My work experience ranges from the fast-paced OPS facilities to the complex slower paced, teaching hospitals. This variety allows me to continue building upon my knowledge of anesthesia care and travel management. With every new facility there is an initial, steep learning curve and then a plateau of familiarity. Analogous to climbing a staircase, the more you practice the easier it becomes. With experience, I’m able to join a new environment with ease and confidence in the high quality of anesthesia care I provide to any practice setting.

I believe the notion that CRNAs and Anesthesiologists are in competition is misguided. There is a role for both in providing the best in Anesthesia care. When asked by a lay person ‘What is the difference between an anesthesiologist and a CRNA?’ My response is as follows: The anesthesiologist is comparable to the scientist and the CRNA is comparable to the engineer. The anesthesiologist promotes the field of anesthesia practice. The CRNA implements the science into practice. With a background in research (PhD), I clearly understand this distinction and respect my fellow MDs. I also firmly believe two anesthesia providers, whether it be 2CRNAs, 2MDs or 1CRNA/1MD, is safer than one anesthesia provider. My work experience includes being a sole provider (small island communities in Alaska) as well as working together with an anesthesiologist. I enjoy both.

Working in several states across the country, I have experience in a wide variety of anesthesia techniques. I’ve worked on the highly technical robotics case using ERAS, TIVAs deep or light, “slow and low” for the elderly, and ‘fun for the young’ pediatric patient. Working with multiple anesthesia groups has given me the opportunity to experience the wide variety in anesthesia care. I have come to know there is no single way to take care of surgical patients. I have, however, developed guidelines for my individual practice. Realtime decisions are made by combining the three circles of knowledge:

3 overlapping circles of knowledge

I find by combining these, I’m able to draw on what works for me while keeping an open mind to new innovations in anesthesia practice.

Charting is always a challenge for a new provider. However, with my experience, I’ve learned the important commonalities among all charting styles. Case codes, times, signatures, and events are common to any charting method. Pixies, medication waste, and pharmacy charges are common to all facilities. Although the methodology requires a high learning curve with each facility, the end results are the same. Among others, I’m familiar with both Epic and Cerner EMRs.

The ever-changing work environment offers many challenges to the traveling CRNA. Interpersonal skills are a must. Early in my career I realized this as I excelled as a practitioner. Becoming a Service Carrier has always been my calling. Helping my patients is of top priority. However, the service to my community does not end there. Over the years I developed a hierarchy of service priorities with Patient Safety above all:

Pyramid hierarchy of service priorities

Anesthesia providers are well aware of lengthy credentialing process. Often health care facilities are left at critical staffing shortages because credentialing has taken longer than expected. Even on a national level credentialing has been sighted as a reason for healthcare worker shortages. As a traveler, I credential two to three times a year and re-credential anywhere between 4 to 5 times per year (as the number of sites where I am credentialed increases).

Over the years of traveling I have been given the opportunity to identify the points of delay. Although, I have no control over the facilities credentialing team, I can provide immediate access to all my credentialing documents and verification contacts. Even though the number of facilities I’ve worked at is more than average, I have a squeaky clean record and exceptional bill of health.