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Welcome to Don’t Eat Your Young — the podcast that brings you stories from the trenches of the incredible, wonderful, exhausting, terrifying, joyous world of nursing.
Host Beth Quaas been in the world of nursing for nearly decades and has worked in hospitals large and small. She's worn the hats of the floor nurse, ICU, ER, and anesthesia. She's been a manager, an educator, and a co-worker.
On Don't Eat Your Young, Beth highlights stories from nurses around the country that are doing amazing things for their nursing colleagues to support them and let them know that they are not alone. This is a show celebrating a positive culture of nursing and care, and we can be a part of this culture by sharing wins — and struggles — across the field.
We will also explore opportunities that are unique in nursing that may inspire you to go in new directions. These voices from the field are an inspiration to care for yourself, and those around you.
Subscribe to the show wherever you get your podcasts. For more information and to support this show, visit donteatyouryoung.com.
Nurses. Making our world better, one shift at a time!
Beth Quaas: [00:00:00] Hello everyone. And welcome back to Don't Eat Your Young. I'm your host, Beth Quaas. Thanks for spending some time with us today. I'm excited to kick off season five with Richard Wilson. He's a CRNA. He's been a long time educator and he's here to talk to us about generational differences and how they can impact our communication and learning from each other.
I would like to welcome Richard Wilson to the show. Um, thanks for being here, Richard.
Richard Wilson: Thanks, Beth, for having me. I'm excited about being here today and, uh, just sharing a little bit about what we've been doing.
Beth Quaas: And I think your topic is just amazing and it fits so well with Don't Eat Your Young, so why don't you tell us a little bit about yourself?
Richard Wilson: All [00:01:00] right, so I am a nurse anesthetist, obviously, and I've been doing this for around 18 years now. I graduated in 06, so I'm coming up on my 19th year. Um, left straight from school and, uh, from my nurse anesthesia training. And about three years later, I kind of joined into academics, which I've been doing for about the last 15 or 16 years.
I love the academic side. Um, as you know, it's pretty exciting. It's really interesting. Uh, keeps you on your toes, obviously, but it is something that I've really been passionate about for the last 15 or 16 years. So I've enjoyed that side of it.
Beth Quaas: What's your favorite part about teaching? I know we all come in a little different.
Richard Wilson: It's a lot of, of changes that go on and I love to see those changes. I love those light bulb moments and seeing that growth and really as many of them know and our applicants and our students and even graduates is that moment where you see them come in and you see the green in their eyes and you see the.
The newness and the [00:02:00] excitement behind them. And then you watch, you know, their transition from a novice to being a competent, to being an expert in what they're doing. And then watching that transition is great. And just seeing that light bulb moment where they're like, okay, now it's all clicking of why I did this and what I'm doing.
And they get it in that groove.
Beth Quaas: Absolutely. Well, I had the pleasure of seeing you speak at one of our national conferences last week, which was amazing. And it was on the topic that we're going to talk about today. And I think it is so important, um, all through our schooling out in our clinical worlds, because, you know, we have a lot of different generations that we're out there working with, um, and in our field for sure.
Nurses come in very experienced from the ICU, and they've already worked with a lot of different generations. But I think once you get into education, then again, it's something totally different. So, just start off and tell us a little bit about the different generations, and we'll go from there. [00:03:00]
Richard Wilson: Yeah, I'd be glad to.
So, um, you know, really what got me involved in this topic and really thinking about this was as an educator for, like I said, 15, 16 years now, it's really important that we look at how we are educating the future of our profession. Right? So as we look at it and we start thinking about what's been going on over the years, and we start thinking about what's really Driven the education models that we're in, there's going to be a lot of different factors.
Some of those are going to be, obviously, the factors of what's going on, especially clinical training programs. What's going on in the hospital and how the hospital's driving it, right? And what are they requiring or what are they asking for out of their learners? Then we've got the, the academic side, the didactic side.
As you look at the university partners, and as we look at the university partners, they obviously have their goals and their missions, visions, and values. Um, but then when we look at really where's education be driven. We have to look at it on the societal end, [00:04:00] and when we look at it on the societal end, that's driven by the fact that we actually have, you know, these, uh, events that happen throughout our lives and throughout our formative years, which really drives us into who we are as a generation, and we'll, we'll talk a little bit about that, but we have to understand that those generations are driving what's going on in the educational side.
We can educate and we can be teachers and we can find the best teachers in the world, right? The most informative, the most educated, the most researched individuals in the world. But unless they're able to actually reach the students, reach the learners, they're not very successful. They're not going to do very well, right?
And that's something that we have to think about. And to understand that, you've got to understand generations. I started teaching when I was, let's see, um, I was about 33 years old when I started teaching. So I obviously at that point in time was not very far off from some of my students in the age range, right?
