Jill Turck @jkturck
Activity by Jill Turck @jkturck
Erin Martin, CRNA, DNP
We’ve all heard the adage, “Those who can do . . . Those who can’t teach.” Whoever coined that phrase had obviously never met a Certified Registered Nurse Anesthetist. As CRNAs, we teach every day – we teach our patients, their families, the public, and those with whom we collaborate professionally. And some of us are fortunate enough teach the next generation of CRNAs. I consider myself lucky to be a member of that group.
I received my Master of Nurse Anesthesia degree in 2005 from the Mayo Clinic College of Medicine, School of Health Sciences Master of Nurse Anesthesia Program. Attending the anesthesia program at the Mayo Clinic was a true privilege, as it is the oldest continually operating Nurse Anesthesia Program in the country – celebrating its 125th Anniversary in October, 2014. As a student in this program, I had the opportunity to work side by side and learn from many of the experts who write the textbooks that line our shelves. When I graduated, I had no idea that I would eventually become a faculty member at my respected alma mater.
When we were all eager new graduates, we had many goals and aspirations. For most of us, spreading our wings and refining our anesthesia delivery skills was at top of that list. Along with that goal, many of us also wanted to impact our profession in some way. For me, becoming involved in education was an effective means of doing just that.
I view the provision of anesthesia to patients undergoing surgical procedures as one of the greatest privileges in nursing and medicine. The trust that patients put in anesthesia providers is great, and so is the subsequent professional responsibility. I feel lucky to be able to both provide this care and educate others on how to do so. In my role as an educator, I strive to instill in students a sense of inquiry and professionalism while providing them with solid didactic and clinical preparation for their anesthesia careers. Just as providing anesthesia to patients is a great privilege coupled with great responsibility, so is providing education to curious minds.
So what does a day in the life of a nurse anesthesia educator look like? One certainty – two days never look the same! Most days involve a variety of activities – preparing lectures, correcting papers, scheduling workshops, attending meetings, working with students on research projects, etc. The amount of preparation that goes into developing an entire course is astounding. I aim to make sure that my courses include the latest evidence, and involve multiple modes of teaching in order to reach all types of learners. This does not happen without the investment of a lot of time and energy – a fact I had grossly underestimated prior to my involvement as a faculty member. The days when I am involved in face to face classroom lectures are the best days, as I have an opportunity to interact with the students. These days may involve lecturing, instructing students in workshops or simulation sessions, or casually visiting with them and hearing about their clinical experiences. The feeling one receives when you see the ‘light bulb’ illuminate for a student is nearly indescribable.
Watching the transformation of a timid, new SRNA into a confident clinician is an amazing experience, and one that is rarely seamless. Every student struggles at some point in his or her program, whether it is with intubations, pharmacology, or communication. Helping the struggling student, and seeing him or her overcome roadblocks is particularly rewarding. Because I also work in clinical practice, I have the opportunity to work side by side with the students I teach. What a gratifying feeling it is to help a student with an induction or emergence, and realize they barely need you there. Working with students also makes me a better clinical practitioner; teaching them how to deliver the best possible care is a constant personal reminder to follow my own instruction.
Although it may sound mundane, preparing lectures and developing curriculum is also a challenging and rewarding aspect of my job as an educator. Examining current literature, staying abreast of the newest technologies and issues within our profession, and figuring out how to most effectively and creatively deliver this information to students is invigorating. Ensuring this information is delivered within the framework of the standards set forth by the Council on Accreditation of Nurse Anesthesia Educational Programs is a crucial component of curriculum development and delivery. Much debate occurs within our profession about the quality of educational programs these days. I feel a great sense of responsibility to make sure that the program of which I am a part delivers the highest quality, most up to date information possible to our learners, and a great sense of pride when I see the high quality CRNAs that are entering our profession.
It’s an exciting time to be involved in Nurse Anesthesia Education. The advent of the clinical doctorate, new technology, and political influences have brought with them both positive and negative chatter within our profession . . . which all leads to interesting dialogue. Why do we need the clinical doctorate? How will it make me a better CRNA? Is more technology beneficial or detrimental? What can we do to ensure our profession remains respected and relevant? As an educator, I have the opportunity to engage in these rich conversations and hopefully provide some answers to these not-so-straightforward questions.
