CRNA 48 | SRNA Survival Guide

As a brand new SRNA, you likely feel a little overwhelmed and intimidated by the road ahead. Whether you’ve already gained acceptance or are just looking to be as prepared as possible while applying, we’ve got you covered!

Today, we are joined by Ashley, Evelyn, and Ruben (current SRNAs) who are sharing their BEST new SRNA survival tips for making your transition into school as smooth and productive as possible. While each guest comes from a different background, they have unique, top-notch advice for setting yourself up for success!

In this episode, Ashley, Evelyn, and Ruben do a deep dive into-

  • Preparing (mentally, emotionally, and socially) for school in the time between acceptance and starting your program
  • Effective tips for setting up your support system and managing social/family expectations
  • Invaluable tech tools, apps, and additional outside resources that you can utilize as an SRNA
  • Designing an efficient study space and creating effective study groups
  • A real and raw discussion about how much free time you’ll have (+ how to best use it!)
  • The importance of creating a wellness plan to manage stress and mitigate overwhelm
  • Key factors you NEED to consider when financially preparing for school

So take a deep breath, and know that you’ve been accepted for a reason, future CRNA! You’ve GOT this! Happy preparing!

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Evelyn @egayle94

Ruben @lubahn

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NEW SRNA Survival Guide With Current SRNAs Ashley, Ruben & Evelyn

This is a special guest episode. We have three guests, which is so amazing and awesome. I want to give you an introduction briefly, and then I’m going to have them tell you a little bit about themselves. In this episode, we’re going to talk about a new SRNA survival guide. If you’re newly accepted or a new student looking for great resources and hearing from vetted experts who have been through the program or are a year and a half in, this is the episode for you. We have Ashley, Evelyn, and Ruben. They are three SRNAs, and all three of them attend Texas Wesleyan. I’m going to let them tell you a little bit more about their nursing background and why they want to pursue CRNA. Ashley, go ahead and take it away first.

I started as a telemetry nurse. I was there for about two years. Shortly after, I went to a pediatric hospital and worked in their cardiac cath lab. That is where I very first saw CRNAs working. That’s what piqued my interest. After probably about eight months, I quit and went to pursue a job in the ICU. There, I went to cardiac ICU for about three years by the time I quit to start CRNA school. Seeing CRNAs live in action is what piqued my main interest.

That’s awesome. I love my cath lab nurses. They know how to hold the jaw thrust. You’re usually over in a no man’s land. Usually, when you get in trouble, you need some help right away. I used to love working in the cath lab with those nurses. I remember mock interviewing you in your car. It’s fun to see that here you are.

It has been great.

Evelyn, go ahead and tell us a little about you.

I worked at a children’s hospital. I worked in the NICU. I was in Level IV NICU for about four years. It was very different. I was following one of my patients to heart surgery. That was where I was first exposed to anesthesia. It wasn’t a CRNA, but I still got to see what was happening at the head of the bed. That’s where I fell in love with the idea of going to CRNA school.

I’m a pediatric CRNA, so you feel your heart with those little babies. They’re so precious. Ruben, I’d love to know more about you and your background.

I’ve been practicing for years. I initially started in the emergency department right out of school. After about a year of that, I transitioned over to the ICU. It was very cardiac-heavy. We did a lot of CB stuff, recovered post-op CABGs, and whatnot. I did that for a few years and traveled around for a year. I then decided I wanted to get back into school.

After some searching and a brief stint in informatics, I was like, “This is not for me.” I opted to go to anesthesia. What sparked my interest in it was some years ago; I was part of a medic school prior to RN school. While I was doing my rotations in OR, trying to get all my intubations in, I was shadowing a CRNA.

At that point, I didn’t even know it existed that a nurse could practice anesthesia. What fascinated me was the GI case. The patient crashed. Seeing him take the helm, work that patient up, and get a pulse back boggled my mind. It’s something that I’m glad I thought of later on down the line. I automatically told myself I wanted to pursue that, and here I am now.

When being a CRNA, make sure to take some time off to exercise and spend quality time with friends and family. Click To Tweet

I love that you guys have all had different backgrounds. I want to point out some things that I have picked up on. A lot of you guys didn’t start off in an ICU unit. Ashley mentioned cath lab, and Ruben mentioned ER, but ER isn’t always considered an ICU for a lot of schools. You made the transition to the ICU, and so did Ashley. Evelyn had a NICU experience, which not all schools take, but you owned that experience. You made the best of it and still were able to gain acceptance.

I want to point out those factors to everyone reading. I also love how you each have had an encounter with a CRNA, which stems from why you chose to pursue it. This is important, and this is also why I stress shadowing experience even if you don’t necessarily run into a CRNA in your work environment. It allows the panel interviewing you to see, “They’ve seen us in action. They know exactly what we do. They know what they’re getting themselves into.” It also makes it relatable and goes to show your unique passion for wanting to pursue the field.

I love the fact that you were a paramedic, and a CRNA taught you how to intubate and you got to see a CRNA manage a crashing patient an endo. That would have had to be a nightmare. Thank you guys for sharing that. All of you are in the same year. You’re about a year and a half in, starting clinicals in January 2022, which is exciting. As for you guys that are reading this, they’re starting clinicals as we speak. I’m excited for you guys.

Let’s go ahead and get into the episode. Let’s talk about some of the first things you guys did when you gained acceptance. I had an episode not too long about how you got in, and you’re like, “Now what?” Many of you guys are already natural overachievers. I hate to say it, but you are, and I’m in that same category. We’re always wanting to do more. While I try to tell people to take a deep breath and relax a little bit, I understand that passion for wanting to brush up on maybe old skills or maybe seek out IVs, or study up your pathophysiology, pharmacology, and whatever it may be. I’m curious. Did you guys do any of those things?