So we were some of the same beliefs, some of the [00:05:00] same values, traditions, and so forth. Uh, now I am obviously teaching students that are almost my child's age. And so we're talking about now, how do we relate to them? How do we bring in what our strengths are as educators? What their strengths are as learners in the different generations?
And really maximize that to get the best experience.
Beth Quaas: You're right. I think that's where you have to start is understanding that there truly are differences. And would you say that we as educators educate the way we learned and the way we understand best? to start out.
Richard Wilson: So we have been molded by those who educated us, right?
And those that mentored us. I have many, many mentors that brought me up through the education realm. Some are obviously my age because they were colleagues of mine and we sat on committees together and we'd reached out to each other when we had questions or had needs that we wanted to look at. But [00:06:00] there were obviously were older than me that really Molded who I was, but, uh, really those experiences in how we were taught is what we look at for the most part because it's what we've become comfortable with.
And really, as educators, we have to become comfortable with being uncomfortable at times. And that's whether we're changing the model of how we present information or teach it, change the model of how we're testing. Uh, change the model of, uh, student led discussions instead of, uh, instructor led discussions.
So all of this has to play into who you are as an educator. Um, but yeah, I think we struggle with it at times, and especially when we get to be in different generations and looking at them. It's because we do what we're comfortable with, which was how we were molded when we came up and the things that we saw that we liked out of our faculty, or even the things we saw that we didn't like.
And we, you know, we made it a [00:07:00] pact that we weren't going to do it that way. So all of that is really played into who we are as educators. And sometimes we have to get out of our own way, uh, to make sure that we are, uh, looking at what are the best practices. Not only do we have to worry about the best practices in, in, in a clinical setting.
You know, as nurses, as ICU nurses or, um, floor nurses, as nurse anesthetists, as physicians, whoever we may be in a clinical setting, uh, we have to look at best practice models and those change over the years. And it's no different with education. Education models in, in, have changed over the years and we have to look at where the best practice models are for education.
Beth Quaas: Right. I would say that you cannot continue doing the same thing year after year after year because it just becomes. Irrelevant, or more difficult to teach, more difficult to understand. I know that I try to incorporate a little bit of everything in the courses that I teach because our learners are different.
I'm even older than you, and so I am far [00:08:00] removed from a lot of technology. My students help me a lot, and my co workers help me a lot in that area. When I was in school, the internet was brand new. So I'm sure students now are very overwhelmed with that piece of it because they can go anywhere to find information.
So that's something that, um, I think was an advantage for me. I had the books that I read and some journals, but I couldn't really dive deep into the internet.
Richard Wilson: Yeah, I mean, we have to take that into consideration when we talk about this and I spoke about it at the ADCE for the AA& A recently is, you know, we go back and my mother was an instructor.
She was a high school math teacher, calculus for over 30 years. And, you know, I remember when she would come home and I would clean off the floor. Yeah. The overhead projector roles, right? Because that's what we learned through. You'd have the overhead projector, put it up on the screen and you would write those out with dry erase markers and you would clean them off.
And then we transition into the chalkboards and dry [00:09:00] erase boards to now, you know, the technology that we have. And like you said. It used to be that not everybody even had an Encyclopedia Britannica, and most of the people on this podcast may not even know what that is, but, you know, it's, it's no, not everybody had those.
So you really had to dive into the information on your own and learn it and find the resources where now the resources are at the tip of our finger. And sometimes that's not a good thing. Sometimes that's overwhelming. To our, uh, to our newer generations, right? Because it's right there at the tip of their finger.
They can look it up at any moment. And so we have to understand as instructors, how do we help guide them? How do we help set boundaries sometimes or just mentor and guide them on? Okay. How much information do you really need on this topic? Where can you go to get the right information on these topics?
But again, if we're not understanding the generations and anxiety that is potentially out there that's associated with [00:10:00] these electronic devices and how much information you get, if we're not understanding. Kind of how they view the world and how they view, uh, the educational piece of it and work life balance and all the other things that go along with it, then we're ineffective as instructors and as educators in being able to guide them.
Beth Quaas: Absolutely. I was sat in on a different learning session when I was at the conference last week and someone talked about, you know, there's students coming up and saying, well, can't you just Record a quick two minute video and give me the down and dirty. Well, unfortunately that's not how foundations are built.
So as much as, um, I know they would like that quick fix, we still have to go back to the basics.
Richard Wilson: We do. I mean, if you don't build the basics, you can't get the advanced principles, the advanced knowledge base that is required in healthcare field. And I know that we look at it and, you know, I'm a nurse anesthetist.
