Anesthesia Guidebook

#110 – How we do interviews with Alison Kent & April Bourgoin Oct 30, 2024

What up yall. This is Jon Lowrance with Anesthesia Guidebook. This is episode #110 – How we do interviews with Alison Kent, MSN, CRNA & April Bourgoin, DNAP, CRNA.

In this episode, April, Alison & I talk about how we conduct CRNA interviews as a leadership team with our Department of Anesthesiology at MaineHealth – Maine Medical Center. Maine Med is the only level 1 trauma center in the state of Maine with 700-licensed beds. We run around 60 anesthesia sites of service a day with a staff of just over 130 CRNAs, 50 physician anesthesiologists, a physician residency & fellowship program and have clinical affiliations with 4 different nurse anesthesiology training programs.

Alison Kent is the Manager of CRNA Services at Maine Medical Center and completed her Master of Nursing in anesthesia at the University of New England in 2006. She’s been at Maine Medical Center as a CRNA for nearly 20 years and has served in the Manager role since 2017.

April Bourgoin is one of two Supervisors of CRNA Services at Maine Medical Center and completed her Master of Science and Doctor of Nurse Anesthesia Practice degrees at Virginia Commonwealth University in 2017. Prior to becoming a CRNA, she served for eight years as an active duty commissioned officer in the Army as flight nurse with the 82nd Airborne Dustoff medevac team. She served two combat tours prior to transferring to the Army Reserves at the rank of Major.

April joined me on episode 93 of Anesthesia Guidebook where we talked about OR fires and this is Alison’s first, but certainly not last, appearance on the show!

These 2 folks are part of the core CRNA leadership team at Maine Medical Center. Together, they truly make the world go round for our team and are like the glue that holds everything together. It’s an absolute privilege to get to work closely with these folks on a daily basis and I couldn’t be more thrilled to have pulled them in on this podcast about how we do interviews.

So, let’s tee this up a bit.

In today’s anesthesia market, you can go anywhere and make a great money and do interesting cases but the thing that will differentiate your experience with a group is the culture of the team. And your experience of that culture begins with your interview. It actually begins a little earlier than that, even, with how the reputation of the team reaches you – maybe through things like this podcast, or when you reach out to inquire about a group or talk with friends & colleagues who may work or have worked with a particular group.

But a really important deep dive into the culture of the team will come on interview day. You should meet some core folks on the team – CRNAs, physicians, trainees, administrative specialists. You should get in the operating rooms and actually see the staff do the work that you’re looking to join them in. You should leave the interview with a very clear idea of what you’re potentially getting yourself into, both in terms of culture and with a thorough run down of the benefits and compensation package.

If you’re listening to this and you’re a practice manager or thinking about getting into a role in which you support your team as a leader, hopefully you find this podcast super helpful.

Alison, April & I talk through our process & structure for interviews, what kinds of questions we ask, what we look for in candidates and how we work to both recruit folks and protect our culture by making sure we’re bringing in people who are a good fit for the team.

A few years ago another chief CRNA asked me if I had any tips on how to conduct interviews. When we talked then, I of course knew that I wanted to get around to doing a podcast on the topic to share the same advice with you. And here it is!

Oh, by the way, what we describe is our process as a leadership team. Our opinions expressed here are our views and do not necessarily represent the views or opinions of our employer. Seth Godin has this great definition of culture where he says, “people like us do things like this.” This is how we do interviews as a leadership team.

We hope you enjoy our story.

If you’d like to apply to work with our team as a CRNA, please reach out to chat or drop your application here: https://www.careersatmainehealth.org/jobs/search

Search for the CRNA roles at Maine Medical Center in Portland, Maine.

And with that, let’s get to the show.

#109 – Leadership 101 – Why it Matters Sep 01, 2024

What’s up yall! This episode dives into fundamental concepts related to leadership and casts a message for why it matters to all of us.

Whether you’re primarily a clinical CRNA/physician anesthesiologist, resident/SRNA, a practice leader/manager, business owner, educator, researcher or policy advocate, leadership has a fundamental role in your day to day life.

In this episode, we talk about:

The art & science of leadership
Position, power, influence
Leadership & management
Leadership & followership
Culture, and how we influence it
The Servant Leadership Model
Jocko’s leadership principles

I’m pulling from my time as an instructor with Landmark Learning and NOLS (National Outdoor Leadership School), both outdoor education schools that thread leadership principles through their risk management and wilderness medicine programs. I’m also pulling from my experience as the chief CRNA at Maine Medical Center, a level 1 trauma center with over 200 staff in the anesthesia department. And some of the content is coming from the work I’m doing as I pursue a PhD in organizational leadership with a research focus on how high performance teams operate in emergencies.

Hopefully you’ll find something you can hang your hat on here.

Leadership is the art and science of influencing others to achieve shared goals.

There’s a ton of different leadership styles & theories out there and I’ll touch on some in the podcast. My personal approach is the Servant Leadership Model, which flips the traditional organizational chart – a pyramidal/triangular structure – on its head and puts the leader at the bottom of the triangle and the most important staff up at the top. The most important folks in any organization are those who are doing the front line work to deliver on the mission and vision of the organization. In the Servant Leadership Model, these folks are the top and the leaders and managers are positioned below them. The job of leaders and managers is to support and empower the folks above them to do their best work in robust and resilient environments where the capacity for the right thing to happen flourishes.

No big deal right? To find out more, check out the podcast!

Servant Leadership Model Download

Leadership Tactics

By Jocko Willink

Be humble
Don’t act like you know everything
Listen, ask for advice & heed it
Treat people with respect
Take ownership of failures
Pass credit for success up & down the chain of command
Work hard
Have integrity – do what you say, say what you do
Be balanced – avoid extreme actions/opinions
Be decisive
Build relationships = this is the main goal of a leader
Get the job done

Willink, J. (2023). Leadership strategy and tactics: field manual expanded edition. St. Martin’s Press.

Thank you to everyone who subscribes to the website & podcast… wherever you do that! YOU are the reason Anesthesia Guidebook is here. Take care and have fun out there!

Jon Lowrance

#108 – AANA Annual Congress Shout Out Jul 31, 2024

What up yall! This is a quick shout out to those of you headed to the AANA conference this weekend, August 2nd, 2024 in San Diego.

I hope that yall have an incredible time and meet tons of new colleagues, see old friends and have fun gettin’ your learn on.

I was talking to one of the SRNAs from the University of New England this morning in clinical and she’s was getting psyched for the conference this weekend. AANA Annual Congress is one of those times where you can kind of lift your head up from the daily grind and look around & see thousands of other CRNAs & SRNAs or RRNAs from around the nation who are all out there doing their thing in anesthesia. It’s such an inspiring time!

While I will NOT be there reppin’ Anesthesia Guidebook, my clinical team from Maine Medical Center and MaineHealth will be.

So first, why am I not putting up a booth and talking about Anesthesia Guidebook… first & foremost, I’m not trying to sell you something. Anesthesia Guidebook is still anchored in the concept of free open access medical education. There’s no subscription fee and I’m not trying to make money off of CE credits. There’s a hundred other ways out there for you to make Class A credit and that just hasn’t become a professional focus on mine. Which brings up the reminder that any anesthesia related podcast you listen to will qualify for free Class B credit in the CPC program. If you’re a CRNA and you routinely listen to anesthesia podcasts, all you have to do is self-report your credits to the AANA and you’ll rack up those Class B credits super fast.

I actually did a brief podcast on this topic way back in Episode #9 of the podcast if you want to hear more about how to do that.

So while there’s no Anesthesia Guidebook table at AANA Annual Congress, you CAN go meet my good friends and colleagues from Maine Medical Center in the exhibition hall. April Bourgoin, Jill Guzzardo and Danielle Beaumont will be there staffing the MaineHealth booth to tell yall about the amazing career opportunities within MaineHealth. We have everything from level 1 trauma center work with my team at Maine Medical Center where I serve as chief CRNA to a full independent practice location in Conway, NH to several other smaller town medical centers throughout Maine, including Pen Bay Medical Center in Rockland, where Jill is the chief CRNA.

So April Bourgoin will be out there this weekend. Dr April Bourgoin one of our CRNA Supervisors at MMC, and she’s been on the show before talking about OR fires back in episode 93. I actually just recorded an episode that I’m editing now with April and our CRNA Manager, Alison Kent, on how we do interviews as a leadership team at MMC. That show is targeted towards other practice managers out there but is obviously also probably valuable for SRNAs as it gives you a behinds the scenes look at how we plan team interviews for people applying to be on our team. So April’s out there… you can also meet Danielle Beaumont, our SRNA Clinical Coordinator at Maine Medical Center. Danielle is amazing in that role as she supports SRN As from the University of New England and Middle Tennessee School of Anesthesia. Danielle also just helped us establish clinical affiliations with Boston College and Northeastern University. We’re pumped to start welcoming primary anesthesia trainees from BC and NU in 2025. And then last but not least is Jillian Guzzardo. Jill is one of our per diem CRNAs at MMC but she also serves as the Chief CRNA at one of our MaineHealth sister hospitals, Pen Bay Medical Center in Rockland, Maine. If you’re looking for a small town, coastal Maine community hospital to practice at, Jill is your girl! Pen Bay is literally on a bluff overlooking the Atlantic Ocean. You have close up water views from work. It’s amazing…. I mean, you can also see the ocean from the top floors of Maine Medical Center, but at Pen Bay, you can probably see what the lobstermen are having for breakfast as they motor by in the morning… it’s right there. Jill is one of my favorite CRNAs… after a few years of holding down the fort at Pen Bay as the chief CRNA, she reached out to me and asked if she could come work off shifts and weekends at Maine Medical Center to keep her high acuity patient care skills up. She literally asked if I would give her the shifts that my core team doesn’t want to work… nights, evenings and weekends. I was blown away.