I looked into a few things like chemistry, some of the math, and medication math. Quite honestly, I don’t know how much help it did for me because, by the time you start, you’re always on the go. They teach you exactly what you need to know. Maybe briefly looking at something helps spark your memory, but I wouldn’t say that it helped me in a big way with those classes going forward.

Chemistry and anesthesia school is so specific. If you try to dive back into your old chemistry, you’re going to be wasting your time on stuff that you don’t need to know for CRNA school. The type of chemistry you need to know is tailored to CRNA and anesthesia. You won’t know what that is unless you’re in the program.

That’s why it could be hard to pick a topic or a subject like an Anatomy or Pathophysiology and know exactly what you need to know because schools dive into those topics and pick out specific things. You’ll find med math helpful when you start clinicals. I’m sure you’re already doing it. That’s interesting. What about you, Evelyn? Is there anything that you did when you got accepted?

I am with Ashley. I did a little bit here and there of math, but it didn’t help either. Mainly, I focused on habits. I set up my schedule of how I was going to study and did blocks. I did two-hour blocks of focusing on a task and then went for a walk for ten minutes to switch my brain on and off. That helped. It’s a big shocker. When you first get in, it’s an overload of information. Creating a path for myself throughout the days was helpful for me.

I have the analogy of drinking from a fire hose. That’s awesome. I love how you focus on your habits. That’s great advice for those of you. If you don’t already have a good study plan in mind, or maybe you don’t even know how you got through your BSN or your ADN, maybe you’re like, “I don’t know how I did it, but I did it,” start honing in on that and start thinking about how can you set aside dedicated time. I also like how you mentioned you took a break because when you’re mentally fatigued, you might as well not even bother trying to study. You won’t be getting anything out of it.

I took a lot of breaks.

CRNA 48 | SRNA Survival Guide
SRNA Survival Guide: When you first get into CRNA, you need to focus on your habits and schedule. It’ll be an overload of information. So you need to create a path for yourself throughout the day.

Sometimes, they don’t even have to be completely zoned-out breaks. A break for me was going to the gym, but I would study at the gym. That felt like a break because I was doing something enjoyable. I was moving my body and getting some pent-up anxiety and energy out that way, but I was learning at the same time. You don’t always have to zone out completely. Don’t get me wrong. My advice is Candy Crush, which I probably wouldn’t recommend, but we all have something that we waste our time on. I love that. What about you, Ruben?

To tack on what both Ashley and Evelyn said, I went back through all my CCRN stuff. I tried reviewing that. I tried memorizing exactly the cardiac cycle and being able to draw it out. I tried focusing hard, but as Ashley said, nothing would have prepared me for those first few days at class. You get the little orientation, but as soon as that’s over, it’s pedal to the metal. It’s information overload. It’s not something that you can prepare for. You pretty much have to go with studying what the professors hand you because there’s so much, and you have to focus on it.

It’s a tailored plan. That’s why for a lot of people who are trying to study on their own prior to school, unless you have a very outlined plan to study and know exactly what you need to study, I would 100% agree. We hope to come back to that a little bit in the fact that we know what you guys need to know. We’re hoping to change this maybe a little bit, so there are some tailored resources for new students. It’s coming down the pipeline.

I hear that a lot from students because there’s no path. It’s like, “Here’s all CCRN information.” That’s a lot of information to study, and not all of that is pertinent to what you need to hone in on at the beginning of school. They don’t talk about Boyle’s Law when you’re getting your CCRN. Thank you guys for sharing that. I hope that gave a lot of the readers some insight.

One of the key things you can do, and I know it’s probably annoying to hear this over and over again, is to relax and talk to your family. Communicate with your friends, family, and anyone who will listen to you. Let them know about what you’re getting ready to endure for the next three years of your life, how “no” is going to be the more common answer and not to take it personally. Did you guys have those conversations with your loved ones?

Absolutely. I got married back in July 2021. After I got accepted, we had a talk. I told her straight up, “This is going to take a lot of devotion and time. I hope you understand that there are going to be times when I can’t go out with our friends. I’m going to have to study.” She was all nonchalant like, “You’re going to study.” The first semester was rough, but a lot of talking sessions got us through. Fortunately, we went through our marriage, and we’re happy. Talk with your loved ones. At the same time, you can’t ignore them, but have them understand that it’s going to take a lot of time, devotion, and hard work and that you need their support as well. You need a substantial support system.

It’s give and take. They have to be understanding. What about you, Ashley and Evelyn?

Thankfully, my boyfriend had gone through a pretty rigorous PT program. He knew what was expected or what to expect from me and not to see me or me not being able to go and do things. It was helpful to have a partner who has gone through something similar with the time demands, but it still requires work as Ruben said. You can’t not give anything to the relationship because they’re going through it with you. You have to make that time for them as well to make sure that they know they’re important in your life.

Evelyn, do you have anything to add?

My boyfriend works remotely, so he was able to come with me. It was a big blessing. Our quality time was tailored toward school. We would take walks, and he would quiz me while we were walking. That helped create some time for us. My family lived six hours away. It was far. I had to prep them like, “I’m not going to come home every holiday. Check up on me, but don’t expect me to do long talks.” It was a big adjustment for me as well.

