#126 – The Opioid-Sparing Opioid – how to master perioperative methadone
Aug 11, 2026
My guests today are Abigail Lee and Johanna Bennett, two Doctor of Nursing Practice graduate students at the University of New England who focused their DNP project on perioperative use of IV methadone.
Abigail Lee attended Southern Maine Community College and transferred to the University of Southern Maine to study nursing. She worked at Maine Medical Center in the Cardiothoracic Intensive Care Unit. She intends to head down to North Carolina to work as a CRNA.
Johanna Bennett went to Saint Anselm College. She started her career in healthcare in the Medical/COVID ICU as a new graduate nurse and worked there for three years before starting CRNA school at the University of New England. Jo will be joining our team at Maine Medical Center to work as a CRNA.
This episode is on the longer side, so here’s your TL:DL, too-long; didn’t listen summary of perioperative IV methadone – the opioid-spairing opioid.
Standard short-acting pure mu-agonists—like fentanyl, hydromorphone, and morphine—often leave our patients trapped in a roller coaster of ‘peaks and valleys,’ leading to oversedation, unexpected pain spikes, and high total opioid consumption in the PACU.
In this episode, we explore why methadone is uniquely positioned as the ‘opioid-sparing opioid.’ Beyond its strong -receptor agonism, methadone boasts NMDA receptor antagonism and serotonin/norepinephrine reuptake inhibition, targeting pain at multiple pathways to blunt central sensitization and wind-up phenomenon.
Key Clinical Takeaways from the Literature:
The Effective Dose: An ideal single dose on induction is 0.2 to 0.25 mg/kg ideal body weight (or roughly 10-20 mgIV). Underdosing (<0.1 mg/kg) eliminates the long-term benefit, while dosing over 0.3 mg/kg slightly increases transient PACU sedation without adding extra analgesia.
Where it Shines: Greatest reductions in PACU pain scores and overall post-op opioid consumption occur in high-nociceptive surgeries—like multi-level spinal fusions, cardiac, thoracic, and major reconstructive procedures.
Safety Profile: A single intraoperative dose displays a safety profile comparable to short-acting opioids—with no increased incidence of delayed respiratory depression, PONV, or QT prolongation in acute, single-dose settings.
I want to share one particular guideline that I’m familiar where the hospital developed a clinical guideline to help their team incorporate IV methadone as a perioperative analgesic.
The key points in this guideline include:
1. Consider using methadone in surgeries lasting greater than an hour which are at high risk of significant postoperative pain, especially when patients are not candidates for epidurals or regional blocks.
2. Avoid the use of methadone in patients who have a baseline prolonged QTc or with those patients who are on buprenorphine or in surgeries less than one hour since the peak respiratory depression is about 45 minutes after administration.
3. The typical dose proposed in the guideline is 0.2 mg/kg of ideal body weight IV with consideration to reduce the dose to 1.5 mg/kg for surgeries that have a same day discharge plan. Rescue doses of 3 to 5 mg are used instead of hydromorphone after the end of the procedure if needed for post-operative analgesia.
4. This center continues to use standard PACU orders for IV and PO analgesia following the use of methadone
5. On the buprenorphine point: Methadone has a significantly lower binding affinity for mu-receptors than buprenorphine so in patients who are actively taking buprenorphine, single dose perioperative methadone is relatively ineffective without alternative strategies like weaning the buprenorphine or interventions tailored for patients with chronic pain or opioid use disorder – which are both beyond the scope of this podcast.
If you want to hear a little more about the challenges around pain management with patients on buprenorphine in particular, please go listen to episode 13 of Anesthesia Guidebook with Aurora Quaye, MD, one of the leading researchers in this space and a pain management specialist at Maine Medical Center in Portland. We recorded that show way back in March of 2020, so it probably is time to check back in and get the latest on all the research and amazing work her and her team have been doing in the last several years.
So, that’s a little primer on where we’re headed today. I want to thank Johanna and Abigail for their incredible walk through of methadone in this conversation, as all as for the tips they share on navigating the DNP project process.
