John Nicotra 10-2-19

Medical Perspectives Healthcare Career Interview

I interviewed my neighbor Jaime who is a nurse anesthetist.

Me: Thank you so much for being in this interview.

Jaime: No problem Johnny.
Me: And you are a nurse anesthetist?
Jaime: Technically it is Certified Registered Nurse anesthetist. CRNA for short.
Me: So, where do you work at?
Jaime: I work at UPMC Mercy. So, that’s full time there and then occasionally I work part-time
at UPMC Passavant.
Me: So, what’s a typical day of work like for you?
Jaime: Depends on how long I work. Somedays I work 8 hours, 12 hours, 16 hours, or 24 hours.
So, the 24-hour shift is what they call an on-call shift. So, you’re there all day and then after the
OR schedule is completed, we’re basically on-call in the hospital and we take care of whoever
comes in as an emergency at night.
Me: So, how many days is it you work in a week?
Jaime: Its usually a 16 hour and 24-hour day. That’s 1 week and if I’m not doing that, I’m going
two 8 and 12-hour days. So, its 40 hours a week.
Me: Where did you go to school and what king of STEM majors did you go for?
Jaime: I went to the University of Pittsburgh as an undergrad in nursing. I got a 4-year undergrad
degree. Then did a 3-year graduate program also at the University of Pittsburgh which focused
solely on anesthesia. And classes, no engineering classes. Lots of math classes, science, biology,
physics, chemistry, multiple classes of the each of those.
Me: How was your college experience?
Jaime: Undergraduate nursing, it’s pretty challenging, but you really don’t know any different. I
mean right after you get out of high school above that its really challenging. So, nursing school
itself at the time you think it’s really hard then you go to graduate school and then you realize
nursing school was not that hard. Graduate school is hard. But you know you have to study a lot.
I probably studied not undergrad, but probably grad school I was probably studying and going to
class 60 hours a week. So, it was pretty rigorous, but you know that going in. So, the University
of Pittsburgh is ranked pretty highly for nursing graduate schools. So, there was probably around
200 applicants for graduate school, and they took from my class around 25. SO, it’s not that easy
to get in. You have to have good grades and good undergrad grades. They look at a lot of things.
You have to do an interview to get in. They look at your grades from undergrad. There’s a
graduate entrance exam you have to take called the GRE. It’s called the Graduate Record Exam.
So, they also get your grades from that and that’s mostly math and science.
Me: What in particular do you enjoy about your job?
Jaime: I always like taking care of people. I mean you’re not going to go into nursing or anything
above that if you don’t enjoy taking care of people, seeing people sick and then getting better.
That’s probably the most gratifying part about it.
Me: What’s the most difficult?
Jaime: My job is probably when people don’t get well. A lot of time surgeries are more palliative
than making people better. They don’t always get better. Sometimes they end up dying. I’ve had
a lot of patients die while taking care of them in the operating room. That makes it the most
difficult.
Me: Can you give a certain experience when you collaborate with others at work?
Jaime: We collaborate basically on a daily basis. I work with other CRNAs. More so with the
anesthesiologists, one on one. So, for me each CRNA has an operating room, taking care of the
patients in that operating room and the anesthesiologists is kind of like your boss. They come
into the operating room, patient goes to sleep, and then they leave. They’re basically overseeing
3-4 operating rooms at a time and there’s a nurse anesthetist in each operating room taking care
of the patient. We call them on a regular basis to let them know how things are going and if we
need them to come in for any reason. Collaborate with the surgeon and the surgeon is doing his
own thing and wants to know what’s happening with the patient the whole time. So, we’re
constantly back and forth communicating. There’s an OR nurse in the room. So those are the
main people.
Me: What advice would you give to students about to enter college?
Jaime: It’s a great career. Nursing in general, there’s always going to be a need for nurses that’re
probably going to never not have a job. Actually, there’s a shortage of nurses in this country. If
you’re thinking about a career in nursing, I would highly suggest doing that. It doesn’t pay the
most, doesn’t pay the least. After you get into grad school and become an advanced practice
nurse and that’s obviously going to pay you more. So, anyone thinking about doing that I say go
for it. I think it’s great.
Me: What opportunities are available to you for professional growth?
Jaime: Not a ton. Right now, as far as being a nurse anesthetist there is a track where you can go
on and get your Doctorate. It’s called the DNP. It stands for Doctorate Nursing Practice. It’s
another year of studying and going to classes and doing a thesis and a big project which for me
the advantages aren’t that great. I mean you don’t get paid any more to do it, you’re basically
paying them. We do continuing education, credits we have to do every year. I believe it’s 60
credits every two years. So, there’s a bunch of way to get continuing education credits by
teaching students, doing CPR classes. There’s a thing called ACLS which stands for Advanced
Cardiac Life Support and there’s BLS, Basic Life Support. We have to be certified in PALS
which is Pediatric Advanced Life Support. So, all these things you have to be recredentialed
every year and you get continued education credits.
Me: Were there any other health care jobs you were considering?
Jaime: You know what from the time I was in high school I kind of knew nursing was the way to
go. The idea was I would go to a 2-year nursing program and then be able to get out of school,
work as a nurse while I was going back to get my bachelor’s degree. That was kind of the idea,