I've been there for, uh, like I said, [00:11:00] almost 19 years now. And I know a lot of people look at nurse anesthesia as an advanced field, which it is. That's why it's a APRN field, you know, but. It doesn't matter what field you are or what level you are in healthcare, you have to have advanced learning. You have to go beyond the basics and you have to continue learning throughout the process and that's what's important.
That's what makes us who we are.
Beth Quaas: I completely agree. So let's talk a little bit about the. the clinical side. So, you know, once you get out into clinicals, you've, you've been with your cohort and they're all relatively the same age. And now you're going out and you're working with many different generations, age gaps.
Don't eat your young is like I said, not just a chronological age. It's where you're at. And even the most experienced CRNAs can be Um, made to feel less than by their younger counterparts and it can go both ways. So how [00:12:00] can we start to bridge that gap?
Richard Wilson: So that's, that's an interesting concept because as we look at it right now in the medical field, if you look from, you know, say the newer nurses all the way up to our experienced nurse anesthetist, right?
Um, and you look at, uh, even some of our surgical techs and so forth. We've got about four different generations within the workforce. Um, and about, uh, you know, looking at some of the studies, about 72 percent of our Healthcare workers or either Gen X Millennials. So we're really looking at that kind of period there, right?
However, we cannot forget our baby boomers that are still there and have a lot of experience and have a lot of knowledge. They may not have a specific degree that others may have, but they've got, you know, as they say the degree of hard knocks. They've been in there working and they've got all that experience.
And we can't forget what everybody brings to the table, right? So we [00:13:00] can't forget the fact that yes, our older generations, our baby boomers who have been practicing for a while, you know, they bring knowledge base, they bring experience, they bring, um, things to the table that are not just, uh, you know, a, a, what does an arterial line look like and how do you analyze an arterial line?
They're bringing a lot of intangibles to the field And into your departments, right, that can help you out a lot. And then we've got our newer ones, we've got our new people who come in, they can really just nail the technology side and get into the specifics of, you know, end tidal carbon dioxide monitoring and stroke volume variance monitoring and looking at how do you calculate cardiac output just using an arterial line.
You know, all these advanced principles and knowledges that we've seen, uh, Grow over the years within our textbooks and within our research, they can bring that to the table. So, if we're going to be effective, we have to bring those two together, [00:14:00] right, and everybody in between. And we do that through, uh, mentorship programs, um, but I think we do that mostly through education.
And what I mean by that is I don't mean education necessarily within the classroom setting. I mean that we have to be purposeful about the education and the conversations we have within the departments, within our educational fields, and, uh, you know, just even in the break room about the differences that exist and not be polarized.
Um, I really am not getting into a political conversation, obviously, but we do live in a polarized world of black and white within concepts, right, or right or wrong within concepts. And we have to remember that we all have, we all bring something important to the table, and when we can start really Uh, having that open discussion and our leadership having that open discussion with our staff, it works well.
I really like to talk to our staff, and I've done a number of these [00:15:00] presentations at state association meetings, had the pleasure of doing it at the annual, um, assembly of didactic clinical educators for the ANA recently, but what I like to do is, is really tailor the conversation towards the, the audience that we have, you know, so if we're in the clinical workforce and we've got a lot of.
Uh, individuals that are the, uh, Gen X and obviously our, um, our Baby Boomers, then we have to gear it towards, hey, you got to understand where the other ones are coming from. And you got to understand as you're precepting, if you understand the other generations and what motivates them, right? What drives them, what their experiences are, what bring, what did they also bring to the table and how do they want to learn, then you can be an effective preceptor or you can be an effective colleague.
At that time, but then we also have to remember to tell the students and I love teaching students in the, in the, um, in the program and talking about it is when you go into clinical setting, you also have to [00:16:00] respect and understand what the older generations bring to the table and it's not just about you, just like we tell the older generations.
It's not just about them and understanding. Yes, we may have some differences in opinions and how, you know, we want to do work life balance or how we want to do. Yeah. Um, uh, you know, what time we want to get off or, or per se, or what kind of cases we want to do, but again, we have 60,000 CRNAs.
Richard Wilson (2): Mm-hmm .
Richard Wilson: So we've going to have differences.
We just need to focus on how do we bring those differences together to actually be collegial, to provide great care to our patients, and to create a wonderful work environment.
Beth Quaas: I love all of that. I tell my students too, when I'm teaching them something, this isn't how I learned it, I learned it this way, but now when you go out and you Encounter someone in my age group that maybe doesn't know the new way that you're learning now, educate them.
[00:17:00] They can learn from you. I learn a ton from my students all of the time. They're, they're up on the latest ICU monitoring and all of that. I haven't done that for A couple decades. So they teach me too and I encourage them to teach, but you have to use tact, right? Because when you're new, when your quotation marks new, um, the older experienced people can look at you and like, you don't know what you're talking about.