Looking into chemistry or math won't really help you much in CRNA classes. Because by the time you start, you're always on the go. Click To Tweet

I love that you guys all did these steps. I’ll never forget my husband when I was in school. There would be so many times when he’d be invited from a church youth group. They’re like, “Can you come to do this?” I’m like, “I want to do those things, but you know the answer is no.” We don’t argue a lot. We had plenty of disagreements, but I don’t like arguing. I got upset because he kept asking me to do something. I was so tired of saying no. I was upset that I had to say no. I was like, “Stop asking me. You know what the answer is, no,” even though I didn’t want to say no.

You’re torn, but the payoff is huge. When you’re done with school, you can have that honeymoon. You can get back to that quality time. Take a nice, big trip together. Let them know that’s coming too. If you’re reading this and have kids, say, “After mommy or daddy’s done with school, we’ll go to Disney World,” or wherever you guys want to go for a family trip. It could be to the beach or some trip that maybe you’ve been putting off. Get them involved and get them excited for the end. Let’s go on from here and talk about what were some tech tools that you guys could not live without.

All three of us had tablets. They were lifesavers because you didn’t have to worry about printing paper. You can transfer all of your PowerPoints and notes over to your iPad. You don’t have to buy highlighters or markers because you can do all of that in different colors if you have a pencil. Overall, it saves time, money, and other little things you might need if you were to have just paper. We had some people who printed off every single PowerPoint. They were thick packets, so it was a lot of paper and ink. It was a lot easier for me, personally, to have the tablet.

I use a combination of handwritten notes versus typing in it. I ended up going with typed notes because I could control F and search through tons and tons of pages of notes to find a certain section. That was helpful for me too.

I do have a tablet, but in those first few weeks of school, I was very stubborn. I’ve always been the paper and pen type of person who writes notes, but after the first few weeks, I knew it wasn’t going to stand. I had to get an iPad. It was the most invaluable thing that I’ve had. You could put so much information on it. There are so many different applications. I would say to invest in one of those that’s a good one.

Which one do you guys have? Does anyone want to share?

I have an older version of the iPad. It was 2018, so it still has some newer features. Go for anything where you can use an Apple pencil or any type of a stylette because it’s very useful.

The iPad sounds like that’s a must. I love how you mentioned typing out your notes and searching with control F. I’ve known about that feature; I needed it, and someone had to remind me, “It’s control F.” That is a great point. I did everything handwritten in school so much that I remember getting cramps in my hand because it was so much writing. Half of my notes are not even halfway spelled out. They’re made-up words that I’ve jumbled together because I was writing so fast. I don’t know how I could read them, but I did.

I was trying to find something that I was looking for, and it was so hard to do that with written notes. You’re spending time looking for things. I love that. Not having to buy paper or highlighters and being able to use the pen to do all those things are all great points. You mentioned apps. Ruben, what are some of your favorite apps?

My favorite is OneNote. I know it’s a bit controversial to use a Microsoft application on an Apple product, but it works fine for me. It’s a big old notepad. It goes for an infinite amount of time and however many notes you can put on it. That’s the one that I use. The other one is AnkiApp. That has been our go-to these past few semesters.

CRNA 48 | SRNA Survival Guide
SRNA Survival Guide: The Notability app on the iPad is great for taking notes. If you’re someone who likes to write out your notes, you can search your handwritten notes on the app. It can register your reading.

What about you, Ashley?

I use Notability on my iPad to do my notes. You can probably do it with OneNote as well. If you’re someone who likes to write out your notes, you can search your handwritten notes on the app so that way, it can register your reading. If you’re like, “Where did I put that note?” you can type it in the search bar, and it will pop up.

It will do your handwriting and whatever you typed out on there as well. Another tip about that is it’s helpful with anatomy images. If you’re trying to remember what a certain part is called, you can use a white marker and write out the name. You can then go back and fill in the blank. You can then easily erase all of it and go back and do it again. That’s useful.

How about you, Evelyn?

I used what Ruben had. I used OneNote for probably two semesters, and then I switched over to Google Docs. I have all of my typed-up notes in Google Docs so I can pull up everything. I’m hoping that when I go to clinical and need to find something, I can type it into my phone and pull up all of my notes if I need to.

I love how you guys all have something different too. That’s neat to hear your perspective. Notability sounds awesome. Another feature about Notability that is good is you can record your lectures live. You can play back, and they’ll go to that part of your notes that it’s playing back so you can watch your notes in real-time. One of the things I did when I was in school to study was to re-listen to my lectures and then retook my notes. Every time I would do that, I’d realize how much I missed the first time around.

Re-listening to lectures is a big key.

You mentioned some other apps, but you also have a physical whiteboard.

A large whiteboard to draw things or write things out over and over again is extremely helpful.

Have you seen the ones that are see-through or clear, and you write with neon pens?

Tablets save time, money, and other little things that you might need if you were to have just paper. Click To Tweet

That’s pretty.

It’s neat that they have that. There are a bunch of different options depending on what you like. Let’s talk a little bit about study groups. We mentioned AnkiApp, but also Quizlet is another one too. There’s also Notion. Is Notion a quizzing platform?

It’s more of note-taking.

It is like Google Docs in a way where you can make your own questions and put the answers to them.

There’s a toggle feature where you can write out the question and then toggle down to see the answer. You can do interactive note-taking if that’s your style. We used that for maybe a semester or two but ended up doing AnkiApp. All three of us did an AnkiApp group.

There are a bunch of options out there. How do you guys structure your study groups?

I don’t think we ever got to meet up as a study group. We had separate study groups outside of class, but we did note-taking where we would listen to the dictation from the lectures and then create AnkiApp notes through that, and then we would share them. I had a separate study group that I would meet up with before tests, but I did a lot more self-study too.