All three of this CRNAs – April, Danielle and Jill – are baller clinicians. I would let any of them take care of me or my family and just love working alongside them in the OR. They’re also incredible CRNA leaders with a deep passion for helping SRNAs & CRNAs thrive in their practices. And they’re generally just inspiring, friendly humans… Kind, generous, optimistic people… who are wicked smahat as we say here in New England.

So if you’re headed to AANA Annual Congress, even if you’re not looking to move your practice to Maine, do yourself a favor and go meet these incredible people. April, Danielle and Jill will be pumped to meet you.

So that’s it… just wanted to drop a quick shoutout to those of you headed to AANA Annual Congress this weekend and say I hope it’s an amazing conference. Go get your learn on, meet some new friends and stop by the MaineHealth booth and tell my friends I said hello.

And with that… I’ll see ya next time!

#107 – No Peace in Quiet with Keli Rueth, DNP, CRNA Jun 29, 2024

What’s up yall this is Jon Lowrance and this is episode 107 – No Peace In Quiet with Keli Rueth.

I’m pumped to bring you this conversation with Keli where we discuss her first published novel, No Peace In Quiet.

This episode was so much fun to record and I think you’re really going to enjoy it. It’s a story that is worth sharing on an anesthesia podcast because it’s a story about how we as anesthesia providers explore the rest of our lives… how we can step out from our clinical roles as anesthesia providers to express our creativity and joy in a different way than being mixologists and potion makers in the OR.

In this episode, Keli and I talk through her process and approach to finding her passion for writing and how she has snuck that in to the nooks and crannies of her life between working as a mother, full time CRNA and professor of anesthesiology at the University of New England.

Keli Rueth is the pen name of Dr Keli Scrapchansky, who, by the way, was one of my favorite people on planet earth even before I knew she was a novelist. Keli started her career at Maine Medical Center just a few months before my wife, Kristin, and I did back 2015. She graduated with her Master’s in Anesthesia from Old Dominion University in 2014 and went on to complete her Doctor of Nursing Practice at the University of North Florida. Keli is one of those people who shows up anywhere with a smile on her face and brightens up the room she walks into. It’s incredibly difficult to get through a conversation of any length with her without laughing about whatever topic is on the table. She’s an easy conversationalist, a masterful clinician and educator and now, a published novelist.

No Peace In Quiet is Keli Rueth’s first novel in a trilogy, the next volume of which has a planned release for later this summer. I thoroughly enjoyed reading No Peace In Quiet and literally couldn’t stop turning the pages as the story developed and unfolded in the small town and surrounding mountains of Quiet, North Carolina.

You can check out Keli’s book at kelirueth.com.

And with that, let’s get to the show!

#106 – What we know about anesthesia school formatting – Cassie Capps May 30, 2024

What’s up yall! I am back after a few months off from the podcast. This is episode 106 – following up: what we know about anesthesia school formatting with Cassie Capps.

This is a follow up show to the episode that Cassie brought to us back in December on the effects of anesthesia school didactic formatting on resident wellbeing… whether in-person, online, synchronous or asynchronous styles have any effect on your wellbeing as a trainee.

Before we get to this show, I’ve got a couple updates for you… our crew at Maine Medical Center has been on a bit of tour this spring attending conferences, job fairs and universities telling the story about our team and why we may be where you want to invest your career as an anesthesia provider. Cat Godfrey & April Bourgoin were just down at AANA’s Mid Year Assembly in Washington D.C. and then Cat made her way on to University of North Carolina at Greensboro to chat with the residents at Terry Wick’s program. She followed up dropping in on UNC-G with a virtual lunch & learn session with Mary Baldwin University’s anesthesia program over in Virginia. And then, Kristin and I just returned last week from Florida International University’s job fair down in Miami. We were so happy to know that even the locals thought it was super hot cause oooooooo….eeeeeeee… it was swimmy humid and all kinda hot down in the Sunshine State. We were stoked to meet a bunch of FIU anesthesia residents and tell yall about our absolutely gorgeous summers and four season climate up in Maine and how we’re probably where you want to start your career if you’re looking for a top notch level 1 trauma center to be at where you’re treated with respect, well-supported and want to join a thriving team that has a ton of fun working together. Just saying.

Part of my intention with Anesthesia Guidebook is to help CRNAs make a successful transition to practice and if you’re looking to do high acuity work in a busy tertiary medical center surrounded by an amazing team and in a phenomenal location, drop me a line and we can chat. I’d love to tell you more about our crew and see if we’re a good fit for where you’re headed.

In other news, this fall I’m teaching at Encore Symposium’s Autumn in Bar Harbor and Acadia National Park conference. If you’re looking for a spot to come knock out some continuing education this year, Encore is headed back to Bar Harbor, Maine, which is just outside of Acadia National Park, from October 14-17. If you’ve never been to Acadia, or Bar Harbor or Maine… this is your chance. Come check it out. Acadia in October is simply stunning… a national park, on an island, in Maine. With your anesthesia friends! You’ll be hard pressed to find a cooler spot to come get your learn on. Hope to see you there!

All right… with that, let’s get to this show. Cassie Capps is back. We first heard from Cassie in late December 2024 on episode 99 of Anesthesia Guidebook and now she’s back to walk us through the impact of anesthesia school didactic formatting on resident wellbeing. Thank to everyone who took Cassie’s survey and provided your insights… the data was actually a bit surprising so let me re-introduce Cassie to you and then she’s gonna get right to it.

This podcast was part of Cassie Capps’ Doctor of Nursing Practice in anesthesiology program at the University of Arizona. Prior to anesthesia training, Cassie was a CVICU Registered Nurse for 8 years and worked in the cath lab for 5 years before that. Prior to nursing school, Cassie completed a Master’s degree in music with a focus on Piano Performance & Pedagogy. Cassie continued to teach piano on the side while completing her doctorate in anesthesiology at the University of Arizona.

Her unique experience with anesthesia school included moving through her program as a single mom of an 11 year old daughter. She also continues to play a big role in the lives of her two former stepdaughters, who are now young adults.

This podcast is coming out in May of 2024 and with that, let’s get to the show!

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#105 – The Impact of Precepting on Clinical Learning Feb 21, 2024

What’s up yall! This is Jon Lowrance and this is episode 105 of Anesthesia Guidebook – the impact of precepting on clinical learning with Jennifer Heiden. This episode is coming out on February 21, 2024.

Jennifer Heiden is completing her Doctor of Nursing Practice in anesthesiology at the University of Arizona and this podcast is part of her doctoral work. In this episode, we’re going to walk through the behaviors, tips & techniques preceptors can do in order to positively impact the clinical learning outcomes of anesthesia residents. Jennifer wants to hear about your experiences either as an anesthesia trainee or as a clinical preceptor in the survey that is attached to this episode. The link is in the show notes. It’s a quick survey, totally anonymous and will be used to help Jennifer complete her doctoral project at the University of Arizona.

Survey Link is Here:

https://uarizona.co1.qualtrics.com/jfe/form/SV_88sSJwSor8yDoGy

Prior to anesthesia training, Jennifer worked in medical, surgical and cardiac ICUs for 8 years on the East and West coasts. Prior to nursing school, Jennifer completed a bachelor’s degree in finance from Boston University and lived in Colorado for almost twenty years hiking, running and climbing in the mountains.

She currently lives in Temecula, California, and has been working through anesthesia school as a single mom to her 14-year-old son. She still enjoys climbing, running and spending time with her son and all their animals.

I hope you enjoy this show. The mission of Anesthesia Guidebook is to help you master your craft as a provider. The art & science of clinical precepting is foundational to raising the next generation of highly competent providers. I’m thrilled to take a fresh look at precepting with Jennifer and you can find lots of other shows on Anesthesia Guidebook that touch on clinical education with links to each of those in the show notes to this episode.

And if you’d like to get the show notes to these podcasts straight to your inbox, along with being the first to know when a new episode drops, subscribe to the show on the website. All that does is send you the episode & show notes, nothing more & no hidden agenda. It’s totally free and I will never sell or distribute your email. So if you want to be the first to know and have all the links right at your finger tips, subscribe to show at AnesthesiaGuidebook.com!

