Ep 57: How CRNAs and SRNAs Can Deal with Stress and PTSD

Working as a nurse anesthetist can be a highly emotional and stressful position as you constantly deal with pressure to perform. That’s why there’s an emphasis being put on health and wellness by people like Jerry Hogan, DNSc, CRNA, ARNP-BC, who is the program director at Rush University. He joins us to talk about this topic and ways that CRNAs and SRNAs can cope with the stress and PTSD brought on from work.  

Read more and get additional resources here: https://beyondthemaskpodcast.com/?p=2238 

Today's rundown: 

2:25 – Our guest today is Jerry Hogan, DNSc, CRNA, APRN-BC

3:37– Opening up with the key points on today’s topic of PTSD, Second Victim Syndrome, wellness, and stress.

5:55 – PTSD is divided into three clusters: re-experiencing, avoidance, and persistent arousal.

7:28 – How much of this is a societal issue?

10:09 – Anesthesia school is very trying and that’s where wellness starts.

13:13 – Jerry believes that healthy people are people that can control their thoughts and feelings and behaviors.

14:28 – We are the ones responsible for our own well-being.  

15:43 – Wellness resources that are available for CRNAs.

17:32 – How do you practice mindfulness?

20:30 – What’s your response when people say we are babying our students?

22:35 – Discussion on cognitive reframing.

26:00 – What Jerry does when his stress level is elevated?

28:31 – Jerry recaps his career and experience in the military, which led him to this field.

34:00 – Final message from Jerry

Ep 56: Courage to Lead: Looking Back at Dick Ouellette’s Time as AANA President

In the latest installment of our Courage to Lead series, we spend some time with Dick Ouellette, CRNA, MEd, who was a two-term president of the AANA. During his time serving in that capacity, Ouellette helped reinvigorate the profession by focusing on education standards and had a heavy involvement in direct reimbursement coming to pass.

Read more about this episode: https://beyondthemaskpodcast.com/?p=2223 

Today's Rundown: 

2:43 – Our special guest today is Dick Ouellette, CRNA   

3:17 – Give us some highlights from your two terms as AANA President.

4:46 – The second thing he was interested in at the time.

6:19 – Where he was focused during the second term.

7:18 – Why were joint committees so important to Dick at the time?

10:39 – Direct reimbursement’s beginning and how it progressed during his term.

16:42 – What’s the significance of direct reimbursement?

19:18 – What would it look like today if direct reimbursement didn’t happen?

23:48 – Education was a big concern for Dick. What was the response when he wanted to increase requirements?

28:08 – Dick shares a great story about Sandy and education.  

28:33 – Moving to 1990 and the commission that formed.

33:06 – The thing that Dick feels we’re lacking the most today.

36:39 – If Dick could pick one other profession, what would it be?

Ep 55: How Smart Leaders Prepare for an Unknown Future with Calvin Stovall

The healthcare industry, much like the world around us, is full of uncertainty. How comfortable are you with the potential for change? Today we talk with keynote speaker Calvin Stovall about actions and principles you can apply to your life to help you continue to grow and perform at a high level.

Read more about this topic and get additional resources: https://beyondthemaskpodcast.com/?p=2231 

Today's rundown: 

1:50 – Our guest today is Calvin Stovall.

4:36 – What can a person do to prepare for uncertainty?

5:43 – Widen your circle to become a better person.

7:01 – What keeps people from stepping out of their comfort zone and meeting new people?

8:51 – We aren’t taught how to fail. How does someone move forward after failing?

11:16 – Putting this podcast together was stepping out for us and a big learning experience.

12:07 – What Sharon would tell her children when things weren’t going well.  

12:59 – You should never stop learning. It’s a big part of being successful.

15:31 – What do you tell people that are scared to step out of their comfort zone?

17:58 – Do you know how much the average attention span has changed since 1980?

20:52 – What Sharon does every year to challenge herself.

22:27 – Calvin has a mastermind group that meets every quarter.

24:41 – How can take that entrepreneurial spirit and apply it to the CRNA industry?

26:29 – The book ‘Think and Grow Rich’ talks about mastermind groups.