Well, yeah, they do. And we can all learn no matter who's trying to teach us.
Richard Wilson: Yeah, and we have to remember the older individuals, you know, when we look at our baby boomers and when we look at our early Gen Xers, right, they, they grew up in a different timeframe. So when we talk about generations and you know, generations are around this 30 year timeframe is really what you, you look at when you're looking at one generational period to another.
It's about a 30 year timeframe, 30 year period. And whatever events happen within our formative years, that's what really defines the generation in [00:18:00] itself, and it defines really the values of that generation. But we also have to remember those values morph. So we actually see one generation who starts with a value, right?
They may start with For example, if you look at some of the literature and you read up on it, it will tell you that Gen Xers really started looking at a true work life balance and started focusing on work life balance. But it wasn't until you got to Gen Y and definitely looking at Gen Z that they really started perfecting what a work life balance was really like and started really focusing on More than it just being a terminology that was used, it was a lifestyle that was lived.
And we have to remember that we can't be mad at them for what they do because we actually started it and they just perfected it, right? We talked about that before. But when we get to our baby boomers and we think about them and, you know, they were not really focused on a work life balance. They were really focused on work and that was a [00:19:00] defining, uh, characteristic of them.
But they didn't grow up with technology like Gen, Gen Y has grown up with technology in their hand. You know, we have to recognize that they just want to be, they just want to feel like they're a part of this workforce. They want to feel like they have a seat at the table and they're respected. And they want to feel like they've made a contribution to the workforce by contributing to the growth and development of those that are coming up that will eventually take their place in the workforce.
Beth Quaas: There is so much to unpack from that. So, I was just talking to one of my students last night. She's graduating very soon. And she was telling me she got a job, and she's working two twelves a week in this new job as a new graduate. Now, years ago, I would have thought How can you not be working full time plus and working overtime and getting experience?
And now I look at that and I think, she's the smart one. You're still going to get your [00:20:00] experience and you're going to work hard, but you're also going to preserve your mental health by living your life as well. So, my thoughts have changed in how, in how we should approach that. When I got out of school, There was no option.
You worked full time, and you worked the shifts they told you you were going to work, and you took vacation when you were told you could take vacation, and now I think it's a totally different landscape, at least in, in our CRNA world. Um, so I'm changing my thoughts. To adapt to what's really going on with the newer generation.
It was hard, but now I can see that they're adapting very well.
Richard Wilson: Yeah. And, and really when we talk about adaptation and we have to think about it, and I'm a very simplistic minded individual, Beth, I'm not, um, overly, uh. Um, you know, try to overthink too many things. Um, and partly because I can't, but, um, when we really look at, you know, adaptation, I mean, [00:21:00] I go back just as simple as, you know, think about TVs.
All right. I remember when I'm aging myself, obviously here is when we used to have the rabbit ears on a UHF connection. And then you would have to walk up to the TV and press a button on a box to get past channel 13. Right? Yeah. And, um, you know, we don't do that anymore, and why don't we do that anymore is because we had advancements in technology.
We had, you know, I believe that we had efficiency that took place, um, and so we don't do that anymore. And we actually, if anybody has that, we think, wow, that's old school. Man, that's, that's really old, right? But that's that. And I try to put things in perspective was actually upgrades for my parents when they were my age, right?
When they were my age at that point in time, they didn't even have that. So I have to think about it and say, well, if, if I was okay with moving past where my parents [00:22:00] had, I have to be okay with my, my children. And those I'm teaching, obviously, that are in this new generation, advancing whatever we had to the next level, and understanding that that doesn't mean it's bad, it just means we're advancing something to the next level, and we have to learn how to sometimes accept that.
I think sometimes we get into our grooves and we get set, um, and it doesn't matter what generation this is, right? But we get into our grooves and we get set and we think, wow, they're changing everything. This is bad. When it's not.
Beth Quaas: Yeah, change is hard. And I would say, especially the farther you get away from some of the change, it's even more difficult.
When we talk about So, I know you also do some, a lot of preceptor work and evaluations and for those out there that are evaluating our younger generation, what would you say to them and how to give a fair evaluation and, and set your [00:23:00] generational biases aside?
Richard Wilson: So, I think the biggest things when we, the evaluation starts from Dave.
One, right? That you see them or for minute one that you have a conversation with them. So your evaluation and Whether it's right or whether it's wrong, whether it's good or whether it's bad, you know, my evaluation of a student's first from the minute I talked to them, you know, for our program, it was the day before when they were calling me to tell me what cases we were doing the next day.