#8 – How to master precepting with Will C0hen

#21 – Best practices in precepting with Obinna Odumodo

#22 – The demo-do teaching technique

#55 – Incivility in the Workplace with Joshua Lea, DNP, MBA, CRNA & Kelly Gallant, PhD, CRNA

#74 – Thrive in Training: how to crush clinical

#75 – Thrive in Training: communicating with preceptors

#104 – At-home cardiorespiratory events following ambulatory surgery – Chuck Biddle, PhD, CRNA Jan 28, 2024

Chuck Biddle PhD, CRNA is a Professor Emeritus of anesthesiology at Virginia Commonwealth University and served as the editor in chief of the AANA Journal for 35 years. His anesthesia education & master’s degree are from Old Dominion University and he completed his PhD in Epidemiology at the University of Missouri.

Chuck is one of my favorite people in the world of anesthesiology. He’s one of those folks who have put the time in over decades to develop a true, deep mastery of their profession while at the same time bringing with them a level of authenticity, integrity and humility that garners true respect. He’s a guide. He’s helped countless physician & nurse anesthesiology trainees develop and gain a love of the work we do. And one of the central focuses of his career has been fervently working to understand the things that put our patients at risk and develop research and insights for practice to advance patient safety.

Which brings us to this show.

In this episode, Dr Biddle turns our attention to what happens to patients after they go home from day surgery. We talk about a study his team did at VCU where they sent patients home with pulse oximeter monitors and tracked their course for 48 hours following day surgery.

We talk how novel this idea is in that very few studies have actually looked at what happens to patients following ambulatory surgery and that a certain segment of these patients – those who have obstructive sleep apnea are at particular risk for devastating postoperative complications. Chuck points to Jonathan Benumof’s, MD 2016 article in the Canadian Journal of Anesthesia titled Mismanagement of patients with obstructive sleep apnea may result in finding these patients dead in bed (full article below). Dr Benumof is a world-renowned physician anesthesiology and expert in airway management and pulmonary physiology. He is a professor of anesthesiology at the University of California – San Diego’s School of Medicine. Over the 15 years prior to the publication of Dr Benumof’s article in which he served as an expert witness in litigation cases, he testified on 12 cases where OSA patients died within 48 hours of surgery. In the article, he unpacks each of those cases and provides the following prototypical dead in bed OSA patient:

“A 58-yr-old continuous positive airway pressure (CPAP)-compliant male (170 cm, 120 kg, body mass index 40 kgm-2) with polysomnography (PSG)-proven severe OSA undergoes orthopedic, upper airway, or abdominal surgery under general anesthesia. The patient has an uncomplicated stay in the postanesthesia care unit until discharged to an unmonitored bed without CPAP or oxygen. After receiving small (and within standard of care) doses of narcotics for pain for 11 hr, the patient is found DIB [dead in bed]. Advanced cardiac life support is either not attempted or fails to return the patient to their baseline state of life (Benumof, 2016).”

This episode is one of those discussions that makes you see the work you do in a whole new light and gives you a renewed sense of ownership over making sure you and your colleagues are doing the right thing for your patients. This show is coming out on 28 January 2024 and was originally recorded at VCU’s studio with a table top microphone back in the summer of 2017. I apologize that the audio is a little hazy but the power of Dr Biddle’s research and passion for this topic are still very much relevant to providers today. So with that, let’s get to the show!

Benumof, J. L. (2016). Mismanagement of obstructive sleep apnea may result in finding these patients dead in bed. Canadian Journal of Anesthesia, 63(1), 3.Download

Benumof, J. L. (2015). The elephant in the room is bigger than you think: finding obstructive sleep apnea patients dead in bed postoperatively. Anesthesia & Analgesia, 120(2), 491.

Hill, M. V., Stucke, R. S., McMahon, M. L., Beeman, J. L., & Barth Jr, R. J. (2018). An educational intervention decreases opioid prescribing after general surgical operations. Annals of surgery, 267(3), 468-472.

Biddle, C., Elam, C., Lahaye, L., Kerr, G., Chubb, L., & Verhulst, B. (2021). Predictors of at-home arterial oxygen desaturation events in ambulatory surgical patients. Journal of Patient Safety, 17(3), e186-e191.

#103 – Dexmedetomidine Deep Dive with Eliana Zimmerman Jan 22, 2024

What’s up folks! This is Jon Lowrance with Anesthesia Guidebook and this is episode 103… a deep dive on dexmedetomidine with Eliana Zimmerman. This episode is coming out on January 21, 2024.

Before we get to the show I want to remind folks that I’ll be speaking in person at the Encore Symposiums’ Autumn in Bar Harbor & Acadia National Park conference running October 14-17 of this year. If you have never been to Maine, this is a great excuse to make it up here. And even if you have been or if you live here in vacationland… there’s scarcely a better place to be than Bar Harbor in October. It’s absolutely stunning. Peak leaf season usually hits in October for Bar Harbor, which is a coastal village just outside the entrance to Acadia National Park. Just google those key words… Acadia National Park – October. Or peak leaf season Bar Harbor. Then sign up for the conference ASAP because this one usually sells out quick. It’s Encore Symposiums’ Autumn in Bar Harbor & Acadia National Park conference, running October 14-17. I’m looking forward to bringing fresh perspectives on what’s new in anesthesia, pharmacology, ERAS, airway management & more for this conference. You’ll also get to meet a bunch of my friends & crew from Maine Medical Center, as this is one our team’s favorite conferences to attend… it’s close to home and has absolutely breath-taking scenery. I hope to see you there!

This is the second show I’ve done specific to dexmedetomidine… you’d have to go back a full 100 episodes… way back to episode #2 for the other show, which I did with Matt Poirier who I continue to work alongside at Maine Medical Center.

In this show, Eliana Zimmerman joins me to unpack the literature on perioperative use of dexmedetomidine, specifically focusing on the clinical impacts of dexmedetomidine in colorectal surgery.

As part of her doctorate research at Northeastern University, Eliana completed a series of expert panel inquires, synthesized with current literature, to arrive at recommendations for best practice concerning the use of dexmedetomidine in colorectal surgery. Her infographic and resources are provided in the show notes.

Eliana Zimmerman graduated Wesleyan University with a degree in Neuroscience in 2017, and University of Pennsylvania with a degree in Nursing in 2018. She worked as an ICU nurse at Jefferson Methodist Hospital from 2019 – 2022. She is currently a nurse anesthesia doctoral student at Northeastern University with an anticipated graduation of May 2025. In her limited free time she likes to backpack, run, and spend time outdoors. Her fiancé, two cats, and dog have kept her sane during the long days of anesthesia training.

References

Chen, C., Huang, P., Lai, L., Luo, C., Ge, M., Hei, Z., Zhu, Q., & Zhou, S. (2016). Dexmedetomidine improves gastrointestinal motility after laparoscopic resection of colorectal cancer: A randomized clinical trial. Medicine (Baltimore), 95(29), e4295–e4295. https://doi.org/10.1097/MD.0000000000004295

Chen, H., & Li, F. (2020). Effect of Dexmedetomidine with Different Anesthetic Dosage on Neurocognitive Function in Elderly Patients After Operation Based on Neural Network Model. World Neurosurgery, 138, 688–695. https://doi.org/10.1016/j.wneu.2020.01.012

Cheung, C. W., Qiu, Q., Ying, A. C. L., Choi, S. W., Law, W. L., & Irwin, M. G. (2014). The effects of intra‐operative dexmedetomidine on postoperative pain, side‐effects and recovery in colorectal surgery. Anaesthesia, 69(11), 1214–1221. https://doi.org/10.1111/anae.12759

Ge, D.-J., Qi, B., Tang, G., & Li, J.-Y. (2015). Intraoperative Dexmedetomidine Promotes Postoperative Analgesia in Patients After Abdominal Colectomy: A Consort-Prospective, Randomized, Controlled Clinical Trial. Medicine (Baltimore), 94(37), e1514–e1514. https://doi.org/10.1097/MD.0000000000001514

He, G.-Z., Bu, N., Li, Y.-J., Gao, Y., Wang, G., Kong, Z.-D., Zhao, M., Zhang, S.-S., & Gao, W. (2022). Extra Loading Dose of Dexmedetomidine Enhances Intestinal Function Recovery After Colorectal Resection: A Retrospective Cohort Study. Frontiers in Pharmacology, 13, 806950–806950. https://doi.org/10.3389/fphar.2022.806950

Lu, Y., Fang, P.-P., Yu, Y.-Q., Cheng, X.-Q., Feng, X.-M., Wong, G. T. C., Maze, M., & Liu, X.-S. (2021). Effect of Intraoperative Dexmedetomidine on Recovery of Gastrointestinal Function After Abdominal Surgery in Older Adults A Randomized Clinical Trial. JAMA Network Open, 4(10), e2128886–e2128886. https://doi.org/10.1001/jamanetworkopen.2021.28886

Qi, Y.-P., Ma, W.-J., Cao, Y.-Y., Chen, Q., Xu, Q.-C., Xiao, S., Lu, W.-H., & Wang, Z. (2022). Effect of Dexmedetomidine on Intestinal Barrier in Patients Undergoing Gastrointestinal Surgery–A Single-Center Randomized Clinical Trial. The Journal of Surgical Research,

Sun, W., Li, F., Wang, X., Liu, H., Mo, H., Pan, D., Wen, S., & Zhou, A. (2021). Effects of Dexmedetomidine on Patients Undergoing Laparoscopic Surgery for Colorectal Cancer. The Journal of Surgical Research, 267, 687–694. https://doi.org/10.1016/j.jss.2021.06.043