28:20 – Why Calvin’s favorite word is passion.

31:12 – What final message would Calvin like to leave for listeners?

32:34 – How to get in touch with Calvin.

Ep 54: How CRNAs Should Prepare for Depositions with Steve Mund

No one ever expects to be a part of a lawsuit but situations arise where CRNAs have to answer questions under oath. It’s an intimidating process, especially for someone who’s never been a part of a trial before, but we’ll help prepare you for a deposition by explaining the process and how you can protect yourself.

***CE CREDIT ALERT: Did you know you can get continuing education credit from the AANA for listening to this episode? Go to AANACKN.com to get the details and get your credit today! And see a list of other episodes that qualify for CE credit here.

Show Notes and Additional Resources: https://beyondthemaskpodcast.com/ep-54-how-crnas-should-prepare-for-depositions-with-steve-mund/2215/ 

Today's Rundown: 

2:23 – Today we’re joined by Steve Mund.

4:07 – Why is this topic so important?

4:59 – Here’s what got Steven interested in depositions.

7:14 – Why would a CRNA ever need to be deposed?

8:26 – Steve explains the deposition process.

10:46 – You need to have a lawyer that represents you personally.

13:26 – It’s important to understand your insurance policy and what it says.  

15:44 – So I’m being sued, what do I do?

17:16 – How often do administrators have to deal with lawsuits?

18:38 – How are depositions different from trials?

21:13 – Being deposed makes people nervous. Here’s what you can do to make sure you don’t speak out of turn.  

22:28 – Charting is extremely important.  

24:24 – What do you do if you make a mistake while you’re testifying?

26:58 – If you feel like you’re losing your cool in that environment, what should you do?

29:48 – Why your demeanor can affect your deposition.

32:51 – What training or resources are available to CRNAs?

37:13 – Final thoughts on the subject.

Ep 53: Sharing the Gifts of Our Past

Past AANA presidents Sandy Ouellette, CRNA, and Nancy Maree, CRNA, join the show for the final episode of 2019. We’ll take a look back at how they’ve seen the profession evolve and discuss the gifts they’ve given and received from the profession through the years.

Show Notes and Additional Resources: https://beyondthemaskpodcast.com/?p=2208 

Today's Rundown: 

1:32 – We’re joined today by Nancy Maree and Sandy Ouellette for another historical episode.

2:27 – Today we want to talk about gifts received over a career in anesthesia.  

3:42 – What drew Nancy into a career as a nurse anesthetist?

5:26 – Here’s what got Sandy into the career and it started at a young age.

8:50 – How has the educational process for nurse anesthetists changed over the past 40 years?

13:47 – Sandy remembers a coup that happened when she began school.

16:28 – Sandy talks about how different many of the processes were.

19:54 – The return on investment is still tremendous for CRNAs.

22:07 – Over 90% of CRNAs spend a career in clinical anesthesia, but Nancy and Sandy moved from clinical to educational. They talk about why.

26:47 – Both ladies have given back a lot to the profession.

31:59 – Nancy gives her thoughts on what she’s thankful for and what the next generation of CRNAs should be thankful for.  

35:45 – Here’s what Sandy is thankful for.  

37:12 – Sharon has a message for Jeremy.

Ep 52: Should CRNAs Contribute to Roth or Pre-Tax or Both?

As much as you love the work you do, eventually you’ll want to step away and enjoy time to yourself in retirement. But what’s the best way to invest for your future? Should you contribute your pre-tax money into a traditional IRA or is Roth a better option? Let’s discuss all the options available to you and what factors will determine the best route to retirement.

Full Show Notes and Additional Resources: https://beyondthemaskpodcast.com/?p=2200 

Today's Rundown: 

1:52 – Today we’re talking whether CRNAs should be contributing to a Roth or a pre-tax retirement account. Or both?

2:43 – There are two sides to remember to this. First you have Roth IRA vs Traditional (or pre-tax) IRA. And now you have Roth 401k/403b vs Traditional 401k/403b

3:43 – There’s no blanket answer. It’s different for everyone.

4:40 – Let’s start with the Roth IRA. Here’s what you need to know.