And we were talking about our anesthetic plan of care, right? So that's when my evaluation started with them. How did they communicate with me? How did we, you know, decide on what the case was going to be and how prepared were they? Then the next morning, I'm continuing my evaluation of them of, was the room set up?
Were they here early enough to set the room up? Uh, did they do a good job of that? Did we progress to getting the patient back in the room? So we have to really understand, and I think a lot of [00:24:00] people think that their evaluation starts the minute the first anesthetic starts with their patient. But we have to recognize that really in our mind, we're starting the evaluation way before them.
And all of that plays into it, and I have a different communication style than some others do. Right? I may have a different communication style than some other geneticists do, or I may have a different communication style than, than baby boomers do, and we have to get into some of that and what is appropriate and what is acceptable.
Um, and I'll give an example here in a few minutes, but when we look at that, it comes down to the conversational piece, and it comes down to communication. That's the big thing about evaluations. Many of our. Gen X and baby boomer type population really are very loving, very caring, and they are some of the best preceptors I have ever seen, right?
And they really want to see these students, these learners thrive and survive, right? They want to see [00:25:00] them really just knock it out the park, and they have a heart for it, and they have a heart for them. But sometimes it leads to evaluations that are not as accurate as they should be.
Richard Wilson (2): Mm hmm.
Richard Wilson: And it frustrates the new learners, because the new learners are in a mindset based on the way that their generation is and their values is, I want feedback.
We always laugh about it or we, we, you can, we can, we talk about it as, and I mentioned it earlier. Really, you look at the baby boomer type population, it was the school of hard knocks, right? I went to work, I learned it, this is what happened. I learned it while I was on the job and I'm good, right? And then when we get into the Gen Xers, they're like, I can't believe this facility's not providing me more education and mentorship.
You know, I'm okay here, but I just can't believe they didn't do more for me. Till we get to the Gen Yers now, and their belief is, why would I ever want to go work for a place that's not willing to mentor me, educate me, and help me out? Uh, in the long run. And so I think we [00:26:00] have to recognize those differences.
And once we recognize those, we can bring evaluations back to, to center where we recognize and we go, okay, well, I understand what they're looking for and what they want from both sides of this and therefore we can have a good conversation today in the morning of to say, here's what I want to accomplish today.
Here's what we want to get done today. Here's how I want to do this today. Right? Have that open conversation at the very end. Give that feedback. Okay. I always encourage preceptors, your feedback, whether it is in nursing, whether it is in nurse anesthesia, whatever it may be in, is how did that individual, how did Richard do today?
Richard Wilson (2): Mm hmm.
Richard Wilson: Don't care how Richard did 17 days ago in the last three times you worked with him. Don't care what you, potential you think Richard has overall, but what did Richard do today? Because I'm going to take that as an instructor, as a clinical instructor, right, as an assistant program director. I'm going to take that information, I'm going to compile that because we know Richard could have [00:27:00] just had a bad day, right?
The preceptor could have had a bad day.
Richard Wilson (2): Yes.
Richard Wilson: So I'm going to compile that. So we always encourage, be honest, be open, be respectful and professional, but be honest and be open with them. And we're finding. And this was really surprising to me at one point, Beth. Yeah, I finally kind of wrapped my mind around this, but it was really surprising when it first happened.
That younger generation? They want to hear what they can do better. They want to hear, we all think that they only want to hear the rainbow butterfly stuff, right? We all, there's a lot of perception out there that we say, um, they only want to hear the good things of what they've done. But there's a lot of them that are really, I want to hear all of it.
Now, I don't want you to be disrespectful to me. But I do want to hear that if I struggled with airways or putting arterial lines in and I had a bad technique, I want you to tell me because I don't want to continue doing that four and five [00:28:00] and six and eight days and look like I don't know what I'm doing not only to you today, but also to those other four and five other individuals.
Beth Quaas: That is spot on. I have found the same thing. They want feedback. They want to be evaluated. They want to be taught different techniques to improve what they're doing. And maybe you've heard, you know, I'm from Minnesota and we have Minnesota NICE up here. And so it seems like it's really hard to get people to be, um, constructive in their feedback or give any feedback at all.
to students, and that doesn't really help them to grow. It doesn't help us as educators to really know what we can do to support them. And so, I love what you say, and I'm hoping that there are some preceptors that can learn that as well. Just give feedback. Like you said, be professional, be constructive, be honest.
But give feedback.
Richard Wilson: They love it and they want it, and they deserve it. Mm-hmm. You know, when you think about it, and I have to think about this, you know, and I [00:29:00] try to think a lot about what would I want if I was in their shoes, right? As, as a learner, as a, as a, uh, teacher, uh, what would I want? And as I look on the learner side of it, I, I want to, I would want to have feedback, right?