Tang, Y., Liu, J., Huang, X., Ding, H., Tan, S., & Zhu, Y. (2021). Effect of Dexmedetomidine-Assisted Intravenous Inhalation Combined Anesthesia on Cerebral Oxygen Metabolism and Serum Th1/Th2 Level in Elderly Colorectal Cancer Patients. Frontiers in Surgery, 8, 832646–832646. https://doi.org/10.3389/fsurg.2021.832646

Xu, B., Li, Z., Zhou, D., Li, L., Li, P., & Huang, H. (2017). The influence of age on sensitivity to dexmedetomidine sedation during spinal anesthesia in lower limb orthopedic surgery. Anesthesia & Analgesia, 125(6), 1907-1910. https://doi.org/10.1213/ANE.0000000000002531

Zhang, J., Liu, G., Zhang, F., Fang, H., Zhang, D., Liu, S., Chen, B., & Xiao, H. (2019). Analysis of postoperative cognitive dysfunction and influencing factors of dexmedetomidine anesthesia in elderly patients with colorectal cancer. Experimental and Therapeutic Medicine, 18(3), 3058–3064. https://doi.org/10.3892/ol.2019.10611

If you want to dive deeper, recommended reading:

Ischemia Reperfusion Injury:
1. “Pathophysiology of Reperfusion Injury” https://www.ncbi.nlm.nih.gov/books/NBK534267/#:~:text=Ischaemia%2DReperfusion%20injury%20(IRI),essential%20to%20salvage%20ischaemic%20tissues
Postoperative pain and the Gut Microbiome
1. Brenner, Shorten, & Mahony 2021

DNP Reference Tools

AGREE II
1. Overview
  1. https://www.ncbi.nlm.nih.gov/books/NBK525667/
1. Manual
  1. https://www.agreetrust.org/resource-centre/agree-ii/
United States Preventive Service Task Force Grading
1. Methods:
  1. https://www.uspreventiveservicestaskforce.org/uspstf/about-uspstf/methods-and-processes
1. Grading System
  1. https://www.uspreventiveservicestaskforce.org/uspstf/about-uspstf/methods-and-processes/grade-definitions
Modified Delphi Technique Assessment of Appropriateness
1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8299905/

Dexmedetomidine-Infographic Download Zimmerman-E-Narrative-1 Download

**#102 – Marriage + Anesthesia School with Brad & Madisson Marcum** Jan 13, 2024
Brad & Madisson Marcum join me to talk about the dynamics of being married and going to anesthesia school together. They met in nursing school, had divergent paths professionally for a bit, with Brad starting nurse practitioner school and Madisson considering anesthesia school. They ended up sharing the same goal of becoming CRNAs and we talk through their approach to applying together, getting into the University of Evansville together and working through the program alongside one another.

In episode 15, I talked with Jenny & Robert Montague about what it’s like for the significant others of anesthesia residents. Jenny has her Master of Science in Nutrition and works as a Registered Dietitian and supported Robert and their 2 kids while he attended the University of New England’s anesthesia program.

In epsisode 50, I caught up with Lein & Nate Woodin to talk specifically on parenting in anesthesia school. Nate is a family therapist and supported Lein and their 2 kids while she went through the University of New England’s anesthesia program.

In this episode, Brad & Madisson Marcum talk about what it’s like to both get into and work through anesthesia school together. We’re planning for this to be the first in a series of conversations with them as they progress through their program. They’re just finishing their first year of training and have yet to start clinicals. I plan to touch base with them down to the road to see how that phase of the program goes.

Folks are often making difficult decisions around when to do anesthesia school. For a couple in my program, the husband went through school 2 years ahead of his wife, who was in my class, and they overlapped for just one semester. A local couple here in Portland stacked their programs end to end with one of them fully completing the program and a semester after that, the other starting anesthesia school. That stretched their anesthesia training experience to a full six years as a couple.

My hope is that this conversation with Brad & Madisson helps you and your partner think through the considerations around what you want to do or how it’s going for you if you’re currently in a program.

Brad hails from Salem, Illinois and spent 5 years as a critical care Registered Nurse in the cardio thoracic & transplant ICUs at Mayo Clinic prior to starting anesthesia school in the University of Evansville’s DNAP program. His clinical interests are regional anesthesia and opioid sparring anesthetic techniques with an emphasis on pharmacology and pharmacogenetics.

Madisson is from Effingham, Illinois and also spent 5 years as a critical care Registered Nurse in the trauma surgical ICU at Mayo Clinic in Rochester prior to anesthesia training. Her clinical interests are regional anesthesia and difficult airway management.

They are focusing their doctoral project on the functionality and effectiveness of virtual reality training in anesthesia programs and plan to utilize Peter Stallo’s SIMVANA VR platform for research. You may remember my conversation with Peter in episode 96 on SIMVANA and virtual reality in anesthesia education. It’s a fascinating discussion on what will likely become a central element to anesthesia education in years to come.

Long term, Brad & Madisson intend to become involved in medial mission trips and create a pediatric charity foundation to provide basic necessities to children in need in their local area following anesthesia school.

Brad and Madisson Marcum

#101 – EKG Lead Selection for Perioperative Monitoring – Mark Kossick, DNSc, CRNA Jan 07, 2024

This is an incredibly special podcast that I’m thrilled to pull forward from our old show, From the Head of the Bed, to Anesthesia Guidebook.

I love that this episode is number 101 because EKG lead selection should be 101-level knowledge for anesthesia providers, yet so many folks have not mastered this fundamental knowledge as part of their practice. I hope you get as much from this as I have over the years.

Dr Mark Kossick was a full professor of anesthesia at Western Carolina University when my wife, Kristin, and I attended the program and he actually just retired in late 2023 from that university. Kristin arranged for Dr Kossick to contribute his expertise to this podcast while we were still in the program back in early 2015 and this episode was released as one of the original group of podcasts that launched From the Head of the Bed that year.

Dr Kossick will give a more detailed introduction of his professional background at the start of this show – and, I’m thrilled to have Kristin’s voice on the podcast with all her pre-Mainer southern drawl – as she introduces him. Dr Kossick was known as an incredibly challenging yet supportive professor. His area of expertise was intra-operative monitoring and the uptake and distribution of volatile anesthetics. He had a passion for the many beautiful curves of the science of anesthesia, whether it was the oxyhemoglobin dissociation curve, the Fa/Fi curve or one of the many other curves that define the science behind what we do every day. Kristin and I and so many other CRNAs from WCU, the University of Alabama at Birmingham and others have learned so much from Dr Kossick and consider ourselves fortunate to have sat in and survived his classes.

This is an incredibly thorough review of the very basics of EKG lead placement, selection and monitoring for anesthesia care. This is a skill and knowledge set that, unfortunately, many anesthesia providers and perioperative nursing staff overlook and blaze past. As Dr Kossick says in the show, simply having a EKG pattern on the screen from careless placement of EKG leads is not enough for safe monitoring. Dr Kossick walks us through the core data on EKG monitoring, including some modified leads, so this show is excellent for both trainees and experienced providers alike.

#100 – Vantage Point January 2024 Dec 31, 2023

Have you noticed how stoked podcasters get about their one hundredth episodes? It’s kind of a thing. If you want to hear interesting shows – check out the hundredth episodes. Or 200th. Or 1000th. Podcasters usually get super stoked about hitting triple digits with their shows and often set up the number 100 episode as some sort […]

#99 – The Effects of Anesthesia School Didactic Formatting on Resident Wellbeing – Cassie Capps Dec 26, 2023

Cassie Capps, BSN, SRNA joins me to talk about the effects of didactic formatting in anesthesia training on resident wellbeing including stress, anxiety, confidence and academic performance. Her specific focus is on the mix of online versus in-person course work for nurse anesthesia trainees. Cassie overviews what the literature says about this topic and is […]

#98 – A Deep Dive on Ketorolac with Elisabeth Stewart, MSN, MSNA, CRNA Dec 06, 2023

Elisabeth Stewart, MSN, MSNA, CRNA focused her Master of Science in Nurse Anesthesia project on the pharmacology of Toradol (ketorolac) and she’s here today to tell us all about it. Elisabeth hails from Wisconsin, holds a BS in Mathematics with a pre-med concentration and engaged in HeLa cell cancer research prior to going to nursing […]

#97 – Safety is a capacity Sep 13, 2023

What up folks! This is another short podcast on the idea that safety is a capacity, not an outcome. This idea comes out of Todd Conklin & Sidney Dekker’s work on organizational safety where they discuss two ways of looking at safety: The Safety 1 Perspective or the old way of thinking is that safety […]

#96 – Virtual Reality in Anesthesia Education: SIMVANA with Peter Stallo Aug 04, 2023

What up yall this is Jon Lowrance and this is episode 96 – virtual reality in anesthesia education: SIMVANA with Peter Stallo. This show is coming out in early August of 2023. First up: I want to give a quick heads up that our team from Maine Medical Center where I currently serve as […]