If you’re looking to eliminate PACU pain spikes, optimize your patient’s chance for enhanced recovery, or rethink your perioperative analgesic strategy, this deep dive is for you.
#125 – Transformational Leadership with Adrian Moran, MD, MBA
Nov 19, 2025
Adrian Moran, MD, MBA currently serves as the Chief Medical and Transformation Officer of MaineHealth, a not-for-profit, integrated health system with over 2000 providers and 23,000 care team members serving patients across Maine and New Hampshire.
Dr Moran joined me to talk about his views on transformational leadership and his professional journey from a pediatric cardiologist at Boston Children’s Hospital to executive organizational leadership roles.
I’m excited to share his story with you because we don’t talk enough about how to transition from being specialized clinicians to working in healthcare leadership.
I asked Dr Moran to join me for this interview given his unique vantage point and journey to executive leadership. MaineHealth’s flagship level 1 trauma center, Maine Medical Center, is where I serve as the Director supporting the Department of Anesthesiology and Perioperative Medicine. Over the last decade, I’ve watched Dr Moran move from his clinical role as a pediatric cardiologist to MaineHealth board member to Associate Chief Medical Officer. I then saw him leave MaineHealth to take on a system level CMO role for a large health system in Wisconsin and then back to MaineHealth as the Chief Medical and Transformation Officer.
Over the years, I’ve seen his leadership style in action and recently heard him describe how the principles of high reliability organizing and servant leadership inform his work, which are ideas we’ve talked about here on the podcast over the last year or so.
In this conversation, we talk about:
the challenges facing healthcare organizations today and what leaders can do to be effective in supporting their teams
what transformational leadership looks like
the value of gaining practical experience and credibility as a healthcare leader
when and why additional education, like an MBA, might make sense for leaders
what motivates Dr Moran and what he sees as his core purpose
In full transparency, this interview was imbedded in a qualitative research course I’m taking as part of the PhD in Leadership & Organizational Develop at the University of Southern Maine. My goal was to explore the narrative arc of Dr Moran’s professional story and hear more about his leadership philosophy and work with MaineHealth.
I think yall are really going to enjoy this episode. Dr Moran is a remarkable leader, a pretty good story teller and incredibly generous for taking time out of his busy schedule to meet with me and share a bit of his story.
Isabella, Joe & David are each SRNAs at Yale New Have Hospital’s Nurse Anesthesia program and are completing this 3-part series as their doctoral project for anesthesia school.
Isabella was a nurse in the cardiac-surgical ICU at Montefiore Medical Center in the Bronx, NY. She decided to pursue anesthesia because she saw what a positive difference anesthesia providers can make on what is the hardest day of many patient’s lives. When she did her OB rotation, she saw the direct impact CRNAs make in the delivery process and how we impact outcomes in these high risk patients. She was inspired by how we can improve the quality of care and birthing experience for patients.
Her and her colleagues who produced this series, Joe Navarrete and David Barksdale, are all advocates of women’s health and through this doctoral project hope to empower other providers to cultivate excellence at their facilities when caring for patients with hypertensive disorders of pregnancy.
This three part series will equip anesthesia residents and providers alike with the core knowledge to effectively manage hypertensive disorders of pregnancy. Many thanks to Joe, David & Isabella for putting this series together!
Please see below for full show notes and references.
David Barksdale is a Nurse Anesthesia Resident at Yale New Haven Hospital School of Nurse Anesthesia and Central Connecticut State University. Before CRNA school, he worked for three years as a Surgical Intensive Care Unit nurse at Rhode Island Hospital and is a combat veteran. He served in the United States Army from 2012-2015 as a combat engineer. In 2013, he deployed to East Paktika Province, Afghanistan, conducting route clearance operations to provide freedom of movement to the infantry and local populations.
David framed his doctoral project around this topic to deepen his understanding of hypertensive disorders of pregnancy and to explore how podcasting can support learning for anesthesia providers.