So here, here's the thing, right? And that's kind of, again, simple minded. Trying to put in simple perspective is. They want to know what they got wrong on an exam. They want to know what questions they got wrong, right? You're an educator. You can, you can vouch for this. It doesn't matter whether they get a 96 or if they get a 66.
They come to you and they were like, I want to know what I missed on that exam because I need to know this material. So that when I go to institute it in the practice setting, I'm doing what is right. I'm doing what is, you know, by the books, by the textbook or by, by the literature, whatever it may be.
Well, all the clinical setting is, is an extension of the didactic courses, right? So they're just learning it. And [00:30:00] it's truly a course in itself. So what those evaluations are, are daily tests. And so if they don't get a hundred on that daily test, they want to know why they didn't get a hundred on that daily test.
What did I struggle with today that can help me so that when I come basically redo this test again tomorrow in the clinical setting, that I can be successful in it.
Beth Quaas: That is awesome. I'm so glad. I'm going to use that. You know what? These evaluations are good. You should want feedback. You should ask for feedback.
What I also tell them, when you get there in the morning, talk with your preceptor that day about what your goals are and give them permission to tell you if you're, if you're doing good or you're maybe struggling in an area, give them permission to tell you that because that takes a lot of, uh, the onus off of that preceptor.
Richard Wilson (2): You've seen this. Preceptors
Richard Wilson: love to teach.
Richard Wilson (2): Mm hmm.
Richard Wilson: Now, yes, there's 60, 000 CRNAs around the nation. [00:31:00] I don't know how many nurses there are around the nation, so I'll just not guess a number. And obviously, when you've got that many, you're going to have some that are better than others. You're going to have some that are more motivated to do it than others, and I completely agree with that.
But when you look at the vast majority of the preceptors I've been involved with, They love to teach. They want to teach. They enjoy giving back to, to the community that gave to them, right, to get them where they're at now. And so, they want to teach, but here's the thing. What if you come in, and let me just say, Beth, that you are, you know, jam up on, uh, being able to bag mass ventilate a patient on induction of general anesthesia, right?
Um, but I think that's important. So I'm like, I'm gonna teach you how to do this. Well, you already know it. So I'm wasting my time trying to teach you and you are getting nothing out of the day because I'm trying to teach you a skill set you already know, which you mentioned that communication on the goals is important because then we have a clear [00:32:00] communication.
They know exactly where you want to be. They know exactly what you need help with. And they are more than happy to do that. Going back to those generational differences we were talking about. Most of the time, what the older generation wants to do for the younger generation is invest in them and have a feeling that they did a positive, had a positive investment in this group to help grow them.
This is how they do it. So, as a student, as a learner, if you come in and you're like, hey, I'm telling you what. One thing I've had a really hard time doing today is, and I'm just going to get something simple here, making decisions on when to get phenylephrine versus ephedrine in these cases or to use norepinephrine or, you know, really looking at what medication should I use when I'm starting to have hemodynamic changes that occur.
Well, that gives me a good hint that, okay, what I'm going to really do, Yeah, I'm going to step back to an induction of anesthesia. You don't need me all up in your business, especially since you've got this under control, right? And we're going to let you handle that part and may [00:33:00] not confuse you anymore with my stuff on it.
But I'm going to pay attention to the hemodynamics of this patient and what's going on under this case. And we're going to have a good discussion when things happen of why you think the hemodynamics are what they are. And what you plan on treating it and why you're going to treat it that way. Now we've actually accomplished something that the learner wanted to accomplish that day, which is building relationships also, but it's also building that individual for when they go into the next cases they have to do and they see these kinds of changes occur.
Beth Quaas: Right. You said communication is key. It's always key. It's a great way to start. It's a great way to end, you know, start your day with. Setting goals and end your day with a great evaluation. Maybe not positive evaluation, it may be some things to work on, but at least it's an evaluation. So, we've kind of talked about didactic and clinical.
You also help applicants be the best people they can be, um, [00:34:00] in CRNA Prep Academy. So, talk a little bit about how nurses can present themselves and what you do, um, in that field.
Richard Wilson: So, thanks for asking, and CRNA School Prep Academy is an educational mentorship program that I had the fortune, um, of being a part of for the last 6 years, I believe it's been around there.
Uh, it was developed by Jenny Finnell out of Ohio, and really. You know, brief of the story is it really just blossomed out of this idea that, uh, somebody, a friend of hers reached out to her about helping guide a few people on how to get into anesthesia school, um, and what makes them strong applicants. Um, she eventually did that and then it blossomed and blossomed to eventually, uh, a business was, uh, started out of this.