I would encourage everyone to re-examine those new-graduate goal lists we all made after graduation, and to thoughtfully consider how you might influence our profession. Maybe your means of influence and improvement is through anesthesia education. Remember . . . those who can do, and those who can do it really well, teach others how! The profession of nurse anesthesia has a long, rich history . . . and with dedicated educators, it will also have a solid and bright future.
Written for AANA - Become a CRNA
Nursing Students hope you have a great conference at this week’s convention NSNA! Stop by our booth 509/511 to learn more about our A Life-Changing Career with Mayo Clinic!
The Summer III Nursing Externship Program extends beyond the borders of Rochester, MN. I learned this when I was first exposed to Mayo Clinic in Michigan and then again, two years later, in Kansas.
As a sophomore pre-nursing student, I was very aware of the Mayo Clinic Summer III Program and the way it helps nursing students connect theoretical classroom knowledge to real life situations. To my amazement, Mayo Clinic attended a career fair at Calvin College, a small Christian school in Grand Rapids, MI. While senior nursing students crowded around the Mayo table to speak about post-graduation employment, I waited to find out about the Summer III program. The HR person’s face beamed when I finally made it through the line and told her of my interest. “Latasha, this last one’s for you,” she said and that’s how I met Latasha Perkins, Mayo Clinic’s wonderful Summer III ambassador. I already had my information packet in hand so Latasha quickly realized I didn’t need logistical details. I needed to know if I was a good fit for Mayo Clinic. So, although it was late in the day, and she probably would have liked to pack up and leave, Latasha sat down to listen to me explain my passion for nursing and all my lofty career goals.
She connected with me on such a genuinely personal level that, by the end of our short conversation, I knew Latasha is amazing and different from any other recruiter I’d ever met. NOW, of course, I recognize that she was upholding what I know to be the Mayo Clinic Values. But back then I was simply struck by the idea that, if Mayo Clinic has people like Latasha, then I want to be there too. After repeating my name about a dozen times, and asking her not to forget me, I promised she would see my application the following December. She laughed good-naturedly and promised not to forget.
My life took an unexpected turn when I decided to take a gap year in my studies and work full time as an EMT in Chicago while transferring to a larger university. I was willing to finish my undergraduate degree a year later than originally planned but I also had to postpone Mayo Clinic. So, nine months after meeting Latasha, I emailed her to explain why I wouldn’t be applying for the 2013 program after all. With little expectation she would recall our meeting, a few hours later, crazy as it sounds, I received her response. She DID remember me and would be expecting my application for 2014. Thank you for not forgetting me Latasha. By remembering and caring, you showed me for a second time, just how special Mayo Clinic must be. Without your warm response, I don’t know if I would have mustered the energy to apply to a long-distance externship so soon after re-starting my life in Kansas City. But I did and I was incredibly excited and grateful to accept my Summer III offer.
Little did I know I would experience the “Mayo Way” once again before actually moving to Rochester becoming a Summer III.
I met Mary, a pre-op nurse at a Kansas Hospital, during one of my clinical days in the CV-OR last Spring. Within minutes of working with our first patient of the day I could tell there was something dramatically different about the way Mary provided care. Despite the fact it was 7AM, and Mary’s third consecutive day working a12-hour shift, I watched as she treated our anxious patient with compassion and reassurance. She took the time to listen to his concerns and answer every question, no matter how small. She had a contagious smile on her face and assumed complete responsibility for helping the patient feel calm and safe. She performed her nursing tasks so diligently that, by the time his family left for the waiting room, she had time to pull a chair to his bedside and simply hold his hand – one person connecting to another. She didn’t see him as just another patient; she saw him as an important individual with highly individual needs.
When the patient was transported to the OR, Mary turned to me and asked what I was doing with my summer. My response was general – just that I would be working as an extern in Minnesota. But Mary immediately gasped with delight and said, “Are you going to be a Summer III?” Before I could figure out how she knew, she said she was a Summer III and it had been the single most impactful experience of her nursing career. She made lifelong friends that summer, was even in one roommate’s wedding, and the women remain close friends years later, getting together frequently even though they live in different states.