This three part series will equip anesthesia residents and providers alike with the core knowledge to effectively manage hypertensive disorders of pregnancy. Many thanks to Joe, David & Isabella for putting this series together!
References:
1. American College of Obstetricians and Gynecologists. Gestational hypertension and preeclampsia: ACOG Practice Bulletin, Number 222. Obstet Gynecol. 2020;135(6):e237-e260. doi:10.1097/AOG.0000000000003891
2. Dimitriadis E, Rolnik DL, Zhou W, et al. Pre-eclampsia. Nat Rev Dis Primers. 2023;9(1):8. doi:10.1038/s41572-023-00417-6
3. Torres-Torres J, Espino-Y-Sosa S, Martinez-Portilla R, et al. A narrative review on the pathophysiology of preeclampsia. Int J Mol Sci. 2024;25(14):7569. doi:10.3390/ijms25147569
5. Hall JE. Guyton and Hall Textbook of Medical Physiology. 14th ed. Philadelphia, PA: Elsevier; 2020.\Chestnut DH, Wong CA, Tsen LC, et al. Chestnut’s Obstetric Anesthesia: Principles and Practice. 6th ed. Philadelphia, PA: Elsevier; 2019.
#122 – Physiologic Changes in Pregnancy with Joe Navarrete
Oct 24, 2025
This episode is part of a three-part series on titled “The Pressure is on: Enhancing Anesthesia Care for Parturients with Hypertensive Disorders of Pregnancy.” In this first installment, Joe Navarrete, a third-year student registered nurse anesthetist (SRNA) at the Yale New Haven Hospital School of Nurse Anesthesia, delivers a high-yield, system-by-system breakdown of the expected physiologic changes of pregnancy.
Part 2 will be #123 – Pathophysiology of Hypertensive Disorders of Pregnancy with David Barksdale
Part 3 will be #124 – How to Manage Hypertensive Disorders of Pregnancy with Isabella Sosa
In this episode, Joe Navarrete guides listeners through changes in the respiratory, gastrointestinal, renal, endocrine, musculoskeletal, nervous, hematologic, and cardiovascular systems, with an emphasis on how these changes impact anesthetic management. Joe covers pertinent topics including airway considerations, anesthetic requirements, dilutional anemia, hypercoagulability, neuraxial anesthesia, cardiac output, and fluid shifts throughout pregnancy. The episode concludes with a brief recap of clinical pearls for anesthesia providers to remember when caring for obstetric patients.
This is an in-depth review for SRNAs, CRNAs, and all anesthesia providers alike looking to refresh their understanding of maternal physiology. Whether providers are preparing for clinical rotations, board exams, or managing complex obstetric cases in practice, this review attempts to cover the bases.
At the time of this recording, Joe Navarrete was a 3rd-year SRNA at the Yale New Haven Hospital School of Nurse Anesthesia in Connecticut, pursing his Doctor of Nurse Anesthesia Practice (DNAP) degree. He earned his Bachelor of Science in Nursing from Rhode Island College in 2019. Joe began the first year of his nursing career on the surgical stepdown unit at Rhode Island Hospital (shoutout to 5 stepdown!).
Within his first year of nursing practice, the COVID-19 pandemic transformed the stepdown unit into a COVID ICU. There, Joe gained experience in managing critically ill patients and often worked alongside anesthesia providers during emergent intubations. These experiences sparked his interest in nurse anesthesia, and he never looked back. He went on to work in the Surgical Intensive Care Unit for 2.5 years before matriculating into anesthesia school and moving to Connecticut with his significant other Rebekah and their beloved cat, Bubba.