And it's helped, I mean, probably thousands of people over these years. And really what the goal is, and I [00:35:00] truly believe in this, is if we can make nurses, right, if we can make them stronger nurses, and I'll speak a little bit about how we do that, but if we can make them stronger nurses, Then they become stronger applicants, who become stronger students, who become stronger professionals.
So this is a way to advance the profession, right? We don't give, uh, influrane anymore. We don't use alethane anymore, right? We don't use thiopental for induction of general anesthesia anymore. We've moved past all of that because of new, new things that we've seen that have advanced the profession. And it's because of the people that came behind those that used inflirane, halothane, thiapentone, those medicines, that really tried to take it to the next level.
And so that's what we're trying to do is grow individuals that are academically strong, who are emotionally [00:36:00] intelligent, that can put all of this together and become a complete package so that they can become more competitive in their application, but also become Just a better overall student and a better overall practitioner.
And we know you sit on admissions processes. Currently, we have some schools I was speaking with in the airport the other day in Tucson. I was speaking with one of the program directors. Um, and their admission rate last year was 7%. About the highest we see out of most schools right now is about, and this is even the newer schools that are starting, is around 15%.
Richard Wilson (2): Right.
Richard Wilson: If you find a school with a 20%, wow, you know, you don't see that hardly anymore. So it's, it's about being the best you, you can be to become that applicant for getting into CRNA school. And [00:37:00] it's not just being able to sit down and answer interview questions. Sorry, I've been doing this for almost 20 years in CRNA school.
I mean, as a CRNA, I've sat on interview panels for over 15 or 16 years, right? You've done them for a number of years. Most people that have done them for as long as we have done them can truly pick out. When somebody is not genuine, or they're making up something, or they're reading off of a cue card, basically, that they studied the night before.
Right? And so that's not what the goal is. The goal is, and we provide, man, this is what I love. I love education. Obviously, I know I love that part of it. I mean, we provide lectures on pharmacology, physiology, emotional intelligence, uh, We provide some other services that are helping guide them, yes, um, but we also are doing ventilator management, ABG analysis, uh, fluid volume stuff, I mean [00:38:00] cardiac physiology, uh, pulmonary physiology, you look at all of that and we feel they become better nurses in the ICU by learning that information, not memorizing, learning it.
Which makes them a better applicant overall.
Beth Quaas: Is there a certain point where you think people should, if they choose to do CRNA Prep Academy, um, at what point do you think they should start looking into that in the process of applying to programs?
Richard Wilson: Preparation for anesthesia school starts in nursing school, or as soon as you know you want to be a nurse anesthetist, right?
That's where it starts. And I know some people don't believe that, and they don't kind of go by that, and that's okay. But I will tell you, and I truly believe this, whether it's nursing school or not, there's no question that I think we all would agree that [00:39:00] preparation to go to anesthesia school does start day one in the clinical setting.
Richard Wilson (2): Yes.
Richard Wilson: As soon as you walk into the ICU, from that day on, you are prepping yourself for anesthesia school. Whether it's through the medicines you're given and you're studying them, whether it's through the physiology of your patients and you're studying them, whether it's through procedures and you're asking the residents and, and, and physicians, what are we doing here?
Why are we doing this? Whether it's learning from the respiratory therapist on ventilator management, why are we doing these techniques? It all sorts in. So I always say that when you're looking at having this competitive factor, right, you can't learn all of this in six months. You have to start early.
Beth Quaas: Absolutely. Well, and like you say, if you're teaching them how to do a lot of this stuff in the units that they're working in now, the earlier the better. Right.
Richard Wilson: And it's the practice, right? You can't learn neuroanesthesia by [00:40:00] doing five intracranial procedures. That you just learned about last week and then say, okay, I'm done.
I'm not going to do this anymore. And then two years later, trying to do an intracranial procedure and really flow with it. How many times did we have to learn vent management when we were in the ICU? I know a lot now, okay, touch the ventilator. And there's a lot of things that go on with that. But you know, when you and I were in ICU, we can make ventilator changes.
Um, and we did ABG analysis and all. And so it's practice. That consistent practice, which starts early, which is what our goal is, teaching the concepts, teaching the educational side of what ABG analysis is, what vent management is, what are the, what are the, uh, cardiac devices, the intra aortic balloon pumps, the impellus, the arterial lines, the PA catheters, teaching what all of these are about so that as they go in And every time they take care of a patient with any of this, they can keep running through that in their mind and then have resources to [00:41:00] go back to so that they can then keep getting stronger and stronger so that when they do apply for anesthesia school, they're that applicant that stands out because they're not coming across as somebody who studied, you know, Dr.
Google. The day before, right? They didn't read the physiology textbook the day before and what you can tell is they're spitting off page, you know, 1733 paragraph 3 on the left side. They really are having a good conversation with you as a practitioner with an understanding of exactly what and why they're doing it.