6:17 – The big debate is pay taxes now or pay them later. Here’s what you should consider.

8:20 – There’s an opportunity cost for utilizing the Roth. What if you took that extra pre-tax money and invested that elsewhere?

10:23 – What are some other reasons we might potentially choose the Roth?

12:25 – If we know you need to control your taxable income, Roth can be utilized.

14:19 – Planning helps you determine what percentage of your money to put into each account?

15:36 – Why the retirement system is skewed against high-income earners like CRNAs.   

17:02 – How can you save more than the $19,000 limit?

18:55 – Jeremy explains backdoor contributions.

21:22 – Here’s the caveat to the backdoor though.

22:55 – Let’s talk about another option for CRNAs that have 1099 gigs.

25:18 – Can you contribute to both Roth and pre-tax within the same employer retirement account?

26:59 – How healthcare can impact your decision.

29:17 – Jeremy’s goal is to help the CRNA community be prepared.

30:47 – Everyone should have a financial check-up every year.

32:02 – Final thoughts on the topic.

Ep 51: Ronald Caulk, CRNA - An Agent For Global Change

Ronald Caulk poured more than 50 years of his life into being a Certified Registered Nurse Anesthetist and his impact on the profession can still be felt today. Among his lifetime of achievements was his determination to have CRNAs around the world recognized for the work they do. Today we’ll look back at his life and his legacy with Sandy Ouellette, CRNA.

Full Show Notes: https://beyondthemaskpodcast.com/?p=2192 

On This Episode: 

1:59 – Sandy Ouellette back in the studio with us today to discuss Ronald Caulk.

2:37 – Who was Ronald Caulk and what did he accomplish?

5:02 – Most of his level of service at the state level was with the Arizona Association of Nurse Anesthetists.

6:09 – He had many AANA contributions.

7:10 – The establishment of the council on recertification and how he ended up meeting his wife Susan Smith.

10:13 – How did Sandy and Ron get involved together?

10:42 – They began working very closely when the idea of the IFNA began.

12:40 – How the IFNA formed.

15:22 – One of Ronald Caulk’s most memorable experiences happened on a trip to Ghana.

17:47 – Tell us about his contributions to the AANA and IFNA.

21:18 – Sandy tells a story about a time they visited North Carolina and Sandy’s jeep got stuck on the beach.

26:02 – How will Ron be remembered?

Ep 50: Promoting Diversity and Inclusion with Dr. Courtney Brown

The nurse anesthesia profession hasn’t traditionally been a field known for its diversity but that’s something leaders are trying to change. At the forefront is Dr. Courtney Brown at Wake Forest. She joins the show to discuss the importance of recruiting people from all backgrounds to nurse anesthesia and what’s being done to make that happen.  

Show Notes: https://beyondthemaskpodcast.com/?p=2150

Today's Rundown: 

2:16 – Welcome in our guest, Dr. Courtney Brown

3:23 – Dr. Brown has made many efforts to improve diversity and inclusion at Wake Forest and that will be our focus today.

3:46 – Why is this topic of diversity so important for our field?

4:35 – We’re behind many other health professions

6:00 – Explain diversity and inclusion and what they mean.

6:28 – An example of a recent graduate that almost didn’t apply to the program because of the marketing materials.

8:26 – Is there a negative perception of nurse anesthesia due to the lack of diversity?

10:26 – Why do people associate promoting diversity with Affirmative Action?

13:37 – Now that things are on the radar, is progress being made?

16:58 – How does recruitment work and what do you look for?

19:01 – Dr. Brown shares the updated statistics from her program.

20:23 – Explaining pipeline programming and how it works.

23:04 – The balance of male versus female in the profession.

24:49 – What can faculty at other programs do to improve diversity and inclusion?

27:20 – Where can the average CRNA start?

31:52 – What should be a part of the national agenda to assist in diversifying our profession?

27:17 – Final thoughts from Dr. Brown.  

Ep 49: Thanksgiving Day Special: Showing Gratitude for the AANA

Happy Thanksgiving! To celebrate this wonderful day of gratitude, we welcome on AANA CEO Randy Moore and AANA Senior Director of Federal Government Affairs Ralph Kohl to help us give thanks for an organization that does so much for the CRNA profession every year.