Bleeser T, Vally JC, Van de Velde M, Rex S, Devroe S. General anaesthesia for nonobstetric surgery during pregnancy: A narrative review. European Journal of Anaesthesiology and Intensive Care. 2022;1(2). doi: 10.1097/EA9.0000000000000003
Bauer ME, Arendt K, Beilin Y, et al. The society for obstetric anesthesia and perinatology interdisciplinary consensus statement on neuraxial procedures in obstetric patients with thrombocytopenia. Anesth Analg. 2021;132(6):1531-1544. doi:10.1213/ANE.0000000000005355
#121 – Tactical Empathy: how to turn resistance into momentum
Sep 23, 2025
What’s up y’all! I’m back at it after a summer hiatus. I actually wrote/recorded this episode back in May 2025, but then summer hit with camping trips, work projects, grad school, home renovations… you know, life! I’m pumped to bring this episode to you finally and this will be followed pretty quickly by a three-part series on hypertensive disorders of pregnancy, which is going to be stellar!
Check out these continuing education conferences with Encore Symposiums if you want to connect in person, as I’ll be speaking at each of them:
2025October 20-23: New England at the Cliff House, Maine
2026October 19-22: Autumn in Bar Harbor, Maine
2026 November 14-18: O’ahu Turtle Bay, Hawaii (Ritz Carlton)
This episode dives into tactical empathy: how to turn resistance into momentum in your conversations.
This could be useful whether you’re negotiating with your 4-year old on taking a bath, rebooking a flight after yours got canceled or in the boardroom trying to implement a new project or proposal.
In this episode, we’ll walk through:
The role of loss aversion in negotiation
Techniques of tactical empathy: naming, mirroring
The power of “yes, and…” (a tool from improv comedy)
How to “start with no” in a negotiation by asking “how am I supposed to do that?” in a kind, vulnerable way.
Why listen to this episode? If you want to become a better communicator, get the best deal in a negotiation or learn how to have entertaining conversations from over the drapes in the OR to a cocktail party, this is for you. Tactical empathy is about leveraging what really matters to you and other people with clarity when communicating.
Don’t hesitate to reach out with questions, comments or feedback. Remember, the work you do is extremely important and incredibly valuable. You are the provider your patients need. Keep up the hard work. Be well and enjoy the journey!
Camp, J. (2002). Start with no: The negotiating tools that the pros don’t want you to know. Crown Currency.
Heifetz, R. A., Grashow, A., & Linsky, M. (2009). The practice of adaptive leadership: Tools and tactics for changing your organization and the world. Harvard business press.
Kahneman, D. (2011). Thinking, fast and slow. Farrar, Straus and Giroux.
Voss, C., & Raz, T. (2016). Never split the difference: Negotiating as if your life depended on it. Random House.
#120 – Appreciative Inquiry (how to listen to your team)
May 02, 2025
Want to work on changing things? Want to learn about your team and listen better? Interested in a pretty good pathway to do that?
Appreciative Inquiry is process of:
Discovering what’s working well
Dreaming about what could be
Designing for future change & success
Realizing the Destiny that this process will bring about
In this podcast, we’re gonna walk through Appreciative Inquiry and Theory U and how these 2 organizational development processes meld together to create a powerful tool for listening to and helping to improve the work your team does. It’s so good!
Our CRNA team at Maine Medical Center worked through this process – really, we’re still working through it – this spring. The full story is in the podcast.
I made a video for this podcast but I haven’t been able to get it loaded to YouTube yet and apparently, it’s too big for this website. In the meantime, you can see the core show notes to the podcast in the PDF below. There’s photos of the Theory U and our list of 10-questions we developed as our Appreciative Inquiry survey we used at Maine Medical Center.
I hope this episode gives you some very practical tools for how to engage with your team better. I’ve found appreciative inquiry to be a great way to have a conversation with groups and find a new way forward. Let me know how it goes for you!
Edmondson, A. C. (2018). The fearless organization: Creating psychological safety in the workplace for learning, innovation, and growth. John Wiley & Sons.
Hollnagel, E. (2020). Synesis: the unification of productivity, quality, safety and reliability. Routledge.
Scharmer, O. (2016). Theory U: Leading from the future as it emerges. Berrett-Koehler Publishers.