All of a sudden I realized I had seen Mayo Clinic in action – again – only this time it was a Summer III who was one of my nursing mentors. I was incredibly impressed by Mary, as a person and as a nurse, but I still couldn’t understand how Mayo Clinic produces such wonderful people. What was the secret? I combed the website over and over again, reading all the information and watching and re-watching the Summer III interviews on-line. I wasn’t skeptical when I heard their comments, I just couldn’t fathom a place like they were describing.
Week One of our Summer III Program began to give me answers. As I found myself standing in the unfamiliar setting of an OR, I sensed right away that there were many things to learn here that nursing school wouldn’t, and just couldn’t, teach. Mayo Clinic would teach me about nursing that goes well beyond medications and procedures.
During week two, a patient came into the OR and, as the anesthesia team began their work, my clinical coach walked to the patient’s side to provide a smile and a hand to hold, I saw the patient’s body relax and it all seemed very familiar. Suddenly it clicked and all made sense as I thought back to Mary in Kansas City. Handholding is an international symbol of care and comfort and it represents the spirit of nursing at Mayo Clinic. That’s what I’d been struggling to identify. The Mayo Way is all about caring.
These are Mayo-trained nurses, I thought to myself, the ones who truly and wholeheartedly believe that the patient always comes first. These are the nurses who are willing to hold hope for a patient when he can’t hold it for himself. Mary and Becky embody Mayo Clinic nursing and now I will too. Thank you Becky for all your support and guidance, and for holding my hand during 10 weeks that have powerfully changed my life.
I am so thankful to be a Summer III. The program has been everything I hoped it would be and I’m convinced we have each been prepared and empowered for an exceptional nursing career. We may be here at Mayo Clinic or, like Mary, hundreds of miles away. But wherever we’re called to serve, we will always be Mayo-trained nurses and people will notice there’s something different about us – some THING that sets us apart from the rest. Thanks to Mayo Clinic, I can’t imagine ever being anything less.
My name is Amelia Howell and I am an LPN at the Mayo Family Clinic Northeast. I have been at Mayo for three months but my journey to get here was a long one. I had dreamed of being a nurse since I was eight and working for Mayo became a dream shortly after.
Two family members have battled cancer. One was treated at Mayo in Rochester. One was not treated at Mayo and passed away within a year of diagnosis. I always felt the quality of care received, or rather didn’t receive, made all the difference, thus making Mayo all the more appealing to me. For me, the best thing about being at Mayo is exactly that. I AM AT MAYO! I have struggled with Cerebral Palsy my whole life and while being a nurse was always my dream, I was often told that it was a foolish dream; eventually I got a push from a very dear friend and went to school. School was no easy feat and I became very ill during my last few quarters making it seem like I was going to be unsuccessful with my nursing career. I pressed on though and eventually, I made it to my pinning ceremony and passed my boards. I had done it, I had become a nurse.
The question now was could I actually make it a career, and then one day I got the call, Mayo was offering me a position. Not only had I succeeded at becoming a nurse when several doctors told me it was an impossibility, I was going to be working for Mayo. My dream had finally been realized. When it came time to start, I was nervous to say the least, I began to question my abilities as a nurse, but then something changed, while orientating at my clinic I was constantly working as part of a team, and in an effort to be part of the team and make teamwork successful I began to feel empowered. I began to have a can do attitude, and realize that I can do this, I have all the skills. Because I felt so empowered I began to volunteer to learn new skills and even to be one of the LPN on a pilot project at our clinic. While I am a long way from being an expert in my field I have several resources and a great support system to help me grow through my career with Mayo. More important to me than the benefits or the reputation I get by being a Mayo employee is the knowledge that should I choose to further my nursing career Mayo would support me. While I have only worked for Mayo a short while it has made a huge impact on my life, not just in my sense of pride and accomplishment, but it has helped me to believe anything is possible. As for my family, I have never seen my mother more proud. Mayo for her has always meant the difference between life and death, it has always meant quality of care and kind nurses. I have yet to have a day where I haven’t thought to myself, today is a good day. I am at Mayo.
