:16
SPEAKER_00: How am I going to wake this patient up?
9:18
SPEAKER_00: And I think emergence is one of those, this is the art of anesthesia, and it takes students a while to get to where it's a little bit more smooth.
9:28
SPEAKER_00: I remember being a student and I was probably in my, maybe my second or third to last semester of nurse anesthesia school, and I emerged this patient and it was rocky.
9:40
SPEAKER_00: Okay, so fine.
9:42
SPEAKER_00: My preceptor looked at me and she goes, okay, well, that wasn't the smoothest emergence, but you got the job done.
9:48
SPEAKER_00: And sometimes we just have to give students that benefit of the doubt that, hey, you got the job done and we'll work on technique, and that's why they're in school for 36 months.
9:58
SPEAKER_00: So if you understand those areas that I talked about, pain management, monitoring, blood loss positioning, and all of those things, you'll walk into clinical way more confident than someone who just spent hours reading about extremely rare complications that they're probably never going to encounter.
10:16
SPEAKER_00: So focus on what's common before worrying about what's uncommon.
10:20
SPEAKER_00: Know those uncommon things in the back of your head because when they pop up, you'll say, Oh, I did read about that.
10:24
SPEAKER_00: But you want to focus on those common situations that you're gonna see.
10:28
SPEAKER_00: So you want to build that depth after you build a solid foundation.
10:32
SPEAKER_00: And the solid foundation are gonna be those common things that you'll see in the operating room with your patient.
10:39
SPEAKER_00: Students often ask me, because I am a program director, they'll ask, like, how exactly do I prepare?
10:46
SPEAKER_00: So here's a routine that I would recommend for students as they are looking at their evening and preparing their routine for clinical.
10:54
SPEAKER_00: Look up your patient, of course.
10:56
SPEAKER_00: That's that's without saying.
10:58
SPEAKER_00: Not just their diagnosis, but actually understand their patient.
11:01
SPEAKER_00: Why is this patient here?
11:03
SPEAKER_00: Why are they having surgery today?
11:05
SPEAKER_00: Um, what is the disease process?
11:07
SPEAKER_00: You need to look those things up to be prepared to manage your anesthetic.
11:13
SPEAKER_00: The second thing I tell students to do is review the surgery.
11:17
SPEAKER_00: So, what are the major steps in the surgery?
11:19
SPEAKER_00: How long will this likely last, right?
11:21
SPEAKER_00: So, if you're preparing for a 40-minute surgery and it's four hours and you're like, wait, what step?
11:29
SPEAKER_00: What did I miss here?
11:30
SPEAKER_00: Um, you really need to have an understanding of how long the procedure might take.
11:34
SPEAKER_00: What positioning is involved?
11:36
SPEAKER_00: How is the surgeon going to get to where they need to be?
11:40
SPEAKER_00: Am I gonna be in supine?
11:41
SPEAKER_00: I mean, not you, but the patient.
11:43
SPEAKER_00: Will the patient be in supine?
11:45
SPEAKER_00: Are they gonna be lateral?
11:46
SPEAKER_00: Are they lateral jackknife?
11:48
SPEAKER_00: Are they prone?
11:49
SPEAKER_00: Like all of those things matter.
11:51
SPEAKER_00: Are there going to be major fluid shifts?
11:54
SPEAKER_00: So some of this is dependent on the patient's comorbidities, right?
11:58
SPEAKER_00: So if the patient has pulmonary disease, renal disease, cardiac disease, you might see different shifts within fluid because they can't handle the fluid as a person who has no comorbidities with their heart, their lungs, or their kidneys.
12:12
SPEAKER_00: What about blood loss?
12:13
SPEAKER_00: We talked a little bit about that.
12:14
SPEAKER_00: What does it look like?
12:15
SPEAKER_00: Is there going to be blood loss, big blood loss?
12:18
SPEAKER_00: Because these are some of the cases you might see where if you're expecting large blood loss, you might be starting your, you know, blood transfusion before they even make incision.
