Beyond The Mask: Innovation & Opportunities For CRNAs

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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 to get the details and get your credit today! And see a list of other episodes that qualify for CE credit here:


Show Notes:


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:

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:

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:

Ep #42: The Role of Nurse Practitioners in Healthcare

Nurse practitioners play such an important role in healthcare so let’s learn more about the profession. The CEO and president of the American Association of Nurse Practitioners join us on this episode to share their accomplishments, challenges, and goals to improve the industry and empower their nurses. Did you know the CEO of the Nurse Practitioners used to work for the AANA? Come join us for a great conversation. 

Here's what we have on this episode: 

1:46 – Welcome in our guests Sophia Thomas and David Hebert

3:06 – What is a nurse practitioner?

4:44 – Tell us more about your organization, AANP

5:47 – Sophia explains how the AANP is structured.

6:44 – David talks about his role at AANP and a little about the role of nurse practitioners.

8:41 – Why lobbying is so important in this line of work.

9:27 – The AANP has really increased their PR and media efforts in recent years.

11:31 – What are the challenges facing nurse practitioners today?

12:29 – David explains why nurse practitioners should be able to work independently.

14:23 – 28 states still require some sort of collaborations and that makes it difficult on NPs.

17:15 – It’s important for everyone in the profession to understand the issues and then get involved politically.

20:02 – Sharon talks about her goals to get nurses involved in the formulation side of the profession.

22:57 – We want to empower nurses to do more than just work and go home.  

23:46 – Quality and cost of healthcare is important to consumers, but so is convenience. These are things that nurse practitioners can provide.   

27:01 – A unified voice in the profession is very important and that’s the goal of the AANP.

28:26 – How does your credentialing work?

30:40 – What is David most proud of in his role at the AANP?

31:51 – David shares his history with AANA and what he remembers about that role.

34:18 – Some final thoughts from Sophia on the history of the profession.  

To get the full show notes and additional resources from Beyond the Mask, click here:

Ep #41: The Importance of Getting Involved with Joe Rodriguez, CRNA

We always talk about the importance of community within the CRNA profession so let’s take it a step further by discussing how and why you should get involved. There are varying levels of involvement, as we’ll get into, but Joe Rodriguez will help us understand what your participation means to the industry.


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


Show Notes


Today's rundown:

2:20 – Introducing our guest today, Joe Rodriguez.

3:08 – His topic today is ‘getting involved.’ Here’s why it’s important.

4:07 – Participating in community at work versus neighborhood is a little different for Joe.

5:09 – Have you always been like this or did you develop this interest in getting involved?  

7:25 – Should everyone be as engaged as Joe? What’s the happy medium?

9:18 – How many CRNAs total compared to AANA members?

11:16 – What is the average CRNA career worth?

12:17 – Do you remember MI 68? Their story shows why it’s important to be engaged.

13:00 – Sometimes people just need to be asked.

14:23 – Why Joe is so passionate about all these regulatory issues.

15:37 – How do you overcome an opponent that’s better funded?

19:12 – Highlighting the progress that Joe has seen through the years.

21:27 – How do you balance your time to get so much accomplished?

23:43 – If he wasn’t a CRNA, Joe would be a lawyer.                           

26:30 – What advice would you give people to get them involved? And specifically for people at different stages of their career – early, middle, late.

Ep #40: Strategies for Handling Media Interviews with Communications Expert Chris Bettin

As CRNAs, we don’t have a lot of experience dealing with the media or being in front of the camera. We’re used to working behind closed doors and out of the spotlight. But there are times whem we’re called upon to be a spokesperson for a place or an event. That’s why we brought on a public relations specialist to give us tips and techniques that make us feel like the experts we are.

Today's rundown: 

1:38 – Chris Bettin is our guest today.  

2:21 – Some background on Chris

2:48 – Chris about to head off on a new endeavor in PR.

3:27 – Why we’re talking about spokesperson training today.    

4:23 – How do you deal with the media and why it’s so important for CRNAs.

5:07 – Every CRNA is a candidate to be interviewed.

6:05 – Scenarios where CRNAs might be called on to be interviewed.

7:21 – What you need to understand about reporters.

8:18 – The biggest fears we have in an interview.

10:15 – Things that Sharon has learned from Chris.

11:35 – The message you’re trying to deliver is critical so don’t wing it.

13:47 – Have a built-in answer ready to give you time to gather yourself.

15:47 – Three techniques for navigating an interview: flagging, hooking and bridging.

20:47 – How can you control your nerves in front of the media?          

21:39 – Do’s and Don’ts of spokesperson training.              

23:20 – Any other techniques you want to share with us?

24:28 – More on Chris’ new company, Crossdot Communications.

Get the show notes and additional resources here:

Ep #39: Understanding Legal Implications of Anesthesia with Lynn Macksey

Lynn Macksey, CRNA, has been an expert witness on more than 50 cases and she’s bringing that knowledge to the show to help us understand the legal side to the profession. She’ll share what she’s learned through the years that will help you protect yourself and keep your name out of a case.  