Written By Amelia Howell
LPN at the Mayo Family Clinic Northeast
Being a part of the Mayo Clinic team has been very rewarding and challenging. I have been a Registered Nurse for about a year at Mayo Clinic in Rochester on a Cardiac Surgery Progressive Care Unit. I would have never thought my transition from a student nurse could have been this successful. From the beginning, everyone I have been in contact with has been very helpful and inviting.
Mayo Clinic ensures new graduates have a smooth transition and feel comfortable and confident before sending them on their “own.” I put own in quotations because everything is a team effort at Mayo Clinic. There is someone to reach out to if I need help or have questions. Whether it is a new nurse that started around the same time as me or a long-time experienced nurse, everyone is totally committed to their profession and eager to help. In addition, Mayo has a ton of online resources available if one is ever in a bind. Teamwork is a value that shines through on my unit and is often discussed by nurses on other units as also being highly valued.
In addition to the extraordinary teamwork that helps ease the transition, one remarkable aspect is the training involved on and off the unit at the beginning of one’s nursing career at Mayo Clinic. Before being introduced to the unit I would be working on, I went through an orientation program that involved an introduction to the core values, expectations, benefits, and history of Mayo Clinic. This opened my eyes to what established us as a well-known and profound hospital to work for and be a patient of today. After that orientation, the orientation on my unit began. This was exciting and nerve racking at the same time. I was anxious to finally become a nurse working for an industry that leads by example and puts the needs of the patient first. Yet having an important role in the team caused me much anxiety.
The orientation on my unit lasted a couple of months because of it being a progressive care unit (PCU). I was part of a program called EPIC (The Essentials of Progressive and Intensive Care). This program was about 2 months long. It brought me back to the basics of each body system and what to expect and watch for with critically ill patients. In order to pass this part of the class, I had to score at least an 80% on a written exam. Also, because we continually monitor heart rhythms on our unit, I had to learn how to read EKG strips. This was quite challenging at first because I was not taught in detail about EKG strips in college. I thought I was never going to remember all the different rhythms! I was obviously wrong, due in large part to the nurses and staff members who taught the classes because they were very helpful and willing to put in extra time if needed. Looking back on the program, I feel as though it was beneficial and important to help me be successful beginning my new career.
Since starting on my unit, I have witnessed an industry that operates effectively and efficiently towards a specific goal for each individual patient. Mayo Clinic is known for putting the needs of the patient first, but it is even more rewarding to be a member that strives for and witnesses this attribute. Every day I come to work I am happy to be there. I am faced with a different challenge each and every day which requires me to critically think which will benefit me as I continue my career as a registered nurse and as I pursue a higher education. Being an employee of Mayo Clinic thus far has been a blessing.
Growing up in a small town in Maine, I never would have envisioned myself moving to the Midwest for a job. My journey to Mayo Clinic actually started in California while I was attending a psychiatric nursing conference and met a group of nurses from Mayo Clinic in Rochester. Every nurse that I interacted with loved their job and felt that they were making a difference in the lives of patients. Some of the nurses had been Summer III Externs and encouraged me to apply for the externship the next summer. When I returned to the University of Maine, I submitted my application, doubting that I would be accepted to such a prestigious program. I had no idea that this decision would mark the start of a life-changing journey at Mayo Clinic.
The 10 weeks I spent in Rochester during the Summer III program changed my perspective on nursing. My placement on an inpatient mood disorders unit, the same unit that the group of nurses I met at the conference worked on, was perfect for my educational background -- I had just completed a Bachelor of Arts in Psychology. I remember move-in weekend like it was yesterday. The chaos of nursing students from around the country moving into the apartments was electric. The energy did not die down during the course of the summer. After a few weeks on my clinical unit, I began to realize that the nurses had not been exaggerating; Mayo was an amazing place that touched the lives of both patients and employees. Returning home for my final semester of nursing school, I faced a difficult decision. Should I apply for an RN position at Mayo Clinic and move 2000 miles away from my family or should I accept an offer for a spot in a Family Nurse Practitioner program on the east coast as I had originally planned?