12:28
SPEAKER_00: Um there are some craniofacial surgeries with the pediatric patient.
12:32
SPEAKER_00: As soon as the surgeon makes incision, we start blood because we know the blood loss is going to be a lot and we want to get ahead of that.
12:42
SPEAKER_00: Is there any special equipment that's required in the operating room?
12:46
SPEAKER_00: So, yes, it's not your job to make sure that the OR team has uh things that they need for the case, but it is your job not to bring the patient back until those things are done.
12:57
SPEAKER_00: Maybe you need special equipment.
12:59
SPEAKER_00: Do you need an ultrasound for IVs?
13:01
SPEAKER_00: Do you need a glidescope or anything like that?
13:06
SPEAKER_00: McGills, all of those things.
13:07
SPEAKER_00: So you want to make sure that you have all the equipment that you need.
13:11
SPEAKER_00: The next thing to be very systematic in what you're doing is review any kind of anesthesia implications.
13:18
SPEAKER_00: Are there any airway concerns with this patient?
13:21
SPEAKER_00: Have they had surgery before and have a difficult airway note in their chart or anything like that?
13:27
SPEAKER_00: Does the patient have any cardiovascular or pulmonary considerations?
13:32
SPEAKER_00: What about pain management?
13:33
SPEAKER_00: What does that look like?
13:34
SPEAKER_00: And how are we going to manage the patient's pain?
13:37
SPEAKER_00: What is their postoperative nausea and vomiting risk?
13:41
SPEAKER_00: If you, those of you who are using Epic, for example, a nice little risk uh notification comes up for patients, but don't rely on that.
13:51
SPEAKER_00: You have to make that assessment for yourself as well.
13:54
SPEAKER_00: And the utilization of regional anesthesia for the patient if it's appropriate.
13:58
SPEAKER_00: We all know, again, that there are some considerations for regional anesthesia for patients that we want to make sure that we know about.
14:10
SPEAKER_00: What else?
14:11
SPEAKER_00: We want to review medication.
14:13
SPEAKER_00: Now, do you review every single medication?
14:15
SPEAKER_00: Yes, you want to look at them.
14:17
SPEAKER_00: But the ones that you want to focus on the most are medication for blood pressure management.
14:24
SPEAKER_00: Um, is the patient on multiple medication for blood pressure management?
14:29
SPEAKER_00: That might give you a little clue as to what their blood pressure might look like in the operating room.
14:35
SPEAKER_00: Are they on anticoagulants?
14:37
SPEAKER_00: Have those anticoagulants been stopped?
14:40
SPEAKER_00: Or are they not supposed to be stopped?
14:42
SPEAKER_00: Who knows?
14:43
SPEAKER_00: Those are things that you want to make sure that you understand.
14:47
SPEAKER_00: What about a patient that has diabetes?
14:50
SPEAKER_00: Are they managed by insulin?
14:52
SPEAKER_00: Are they managed uh with oral medication?
14:57
SPEAKER_00: How many medications are they being managed with?
15:00
SPEAKER_00: What was their last blood sugar and what does their blood sugar normally range?
15:04
SPEAKER_00: Does this patient utilize uh steroid therapy?
15:08
SPEAKER_00: Why do we need to know that?
15:10
SPEAKER_00: Because we might need to give them a stress dose of steroids, um, any kind of psychiatric medication, of course, pulmonary medication, we're dealing with the lungs, um, and anything that changes your anesthetic management.
15:23
SPEAKER_00: Now, if the patient's on a multivitamin, do you need to know that and do you need to weigh that into your anesthetic management plan?
15:31
SPEAKER_00: Probably not, but make sure you don't leave out any kind of herbal medication.
15:36
SPEAKER_00: And of course, GLP ones and GLP medication have been, you know, running rampant in our OR.
15:43
SPEAKER_00: So you want to make sure you know if the patient is on any of those medications and when was that stopped?