#95 – Could ChatGPT be a CRNA? Jun 05, 2023

Quick 5-Question Post Podcast Survey HERE Today I’m joined by John Fratianni who created the content for this episode as part of his Doctorate in Nurse Anesthesia Practice at Virginia Commonwealth University in Richmond, Virginia. John earned a Bachelor of Science in Nursing at the University of North Carolina at Chapel Hill, a Master of Science […]

#94 – Shorts – Cue Ball May 17, 2023

All right what’s up folks this is Jon Lowrance and it’s May 16, 2023. This is episode 94 – and I’m calling it “shorts: cue ball.” And I don’t mean shorts like the things you wear but shorts like, this will be brief and there will be more episodes like this to come… you know, […]

#93 – OR Fires with April Bourgoin, DNAP, CRNA Feb 12, 2023

In this episode, I speak with Dr April Bourgoin, DNAP, CRNA about operating room fires – how they can start and how we can respond to them as anesthesia providers. This show was originally released in 4 years ago in February of 2019 on the podcast From the Head of the Bed and was recorded […]

#92 – How to Prevent Periprosthetic Joint Infections with Brian McGrory, MD Jan 28, 2023

If you get this post by email: THANK YOU! You’re in a select group of supporters of the show who have followed the posts on the website and I can’t thank you enough. Your interest, feedback and willingness to share these episodes with your friends & colleagues is much appreciated. Shoot me a reply, social […]

#91 – Vantage Point for January 2023 Jan 22, 2023

What up yall. This is Jon Lowrance. I’m still here. 😂 We’re still here. This is the first episode of 2023 and the first episode on Anesthesia Guidebook since October – October! I’m so glad to get back to the podcast and bring you this update. This is a re-cap of the last few months […]

#90 – The Environmental Impact of Desflurane with Jacob Bonnema Oct 05, 2022

Climate crisis is a growing global health problem, one which the field of anesthesia contributes to with its use of volatile anesthetic gases. This podcast is part of the doctoral project of Jacob Bonnema and it aims to increase knowledge and awareness of the environmental effects of volatile gases, particularly desflurane, to empower providers to […]

#89 – Distraction in the OR with Heather Turcotte, DO Sep 05, 2022

What’s up y’all this is Jon Lowrance and this is episode 89 – Distraction in the OR with Heather Turcotte, DO. Y’all, I am so stoked to bring you this conversation… I caught up with Dr Turcotte earlier this summer as she was finishing her residency in anesthesia and I’m pumped to finally get this […]

#88 – Combat Trauma Anesthesia with Dustin Degman, MSN, CRNA – Part 3 Aug 28, 2022

This is episode 88 and it’s part 3 off a three-part series with Dustin Degman, a CRNA formerly with the United States Army. In the first episode, we discussed Dustin’s experience in Afghanistan serving at a forward operating base in Paktika Province in 2012. We talk about what makes up forward surgical teams and the […]

#87 – Combat Trauma Anesthesia with Dustin Degman, MSN, CRNA – Part 2 Aug 21, 2022

What’s up yall this is Jon Lowrance with Anesthesia Guidebook. I am so pumped to bring you this series of 3 episodes on Combat Trauma Anesthesia! This is episode 87 and it’s part 2 off a three-part series with Dustin Degman, a CRNA formerly with the United States Army. In the first episode, we […]

#86 – Combat Trauma Anesthesia with Dustin Degman, MSN, CRNA – Part 1 Aug 14, 2022

What’s up yall this is Jon Lowrance with Anesthesia Guidebook. I am so pumped to bring you this next series of 3 episodes! This is episode 86 and it kicks off a three-part series with Dustin Degman, a CRNA formerly with the United States Army on combat trauma anesthesia. In this first episode, […]

#85 – The McLott Mix – Part 2 with Jason McLott, MSN, CRNA Jul 19, 2022

Jason McLott, MSN, CRNA developed a mix of medications for doing opioid-free anesthesia that came to be know as the McLott Mix. It’s a combination of dexmedetomidine, lidocaine, ketamine and magnesium. Jason is clear that the McLott Mix helps achieve opioid-free anesthesia, not opioid-free analgesia, recognizing the role of opiates, if needed, in post-operative analgesia […]

#84 – The McLott Mix – Part 1 with Jason McLott, MSN, CRNA Jul 12, 2022

Jason McLott, MSN, CRNA developed a mix of medications for doing opioid-free anesthesia that came to be know as the McLott Mix. It’s a combination of dexmedetomidine, lidocaine, ketamine and magnesium. In this episode, Mr McLott himself unpacks the story of the mix’s development, efficacy and principles for opioid-free anesthesia. He’s clear that this mix […]

#83 – Positive Deviance as a Catalyst for Change with Cherie Burke, DNP, CRNA Jul 09, 2022

“Positive deviance is really about… taking those things that people are doing right and sharing them with everyone so that everyone is doing things to improve our patients’ care, our patients’ outcomes.” Cherie Burke, DNP, CRNA Dr Cherie Burke joins me to unpack how positive deviance can be a catalyst for change in healthcare. Positive […]

#82 – How Change Management can Build Value with Randy Moore & Desirée Chappell Jul 05, 2022

Randy Moore, DNP, MBA, CRNA and Desirée Chappell, MSNA, CRNA join me to talk about change management in healthcare. They are both on the leadership team with NorthStar Anesthesia, which provides perioperative services at over 200 facilities across 20 states. This conversation focuses on how leaders can navigate change, develop culture and build successful anesthesia […]

#81 – How to Navigate the Business of Anesthesia with Tracy Young, MSNA, CRNA, MBA Jun 30, 2022

I caught up with Tracy Young, CRNA, MBA & CEO of YPS Anesthesia Services in Houston back in November 2019 to talk about the business of anesthesia. Tracy is one of the most sought-after experts on the business of anesthesia not just at CRNA conferences but throughout the healthcare management & business industry. In this […]

#80 – How to do 1099 Anesthesia Work with Sandry Gaillard, MSN, CRNA Jun 25, 2022

What’s up yall, this is Jon Lowrance with Anesthesia Guidebook. This is episode 80 – how to do 1099 anesthesia work with Sandry Gaillard, MSN, CRNA. This is the second episode in a short series on the business of anesthesia. I’m gonna do a little run of interviews and topics on the business of anesthesia […]

#79 – The Future of Healthcare with Navin Goyal, MD & Saket Agrawal, CEO with OFFOR Health Jun 24, 2022

What’s up yall this is Jon Lowrance with Anesthesia Guidebook. I’m really excited to bring you this episode on the future of healthcare with Dr Navin Goyal and Saket Agrawal of OFFOR Health. This is episode 79 of anesthesia guidebook and it’s coming out on June 24, 2022. This is one of the most interesting […]

#78 – Thrive in Training: how to transition to practice May 29, 2022

This episode covers advice for the last six months of anesthesia training, transitioning out of training and into the first six months of your anesthesia practice. The year encompassing your last six months of training through boards and your first six months of practice is epic! There’s a huge learning curve you encounter during your […]

#77 – Thrive in Training: how to land your first job in anesthesia with Jon Bradstreet, MSN, CRNA May 23, 2022

In this episode, I talk with Jon Bradstreet, MSN, CRNA who at the time of this recording was the chief CRNA/Director of CRNA Services at Maine Medical Center, Maine’s only level 1 trauma center. Jon was the chief CRNA who gave me my first job in anesthesia. At the time he hired my wife and […]

#76 – Thrive in Training: the SEE & NCE exams May 22, 2022

This episode covers the NBCRNA’s SEE & NCE exams for SRNAs/RRNAs. Get these on lock down. Thrive in training. The Self-Evaluation Exam (SEE) is a 240-question computerized adaptive exam that’s designed for three reasons: help the SRNA gauge their progress in their training program help program faculty gauge how well they’re preparing students help SRNAs […]

#75 – Thrive in Training: communicating with preceptors Apr 17, 2022

In this episode, the founders of From the Head of the Bed… Jon Lowrance, Kristin (Andrejco) Lowrance, Brad Morgan & Cassidy Padgett, talk about how to communicate with preceptors as anesthesia trainees. This conversation was recorded as one of the original podcasts released at the launch of From the Head of the Bed, the podcast […]

#74 – Thrive in Training: how to crush clinical Apr 15, 2022

This episode offers a run down on how to prepare for the clinical phase of anesthesia training. We touch on practical tips like which apps are helpful, what gear to utilize & how to acclimate to the clinical environment as well as meta issues like developing emotional intelligence and the right kind of attitude to […]

#73 – Midlife Van Life: reinventing work-life balance with Kyle & Jen Steen Apr 05, 2022

This show is so much fun and launching this now coincides with the launch date of my friends’ journey, which you’ll hear all about in this episode. Kyle & Jen Steen have been friends of mine for the last 7 years. Kyle’s been a CRNA for 13 years, Jen is a fashion designer and […]

#72 – Thrive in Training: finding balance with Temima Luchansky & Maya Kelkar Mar 19, 2022

In this episode, I’m joined by Temima Luchansky & Maya Kelkar, the 2 current SRNA reps to the AANA Health & Wellness Committee, to talk about how to find balance in anesthesia training. Now if that immediately sounds impossible to you, then you’re listening to the right podcast. We’re going to talk about a very […]