Scharmer, O. (2025). Theory U process of co-sensing and co-creating. Presencing Institute. https://www.presencing.org
Whitney, D., & Cooperrider, D. (2005). Appreciative inquiry: A positive revolution in change. Berret-Koehler Publishers.
#119 – Psychological Safety & Just Culture
Apr 26, 2025
Yo yo! Today, we close out our 3-part series on systems thinking with this episode on psychological safety & just culture.
Part 1 (Episode 117) introduced systems thinking & high reliability organizations.
Part 2 (Episode 118) walked through resilience engineering, safety differently and synesis.
Part 3 (this episode) threads these topics together with psychological safety & just culture.
This three part series invites you to think about your home team and professional practice.
How does your team handle errors & mistakes? Are you safe to fail and be honest about mistakes & near misses? Are mistakes and mishaps talked about?
Do you usually take feedback well and look for ways to grow or get defensive and think it’s always someone else’s fault? What about the other folks on your team?
Psychological safety is about the freedom to speak up without fear of embarrassment or punishment. Psychological safety doesn’t just happen. Organizational leaders need to talk about it and normalize it – truly, make it part of your team norms. Psychological safety doesn’t skirt accountability. Accountability is a key part of a psychologically safe culture. We’ll talk more about it in the show.
Just culture extends the idea of psychological safety to the organizational environment and the team’s approach to errors and mistakes. Just culture encourages teams to look at systems factors for why things break down. People don’t make mistakes willfully. Willful harm with malicious intent is recklessness or sabotage. That’s not a mistake. Mistakes are always unintentional because people don’t show up to work planning how they’re going to accidentally drop the ball and screw things up. Just culture looks at mistakes from the standpoint that perhaps the system is broken and sets frontline staff up for failure. A systems fix is like a rising tide that lifts all boats. Just culture sees the systems as the usual point of failure, not the frontline worker. Front line workers are often the source of resilience and capacity within systems.
We talk about these things and more in the podcast as we thread all three parts of this series together.
As a reminder, I’ll be in Hilton Head, SC next month teaching with Encore Symposiums and back at the Cliff House in Maine this October with Encore. Come check us out if you’re looking for a great continuing education conference!
Your values build your system, your system creates your culture, your culture generates your results.
Dekker, S. (2016). Just culture: Balancing safety and accountability. crc Press.
Dekker, S. W., & Leveson, N. G. (2015). The systems approach to medicine: controversy and misconceptions. BMJ quality & safety, 24(1), 7-9.
Edmondson, A. C. (2018). The fearless organization: Creating psychological safety in the workplace for learning, innovation, and growth. John Wiley & Sons.
Edmondson, A. C. (2023). Right kind of wrong: The science of failing well. Simon and Schuster.
Schein, E. H. (2010). Organizational culture and leadership (Vol. 2). John Wiley & Sons.
Senge, P. M. (2006). The fifth discipline: The art and practice of the learning organization. Broadway Business.
Weick, K. E., & Sutcliffe, K. M. (2015). Managing the unexpected: Sustained performance in a complex world. John Wiley & Sons.
This is Part 2 of a 3 part series on organizational development – how we work and live together as teams in healthcare so we can do our best work, master our craft, take amazing care of patients and actually enjoy the work we do. (no big deal)
In the first part (Episode 117), we talked about systems thinking and patterns of high reliability organizations (HROs). Systems thinking helps us zoom out to consider the complexity of situations and the various levers that influence outcomes. High reliability organizations adopt specific systems thinking practices to achieve consistent success in safety-critical, complex environments.
Resilience engineering builds on systems thinking and HRO theory by teaching us how to develop adaptive capacity, build for success (not just avoiding error) and bounce back when things don’t go well. Safety differently is about seeing safety as not the absence of mistakes and errors but the capacity for the right thing to happen. It also recasts the worker not as the weak link in a complex system (the point of failure), but as the source of resilience and capacity. Front-line healthcare workers – you and me – are often the ones who find the workarounds and get the job done despite suboptimal conditions.