15:50
SPEAKER_00: So review one anesthetic topic, not 45 million, just review one, not 10, just one.
15:59
SPEAKER_00: Um, maybe today it's going to be induction drugs.
16:02
SPEAKER_00: Induction drugs are so important.
16:04
SPEAKER_00: Students need to understand them like the back of their hand.
16:08
SPEAKER_00: Um, maybe tomorrow it's difficult airway.
16:11
SPEAKER_00: Maybe the next day you want to focus on emergence.
16:14
SPEAKER_00: So small daily improvements become massive over time.
16:18
SPEAKER_00: If you feel comfortable and confident, and you know, let your preceptor know what skills you have been working on and that you're trying to get better.
16:28
SPEAKER_00: Um, usually when I have a student, I may ask them, like, hey, what have you been working on or what do you want to work on?
16:36
SPEAKER_00: And, you know, because I do pediatric anesthesia and it's a specialty.
16:40
SPEAKER_00: By the time the students get to me, they've been in clinical for at least a year, if not longer.
16:45
SPEAKER_00: And so maybe they want to work on, you know, a deep extubation.
16:50
SPEAKER_00: Maybe they want to work on their analgesic management.
16:54
SPEAKER_00: Maybe they want to work on placing IVs.
16:57
SPEAKER_00: I don't know.
16:58
SPEAKER_00: But sometimes I feel like as preceptors, we don't let the student guide the learning and they know best what they need to learn now.
17:05
SPEAKER_00: I'm not saying as a preceptor, you just sit back and the student is making like vast mistakes and doing all these things that you don't correct that.
17:13
SPEAKER_00: I'm saying that we do want to focus on the active learning that the student uh knows that they need to uh work on to get better.
17:23
SPEAKER_00: Sometimes you need to stop studying, and that sounds weird.
17:27
SPEAKER_00: Like she's a program director, she's a preceptor, and she's telling students to stop studying.
17:32
SPEAKER_00: I don't mean forever.
17:35
SPEAKER_00: There comes a point where another hour of studying produces basically no benefit.
17:41
SPEAKER_00: My students will tell you that I tell them, study in increments, take breaks, and when you're getting overwhelmed, just put the book down because you have to come back.
17:50
SPEAKER_00: Your brain needs to recover.
17:53
SPEAKER_00: Um, you know, there are times where students will study from 9 to 5 on a Thursday, and they're just like, I'm just gonna study and sit and marathon and all of this.
18:02
SPEAKER_00: I can guarantee you that if by five o'clock that evening I said, hey, let's look over the things that you studied at 9 a.m., most of them won't have any recollection of what it was.
18:12
SPEAKER_00: So brain recovery, really important for students so that they can fit more information in there.
18:20
SPEAKER_00: What are some of the signs that you're over-preparing?
18:24
SPEAKER_00: And that sounds crazy, but when students get to a point of over-preparation, if you will, that's leading to burnout for these students.
18:33
SPEAKER_00: So let's talk about what burnout actually looks like.
18:37
SPEAKER_00: Some of the warning signs.
18:39
SPEAKER_00: You never feel like you're prepared.
18:40
SPEAKER_00: You walk into space and you're like, I don't know, I can't even fathom what's going on in here.
18:45
SPEAKER_00: So you feel like you're just never prepared for the case.
18:49
SPEAKER_00: You read until you're too exhausted to remember anything.
18:52
SPEAKER_00: Kind of what I said earlier.
18:54
SPEAKER_00: Like if students do marathon study, most of the time, eight hours later, they have zero recollection of what they studied in the beginning of the day.
19:03
SPEAKER_00: You compare yourself constantly, right?
19:07
SPEAKER_00: Um, when you compare yourself to other students, terrible, terrible, terrible, you are going to burn out.
19:16
SPEAKER_00: Your pathway is not their pathway.
19:19
SPEAKER_00: Their pathway is not your pathway.