Is that how you guys do it, too, Ashley and Ruben?

I didn’t do a whole lot of study groups. I did a lot more self-study, but I have a roommate who is someone else in my class, so it’s easy to bounce ideas or recheck information with them. Everyone in the programs will say it’s crucial to have a study group or other people that you can talk to and ask questions about because there is sometimes information that you heard differently, or they can explain it to you in a different way.

I will tack onto that. I was with Evelyn in the sense that we would have our AnkiApp group. I have my own little study group as well that we would get together. I would recommend that if you do a study group, don’t do a large study group. Some people would get together with 8 to 10 people at a time. When too many people join in, it turns into a social hour. It isn’t turned into a study. I would say the max is about four people. Sometimes, you will miss something in the lecture, or you don’t understand something, and they’ll be able to elaborate more or explain more to where I can understand it, and then it will click.

CRNA 48 | SRNA Survival Guide
SRNA Survival Guide: If you’re going to do a study group, don’t do a large study group. When too many people join in, it turns into a social hour. It isn’t turned into a study. Max number of people would be about four.

Everyone learns a little bit differently. They might have learned a topic differently or understood it differently. It will give you a different way to understand it yourself. I love how you mentioned keeping it small. That’s 100%. Maybe also avoid wine. In the pre-pandemic era, I had a group of people that I would meet with. If we got a little too out of control with the wine, it was nice and fun, but it wasn’t conductive.

What we did was we would commute to class. We had a two-hour drive to class. We would do it for four days a week, so it was a lot. There is a lot of intimate time being in a car for four hours, four days a week. We would quiz each other on the way to class, so it worked out well. We had a study guide, and we would ask each other questions. I encourage you if you guys can do that. They may know the answer to a question that you don’t know, and then you can ask them to explain it. It’s a way that you can study from someone else.

I like how you mentioned splitting up the AnkiApp flashcards. You’re going to go through the whole notes yourself, but that’s what I want to caution you about. Do not rely on other students to do work like that for you if you know it’s going to help you to do everything yourself. It’s the same thing if you have a study guide. Don’t split it up with a classmate because you’re going to miss out on your learning information by doing the study guide.

Flashcards are different, but mostly, I want to point out the study guide. Make sure you’re taking the time to do your thorough homework and doing the whole study guide yourself versus relying on splitting it up with people. I like all the other tips you guys gave us. It’s excellent. Let’s talk about some YouTube videos or podcasts that you guys utilize in addition to your lectures to help you.

I personally would use a YouTube channel called NYSORA. He’s an anesthesiologist, and he will speak about regional blocks. I’ll tailor his videos to what we’re learning in class. There’s a slew of videos on his channel that you can look at. That’s predominantly what I would use. There is also another one, but I can’t remember the name. I’m sure Ashley or Evelyn will bring it up, but he’s a PA.

It’s Ninja Nerd. I used him a lot too.

I heard a lot about him. Kenhub is another one. There is also one called MedCram. There are all kinds of good ones. I don’t know if you guys have a blog post on this stuff. Do you have a list of anything that you guys have?

We have a podcast list. It’s the top ten anesthesia podcasts that we have thought have been useful. I know Evelyn and I do podcasts a lot to multitask. If you’re going out on a walk because you need a break from your office or your desk, or if you’re working out, it’s another way to try and remember that information without looking at your laptop or re-watching a lecture or PowerPoints. It’s been nice to have another resource that you can use and listen to.

One of them is ACCRAC.

That was one of my favorite podcasts to listen to because there were condensed, very specific things that we could take away from it.

It's crucial to have a study group or other people that you can talk to and ask questions. Sometimes your information can be wrong. Click To Tweet

APEX Live has a good one for more board prep. There are a lot of good ones out there. I created this ultimate resource guide that has podcasts, apps, books, and YouTube channels. I can always link that to you guys if you don’t already have that guide, but it has a bunch of them. I need to add SEDATION NATION on there too.

There’s a plethora of information. It doesn’t mean you have to utilize them all. Honestly, I would suggest not trying to use them all because you’re going to spread yourself too thin. I would hone in on what you think you need the help with the most and focus on that area as far as what extra things to listen to.

You need to be focusing on your lectures and the material they’re giving you, not listening to tons of extra topics. If you’re struggling with anatomy, chemistry, or different specific topics within your anesthesia, go to the podcasts or YouTube channels and try to hone in on what you need to learn in a different way because they may teach it differently than what you learned in class.

I like how you guys mentioned how you multitask and go to the gym or walk. There is something about moving your body. It has been proven that if you physically move your body while you learn, you remember it better. I don’t know the neuroscience behind it, but I know it’s a real thing. I found an arc trainer. For me, that wasn’t too bouncy. If I were on an elliptical, I’d be throwing up, but if it was an arc trainer, it would be smooth enough to where I could read and flip through my notes. Multitasking is a great thing, like when you’re folding socks while trying to find the matching one.

You have to try and utilize every bit of your time to listen to a lecture or study because that’s vital. Channeling all your focus into everything you do at school is good.

One thing we did was we listened to lectures at two times speed to go back over our notes and make sure that we got things correctly. That helped save some time too.

I love that. That’s a good tip. Do you guys have your own study space office with a closed door? Where do you guys try to do most of your studying?

It’s different for all of us.

Ashley, go first.

I have my own office, thankfully. I set up a desk. That’s also where my big whiteboard is. I have a little couch in there to get away from the chair, the whiteboard and a place that’s quiet that you can go and zone into your own space have been the most useful for me.