Beth Quaas: What is the feedback you are getting from the people that go through that program and And are they getting into programs? Are they feeling that they were so much better prepared?
Richard Wilson: So yeah, we've actually gotten good feedback from the applicants and from some of the um, the program faculty is looking at, you know, they're able to [00:42:00] tell and some have said, look, I can tell some of them that have gone through the program because we feel like they have a great base underneath them before they even get to the program.
We have a lot of applicants that, um, really say, look. What I'm looking at here is when I went into the interview, I felt so much more comfortable with the knowledge base I had because of the prep side that I had with CRNA School Prep Academy, that I felt comfortable with what I was talking about versus not.
Right? Um, we have, uh, I think a little over and I'd have to get back to some of my numbers. We were just talking about this last week and in the business side of it. Yeah. Is within the last six or so years, I believe we've got somewhere over 650 that have been accepted into anesthesia programs and have finished programs, right?
We have several that have finished programs and gone on and are practicing now. Um, so, you know, it's really turned out to be a pretty good thing overall, in our opinion, obviously, [00:43:00] and really just start off with the goal of how do we make Stronger nurses, because that's what we're looking for in anesthesia school.
And it was a passion I had, uh, literally just out of just purity, grace, I guess you could say. I ran into Jenny's name in CRNA School Prep Academy. I ran into this, reached out to her and I was like, I'd love to be a part of this. And we just have had a great relationship ever since.
Beth Quaas: I think it's just a great program for people to be able to get their questions answered because when you start applying without that, it's hard to know what you're getting into.
And so to have that, to be able to ask questions and learn more and then not just learn it, but go back to your ICU and put it to practice.
Richard Wilson (2): I
Richard Wilson: think
Beth Quaas: that's amazing. What a, what a boon for them.
Richard Wilson: Yeah, it really is. And I mean, think about it. When we, I don't know about you Beth, but I graduated in 2006. [00:44:00] And, um, I didn't get in my first attempt.
Um, I was weightless in my first attempt. I guess they were smarter than I thought they were at the time. Um, but When we really look, and even when I started doing, uh, faculty, uh, in 2010, it's 2009 2010. You know, acceptance rates were as high as 30 and 35 percent in some programs. When you think about it, I mean, we, I know at one point we had about 95 or 115, 125 applicants.
That were going into around 30 to 35 spots overall now, most of these programs are seeing 350 applicants for 35 programs. And so we've seen a huge shift and that's our goal is how do we. Take all of these people that want to get into anesthesia school because, you know, it's no longer the best kept secret.
It's out there. Everybody knows what we do, and I'm glad they do. And [00:45:00] I want to see the people that come in behind me, I want to see them stronger than I am. I want to see them providing better care than me, right? Because eventually they're going to have to take care of me. And I always tell this to the students, I don't want to all of a sudden be laying on the operating room table or have a family member laying on the operating room table, look up and I think, oh crap, I graduated them, right?
None of us want that. Right. And so I always think, how do we do that? Well, all of that starts at the foundation. And if we can make the foundation stronger, then we make the entire profession stronger.
Beth Quaas: I completely agree. It has been such a pleasure having you here today. I know that you have, um, passed on information that we can all use.
Applicants, students, preceptors, both new and experienced. What else would you like to share with our audience today? [00:46:00]
Richard Wilson: So really what I like to say is be passionate about what you do and love what you do. You're not going to love every minute of what you do, we all know that, but be passionate about what you do.
And always think, how can you give back in the manner that was given to you? Somebody had to precept me. Somebody had to be my mentor. Somebody had to be my teacher when I was going through school, right? And that is why I'm where I'm at today. No questions asked. And so, that's why I try to give back. Um, I tried to give back in the manner of, you know, faculty mentorship because so many people mentored me as I was coming through in my early years that I love to have new faculty contact me and say, Hey, can you help me with something or can we collaborate on something?
Because then I feel like I'm giving back, right? I'm one of those older guys. I'm going to give back to the people that are coming up within. So I always say, don't [00:47:00] forget those opportunities. Please don't overlook those opportunities. And always look at what you can do for the next generation coming up that are going to be not just the next generation of providers, but also the next generation of leaders.
Beth Quaas: I appreciate that. I know you are here to make all of us better just by educating us, and I so appreciate that. I know that anyone that wants to get in touch with you, um, you'd be more than happy to help them, and all of your contact information will be in the show notes. So please reach out to Richard with anything.
I know he's a great speaker, not just here today, but I've heard him speak live, and, um, he's amazing. So please reach out if you need anything. Want help from Richard in any way. Thank you so much for being here today. I would love to have you back on again
Richard Wilson: Thank you, Beth. I've enjoyed [00:48:00] it