19:21
SPEAKER_00: And sometimes you just have to let your pathway be what it is because everyone gets to the final goal at the same time.
19:29
SPEAKER_00: Um, you reread the same pages because you're too tired to focus.
19:33
SPEAKER_00: I remember I used to do this in school.
19:36
SPEAKER_00: I would focus on topics that I was very comfortable and confident in because it made me feel good, that I was like, oh yeah, I know that.
19:44
SPEAKER_00: But then throw cardiac in my face.
19:46
SPEAKER_00: And I was like, oh, like, why are we doing this?
19:49
SPEAKER_00: You have to go through the topic areas that you're not so confident in in order to get better at it.
19:57
SPEAKER_00: Other ways that you know you're burning out as a student, you stop enjoying learning.
20:03
SPEAKER_00: Like it's just a chore at this time.
20:05
SPEAKER_00: That's no good.
20:06
SPEAKER_00: Like we have to figure out and focus on how we can get students back to enjoying what they're doing.
20:12
SPEAKER_00: You feel guilty whenever you relax.
20:14
SPEAKER_00: You sit down for five minutes, you're like, I need to get up and study, I need to look at respiratory, I need to study for my C exam, things like that.
20:21
SPEAKER_00: Those aren't signs of dedication, those are signs of burning out.
20:25
SPEAKER_00: So they're signs that your system is telling you they're not sustainable.
20:29
SPEAKER_00: So remember that clinical one is a marathon.
20:32
SPEAKER_00: Otherwise, we'd have everyone in clinical for two weeks and then they're done.
20:36
SPEAKER_00: It's not a sprint.
20:38
SPEAKER_00: Your goal isn't to survive one rotation, your goal is to kind of thrive in that environment and learn everything that you can.
20:46
SPEAKER_00: So, your goal is to become a safe CRNA over the uh three years that you're in training.
20:52
SPEAKER_00: That's what we are looking at when we look at um clinical preparation and becoming a CRNA.
20:58
SPEAKER_00: So, how do we do this?
21:00
SPEAKER_00: Please do not skip breakfast as an sRNA.
21:03
SPEAKER_00: Morning preparation should be pretty simple.
21:06
SPEAKER_00: Wake up early enough that you're not rushed, right?
21:09
SPEAKER_00: Because rushing just you leave things, you forget things.
21:12
SPEAKER_00: Eat breakfast, even if it's a granola bar, even if it's a piece of toast with peanut butter, bananas if you're not allergic, and things like that.
21:19
SPEAKER_00: You do want to have some something in your stomach, um, some sugar, some carbohydrates as well.
21:25
SPEAKER_00: Hydrate.
21:26
SPEAKER_00: Review your patients um briefly and visualize what your anesthetic is gonna look like.
21:31
SPEAKER_00: So you will also want to think through your induction.
21:35
SPEAKER_00: Um, thinking through, like, okay, what does my laryngoscopy look like in the beginning?
21:40
SPEAKER_00: It's more difficult.
21:41
SPEAKER_00: Am I putting the blade in deep enough?
21:43
SPEAKER_00: Am I sweeping the tongue?
21:44
SPEAKER_00: Like, am I doing all those things?
21:46
SPEAKER_00: And visualize what that looks like.
21:48
SPEAKER_00: Think through your maintenance and emergence phases as well and possible complications.
21:54
SPEAKER_00: Sometimes when I'm in clinical and I'm with a student, I'm like, okay, what's the worst thing that can happen in this case?
21:59
SPEAKER_00: And sometimes.
22:00
SPEAKER_00: Sometimes it's a laryngospasm or bronchospasm.
22:02
SPEAKER_00: And then we talk about, well, how can you treat that?
22:05
SPEAKER_00: And they tell me, and I'm like, okay, great.
22:07
SPEAKER_00: So if we can treat the worst thing that can happen in this case on our end, then we're in pretty good shape.
22:12
SPEAKER_00: You want to walk into the OR with some simulance of confidence.