CRNA 48 | SRNA Survival Guide
SRNA Survival Guide: Everyone goes through anxiety that is why it’s important to have a group of friends, or even one or two. Your friends and your family are there to help lift you up and make you feel better.

Evelyn, where are you? Are you in your living room?

When I was over in Fort Worth for school, I was in a tiny apartment. Since my boyfriend worked from home, we had our dining room table. He had the other side, and I had one side. It was very tight. I had whiteboards and chalkboards all over my walls. I made do with what I had, and that was about it. It was nerve-wracking at times because I would have to put headphones on and do what I could.

I noticed you put noise-canceling headphones as one of the items that you would have for school. That’s a good one. If you don’t have a separate space, I would agree with that.

As for me, once I got accepted, I was very adamant that I was going to get a nice standing desk to utilize in my study. Mind you, this was pre-pandemic, so once it hit and my wife had to start working remotely, she took over. We were in Fort Worth. We would study in the living room, and she would have the desk as her station, but now that we are in Jonesborough, Arkansas, which is where my clinical site is, we were able to rent out a 3-bed, 2-bath, and have 1 designated room for the study area. She also has to go to work again, so I have the desk all to myself.

My husband was all into getting a standing desk. He now has a sitting desk. He sat on a medicine ball for a while with it. I thought you were going to say something along the lines that you don’t like the desk. It’s important to have your own space. If you can’t get the noise-canceling headphones, it’s so easy to get distracted.

What’s around me sometimes can affect how I study. I’m like, “I need to do that. There are dog paws that are dirty and tracking mud all over the floor.” You guys have already mentioned a little bit about it. Ruben, you said something about dedicating all your free time to studying. I also want to hone in on the fact that you do need that break. Let’s talk about your free time. What do you do with your free time? How do you spend it? How much of it do you think you have or feel like you have?

Granted that our program is front-loaded, a lot of our didactic is spent in that first year in class and studying. I didn’t have a lot of free time then. I’ve loved playing guitar. I’ve played for several years. Now, I have more time to do that. It’s pretty much how I decompress and relax.

What about you, Ashley?

In the very beginning, there was not a whole lot of free time. I did go on walks to get sunshine and fresh air. I have two dogs, so I would walk them. I do that every day and try and make some time for that. Exercise if you can get the time in for it. We do have a little bit more free time now. It’s the same thing. I like to be able to exercise every morning, go on those walks, and then spend that quality time with friends and family because we already know once clinical starts, it will be rare.

How about you, Evelyn?

It's very vital to utilize every bit of your time to listen to a lecture or study. Channel all your focus into everything you do at school. Click To Tweet

I’m along the same lines as Ashley. I usually am outside. In my spare time, I’m outside either with family or friends. I took lots of walks as my breaks. I probably did 3 or 4 walks a day. I was walking my dog and getting vitamin D. It was a very hard adjustment to sit down for long periods of time indoors. It was not my personality, so that was helpful. I like to work out a lot too, so I structured my week to where I could get at least four days of weightlifting in. That helped with anxiety and stress relief but also gave me more quality time with friends and family too.

You guys all have great habits. I love that. I also want to put it in perspective too, because there are those of you who think you’re not going to have time to do anything. Unfortunately, this gets to be a real common thing you hear. When people misinterpret it, you have no free time. I look back, and here I am, a mom of three, running a business. I’m not working full-time anymore at the hospital. I work three days a month approximately.

I went from working between the business, working in the hospital, and being a mom in 80-hour work weeks. We don’t watch TV. We don’t do anything on the weekend. It’s work from Monday through Sunday. I looked back, and I was like, “CRNA school was nice,” because we got to watch Netflix on a Saturday. We didn’t have kids, so that made a big difference too.

Everyone’s situation is going to be unique. I want to reassure you that you will have time for yourself. You’re not going to be spending 80-hour weeks. It’s more like a 50 or 60-hour week. It’s not that that’s nothing. Don’t get me wrong. You will have an hour or maybe even two in a day to zone out and take some time for yourself.

Even if you have a long day or even if you have a 14 or 16-hour day, it doesn’t mean that you’re going to have that Monday through Sunday. You’re going to have a day where it’s going to be a little bit lighter. You’re going to have breaks between your classes, or maybe you get out of clinical a little bit early one time, or maybe you stay late the next day. It’s going to wax and wane.

On some weekends, you’re going to spend all weekend studying. On some weekends, you’re going to be able to go out to see a movie, go out to dinner, or have that relaxation time. I typically would study during the day on the weekend from 10:00 AM to 3:00 PM or 4:00 PM and go to the gym, and then my evenings would be for my husband and me. We would watch a movie and eat dinner together.

That was almost every Saturday unless I had some big thing that would prevent me from doing it. I tried to get my stuff done during the day so I could relax with friends or family in the evening. That was almost every weekend. That felt good. You do have a life. It’s going to be 110% different from what it was like when you were working full-time as a nurse. It’s all about perspective too.

When you get used to your routine, it’s easier.

The adjustment part is hard, and then when you’re done with school, you’d be like, “What do I do now?” You’re going to be like, “I feel like I’m not doing what I need to be doing,” because you got so accustomed to always studying and always having something to work on outside of clinical. You were used to juggling all the things, and then all of a sudden, all you have to juggle is a job or your personal life. You’re like, “Wait.” It quickly becomes overwhelming. You’re like, “I have no time anymore. I have all these things that I’m doing outside of work. I’m so busy.” It’s perspective.

You will always find things to do to fill your time. It’s a matter of how enjoyable they are and what those things are at school. Pretty soon, it will be the gym, vacationing, hanging out with friends, and taking your kids places if you eventually have kids. It will be okay. Self-care is a must, and you have to take that time for yourself because you will go insane if you don’t.