No one shows up to their job with the intention to make mistakes, get hurt or put patients at risk. Mistakes are always unintentional. Willful acts of harm are something totally different. Blaming and shaming workers (forms of punishment & embarrassment) are counterproductive and stem from leaders who do not understand what’s actually going on or the best ways to run their organizations and build thriving teams.
Synesis, which sounds like a scary word, stems from the same Greek word that system and synergy come from and is actually kind of a cool idea. It’s the way we balance the often competing interests of productivity, safety, reliability and quality. We need to figure out how to do all of these things concurrently in healthcare. I’ll share some stories and examples of how to do that as an anesthesia provider in this episode.
So that’s where we’re headed with this podcast!
In Part 3, we’ll come back and talk about psychological safety and just culture, which thread all three episodes in this little mini-series together.
As a reminder, I’m teaching with Encore Symposiums next month in Hilton Head, South Carolina and back at the Cliff House in Maine this October. If you’re looking for a continuing education conference where we’ll talk more about all of this – or if you’re a resident or graduate student looking to check off one of your state/national meetings, come check us out! I’d love to see you there!
As always, you can come work with us at MaineHealth – Maine Medical Center. We have a phenomenal team of CRNAs, physician anesthesiologists, surgeons, OR nurses & CSTs, anesthesia techs and admin specialists. If you want to be part of a growing team of providers doing world class work at a level 1 trauma center in a spectacular city, check us out!
Epstein, R. M., & Krasner, M. S. (2013). Physician resilience: what it means, why it matters, and how to promote it. Academic Medicine, 88(3), 301-303.
Hollnagel, E. (2020). Synesis: the unification of productivity, quality, safety and reliability. Routledge.
Larouzee, J., & Le Coze, J.-C. (2020). Good and bad reasons: The Swiss cheese model and its critics. Safety science, 126, 104660.
Senge, P. M. (2006). The fifth discipline: The art and practice of the learning organization. Broadway Business.
Sutcliffe, K. M. (2011). High reliability organizations (HROs). Best practice & Research clinical anaesthesiology, 25(2), 133-144.
Wears, R., & Sutcliffe, K. (2019). Still not safe: patient safety and the middle-managing of American medicine. Oxford University Press.
Weick, K. E., & Sutcliffe, K. M. (2015). Managing the unexpected: Sustained performance in a complex world. John Wiley & Sons.
World Health Organization. (2021). Global patient safety action plan 2021-2030: towards eliminating avoidable harm in health care (9240032703).
#117 – An Intro to Systems Thinking and High Reliability Organizations
Apr 13, 2025
Yo! This episode introduces the concepts of systems thinking and high reliability organizations. It’s the first part in a 3 part series. Part 2 is gonna dive into resilience engineering and safety differently. Part 3 is all about psychological safety and just culture.
These 3 shows unpack crucial intel for front-line providers, equipping them to understand their roles and how to develop their clinical impact. It’s also for organizational leaders and practice managers and will help you think about how to design better systems and support your team so they can thrive.
Systems thinking is the process of zooming out beyond simple cause-and-effect understanding (i.e. linear causality models) of how errors happen. It encourages people to consider the complexity of their environments and the power of leveraging changes in your processes and systems.
In this episode we cover:
Learning organizations and their 5 characteristics:
Personal mastery
Mental models
Shared vision
Team learning
Systems thinking
High reliability organizations and their characteristics
Preoccupation with failure
Reluctance to simplify
Sensitivity to operations
Commitment to resilience
Deference to expertise
How these ideas link to resilience engineering and safety differently
“Every organization is perfectly designed to get the results it gets” (Batalden, 2015).
If you don’t like the results you’re seeing, you need to change the system. Whether this is your anesthesia team, hospital/OR or your personal life. If the outcomes are not what you desire, you need to adopt a systems thinking approach to change. This episode will walk you through how to do that.