Full show notes: https://beyondthemaskpodcast.com/?p=2172 

On this episode: 

1:37 – Thanksgiving morning!

2:00 – We’re thankful for our guests today, Randy Moore, CEO of the AANA, and Ralph Kohl, the Senior Director of Federal Government Affairs for the AANA.

2:35 – This podcast will focus on giving thanks for the AANA.

3:12 – Ralph explains what he’s thankful for.

4:15 – What this organization means to Randy.

6:31 – What mentors – past or current – are you thankful for knowing? Randy first.

8:13 – Ralph on his mentors.

10:23 – What does success look like for the AANA from Randy’s perspective?

11:49 – Ralph’s idea of success.

12:39 – What should every CRNA be thankful for?

14:49 – How would you explain your enthusiasm for the AANA?

18:43 – How do you want to be remembered if you move on, Ralph?

20:55 – What about Sharon, what are you thankful for from the AANA?

22:00 – Jeremy shares what he’s thankful for.

Ep 48: How OSAEMR is Changing Data Collection for CRNAs

Dan Simonson and Jack Hitchens are long-time CRNAs that identified a need in the profession to be able to easily track and manage data. That’s why they created the Open-Source Anesthesia Electronic Medical Record, which they believe provides great value – at no charge – to CRNAs around the world. Find out everything you need to know about OSAEMR and its future.

Full show notes: https://beyondthemaskpodcast.com/?p=2163 

Today's rundown: 

1:55 – Welcome in our two guests, Dan Simonson and Jack Hitchens.

3:55 – Today’s topic is OSAEMR or Open-Source Anesthesia Electronic Medical Record. Here’s some background on what it is.

4:46 – Why is this important for our profession?

5:32 – This even allows you to track your data as a student.

6:26 – This is a project Dan and Jack have worked on for five years. Here’s how it all started.

8:54 – A labor of love for Dan and Jack.

10:21 – It’s been a way for both guys to contribute to the profession and more than 400 CRNAs are using it now around the world.

11:44 – How does this interface with other systems already in place?

13:10 – Have these EMRs been helpful in the development in OSAEMR

15:02 – Is there a reason people wouldn’t want this data out there?

16:14 – What is OSAEMR’s motto relative to data?

17:28 – There’s no data being captured in plastics work but this can change.

20:04 – Pain management procedures are going to be a part of the data collection.

21:09 – Here’s what CRNAs can do to help OSAEMR continue to move forward and grow.

23:04 – There are three versions of the product currently.

25:56 – What are the near-term goals for the product?

26:51 – Final thoughts from Dan.

Ep 47: How Legal Cases Have Shaped the CRNA Industry

We were on location at the North Carolina Association of Nurse Anesthetists and wanted to get a historical perspective on CRNAs. With the help of past AANA presidents Sandy Ouellette and Nancy Maree, we take a look back at the important battles fought and won by nurse anesthetists through the years that help shape the way our industry operates today.

Full show notes: https://beyondthemaskpodcast.com/?p=2167 

On today's show: 

1:37 – We’re recording live from the North Carolina Association of Nurse Anesthetists meeting.

1:51 – Two popular guests, Nancy Marie and Sandy Ouellette, join the show.

2:37 – Sandy highlights some of the past challenges that will help CRNA’s unite and fight future issues.

3:12 – Background on Frank vs South and why that decision is still important today.

5:04 – The next important case involved Dagmar Nelson in the 1930s.

6:34 – The road to reimbursement was a 7-year process in the 1980s.  

7:50 – How the ANA helped turn around the industry when it began dying out in late 80s.

9:25 – The ongoing issue of federal supervision of nurse anesthetists in Medicare. Why we need to remove it and what role states are playing.  

13:31 – ANA threw their support behind antitrust cases.

18:06 – Antitrust fights still go on today.

19:24 – Nancy explains the antitrust and fraud case against Twin City Hospitals in 2004 and what came from it.

23:42 – What role has the ASA played in all of the challenges and crises the industry has faced?