CRNA 48 | SRNA Survival Guide
SRNA Survival Guide: For student loans, if you have a parent that is willing to co-sign on any loans with you, do it. It might be cheaper than going through your federal financial aid.

Not to go down a rabbit hole with this topic and not to make you guys uncomfortable, but I want to briefly touch on the fact that anxiety and depression are rampant, and that stems a lot from the mental pressure that you’re put under, and the fear of not doing well, not passing, or not getting that degree after all this time and money invested. We also put some pressure on ourselves because of other people. Other people are watching you in this program. It’s like, “Everyone knows I’m in it.”

You’re being looked at, and what you feel is scrutinized from every angle. It can swallow some people and put them in a dark place. What do you guys do to get yourself out of that mindset when you start going down that rabbit hole of thinking, “I’m not good enough,” or having anxiety? I suffered from panic attacks. The anxiety was so much that I couldn’t handle it. Do you guys catch yourself doing that? Is that when you decide to take a break? Do you practice breathing techniques? Do you rely on your support? How do you seek out help and guidance when you get that way?

All of us went through that at various times. It’s important to have a group of friends, or 1 or 2. Evelyn was my very first friend in CRNA School. Thankfully, we were always in the opposite mindset, so if I was like, “I feel like I’m not doing well. I can’t do this,” she would be super positive that day, and then whenever she was feeling down, I’d be super positive that day.

Your friends and family are there to help, lift you up, and make you feel better. If you’re struggling and not getting something, use that as a key. You need a break. Leave your desk and try and get some fresh air or meditation. That has been useful. I’d go back to exercise too. Get your mind and focus away from it for a second, or also listen to happy, upbeat music. I created a playlist that is all motivational and inspiring. It usually helps turn my day around if it’s going downhill.

I love that. What about you, Ruben?

It’s important to realize that you’re not alone. I guarantee that everyone in the program has felt like that someday or another. It is very important to have that support system. I’ll use my wife as an example. There are times when I feel like, “I’m not going to make it. All of this was for nothing. I’m in so much debt, and you’re going to marry me, so you are now too.” She will settle me down, and we’ll talk it out. It’s also important to realize why you pursued this. There’s a reason. The ultimate reason for me is that I wasn’t happy at the bedside. I needed more, and anesthesia was the ticket. Looking back now, it’s the best decision I’ve made thus far, minus marrying my wife.

I love you going back on your why, and Ashley, I love your motivational music. These are great insights. Evelyn, do you have anything to add?

Ashley was awesome. She was my partner. Going through rough days, Ashley was there for me as well as my boyfriend. Meditation also helped. When I was in my first couple of months, I was very dedicated to meditating in the morning and sometimes at night too. I also did therapy. I started therapy when I was a nurse, and I did keep that going through CRNA school. It was amazing for me. I know our program has therapists that you can do for free, too, so that might be something that people can utilize at their schools. I can’t say enough things about therapy. That was a big game-changer for me.

That’s awesome. I love this. This is so good. To reiterate, you got to have support. As much as your loved ones are always going to be there for you because they love you, classmates are huge as well because they understand exactly how you’re feeling. They can be your cheerleader. They know how much it means when you cheer them on, so they’re going to cheer you on too. You’re in it together. You’re on the battlefield together. You’re going through it together. That’s a great point.

Meditating is very hard for me. It still doesn’t come naturally. I force myself to do it even if sometimes I’m like, “I don’t know why I’m doing this.” To me, it’s more about breathing. If I think about it, “You’re not meditating. You’re just breathing.” When I focus on my breath, I can meditate because if I focus on trying to meditate, my brain goes crazy. I’m like, “I have laundry to do. I’ve got socks to fold.” I think of everything I have to do, but if I focus on my breath, I can shut my mind off. That’s the only way I can do it. I encourage you, if you’re not sure about meditation, to keep practicing and trying it. It feels good.

It's important to realize that you are not alone in the CRNA program. It's key to have that support system. Click To Tweet

The quickest way to turn off your sympathetic nervous system is by your breath. If you can control your breath, you can get yourself out of that fight or flight, which is where your cortisol is released, which causes anxiety and panic attacks. If I had had this tool back in school, I know I would have suffered from fewer panic attacks.

Unfortunately, I didn’t discover this type of meditation until way late because I started having issues with my pregnancies because of my anxiety. I was forced to learn how to do it, or else my babies would suffer. That’s when I started taking it to heart. I was like, “You’ve got to get your anxiety under control.” Before you even start school, you should start practicing this stuff.

There’s nothing wrong with being in therapy. I do therapy too, and I love it. It’s one of the best investments I’ve made for myself. All students should have it. When I told my husband I was doing it, I was like, “Don’t be offended that I’m not using you, but I need someone who’s not emotionally attached to me to give me this advice and guidance. I need someone who’s completely detached from me emotionally and can look at me and call me out.”

It’s asking yourself why. If you have a feeling or an emotion, why is that? Is that such a bad thing? Are you unworthy? You’re getting down to the root cause of why you feel this way and what drew that emotion out of you. A lot of times, we’re dealing with having a bad day. A lot of these negative thoughts that we’re thinking about that bad day are things we’re doing to ourselves.

There are things we’re putting in our own minds. We’re judging ourselves. It’s not anyone else. It’s you, so until you can address what you feel that made you feel this way, you’re always going to feel icky, but if you can address it as it’s happening, it’s powerful. It means it will still happen, but you can train your brain to catch it. You go from being miserable to happy again.

