I debated about where to post this thread, and decided on this heading for maximum exposure. Those of us who have done this for a few years, and held a few positions, have experienced things that left us saying to ourselves "I never take another job where X is true again." All in all, that's pretty valuable information, and can be helpful to anyone looking at getting a first job, or looking to change jobs. Here are a few things I've learned:

I'll never again take a job where there is really stiff competition, either between hospitals or anesthesia groups. In one case, I worked for an anesthesia group in Wichita, where several different anesthesia groups all worked at all the hospitals. In another case, I worked at a hospital in a smaller city where there were two hospitals, both in stiff competition with each other. No matter the situation, the surgeons come out ahead, and anesthesia suffers for it. No one can say no to any surgeon. If orthopod X decides it is convenient to do his knee scope at 6 PM, he'll be allowed to do it, because everyone is afraid to anger that surgeon and send him to "the other" hospital or anesthesia group. That seriously impinges the personal life of the anesthesia provider. (Yes, we have to try to keep our surgeons happy everywhere. And there are always cases that are urgent or even emergent, and all of us will do those cases willingly, knowing it is for the benefit of the patient. My problem comes when we do it for the benefit of the surgeon's schedule, our life be damned.)

I'll never again take a job with a flat salary that requires call. My time is valuable to me, and if the hospital wants me to be on call, I expect some payment for that. I expect additional payment if I am called in. If you take a call position for a flat salary, you can and will be called in at all hours for nitnoid nonsense. Why not? There's no cost to your employer. I'll never forget being awakened and called in at 10:30 PM for an IV start on a patient who was a supposed "tough stick." The IV turned out to be a chip shot, and the nurse simply too lazy to have ever even looked.

I'll never again take a job that places the nurse anesthesia staff under the supervision of the department of nursing, particularly where the CRNA's are "managed" by the OR director. The problems under such a scheme are multitude. Management then sees you as just another staff nurse, and expects you to behave like a staff nurse, and expects you to put up with staff nurse nonsense. I did not work this hard to be treated like just another nurse. (Sorry to those who are not CRNA's yet if this attitude seems elitist. That's just the way it is.) But a bigger problem is that if management sees you as just another staff nurse, so will the OR staff, which can lead to power struggles, to the detriment of patient care.

Enough for now. Anyone else have other examples of "I'll never do that again?"

Kevin