The values you embrace shape your culture. Your culture builds your systems. Your systems generate your results.
Quick reminder: I’m teaching at Encore Symposium’s Hilton Head conference May 19-22 and then again with their fall conference at the Cliff House here in Maine that runs October 20-23, 2025. I love seeing y’all in person at these conferences. If you come because you heard about it here on the show or are just there and have checked the show out before, come holler at me! I’d love to chat with you about what you’re up to and what your practice is like.
Be sure to check out Part 2 and 3 of this series and I’ll see you there!
Epstein, R. M., & Krasner, M. S. (2013). Physician resilience: what it means, why it matters, and how to promote it. Academic Medicine, 88(3), 301-303.
Hollnagel, E. (2020). Synesis: the unification of productivity, quality, safety and reliability. Routledge.
Larouzee, J., & Le Coze, J.-C. (2020). Good and bad reasons: The Swiss cheese model and its critics. Safety science, 126, 104660.
Senge, P. M. (2006). The fifth discipline: The art and practice of the learning organization. Broadway Business.
Sutcliffe, K. M. (2011). High reliability organizations (HROs). Best practice & Research clinical anaesthesiology, 25(2), 133-144.
Wears, R., & Sutcliffe, K. (2019). Still not safe: patient safety and the middle-managing of American medicine. Oxford University Press.
Weick, K. E., & Sutcliffe, K. M. (2015). Managing the unexpected: Sustained performance in a complex world. John Wiley & Sons.
World Health Organization. (2021). Global patient safety action plan 2021-2030: towards eliminating avoidable harm in health care (9240032703).
If you don’t like the results you’re seeing, you gotta change the system! Every system is perfectly designed to get the results it gets!
#116 – What Mouth-to-Mouth Resuscitation has to do with Systems Thinking
Mar 22, 2025
On the corner of Skyland Drive and 23 in a little town called Sylva in Western North Carolina, sit’s PJ’s gas station. One hot summer day back in 2005, I was filling up the tank in a convalescent transport van on my very first day as an EMT-Basic. That’s the most basic, entry-level certification of […]
#115 – The NBCRNA MAC Program: How CRNAs Recertify
Feb 24, 2025
Hey y’all! First of all: thank you to those of you who have subscribed to the website and get these posts right to your email inbox. That’s all that happens: the podcast is free and subscription to the show just means you get the content straight to you as soon as it’s live. I never […]
#114 – Leadership: how to get stuff done
Feb 17, 2025
This podcast is for leaders, clinicians, residents & students who need to get wildly important things done. It’s about how to prioritize when so much of your work seems important. How to find balance when so much seems to be coming at you. How to get started at achieving your biggest goals. This episode will […]
#113 – Sabbatical in Spain with Matt Moody, CRNA
Feb 09, 2025
Matt & Alison Moody took a year off of working as CRNAs to live and travel in Spain with their then 4-year old daughter. This is part of that story. The two were living and working as CRNAs in Asheville, North Carolina when they caught the idea to take a year off of work and […]
#112 – How to Transition from Clinician to Chief CRNA
Jan 25, 2025
What’s up y’all! This is Jon Lowrance and this is episode 112 – How to Transition from Clinician to Chief CRNA. Y’all are going to love this conversation. So… I almost don’t know where to begin cause there’s so much to talk about… This is an episode about chief CRNAs but so much more. It’s […]
#111 – How to do Medical Mission Trips with Stacey Such, CRNA
Nov 24, 2024
What’s up yall! This is Jon Lowrance and this is episode 111 – How to Prepare for Medical Mission Trips with Stacey Such, MSN, CRNA. (Stacey pronounces her last name, Such, like “Suke/Duke.”) Before we get to this show, I’d like to give a quick shout out to the CRNAs, SRNAs & physician anesthesiologists who […]
#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 – […]
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 […]
#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 […]
#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 […]
#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 […]
#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 […]
#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 […]
#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 […]
#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 […]
#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 […]
#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 […]
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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