It’s like those thought errors. It’s not necessarily a real thought. It’s just you taking a situation and twisting it a bit. It was helpful to sit down with somebody who had already been through a doctorate program and could help guide me through my thought errors. That was a helpful thing for me.

Thank you for sharing that. I’m sorry. You guys didn’t know I was going to be asking you all this stuff. You’re like, “This is getting deep.” To wrap this up a little bit, let’s touch on financials quickly because that’s important. I know that’s a reason why a lot of students struggle and maybe even do not get through school. What did you guys do financially prior to starting school and even during school? I’ll make this easy. Ashley, we’ll start with you.

I did save up a little bit of money, but not nearly as much as I would have hoped for because I didn’t think I was going to get in the year that I got in. I thought I was going to have another year. I would suggest starting to save even if you’re just thinking about it. Start putting a little bit of money away in case this is going to be one of your goals in the future. I still have some money there. It’s good to have it in case of an emergency.

As far as student loans go, I know this probably isn’t an option for everyone, but if you have a parent that is willing to co-sign on any loans with you, it might be cheaper than going through your federal financial aid. I know I have a lower interest rate than what I would have had. To tackle what you were saying about therapy, our school offered therapy for students for free. I know therapy can be expensive. If you’re worried about that, that’s another option to look into at your school.

That’s awesome. I love it. You’re right about the private student loans. I did a ton of them. They’re getting better with a 100% better interest rate. The only catch is you don’t qualify for any kind of loan forgiveness program, which I’ve never wanted to try for anyways. I’m going to get that stuff paid off. A lot of them were half the interest rate of a government loan, and then when you refinance, there is 3% interest these days. It’s pretty cheap these days to borrow money.

CRNA 48 | SRNA Survival Guide
SRNA Survival Guide: When attending CRNA classes, just trust yourself. You’re going to be in over your own head in the first semester. So it is important to trust that you are there for a reason.

That’s a great point, especially if you have a co-signer if you need one. If you have a spouse or anyone like that during the program, you typically probably wouldn’t need a co-signer while they could technically be. If you’re single, usually, you need a co-signer of some kind if you don’t have any finances coming in. Evelyn, do you have any suggestions? What did you do financially?

I was able to save up quite a bit during my four years of working bedside. I was able to put a lot into savings. I didn’t know what year I was going to get into partly because of NICU, so it made things a little bit more difficult, but I ended up working with Thrivent. Natalie Kratzer has been great. She has helped me transition from my 403(b) and made it into a Roth IRA. I’ve done a lot of things on the outside that I wouldn’t have known about. She has been helpful in finally figuring out, “We’ll do this federal loan here and do some private loans towards the end.” We’re strategizing what to do throughout the program.

I love that. Natalie is awesome. For those of you guys who are not familiar, Natalie with Thrivent Financial is like a saint. She has a sister-in-law who is a CRNA. That’s how she got exposed to the CRNA world. She watched her sister-in-law and brother struggle financially during school and was like, “Why is this not being addressed?”

She has made it her mission as a financial planner to help CRNAs and SRNAs be more financially secure. She wants to help you meet your goals. She only works with CRNAs and SRNAs. She’s awesome. Especially if you have years leading up to anesthesia school, work with her now. She will help you get where you want to be before school starts. She will set up a plan. Ruben, what did you do?

I was doing what Ashley did. I tried to save as much as I could in my savings. I made it a point not to have any outlying payments, whether it’s on my car or credit card bills, so I could focus on supporting myself and my wife. She works, so she helps out with the household too. Don’t be scared to get student loans if that’s what you’re ultimately going to have to do. It’s all going to pay off in the long run. If you believe in yourself and work your butt off at the tail end, you’ll be able to pay them back eventually. Don’t hesitate.

I maxed every single time. I took out extra wherever I could. I don’t know if this is smart. I don’t know what Natalie would say to this, but it made me feel good to take out extra and tuck it away, but I did end up burning through it by the end of school. We went to Puerto Rico for a vacation. I was at my friend’s wedding in Baltimore that I had to commute to. That was expensive. There would also be instances where my car broke down, or my dog got sick. Life happens.

I had saved about $10,000 prior to starting school, which for me, felt good, but it wasn’t enough. It didn’t last the whole time, but because I was able to get extra loans intermittently, I did have plenty of money during school. I do remember graduating. I took the board in August 2014 and started my first job in October 2014.

I was so broke at that point that I ended up taking out a $10,000 credit card advance loan because I had good credit. It was 0% interest for eighteen months. I maxed my credit card limit at $10,000, but I got that paid off in eighteen months. That $10,000 got us through to when I got my first paycheck in October 2014. Having good credit is important because it can save you in that area. Pay off your credit card bills.

I still had a car payment in school, but we cut back on many things. We didn’t have cable. We rarely ever went out to eat. We kept our Netflix subscription. That was about it. I did have a gym subscription for like $30 a month, but otherwise, we were very low-key as far as our expenses. Savings is key. Don’t be afraid to take out loans. There are other loan options and federal loans. Know that and look into what those would be. Maybe work with a financial planner if you can, but otherwise, budget out what you need, figure out how much you need to get through school and make sure it happens.

What it comes down to is knowing what you need month-to-month and planning for the unexpected. If you have planned for the unexpected, it will get you through those rough times. Knowing that grandma will send you $4,000 if you need it, talk to her about it. Make sure you have that backup plan. Don’t say, “I hope it will be okay.” I hope so too, but you don’t want to put your schooling on the line for it. This was so good. What’s a piece of advice you can give for the mental preparation for students going into school?

