Tips for Shadowing a CRNA

Shadowing a CRNA or anesthesiologist has become a requirement for many programs. Unfortunately, it is becoming increasingly hard to get a shadow experience. Many of the large centers that used to offer these experiences to everyone have since moved to only allowing current employees to shadow. Regardless, you need to find an experience and following are some tips on what to do and look for during your shadow day.

Ask Everyone

While it is becoming much harder to find a shadow experience it is no excuse for not doing one. It is becoming a program requirement and an important part of the process. For those of you at large academic medical centers, congrats. This should be easy. Ask a CRNA directly or find someone in the anesthesia department. Most large centers will already have a program in place that will allow you to pick a day and shadow someone.

For those of you at smaller community hospitals, have no fear. You will still have anesthesia providers. It might be a CRNA or it might be an anesthesiologist. To my knowledge, you just need to shadow an anesthesia provider (check this with individual schools – email them and ask them if shadowing an anesthesiologist is acceptable). If you get the green light to shadow an anesthesiologist, the easiest way to set a date is when they are bringing a patient to the ICU. This way they know you are an ICU nurse and not a random person. Let them know you are thinking of going back to school and would like to weigh all your options. If they say no, don’t worry. Ask the next one that brings another patient. One is bound to say yes. You just have to stay persistent.

If you still are having trouble ask anyone and everyone. I was talking to one of my colleagues about wanting to shadow a CRNA (as we didn’t have them at our hospital) and she let me know that she worked at a small surgery center where they used them. She set me up and I was able to shadow him. So, ask around. There is someone somewhere that will let you spend a day with them.

The Anesthesia Community is Small

Keep in mind the anesthesia community is small. What does that mean for you? Well, chances are the person you are shadowing knows someone who knows someone. While most of the people you are shadowing are not making a direct decision on whether you get a seat, they can easily make a call or shoot a text that can make or break you. This is especially important for those of you shadowing someone who works at a university with a program. If you work and want to go to school there keep in mind they can and will talk to people who make decisions.

It is a Favor to You

This is a favor to you! Not the person you are shadowing. Ever do a favor for someone and it becomes a burden? Same goes for your shadowing experience. If you are a burden, your experience will not be as good as it could have been. So put yourself in the shoes of the person you are shadowing. If you work in the ICU you understand your work can be hard. Do you want someone standing over your shoulder asking you what you are doing all day? Probably not. Just let the person you are shadowing control how the day goes. It will be better for you if you go with the flow.

Quick list

  • Create a relationship prior to showing up for the shadowing experience
    • If you have the name/email of the person you are  shadowing, shoot them an email and tell them a little about yourself. This also gives them an opportunity to set expectations with you prior to your arrival.
    • Also ask what you should bring – if they don’t have a locker for you (most won’t) only bring your keys, phone, and money for lunch if you will be there that long
  • Be prompt – they are working and will be highly annoyed if you are late
    • Being late gets the day off to a bad start and you may not be able to recover
    • We have a room to set up in the morning – it is something you want to see
    • Most of us have routines and you being late will cut into that
  • Be kind – no one wants to spend a day with someone that is rude or has a chip on their shoulder
  • Stay engaged – those that stay engaged will get better information, demonstrations, and instruction
  • Have specific questions – shows that you did at least a little research
  • Stay OFF your phone – I have seen this many times
    • Being on your phone makes it look like you are bored (remember it’s a favor to you)
    • It is also rude and annoying
    • My thought is if you are playing on your phone, go do it somewhere I am not working
  • Ask for advice – they have been through it before
    • What it took to get in – never know if you can get a nugget
    • Their thoughts on the program they went to
    • Any other advice they have for you specifically – how to make you a better candidate  
  • Evaluate what they are doing
    • As this becomes more of a requirement, more and more people shadow
    • Don’t just go through the motions
    • Take a long hard look at what they are doing and make a decision if it is really something you want to do
      • If 8 hours makes you question whether anesthesia is for you or not it is an 8 hours well spent. It is not for everybody

Take Notes

Image by David Mark from Pixabay

Take notes during your shadowing experience. Look at what drugs the anesthesia provider is using and write them down. What kind of airway did they use? Are they placing any lines? If so, ask them why. Check out the anesthesia machine and the ventilator. Watch emergence and ask what criteria they look for in order to extubate their patient safely. In short, evaluate what they are doing and take notes on it. After your experience go home and type your notes out.

Bullet point

  • What surgery you saw (of course not using any patient identifiers)
  • What drugs were used
    • Quick note on pharmacology and why these drugs are used in anesthesia
  • What type of airway
  • Do this for each individual case that you stayed for if more than one

If you shadow again, do the same thing for each experience. Make sure that you note this was a separate shadow experience. I shadowed multiple providers in multiple settings. I printed my notes along with my resume on the thickest paper I could find and took them to each interview. At that time, shadowing wasn’t as common as it is now. Not only did it show I took as many opportunities as I could (remember, smash minimums), but having my experiences in front of me allowed me to actually talk about them and what I got out of each experience. Note: don’t talk about things you can’t explain.  If someone on the interview panel asks you a question you can’t answer, you’ve put yourself in a difficult situation. Don’t do it.  

Shadow Again?

Yes! Remember: smash minimums. If the program is asking for a shadow experience, it doesn’t mean you can’t do more than one. Doing more will set you aside from other applicants and it reinforces that you understand what kind of work you will be doing. The more you do, the better off you will be.

Should you shadow the same person? Shadowing the same person twice may make them more comfortable with you in case you want to ask them for a letter of recommendation. Do NOT ask them for one at the end of the experience unless you have a previous relationship. They do not know enough about you. They won’t be able to say much and therefore it will be worthless to you. Plus it will put them in an awkward spot. If you think you want to ask them, ask if you can shadow again and ask them after the second experience. This would be the only reason I would recommend shadowing the same person twice. If you are not worried about a letter of reference then try and shadow someone else. Every anesthesia provider is different and you will get a completely new experience. I always tell prospects it is good to see different environments (trauma center vs ambulatory surgery center) if you have the opportunity to do so. Seeing the same surgery over and over again doesn’t do you much good.

While shadowing seems like another hoop to jump through, don’t look at it that way. You can glean a ton of information from spending time in the OR with someone. It gives you a great idea of what CRNAs do and if it is something you really want to pursue. It can also lead to important relationships that can give you an upper hand on getting into a program. Don’t take it lightly.

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