My desire for a varied med-surg nursing experience and love of change led me to apply for a position on the general care float staff at Mayo Clinic in Rochester. The decision to postpone my plans for FNP school and accept the RN position came easily after I thought about the extremely diverse experience I would have in my first new grad position. Mixed in with my excitement about the new job were strands of fear. Would a position floating to 35 general and progressive care units prove to be too much for a new grad? Even my professors voiced concern about it. Would it be difficult to meet new people when I did not have a unit to call home? What would orientation look like?
Orientation would be a four-month process of first becoming familiar with one unit and then floating to all of the inpatient general care specialties at Mayo Clinic Hospital, Rochester. The experience provided me with the foundation I needed to feel comfortable practicing independently but also showed me that I was never alone. As a float staff nurse, there is no way that I can remember every unit specific procedure. Working with unit-based preceptors, I found the most important lesson learned was never to be afraid to ask any question.
Fast forward one year. Being an RN on the Float Staff has been everything I could have hoped for; it has given me a diverse med-surg experience and fostered my love for change. I have never felt that floating was too overwhelming, because of the extensive orientation and support that I feel from my peers and managers. Contrary to my original fear, floating has allowed me to meet and befriend people from around the hospital. I have found ways to become involved outside of my role as a staff nurse. I am my unit’s wellness champion, and I volunteer for the No One Dies Alone Program. Floating has nurtured personal skills such as flexibility, patience, and confidence. Nursing at Mayo Clinic really has provided me with a life-changing experience and will continue to do so as I start orientation again for an ICU Float Staff position next month.
It was a quiet morning on Fr4C. My clinical coach and I had been very productive all morning. We were all caught up on orders, assessments, charting, and medications. We had just sat down to look up some notes on our patients, and my coach had brought along an EKG book for me to browse because I had some questions about bundle branch blocks.
As we were sitting at the nurse’s station, we noticed that the O2 levels on one of our patients had dropped a bit. My coach went into the room to make sure the monitor was on correctly. After a minute, I went in to make sure everything was okay. The patient’s oxygen levels were still dropping, and he wasn’t responding to us. We put oxygen on, got a blood pressure, tried to wake him up, and kept watching the monitor. As we were watching, his heart rate and O2 levels kept dropping rapidly. We called the doctors and then the Rapid Response Team. Nurses from our floor had noticed and had come in to help us out. Within one minute of calling the RRT, we had to call a Code because there was no pulse.
What happened next will stick in my mind forever. Almost instantly, there were 20 people in the room. They each took a job and performed it expertly. Within seconds, they had started CPR, attached the AED, were administering breaths, had begun to intubate the patient, and were giving medications. Everyone was calm and collected. They were working as a single unit, as a team, to try and save this patient.
During this time, I was able to sit with the wife of the patient. She was holding a pamphlet in her hands with some Bible verses on it. I asked her if she would like me to pray with her. She said yes, and as 20 people were attempting to save her husband’s life, I was able to pray with her. I then escorted her out to the waiting room where a chaplain met with her.
Going back to the room, I was able to watch the amazing teamwork and precision that the health care team had. In the end, they were able to re-establish the patient’s pulse. I was the one who was able to go tell the wife that her husband was still alive and was moving to the ICU. I don’t know a lot of what happened to him after that day, but the memory of that experience will be burned into my memory.
It was the single most terrifying moment of my life, and yet it was one of the most powerful. The nurses from my floor who ran into the room saved a patient’s life that day. I was able to be with a family member during a very terrifying and vulnerable moment. The respect and admiration that I had for the nursing profession grew exponentially after that day. I had a glimpse of what nursing really is -- a collaboration of people with expert training who truly care about patients working together to improve lives.
I am happy to contribute a story about my experience in the Emergency Department at Mayo Clinic Hospital – Rochester, Saint Marys campus. Every day I'm excited to go to work. When I'm not learning from my clinical coaches, I'm learning from my patients.