#71 – Thrive in Training: destroying didactics with Jenny Finnell, MSN, CRNA Mar 13, 2022

Jenny Finnell, MSN, CRNA joins me to talk about how anesthesia trainees can master the didactic phase of their training. We cover lots of tips in this show: everything from how to make challenging content stick to how to get organized, which apps & resources are helpful and how to maintain mental wellbeing during anesthesia […]

#70 – Thrive in Training – Growth Mindset with Jenny Finnell, MSN, CRNA Mar 06, 2022

Jenny Finnell, MSN, CRNA, the creator behind the CRNA School Prep Academy joins us today to talk about growth mindset. Learning to develop a growth mindset is key to pushing beyond where you’re at currently to where you want to go. Carol Dweck is a psychologist and the Lewis and Virginia Eaton Professor of Psychology […]

#69 – Thrive in Training: how to start strong Feb 28, 2022

The key to thriving in training is setting a trajectory in life based on your deep interest, learning to embrace deliberate practice in your craft, remembering your why and locking on to the hope that comes with knowing your goal is worth the work you will put in. This series is designed to help physician […]

#68 – Thrive in Training: how to prepare for anesthesia school Feb 21, 2022

The Thrive in Training series is designed to help physician and nurse anesthesia residents succeed in anesthesia training. The key to thriving in training is setting your trajectory in life based on your deep interest, learning to embrace deliberate practice in your craft, remembering your why and locking on to the hope that comes with […]

#67 – How to Thrive in Training Feb 20, 2022

This is the first episode in a series that will focus on helping anesthesia residents thrive in training. This is designed for physician and nurse anesthesia trainees and will unpack crucial beta for helping you dial your game in during anesthesia training. In this first episode I discuss finding your why behind going to anesthesia […]

#66 – The CPC Assessment (Exam) Overview Feb 12, 2022

This is run down specifically on NBCRNA’s Continued Professional Certification (CPC) Program Assessment (or Exam) for CRNAs. Episode 64 was a 10-minute run down on the whole CPC Program – a quick overview. In episode 65, I did a whole hour-long deep dive on the program, including the CPC Assessment. This episode cuts out all […]

#65 – 1-hour CPC Program Overview Feb 12, 2022

This is an all-new 1-hour overview of the NBCRNA’s Continued Professional Certification (CPC) Program for CRNAs. In April of 2019, I interviewed John Preston, DNSc, CRNA, FNAP, APRN and Lisa Kamen, CAE of the NBCRNA on the CPC Program for the podcast From the Head of the Bed. At the time, Dr Preston was the […]

#64 – 10-minute CPC Program Overview Feb 11, 2022

This is a short overview of the NBCRNA’s Continued Professional Certification (CPC) Program for CRNAs. In April of 2019, I interviewed John Preston, DNSc, CRNA, FNAP, APRN and Lisa Kamen, CAE of the NBCRNA on the CPC Program for the podcast From the Head of the Bed. At the time, Dr Preston was the Chief […]

#63 – Anesthesia Billing Models with Ian Hewer, CRNA Feb 02, 2022

Dr Ian Hewer is the program director of Western Carolina University’s Doctor of Nursing Practice in nurse anesthesia program. At the time of this interview, Ian had been a CRNA for 20 years, was an assistant professor in WCU’s nurse anesthesia program, held two master’s degrees – one in sociology, the other in anesthesia – […]

#62 – How to do Anesthesia for Global Outreach – Part 2 with Mason McDowell, DNAP, CRNA Jan 11, 2022

This is part 2 of my conversation with Mason McDowell, DNAP, CRNA. In 2014, he, along with his wife and 2 young daughters, sold everything they owned and moved full time to the heart of Africa… to the town of Beré in the nation of Chad, to provide anesthesia services at hospital with severe resource […]

#61 – How to do Anesthesia for Global Outreach, Part 1 – Mason McDowell, DNAP, CRNA Jan 11, 2022

This podcast and the one to follow are pure gems. You’re gonna hear from Dr. Mason McDowell who in 2014, sold everything he, his wife and 2 young daughters owned and moved full time to the heart of Africa… to the town of Beré in the nation of Chad to provide anesthesia services at hospital […]

#60 – Kate Balzano-Cowan Paid Off >$100k Debt in a Year Dec 28, 2021

All right y’all, you’re about to hear from Kate Balzano and how she paid off over $100,000 in student loan debt in a year. There’s three reasons I wanted to bring Kate’s story to you: The first is that Kate is all around an amazing human. I have the privilege of working with her on […]

#59 – How to Achieve Your Goals Dec 25, 2021

This is episode 59 – How To Achieve Your Goals. This is one of my favorite episodes and the content here is something that I come back to again and again. I’ve listened to it probably 5 or 6 times since I first released it and every time I come back to this, I leave […]

#58 – How to Recharge & Create Rhythm in Your Life Dec 13, 2021

When’s the last time you put your cell phone down and did something relaxing or to recharge your energy? When’s the last time you felt relaxed and refreshed? Can you imagine feeling refreshed & relaxed, clear-minded and rested on a regular basis? Tanked up? Ready to charge? Finding rhythm and downtime to recharge seems wildly […]

#57 – Incivility in the Workplace – Joshua Lea, DNP, MBA, CRNA & Kelly Gallant, PhD, CRNA Dec 12, 2021

Josh Lea, DNP, MBA, CRNA and Kelly Gallant, PhD, MSN, CRNA join me to discuss workplace incivility in anesthesia training. We discuss the role of precepting SRNAs and anesthesia residents, root causes and implications of incivility and processes for improving healthy work environments. Josh Lea, DNP, MBA, CRNA is a professor of anesthesia at Northeastern […]

#56 – Guided Relaxation with Matt Zinder, MS, CRNA, CH Dec 09, 2021

In this podcast, Matt Zinder, MS, CRNA, CH walks us through a fifteen-minute guided relaxation session that is sure to leave you feeling refreshed and renewed. You should try this at home, on your lunch break or to help you go to sleep at night. Get to a place where you can close your eyes […]

#55 – How to Be Well During the Pandemic – Matt Zinder Dec 09, 2021

This podcast was originally published on From the Head of the Bed on March 17, 2020. That was during the early stages of the COVID-19 pandemic. Now, in December 2021, as the pandemic has stretched out nearly 2 years, we’re revisiting Matt Zinder’s advice on how to be well and cope with the stress and […]

#54 – Hardship in Anesthesia School Dec 08, 2021

This episode speaks to why anesthesia school/residency is hard and what we as SRNAs, residents, program faculty, preceptors, CRNAs and physician anesthesiologists can do about it. Anesthesia training is hard because life is hard and doesn’t stop just because you enroll in an incredibly difficult program. Anesthesia school is also hard because anesthesia school is […]

#53 – Overcoming Setbacks in Anesthesia Training Oct 27, 2021

I originally released this podcast on April 4, 2020 to offer advice & encouragement to SRNAs who had been furloughed from clinical due to the COVID-19 pandemic. While elements of this show speak specifically to that context, the themes ring true for overcoming any set back during anesthesia school. At the time, our level 1 […]

#52 – SRNA Wellness in COVID-19 with Adrienne Chavez & Kelly Gallant Oct 24, 2021

This podcast was originally posted on April 13, 2020, in the early stages of the COVID-19 pandemic. At the time of this podcast both Kelly Gallant and Adrienne Chavez were SRNAs completing their anesthesia training. They have both completed their training and passed boards as CRNAs. This show continues to have value for SRNAs & […]

#51 – Provider Wellness with Christine Hein, MD Oct 15, 2021

This is one of my favorite podcasts that I’v recorded. If you’ve had the privilege of working with or getting to know Dr Christine Hein, MD, – or once you listen to this podcast – you’ll know why! Christine Hein, MD is an emergency medicine physician and the Chief Wellness Officer at Maine Medical Center, […]

#50 – Parenting during Anesthesia Training with Lien & Nate Woodin Oct 01, 2021

I’m joined today by Nate & Lien Woodin who are married and the parents of two boys – aged 6 & 9 as this show comes out on the first of October 2021. If you’re a critical care nurse, medical student, resident or SRNA – or a spouse or partner to one of these folks […]

#49 – Local Anesthetics with Skyler Rouhselang, BSN, SRNA Sep 27, 2021

This episode was originally published in April 2019 on From the Head of the Bed… a podcast for the anesthesia community. In this podcast, Skyler provides a thorough overview of local anesthetics including relevant anatomy and physiology (i.e. nerve fibers, sodium channels, pKa, etc), types of local anesthetics and factors that effect onset, potency, duration […]

#48 – IV Induction Agents with Ashley Scheil, BSN, SRNA Sep 27, 2021

This episode was originally published in April 2019 on From the Head of the Bed… a podcast for the anesthesia community. In this podcast, Ashley walks us through an overview of the most common IV anesthesia induction agents. We cover propofol, ketamine, etomidate, barbiturates (e.g. methohexital), dexmedetomidine and benzodiazepines (e.g. midazolam). A run down of […]

#47 – Pharmacodynamics of Volatile Anesthetics with Skyler Rouhselang, BSN, SRNA Sep 25, 2021