22:16
SPEAKER_00: And confidence doesn't mean being cocky, like, hey, I know everything I'm doing and all of that, but just confident in your preparation, right?
22:23
SPEAKER_00: You don't want to cram.
22:25
SPEAKER_00: You're not taking an exam.
22:27
SPEAKER_00: You're taking care of patients.
22:29
SPEAKER_00: And so taking care of a human being, you want your focus to be calm and not panicked.
22:36
SPEAKER_00: One of the things I wish that every sRNA could understand is that they need to give themselves permission to be a student.
22:45
SPEAKER_00: Give yourself permission to learn.
22:48
SPEAKER_00: No one expects you to function like someone with 20 years of experience or anything like that.
22:54
SPEAKER_00: I remember one of my students early on said, Dr.
22:58
SPEAKER_00: B, how do I learn and speak anesthesia the way that you do?
23:03
SPEAKER_00: And I said to her, girl, you've been here for six weeks.
23:07
SPEAKER_00: I've got 22 years on you.
23:09
SPEAKER_00: So make sure you're giving yourself that space to just be a student.
23:13
SPEAKER_00: Ask thoughtful questions.
23:15
SPEAKER_00: That's super important in the operating room.
23:19
SPEAKER_00: And try to become better every day, right?
23:21
SPEAKER_00: One of the things that athletes understand, and there's been quotes and memes and all kinds of things, is 1% better each day, and that you end up getting to your goal.
23:31
SPEAKER_00: Your preceptors, they don't remember the students who knew every answer.
23:35
SPEAKER_00: They remember the students who were teachable.
23:38
SPEAKER_00: I can say that absolutely true at being a clinical preceptor.
23:44
SPEAKER_00: I remember the students who just had that thirst for learning, who made mistakes, but they were so open to being educated and all of those things.
23:55
SPEAKER_00: So that's that's really important.
23:58
SPEAKER_00: So I want to leave you with a couple final thoughts.
24:01
SPEAKER_00: Preparation should actually make you calmer, not more anxious.
24:06
SPEAKER_00: If your preparation is making you anxious all the time, if it's taking away from your sleep, your health, your relationships, then something has to be changed.
24:15
SPEAKER_00: You have to change something.
24:16
SPEAKER_00: Being a successful sRNA isn't about who's studying the most.
24:21
SPEAKER_00: It's about studying the smartest, protecting your sleep.
24:25
SPEAKER_00: You cannot function on two hours of sleep as a student, protecting your mental health, right?
24:32
SPEAKER_00: Um protecting your relationships.
24:34
SPEAKER_00: Sometimes our families need to understand, like, hey, I'm not going to always be present as a student or synesthetist, but I'll be there, right?
24:42
SPEAKER_00: You want to protect your joy, be happy, understand the career path that you're going down.
24:48
SPEAKER_00: And so many opportunities will be ahead of you because when you become a CRNA, um, your patients won't benefit from the student who stayed awake until three o'clock in the morning, memorizing yet another chapter of Nagelhout or another chapter of Barish.
25:03
SPEAKER_00: They're going to pre-benefit from a provider who is rested, they're focused, and they're calm in situations and very thoughtful.
25:14
SPEAKER_00: With that, you're able to make great decisions when it matters the most, right?
25:20
SPEAKER_00: So you just want to be really introspective when we're taking care of patients.
25:25
SPEAKER_00: So thanks for joining me on another episode of CRNA Notes from the Classroom to Clinical.
25:31
SPEAKER_00: If today's episode helped you as a student, make sure you subscribe so you don't miss the next one.
25:37
SPEAKER_00: Share it with a classmate.
25:40
SPEAKER_00: So, you know, I just want to really reach out to more student nurs anesthetists who are working hard to become safe and compassionate providers.
25:48
SPEAKER_00: So until next time, remember, CRNA notes from the classroom to clinical.
25:54
SPEAKER_00: We'll see you in the classroom.