Before going to school, remember to take it one day at a time. Click To Tweet

Be excited about it. Hype yourself up. You’re going to get freaked out no matter what, so expect it. In that way, you can prepare. Once you get in, you’ll know what to study and study hard.

Trust yourself. During the first semester, I constantly was in my own head. You’re there for a reason, so it is important to trust that you are there for a reason. As Ruben said, work as hard as you can.

How about you, Ashley?

I like the quote, “One day at a time.” Whenever things are hectic, that’s all you can do. Take it one day at a time and get done whatever you can get done. Three years seems like a long time, but it does fly by. It sometimes seems like, “I can’t do this. It’s too much,” but you can, and you get through it. Take it one day at a time, and you’ll eventually get there.

I always like to say the days are long and the years are short. When you’re in the thick of it, it feels like it never is going to end, but the next thing you know, it’s graduation day, and you’re like, “Oh.” Every day is long. It’s unsettling that you don’t know what’s next. You’re living in the sense of not knowing. That can be scary and uncomfortable, but you have to embrace that. You have to adapt.

In clinical, you have to adapt. You could have a straightforward case, and they could code. You hope that everything works out smoothly. Even in the didactic portion, you’re going to have ups and downs. In clinical, you have ups and downs. I love your points. Trust yourself. You’re there for a reason. They picked you because you’re capable and worthy, and you are worthy. Go back to your why. You want this. Therefore, you deserve it. You’re working hard for it. All this is from your hard work and effort. Trust yourself that you can do it.

Ruben said to study hard. Sometimes, we put this immense amount of pressure to do more, but what I want to reiterate is you need to also be efficient in the sense that you need to know yourself. You need to know what works well for you. Something can feel hard, but it might not be efficient and might not be doing you as much good. Hone on what you think works well for you and test it. The only way to know is to test it and see. If that didn’t work, strategize or talk to a peer. What are they doing? What are they not doing well? Also, be observant of yourself and others.

You work hard by paying attention to what you need and listening to yourself when you need that break too. Part of studying hard is knowing when to take that break. Get out of your own head. You guys are getting ready to embark on clinical, so please give yourself grace. Even though you’ve been an ICU nurse and are at the top of your game, you’re walking into a brand new realm.

You’re going to have some nice preceptors and some not-so-nice preceptors. You’re going to have some nice doctors and some not-so-nice doctors. You’re going to be told, “You’re not doing this right. You’re doing that wrong. You could do that better.” You’re going to feel like, “Man,” but take a deep breath and be like, “It’s okay. This is a part of the plan. This is part of what I need.” I need someone to say, “Watch those teeth.” I need someone to say, “Watch the lip.” You might get the airway, but you have a fat lip. That’s okay. We’ve all been there.

If you ever think that you’re not getting your A-lines or intubations, or you don’t know you’ve returned your ventilator, we’ve all been there. We’ve all done it. We’ve all tried to wake up a patient and realize they’re still on nitrous. You’re like, “They’re not waking up. I still have my nitrous on that 70%.” We’ve all been there, so give yourself grace.

Laugh at yourself too. You’ve got to be lighthearted in the sense that you’re going to make mistakes. It’s owning up to those mistakes and not taking them personally, and knowing that we all make them. I want to tell you guys about this. See how the surgeon reacts. See how they treat everyone else. 9 times out of 10, if a surgeon is nasty to you, they’re not just nasty to you. They’re nasty to a lot of other people too. To take that personally is not worth it. Kill them with kindness, smile, apologize, move on, and say, “I’ll get that off my back. I’ll go to the next guy. He’s cooler.”

Even if he is a nice guy, he could be having a bad day. Maybe his grandma’s sick, his kid’s sick, or maybe their dog died. You don’t know why someone’s in a bad mood. You assume that you’re the one who caused the bad mood, but more than likely, you didn’t. Remember, if your patient moves and they’re doing an ankle surgery, and they don’t get their sutures right, it will be okay. The patient’s going to be okay. The surgeon might yell at you but in the big scheme of things, who cares?

Don’t take it too seriously. Do it one day at a time. I love that. I use that a lot. Give yourself a high five. Don’t even say anything. Look in the mirror and give yourself a high five. When you wake up for clinical, do it. You’ll get goosebumps if you do that. I promise. It’s going to give you that energy boost like, “Look at where I’m at. Look at what I did. I’m here. I’m doing this. I’m putting myself through it. I’m going to show up. I don’t know what kind of day it’s going to be, but I’m here, and I’m embracing this.”

I’m proud of you guys. I’m excited about this next venture in clinical. I’m always here if you have any questions. I always tell my students, “You can pick my brain. I might not know the answer, but if I was thrown in this situation, this is what I would start thinking about.” A lot of it comes down to tip-toeing around on how to ask appropriate questions and the timing of that.

You’ll learn that over time. Don’t be afraid to ask questions. You owe it to your patient and yourself to ask questions. Don’t let anyone ever make you feel bad about asking questions. Thank you so much for joining us. Ashley, why don’t you tell people about SEDATION NATION quick and let people know where they can reach you guys?

We created a website. It’s www.SedationNationAnesthesia.com. We have blog posts on there. We’re hoping to get some more out soon, and then you can also find us @Sedation_Nation on Instagram. Our goal is to bring more relatable content and hopefully blog posts with guests, bloggers, or writers who have experienced something that you might be going through as well and read a story that someone else is going through something that you’ve gone through. You’re not alone.

That’s awesome. I’m excited for you guys and that you guys are doing that. It’s a great resource. Thank you guys so much again for coming to the show. I appreciate you. Stay in touch and take care.

Thank you.

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