26:30 – The recent Anesthesia Care Team statement and why many believe it’s restrictive.

29:13 – What can ANA members do today to help the association succeed and remain strong moving forward?

30:36 – Why membership is so important for ANA.

32:24 – New students and new graduates seem to be the biggest hole in membership.

36:20 – Can the ANA be listening to members better? Here are issues they have spoken out on.

40:24 – Jeremy’s perspective as an outside on the membership issue.

44:11 – Final thoughts from Sandy on why it’s such a great time to be a CRNA.  

Ep 46: Employment Contracts – Prevalent Issues with Mark Silberman

Accepting a new job is such a rewarding feeling that motivates you to get to work and continue growing your career, but understanding your employment contract first is vital. Mark Silberman, legal counsel for the AANA, will break down the specifics of a contract, what you need to know, and how to protect yourself. Plus, he’ll help us understand the different types of employment statuses and which is better for CRNAs.

***CE CREDIT ALERT: Did you know you can get continuing education credit from the AANA for listening to this episode? Go to https://knowledgenetwork.aana.com/home to get the details and get your credit today! And see a list of other episodes that qualify for CE credit here: https://beyondthemaskpodcast.com/series-ce-credit

Show Notes: https://beyondthemaskpodcast.com/?p=2142

Today's rundown:

2:29 – Welcoming on our guest today, Mark Silberman, who is legal counsel for the AANA

3:05 – What we’re talking about on this show and why it’s important.

4:17 – Mark breaks down the parts of a contract and what you need to know about one.

5:45 – A real-life example from a CRNA of a contract that didn’t get put in writing.

6:47 – Let’s define the differences between an employee and an independent contractor.

9:08 – Mark explains independent contractors even further.

10:20 – Trying to understand why some independent contractors are classified that way when they appear to be an employee.

12:02 – It all comes down to what is the intention.

13:16 – You have to remember that employers will almost always have leverage because they hold the commodity: the job.  

13:57 – Define ‘employee at will’ and how many states have that status.

15:48 – What’s the difference between job description and employee contract?

16:59 – Job descriptions are not enforceable. The contract specifics are.

18:02 – Does every CRNA need a contract?

20:06 – The biggest mistake people make when they’re looking at a contract.

21:44 – What are the most important things CRNAs should pay attention to in a contract?

20:07 – Can you re-negotiate your contract?

24:31 – Let’s talk non-competes. Every state has its own interpretations of these.

27:46 – How do we find out if these non-competes are enforceable?

29:12 – What happens when a new employer takes over?

31:39 – Should Independent contractor CRNAs incorporate for protection?

33:11 – Final words of wisdom for CRNAs entering a contract.

Ep 45: Empowering Nurses in Electoral Politics

Nurses have all the right attributes to be successful in politics but there are so few in office around the country. We want to help change that by empowering nurses to feel confident and comfortable running for office. We’ll spend this episode discussing why it’s an important topic and we’ll learn more a new campaign school that Sharon Pearce and Kimberly Gordon are working to launch in 2020.

On this episode: 

1:52 – Introducing our topic and our guest Kimberly Gordon.

2:19 – Sharon talks about what her and Kimberly have done together in the past.

3:45 – Why is this topic so important?

4:57 – Only two nurses serve in office at the Federal level right now.

5:21 – Why aren’t there more nurses in office?

7:01 – North Carolina has three nurses in state legislature, including Gale Adcock.

8:10 – Who are the two nurses on the national level?

8:52 – Neither of those are advanced practice nurses, which we’ve never had at the Federal level.

10:01 – Let’s talk about the breaking down barriers project Sharon and Kimberly are working on at Yale.

12:37 – We’ve met nurses from all over the country and they feel like this is very important.

13:40 – We as nurses are really late to this game. Physicians have been training people for politics since the 70s.

14:34 – Is it intimidating for nurses to consider running for office?

15:35 – Occupation-specific schools have become popular for a reason.

16:29 – A huge barrier is we don’t like to ask for money or help and that’s an issue.                                                                                                                   

18:41 – We’re not asking people to run for governor. We want to build a pipeline that starts in county commissions, school board, places like that.