This episode was originally released in April 2019 on From the Head of the Bed… a podcast for the anesthesia community. In this podcast, Skyler walks us through the pharmacodynamics of volatile anesthetics. We talk extensively about the concepts related to minimum alveolar concentration (MAC), the mechanism of action of volatile anesthetics and the physiologic […]

#46 – Pharmacokinetics of Volatile Anesthetics with Skyler Rouhselang, BSN, SRNA Sep 25, 2021

This episode was originally released in April 2019 on From the Head of the Bed… a podcast for the anesthesia community. In this podcast, Skyler gives a succinct run down on the pharmacokinetics of volatile anesthetics. We talk about uptake, distribution, elimination and metabolism and unpack concepts such as blood gas solubility, oil gas solubility, […]

#45 – The Anesthesia Machine with Ashley Scheil, BSN, SRNA Sep 22, 2021

In this episode, which was originally released in April of 2019 on From the Head of the Bed… a podcast for the anesthesia community, Ashley provides an incredibly detailed run down of the anesthesia machine: the flow of gas through the machine, high, intermediate and low pressure system components in the machine, variable bypass vaporizer […]

#44 – Clinical Flow: from OR set up through intubation with Ashley Scheil, BSN, SRNA Sep 20, 2021

In this episode, Ashley and I talk through how to set up an operating room anesthesia workstation, perform a preoperative patient assessment and progress through an IV induction and intubation. You’ll hear Ashley walk you through everything from how to do a quick machine set up, where to put your tape, how to introduce yourself […]

#43 – LVADs in non-cardiac surgery with Ben Levin, MD Sep 16, 2021

This podcast was the last episode I published on From the Head of the Bed and originally came out on July 4, 2020. In August of that year, I launched Anesthesia Guidebook and this episode is being re-released on September 16, 2021. In this episode, I have the privilege of speaking with Ben Levin, […]

#42 – Opioid Free Anesthesia with Tom Baribeault, DNP, CRNA & Jayme Reuter, MS, CRNA Sep 13, 2021

This episode was originally released on From the Head of the Bed on March 3, 2019 and recorded in Scottsdale, Arizona. Tom Baribeault, DNP, CRNA and Jayme Reuter, MS, CRNA talk with me about opioid free anesthesia. We discuss the progression to opioid free anesthesia (OFA), where OFA fits into enhanced recovery programs and the […]

#41 – Regional Anesthesia with Shane Garner, MS, CRNA, NSPM-C Sep 05, 2021

This episode was originally released in April of 2020 on From the Head of the Bed… a podcast for the anesthesia community and is being re-released on 5 September 2021 on Anesthesia Guidebook. In this episode, I speak with Shane Garner, MS, CRNA, NSPM-C about an introduction & overview of regional anesthesia. We discuss: opioid-free […]

#40 – Gas and Grass: Anesthetic Considerations for Care of the Cannabis User Sep 01, 2021

Study Link: http://depaul.qualtrics.com/jfe/form/SV_9Y32tyhtj6i8GZU Nicole Kellogg, BSN, SRNA and Elizabeth Fullford, BSN, SRNA join me to discuss the anesthetic considerations for cannabis users. This podcast is part of a study they’re conducting on the efficacy of an educational podcast for SRNAs and CRNAs. PLEASE COMPLETE THE PRE-SURVEY AND POST-SURVEY HERE. The study will be live through […]

#39 – The 5 Keys to Achieving Financial Independence with Shane Garner, MS, CRNA, NSPM-C Aug 30, 2021

In this episode you’re going to hear from Shane Garner, MS, CRNA, NSPM-C on the 5 Keys for Achieving Financial Independence. This show was originally released in April of 2020 on From the Head of the Bed and I’m pulling it forward to Anesthesia Guidebook on August 30, 2021. I’m pumped Shane brought this […]

#38 – The Master Anesthesia app with Matthew Willis, DNP, CRNA Aug 25, 2021

Dr Matthew Willis is the CRNA who created and produces the educational app Master Anesthesia, which is available from the App Store and Google Play Store. I’ve been using this app for the last several months and I’m super impressed at a few things: it’s packed with real-world information that’s evidence based from case […]

#37 – Emotional Intelligence of SRNAs with Shawn Collins, DNP, PhD, CRNA Aug 22, 2021

This episode is coming out on August 21, 2021 but it FIRST came out way back on September 19, 2015. The show is on emotional intelligence of SRNAs with Dr Shawn Collins, DNP, PhD, CRNA. At the time of the interview, Dr Shawn Collins was the nurse anesthesia program director and the interim dean […]

#36 – DNP: The Future of CRNA Education with Shawn Collins, DNP, PhD, CRNA Aug 17, 2021

This episode originally appeared on the podcast From the Head of the Bed on August 6, 2015. It’s re-released here on August 17, 2021. Dr Shawn Collins, DNP, PhD, CRNA and I discuss the transition from Master’s level training for CRNAs to practice doctorates, most commonly the Doctor of Nursing Practice degree or DNP. […]

#35 – Asynchronous learning and the future of anesthesia education Aug 15, 2021

This podcast follows up on the previous show which discussed free open access medical education (FOAM) and the use of social media in anesthesia education. Here, I discuss the power of asynchronous learning to shape the future of anesthesia education. The power of asynchronous learning comes from the ability of content experts to produce something […]

#34 – FOAM and social media in anesthesia education Jul 31, 2021

Free open access medical education – or FOAM – is any medical educational content that’s shared freely on open access platforms, meaning the public can consume it without having to be a member of an organization or pay a subscription fee. The reason it’s significant is that it brings evolving science & literature – and […]

#33 – Flow and the Can-O-Calm Jun 30, 2021

In this episode, I tell you a story about whitewater paddling and unpack the concept of flow described by psychologist and author Mihaly Csikszentmihalyi, PhD. I also present the Can-O-Calm for the first time on the podcast. This secret, magical, weightless and even sterile (when you need it to be) tool will help get you […]

#32 – Harnessing the power of deliberate practice Jun 20, 2021

This podcast discusses deliberate practice, a concept developed by renowned cognitive psychologist Anders Ericsson, PhD. Deliberate practice is the kind of practice that top performers employ in order to reach the very highest levels of excellence across domains. Ericsson studied countless musicians, athletes, dancers, chess players, medical professionals and others to uncover the secrets and […]

#31 – Expertise in Anesthesia with Denham Ward, MD, PhD May 30, 2021

This episode originally released on From the Head of the Bed in February of 2017. Denham Ward, MD, PhD joined me to talk about expertise in anesthesia. At the time of this recording, Dr Ward was the director of the Academy at Maine Medical Center Institute for Teaching Excellence and professor of anesthesiology at Tufts […]

#30 – The mid-to-late career phase with Cindy Farina, DNP, CRNA May 29, 2021

In this episode Dr Cynthia Farina and I talk about the mid-to-late phase of your career as a CRNA. Every stage of your career has unique challenges & opportunities. There’s so much attention focused on getting into CRNA school, the SRNA/resident/training phase and becoming a new CRNA… this conversation is for the part of your career […]

#29 – On Retirement with Eric Carlson, CRNA May 22, 2021

I caught back up with Eric Carlson, CRNA to discuss his recent retirement and advice he has for anesthesia providers still in the thick of it. Eric was interviewed by Kristin Lowrance, MSN, CRNA way back in 2015 for our podcast “From the Head of the Bed.” We just re-released that podcast as #28 – […]

#28 Can’t Intubate, Can’t Oxygenate (CICO) during stat C-section: a case study with Eric Carlson, CRNA May 10, 2021

This podcast was originally published on March 1, 2015. In this episode Kristin Lowrance, MSN, CRNA talks with Eric Carlson, CRNA about a case where he was called for a stat Cesarean section and after a rapid sequence induction, he could not intubate or oxygenate the patient. The case was at 2AM and Eric was […]

#27 – Total knee arthroplasty in the COVID-19 era with Adam Rana, MD & Ryan Mountjoy, MD Apr 28, 2021

This episode outlines the overnight transition to same-day surgery & discharge for total knee patients at Maine Medical Center. Surgeon Adam Rana, MD was informed on a Tuesday afternoon in December 2020 that elective cases requiring overnight hospital stays were being canceled effective immediately. He reached out to physician anesthesiologist Ryan Mountjoy, MD, along with […]

#26 – Mobile, pediatric dental anesthesia with Paul Samuels, MD Apr 24, 2021

Paul Samuels, MD is a pediatric physician anesthesiologist who works with SmileMD to provide mobile anesthesia for dental offices. We talk about the unique characteristics of working in a mobile anesthesia setting for pediatric dental cases. Topics include: skills required to excel as an anesthesia provider in a mobile, pediatric setting preoperative screening of patients […]

#25 – Preventing Hypothermia in Arthroplasty Surgery with Brian McGrory, MD Apr 19, 2021

My guest today is Dr Brian McGrory. His is an orthopedic joint replacement surgeon at Maine Medical Center in Portland, Maine. He earned his bachelor’s degree in chemistry biology at Cornell, attended medical school at Columbia, followed by residency in orthopedic surgery at the Mayo Clinic Graduate School where he also earned a Master’s […]