but it didn’t work out that way. I ended up not working and I graduated from a 2-year diploma
program and went back to Pitt and got my undergrad degree that took 4 years. There’s lots of
medical careers, but I never really considered anything else. Medical school was something I
thought wasn’t a fun thing to do but nursing only takes 4 years and you can work as a nurse and
then go back to grad school. Being physician that’s 4 years undergrad, 4 years medical school, 4-
7 years after medical school depending on what physician you want to be so you’re talking 12-14
more years total.
Me: What made you decide to go into this field?
Jaime: When I was in high school, my dad knew a guy who was a nurse anesthetist and he told
me if you want to do nursing this is the track you want to take. This is going to get you the
farthest and the most money and this is what I did. Aside from having a couple of surgeries when
I was younger. When I was a teenager, I got my appendix out, crushed my thumb between two
helmets when playing football so it was dislocated and needed surgery. So, I kind of liked being
exposed to that in the hospital, the anesthesia, and the people doing that.
Me: What advice would you give to students unsure of which medical profession they want to
pursue?
Jaime: I think by the time you get to college and you decide you just want to do nursing. A lot of
people are undecided at that point. They know nursing, but there are so many types of nursing
you can go into after you get into school. There’s geriatric, pediatric, obstetric, and critical care
nursing. There’s an array of different fields. I think a lot of kids’ research which field makes the
most money because that sounds good at the time. Sometimes people get into it and they realize
that you make that much money doing this, but it’s not that interesting so they fall back on
something else that doesn’t make as much money. So, I think it’s kind of a personal thing like
once you get into it you decide which way to go.
Me: What can we do now as high school students to prepare to enter a STEM major or medical
major?
Jaime: You definitely want to focus on all your science and math classes because for my job its
all science and math. That’s pretty much all I do on a daily basis calculating drug dosages and
the patient’s vital signs and then you see something happen to the patient while under anesthesia
and you want see why their heart rate is 200 when it was 80 a minute ago. So, there’s a path of
physiology behind that and every drug you give and how it effects the body, it does this to the
body, there’s side effects of drugs. So, those are the classes I would focus on if you’re going to
do anything in medicine.
Me: What’s your salary?
Jaime: A starting CRNA makes $70 an hour and that’s around $150,000 a year. The top is
around $250,000 a year and I’m pretty much maxed out. I can anywhere and make more money
than in Pittsburgh because historically it is not a high paying city for nursing since there are so
many nurses and hospitals. If you go out to the middle of Montana where there’s a little
community hospital and they can get people to come out there. They’ll pay you $300,000-
$350,000 a year for my job and that’s more than the physicians that work there.
Me: What degrees do you need?
Jaime: You need a bachelor’s degree and when I was in school it was a master’s degree and
there’s some 80 schools in the US for anesthesia. Up until recently they’ve only allowed a
master’s degree to graduate, but now they’re changing it and by 2025 all the schools have to be
changed over to a doctorate. So, by 2025 if you go to anesthesia school, you’ll graduate with a
doctorate degree.
Me: What’re the consequences or risks if you’re held viable or certain mistakes?
Jaime: So, there’s medical malpractice. If you work for a hospital, they’ll cover you for medical
malpractice. They pay some kind of liability insurance as a group so if you make some kind of
medical mistake you can be sued by the patient, surgeon, or family. Most big health systems like
UPMC pay that for you so you’re covered even though you can be taken to court by the patient
or family. Luckily, I’ve never had to be involved in that, but I think that’s what happens.
Me: How stressful is it being in that environment and having to do your job perfectly?
Jaime: Depends on the patient, you can have a perfectly healthy person come in to have their
gallbladder out. 99% of the time everything goes smoothly. You give them their drugs, they go
to sleep, get their gallbladder out, wake them up, stay at the hospital for a day, and go home.
Now there’s very sick people that come into the hospital and from intensive care that’re super
sick. They’ve got like ten different medical problems going on at once and are super feeble. So,
those patients are a little riskier, little more stressful, and anything you give them can tip them
over the edge and they end up dying. Mercy has a level one trauma center. We call it the gun and
knife club. Comes in on a Friday, Saturday night from the Hill District. We get guys shot all the
time, get stabbed so we have to take care of those patients. Those patients don’t get a lot
anesthesia because most anesthetics drop your blood pressure since if you’re stabbed or shot you
already have low blood pressure from shock or blood loss, so those patients are harder to take
care of.
Me: What’re your job responsibilities?
Jaime: Job responsibilities are giving the patient anesthetics, making sure they’re unconscious,
and making sure they have no memory or recollection of the surgery which we do with drugs.
The biggest responsibility will be to make sure you wake up and don’t stay asleep or die. That’s
the big one. We take care of patients on the floors that’re having issues like not breathing and
need a artificial breathing tube. Anybody who’s sick on the floor, not in the ICU, who’s having
some issue not breathing or low blood pressure, they call us to come up to manage the airway
and other physicians there will take care of everything else.