19:32 – Maybe one day we’ll have a nurse as president.

19:55 – What kind of timeline are we talking about for this project?

20:34 – Yale has provided so much acceptance and assistance through this process.

21:39 – “If you’re not at the table, you’re on the menu.”

22:51 – Applications open on January 1, 2020.

Get the full show notes and additional resources here: https://beyondthemaskpodcast.com/?p=2135

Ep 44: Medicare Decisions For The Retiring (or Retired) CRNA

Retirement means many different things but one of the most important is transitioning to a new healthcare plan. For many people, Medicare becomes the best option but it can be difficult to sort through and understand. Who is eligible? What are my options? How much are premiums? We brought on Medicare guru Joanne Giardini-Russell to clear up a lot of questions for us.

On this episode: 

1:51 - Today we're talking about Medicare decisions for the retiring or retired CRNAs.

2:48 - Our guest today is a Medicare expert, Joanne Giardini-Russell

3:29 - Joanne gives us her background in the industry.

5:47 – Let’s start with the basics: what is Medicare?

7:09 – Who is eligible for Medicare and is it mandatory?

8:22 – If I’m still working at 65, does that effect anything?

9:44 – You don’t have to take Medicare at 65. It’s important to know that everyone’s situation is different.

11:14 – Understanding how the Health Savings Account plays into your decision.

11:54 – A lot of people don’t understand that premiums are income-related.

13:09 – When you start talking about retirement, planning needs to begin as soon as possible to work through options like these.

13:43 – Your HSA contributions get taxed and many people don’t know that.  

14:40 – What does the acronym IRMA mean?

17:51 – Client story about a couple found out they were paying more than they needed to for premiums.

19:35 – Are there other costs for Medicare beyond the premium?       

21:11 – You have two choices to handle the 20% beyond Medicare’s coverage.

23:02 – What are the pros and cons of the Medicare Advantage plan?

25:27 – What else does a CRNA need to know after they enroll? Let’s talk basics.

27:22 – If you’re over 65 and you’ve enrolled in Medicare, can you make changes or are you stuck?

28:44 – Pre-existing conditions do come back into play with Medicare.

29:33 – It’s very important to know that people with pre-existing conditions have one shot to get into Medicare. Here’s what you need to know.

30:23 – How much flexibility do you have in picking an insurance carrier?

32:29 – What are my annual requirements with Medicare coverage?

35:19 – Final thoughts from Joanne

Show notes and additional resources: https://beyondthemaskpodcast.com/?p=2123

Ep #43: The Future of Healthcare with Steve Mund

What does the next 5, 10, 20 years look like for the healthcare industry? That’s a question everyone would love an answer for, but there are many opinions out there. We sat down with Steve Mund to pick his brain on everything from insurance to costs to payments and more.

On this episode: 

1:59 – Introducing our guest on this episode, Steve Mund.

2:29 – Sharon shares some background on Steve.

4:24 – It’s an interesting time in healthcare and there’s no way to predict how it will change in the years to come.

6:57 – How to be a problem-solver for your department.

7:58 – The three payment models healthcare needs to engage in for the future.

10:14 – What about the accountability on the patient side?

11:19 – The providers get penalized but what about the payer?

12:57 – Jeremy shares a recent discussion he had with an insurance executive about drug costs.

14:01 – Let’s talk about mergers. Are their benefits to these large mergers?

14:59 – One prediction projected operating margin to be -16%.

15:55 – The length of stay can be an area of improvement potentially.

16:47 – Hospitals only operate on a 2.5-4% margin.

17:41 – Where is all the money going?

20:04 – What factors are driving the utilization of healthcare?             

22:03 – What does Steve see as the future of healthcare payers?

23:36 – The best way to stay informed is Becker’s Review.

25:29 – How do you determine value in healthcare these days?

26:58 – So how can providers show their value to their organizations?

27:42 – How can we help cut down on waste in financial, clinical and personnel areas?

29:16 - The waste isn’t always about money, it’s also about time.

30:40 - Some final thoughts from Steve.

Show notes: https://beyondthemaskpodcast.com/ep-#43:-the-future-of-healthcare-with-steve-mund/2115/