An experience at Mayo that I will never forget happened one night in critical care. My patient was involved in a serious motor cycle trauma. Ejected from his motorcycle, he sustained trauma to his head and multiple abrasions to his body. After evaluation and multiple X-rays and CTs, it was determined that he had no further injuries. The ED trauma team worked like a well-oiled machine. Every step of his care was excellent, and he was guided through his evaluation by the trauma nurse and trauma consultants, who helped him stay calm. The writer for the trauma took the time to explain to me what was happening during the assessment and gave me the opportunity to comfort the patient. I did my best to comfort him, and I assured him that his safety and health were our number one priority. I also assisted in finding his friends for him, who were relieved to hear that his head injury was minor and that he should recover completely. After it was established that he no longer was considered a level 1 trauma and was stabilized, the team went back to their other patients, and I was able to further talk with him.
During his assessment I asked him about his past medical history and he explained that he’d been in multiple accidents but that his guardian angel always protected him. He said that in his line of work, he has learned to live everyday as if it was his last. He had been in multiple motor vehicle collisions and in every one he came out with minor injuries. At first when I heard this, I was stunned. I could not believe that he would want to ride a motor cycle without a helmet after all of these accidents. He loved riding his bike and it gave him the freedom to “feel like he had some control over his life.” He preferred to leave it in his guardian angel’s hands. At this moment I realized how powerful faith can be. This patient’s beliefs were so firm that no matter how many doctors and nurses explained to him how “lucky he was this time” and that “you really should wear a helmet,” he was still going to drive his motorcycle as if nothing ever happened. After his lacerations were cleaned and sutured he was discharged home. He thanked us for his care and stated that he had been taken good care of and that he was tough and would be fine.
I now understand why the patient’s beliefs determine what is best for them and why their faith plays a huge role in their treatment. After this trauma I realized the importance of having trust in your co-workers and why it is so important to work as a team. During my summer III experience, I feel that I impacted my patients by comforting them and providing them the best care possible. However, I also feel that I’ve learned so much more from them and the nurses and consultants who treat them. At Mayo, the patient’s needs come first, and I see it in every nurse in the emergency department, and I’ve tried every day to mirror the care that they give. The emergency department team is one that I have been proud to be a part of for the past ten weeks, and I appreciate the opportunities to learn from them as well as the kindness they showed me.
When I arrived at Mayo Clinic in Rochester, I had just come fresh off a very thrilling clinical experience on a cardiothoracic surgical unit at UW Hospital. The unit was a combination of intensive care, PCU and general care, and I felt like I had seen a lot, maybe even a bit more than some of my fellow nursing students. On some of my last days, I was able to visit with a patient on ECMO. My nurse working with me told me I most likely would never see this again. I could not have imagined that just one month later, my first day on the unit, I would see two other patients, both on ECMO, receiving dialysis through their lines.
What I appreciate most from the time spent here in Rochester was my opportunity to work with patients as young as three days old to patients in their 90s. Nowhere else could I have gotten such an incredible variation in patient types and needs.
When I leave here I will remember many of my patients. I have learned how it is to create some separation from the patients I care for day in and day out. But that doesn’t mean that once I’m back in Madison, I won’t wonder every so often how the patient I gave hand massages to each dialysis session is doing, or how the young boy who received a long awaited kidney transplant is holding up, or how the family who lost their father suddenly to stroke is coping with the loss. This summer will always be a part of who I am as a nurse, and I can’t thank enough the nurses who helped me through this learning process.
As the last week quickly approaches two events stand out. At the beginning of the week, one of our young patients received his kidney transplant. He has been in and out of the hospital for over three years and I spent many days with him and his family over the course of this summer. I worry about his quality of life and can only hope that this transplant will work and give him some semblance of a childhood. At the end of the week, another of our young patients, who had just transferred from the ICU to his rehab unit, passed away suddenly. These moments struck me most because the sick people are so young and so innocent. This summer is a true realization for me of the fragility of life and how quickly it is taken from us. When I leave Rochester, I will continue to remember and hope for these boys and their families. In the end, no amount of separation can protect us as nurses from caring for those we care for. I am grateful to Mayo and the Summer III program for providing me with such a full learning opportunity.