Student registered nurse anesthetist experience leads to practices changes at clinical site

As part of the MUSC Anesthesia for Nurses (AFN) program, students participate in a series of 19 clinical rotations in various settings administering anesthesia to all types of patients. During their anesthesia practicums students also complete an evidence-based clinical correlation presentation that allows them to take what they’ve learned in the classroom, during clinicals, and through reviewing current literature to make recommendations for providing the best patient care possible.

This year, Kendall Cole’s, Class of 2021, presentation led to positive changes at Spartanburg Regional Medical Center (SRMC).

Cole has her Bachelor of Science in Nursing and has been a registered nurse for six years. As an intensive care unit (ICU) nurse, she had the opportunity to shadow certified registered nurse anesthetists (CRNAs). She was drawn to the fast-paced, problem-solving skills required to administer anesthesia. “Choosing an anesthetic for a patient is like solving a puzzle,” she said, “which is why I knew anesthesia would be a rewarding and challenging career.”

When tasked with developing her evidence-based clinical correlation presentation, she recalled a patient case she experienced while on a clinical rotation at MUSC’s Ashley River Tower. In this case, the patient was paralyzed while under anesthesia in order for the surgeon to operate. Before being woken up from anesthesia, Cole needed to reverse the paralysis by administering a drug called sugammadex to the patient. Unfortunately, the patient experienced a severe allergic reaction to the drug, which required treatment with several medications readily available in an “anaphylaxis kit” nearby.

Cole’s presentation, Sugammadex: Suspected Allergic Reaction, was a product of this patient experience and reviewing current evidence-based research. The presentation reviewed the pathophysiology of an anaphylactic reaction, the pharmacology of sugammadex, and discussed the treatment for suspected anaphylactic reaction related to a case study involving sugammadex. She ultimately recommended that clinical sites implement an “anaphylaxis tackle box” to treat patients quickly. The tackle boxes should consist of anaphylaxis treatment medications, such as epinephrine, diphenhydramine, famotidine, hydrocortisone, and albuterol.

“A lot of the learning comes through reflection on a clinical experience; thinking about what was done well and where there might be opportunities for improvement,” said Candace Jaruzel, Ph.D., CRNA, assistant director and director of Clinical Education for the AFN program. “Our students benefit from taking that prior knowledge and then conducting a current literature review to become a better practitioner. Everyone learns something through the evidence-based clinical correlation presentations – even me.”

Her presentation and recommendation were well-received by the faculty, her peers, and SRMC, one of the clinical sites affiliated with the AFN program. SRMC plans to put the tackle boxes into practice at their facility.

For more information about the Anesthesia for Nurses program and the student experience, visit chp.musc.edu/dnap.