#24 – Social media leverage & landmines with Jason Bolt, DNP, CRNA Apr 02, 2021

Dr. Jason Bolt, DNP, CRNA is a YouTuber and social media influencer in the anesthesia community. He graduated from Union University with his doctorate in anesthesia in 2019 and now practices in a collaborative group in the Bay Area. He offers mentorship through his YouTube channel memberships and enjoys helping others reach their goals in […]

#23 – Serotonin Syndrome with Trent & Katie Bishop, CRNAs Mar 27, 2021

Today my guests are Trent and Katie Bishop, a CRNA couple who practice independently and live in Durango, Colorado. We’re going to talk about serotonin syndrome and cases that both Trent and Katie have recently experienced as providers in their practice. Trent has a background in biology and EMS prior to pursuing a career as […]

#22 – The Demo-Do Teaching Technique Mar 09, 2021

“Tell me and I will forget. Show me and I will remember. Let me do and I will understand.” – Confucius Demo-do teaching is all about “show me and I will remember.” Demo-do is a simple process where educators outline what will be demonstrated, then demonstrate the process as it should be performed, then coach […]

#21 – Best Practices in Precepting with Obinna Odumodu, BSN, SRNA Mar 01, 2021

Please follow the link below to complete the survey associated with this podcast for Obi’s research with the University of Saint Francis: Effectiveness of a Nurse Anesthetist Preceptor Training Survey https://www.surveymonkey.com/r/9M7VG92 Obinna Odumodu, BSN, SRNA is currently completing his doctorate in anesthesia at the University of Saint Francis in Fort Wayne, Indiana as of February […]

#20 – Rural Independent CRNA Practice with Chuck Frisch, DNP, CRNA, FAAPM, CH Feb 20, 2021

Today my guest is Chuck Frisch, DNP, CRNA, FAAPM, CH, a CRNA with over 35 years of experience in anesthesia who serves as the director of anesthesia at Box Butte General Hospital in Alliance, Nebraska. He’s here to talk about rural, independent CRNA practice. Chuck initially studied molecular, cellular & developmental biology in college before […]

#19 – Anesthesia Top Drawer Run Down – Part 3 Feb 18, 2021

The Top Drawer Run Down is a 3-part series covering the 39 most commonly administered intravenous medications in anesthesia. These medications are often found in the top drawer of anesthesia carts in the United States. The Top Drawer Run Down was originally posted on From the Head of the Bed… a podcast for the anesthesia […]

#18 – Anesthesia Top Drawer Run Down – Part 2 Feb 06, 2021

The Top Drawer Run Down is a 3-part series covering the 39 most commonly administered intravenous medications in anesthesia. These medications are often found in the top drawer of anesthesia carts in the United States. The Top Drawer Run Down was originally posted on From the Head of the Bed… a podcast for the anesthesia […]

#17 – Anesthesia Top Drawer Run Down – Part 1 Jan 31, 2021

The Top Drawer Run Down is a 3-part series covering the 39 most commonly administered intravenous medications in anesthesia. These medications are often found in the top drawer of anesthesia carts in the United States. The Top Drawer Run Down was originally posted on From the Head of the Bed… a podcast for the anesthesia […]

#16 – Ondansetron for preventing spinal-induced hypotension with Jenny Li, BSN, SRNA Jan 01, 2021

In this episode, I talk with Jenny Li, BSN, SRNA about using pre-procedural ondansetron to prevent spinal-induced hypotension in elective cesarean-sections. Ms Li is completing her Doctorate of Nursing Practice (DNP) at the University at Buffalo and structured her doctoral work around this topic. She received a Bachelor of Science in Psychology from University of […]

#15 – Significant Others and Anesthesia School with Jen & Rob Montague Dec 22, 2020

Today I’m joined by Jennifer & Robert Montague to talk about the experience of significant others in anesthesia school. Rob is currently a second-year SRNA at the University of New England and Jen, his wife, is a Master’s-prepared Registered Dietitian who has taken on the lioness’ share of providing child care and homeschooling responsibilities for […]

#14 – Board Preparation with LTC Peter Strube, DNP, CRNA Dec 12, 2020

Lieutenant Colonel Peter D. Strube is a CRNA who graduated from St. Mary’s University school of anesthesia in 2006 with a master’s degree. His undergraduate degree is from Luther College in Decorah, Iowa. He was awarded the Doctor of Nurse Anesthesia (DNAP) in June of 2017 and is currently enrolled in his MBA. Lieutenant Colonel […]

#13 – Perioperative Buprenorphine Management with Aurora Quaye, MD Dec 04, 2020

Aurora Quaye, MD is an anesthesiologist who specializes in regional anesthesia and pain medicine at Maine Medical Center in Portland, Maine. She completed her residency at Massachusetts General Hospital and a fellowship in Regional Anesthesia at Brigham and Women’s Hospital. Dr. Quaye’s clinical interests include decreasing the use of opioids for pain management, in improving provider education […]

#12 – Ten Things Every Anesthesia Provider Should Know Nov 29, 2020

The following ten ideas have the power to change your attitude towards and even the trajectory of your professional career and life. There’s three core domains to developing as an anesthesia provider: your knowledge base, skill set and attitude. Each are unique and require different kinds of effort or deliberate practice to grow & improve. […]

#11 – Cognitive Aids Make You More Effective in Emergencies with Ryan Mountjoy, MD Oct 31, 2020

This episode is a continuation of the series on Leadership in Emergencies… the art & science of resuscitation. Be sure to go check out episode 7 of the podcast where I give a quick run down of leadership in emergencies and how we can work towards improving our individual & team performance in anesthesia […]

#10 – 10 Quick Tips for Learning Airway Management Oct 31, 2020

This is a distillation of 10 key tips to help folks who are learning airway management improve their skills. This show gets straight to the point: 10 tips for airway management in 10 minutes. 10 Tips for Airway Management 1. Develop a growth mindset and practice deliberately 2. Do a good airway assessment 3. Develop […]

#9 – How to Earn Class B Credits with Podcasts Oct 21, 2020

The NBCRNA CPC Program allows for CRNAs to earn Class B Credits by listening to podcasts; this episode tells you how. The National Board of Certification & Recertification for Nurse Anesthetists (NBCRNA) recognizes anesthesia-related podcasts, like Anesthesia Guidebook, as valid sources of Class B credit in their Continued Professional Certification (CPC) Program that all CRNAs […]

#8 – How to master precepting with Will Cohen, MSN, CRNA Oct 17, 2020

Today I’m joined by Will Cohen to talk about clinical precepting. We discuss ways to create effective learning environments, how to expect excellence while being supportive and other tips for mastering the art of precepting. Will created the Facebook page CRNA Preceptors and has become well known in the CRNA world for creating masterfully crafted […]

#7 – Leadership in Emergencies – how to master the art & science of resuscitation Oct 12, 2020

Leadership in emergencies is about leadership outside of emergencies. The art and science of resuscitation involves understanding and mastering both the systems design and human factors at play in emergencies. In this episode, I unpack research by Weinger, et. al. (2017) to help us see the potential for improvement in our response to emergencies as […]

#6 – Van life in anesthesia school with Marcus House Oct 02, 2020

Today I talk with Marcus House, BSN, SRNA about his decision to live in an ambulance during remote clinical rotations in anesthesia school. Marcus is currently working towards completing his Doctor of Nurse Anesthesia Practice at Missouri State University. He holds Bachelor of Science degrees in Education and Nursing, both from Southeast Missouri State University. […]

#5 – The CRNA Chase with Kiki Mattress, MSNA, CRNA Sep 24, 2020

Kiki Mattress, MSNA, CRNA runs the blog The CRNA Chase which seeks to “empower, inspire, and educate” people who are interested in becoming CRNAs. In this episode, I talk with Kiki about her journey to become a CRNA and her passion for helping others understand and be successful on that same path. “Don’t just talk […]

#4 – Front Line Heroes with M.J. Hiblen Sep 20, 2020

MJ Hiblen is an illustrator from Norwich, United Kingdom who’s first book of art titled, Front Line Heroes is available now from Eyewear Publishing. This book is incredibly powerful. I’ve followed MJ’s work on Instagram since the early days of the COVID19 pandemic when he began drawing images depicting the coronavirus as a classic comic-book […]

#3 – Succinylcholine – Michael Mielniczek, BSN, SRNA Aug 31, 2020

This episode on succinylcholine will unravel the mysteries and controversies around the medication – from it’s molecular shape and how that influences which receptors subtypes and locations it exerts its effects on to practical information on dosing and how to optimize airway management while mitigating the side effects of succinylcholine. At the time of this […]

#2 – Dexmedetomidine – Matt Poirier, MSNA, CRNA Aug 29, 2020

This is a quick run down on the use dexmedetomidine in the perioperative environment.

#1 – Anesthesia Guidebook Origin Story Aug 24, 2020

Welcome! You made it! This is episode 1: the origin story, the backdrop, the context to who we are, where we’re from and where we are headed. Check out the podcast in your favorite player or right here on the website to hear our story, which is all about YOUR STORY! You’re on a path […]

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