Today's rundown: 

1:47 – Lynn Macksey is here with us today to talk medical legal implications in anesthesia.

2:18 – Some background on Lynn.

2:32 – How she decided to make the transition into anesthesia after 20+ years in ICU.

4:43 – Why this topic today is so important.   

5:29 – Keeping yourself from being named in a case is so important.

5:59 – What are closed claims?

8:14 – Lawsuits now include everyone that has control.

10:08 – What are the reasons for surgical or anesthesia related lawsuits?  

13:07 – The four elements of a medical malpractice case that must be present for negligence.

14:54 – What specific cases have you been involved in that might have changed your practice?

18:13 – A story about a former Saturday Night Live cast member.  

21:02 – We learn so much from our mistakes.

23:37 – What range of money is involved in these types of cases?

25:48 – Final thoughts from Lynn on this topic.

Get the full show notes and additional resources by clicking here. 

Ep #38: Courage to Lead: A Conversation with Former AANA President Terry Wicks

Our first installment of the presidential leadership series begins with a conversation with former AANA president Terry Wicks. His decorated career includes this year leading the organization in 2006-07, and we’ll go back with him to discuss the highlights, the challenges, and what he still remembers about the experience. You’ll enjoy some great stories along the way.

The rundown for today's episode: 

1:53 – Welcoming Terry Wicks to the show.

2:19 – Introducing the Presidential Leadership Series we’ll be doing.

3:26 – Sharon has a story about Terry she wants to share first.

5:02 – Terry talks about the new endeavor he’s taking on at UNC-Greensboro.  

6:14 – Highlights from his year as president of the AANA from 2006-07

8:52 – There were some challenges as well.   

10:28 – We want to do this series to teach people about the history of the industry and those that have impacted CRNAs.  

11:45 – The accessibility of leaders has been so rewarding.

13:17 – What Terry enjoyed best about being the AANA president.  

14:40 – What the travel is really like for an AANA president.  

16:32 – Another unforgettable story that Terry will always remember.  

18:14 – What advice would you give an incoming AANA president?

20:20 – What ways did your experiences shape your participation in the AANA after you left office?

22:30 – Helping people deal with substance abuse has become a passion.  

23:46 – What advice would you share with new CRNAs?

25:09 – Is there another profession you’d like to be a part of if you had your choice?

26:50 – Some parting words from Terry.  

Get the full show notes and additional resources by clicking here. 

Ep #37: Spotlighting the IFNA – A Global Anesthesia Community

The International Federation of Nurse Anesthetists is celebrating 30 years as an organization in 2019 and we had the chance to spend some time with four current board members and one past president. During this episode, we had the chance to talk about the IFNA’s history, its mission, where it hopes to go in the future, and much more.

Check out the full show notes by clicking here. Read the rest of this entry »

Ep #36: First Impressions – How to Prepare for Your Interview with Laura Ardizzone, CRNA

Whether you’re looking for that first CRNA job or you're a veteran in the industry, the interview process can be stressful. It’s easy to question yourself and your preparation. That’s why we wanted to bring on a guest from one of the country’s top medical centers to give you an inside look at the interview process and share tips to help you land your next job.

Visit the Beyond The Mask Podcast website...

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Ep #35: The Relevance of Nurse Anesthesia in Evolution of the Profession

There’s some concern in educational circles that the history of nurse anesthesia has lost importance during the evolution of the profession. We want to dive into that topic today and explore the history, accomplishments, and milestones with two experts on the subject. Sandra Ouellette and Evan Koch will provide historical insight and some wonderful information on this episode.

Check out the full show notes by clicking here. Read the rest of this entry »

Ep #34: To Block or Not to Block: The Story Behind the Block Buddy App

Peripheral nerve blocks are a growing type of regional anesthesia and there’s an app out there that serves as a reference guide for CRNAs. We brought on Block Buddy co-founders Scott Urigel and Jeff Molter to find out how the idea was developed and how it’s benefiting the industry.

Check out the full show notes for this episode by clicking here.  Read the rest of this entry »

Ep #33: Understanding Malpractice Insurance Options with the AANA’s John Fetcho

Protecting yourself should be a priority for every CRNA and often times it’s easy to think that you’re already covered. But there are many options to consider with malpractice insurance, from the policy type to the company that you purchase the policy through. John Fetcho, Director of AANA Insurance Services, joins us to these differences and clear up any misconceptions we might have.

See the full show notes on our website here. Read the rest of this entry »

Ep #32: Tom Baribeault - Opioid Free Anesthesia

This week, we have the pleasure of speaking with Tom Baribeault, Chief CRNA at Lexington Surgery Center and Founder of the Society for Opioid Free Anesthesia (SOFA). He discusses his personal experiences with eliminating opioids in his own practice, and the challenges of breaking away from standard anesthesia practices. Tune in to find out what kind of opoid replacements are being used, as well as how you can begin to implement non-opioid strategies with your patients.