Anesthesia Guidebook

Jon Lowrance
  • 4.8 (187)
  • MEDICINE
  • UPDATED MONTHLY

Anesthesia Guidebook is the go-to guide for providers who want to master their craft. We help anesthesia providers thrive in challenging, high-stakes careers through our relevant, compelling guides. You’re on a path to becoming a master anesthesia provider. We’re your go-to guide for deepening your anesthesia practice.

  1. 3D AGO

    #116 – What Mouth-to-Mouth Resuscitation has to do with Systems Thinking

    On the corner of Skyland Drive and 23 in a little town called Sylva in Western North Carolina, sit’s PJ’s gas station. One hot summer day back in 2005, I was filling up the tank in a convalescent transport van on my very first day as an EMT-Basic. That’s the most basic, entry-level certification of working as an Emergency Medical Technician or EMT.  My convalescent transport van had a wheelchair ramp and my role as an EMT-B was not to do 911 calls, but to drive this glorified shuttle bus. My role was to transport people to and from their doctor’s appointments. Maybe to help them get home after being discharged from the hospital. If you were too sick for a taxi but not quite sick enough for an ambulance, I was your guy. The guy training me that day, a senior paramedic, was actually a good friend of mine and happened to also be my boss at a local outdoor education company. Everyone affectionally called him “the Padj,” a shortened third-person version of his last name, Padgett. The Padj ran Landmark Learning, which offers wilderness medicine educational courses for outdoor guides and enthusiasts and eventually became the Southeast training center for NOLS Wilderness Medicine. Pretty much everyone who taught for NOLS Wilderness Medicine had a part time gig working in EMS and so that became my path too and this was my first day on the job. I felt supremely important because of two things: as part of my standard issue uniform, on my thick polyester blue shirt, I was wearing a chrome name badge that said “J. Lowrance, Since 2005” and I had a big, heavy, professional walkie talkie. We had no more checked out the van and driven a mile down the road from base to fill up with gas at PJs when the tones went off on the walkie talkie, indicating a serious 911 call had just been dispatched. As I was pumping gas and the Padj was relaxing in the passenger seat, the radio crackled with the call: there was an unresponsive patient about a half mile down the road from where we were. We looked at each other and shrugged, knowing that even though we were essentially in a shuttle bus with next to no medical supplies, we wanted to see if we could help. We hurriedly paid for the gas, jumped in the van and ended up beating the ambulance to the house where the 911 call came from. We were met by a distraught woman in her 60’s who told us she couldn’t wake her husband up. We went in the house through the side door, immediately finding ourselves in her kitchen. The bedroom was just off the kitchen and walking in, I remember the time on the bedside clock – one of those little rectangular digital clocks with red numbers: the time was 10:10 in the morning. Photo credit: OpenAI (2025). ChatGPT 4o version. [Large language model]. https://chatgpt.com.  The man was large, heavy and not moving. He looked like he was still asleep except he was a deep shade of purple… not quite blue yet, but definitely not alive-looking.  The Padj called out to him and checked a pulse. Nothing. My heart, however, was racing.  As my palms began to sweat, the Padj looked at me serious, which he never did, and said quietly out of respect for the man’s wife, standing in the doorway, “dead on arrival or do you wanna run the code?” I could hear the sirens of the ambulance approaching the house. “Let’s do it.”  We heaved the man onto the floor… he was heavier than I thought he would be. It dawned on me that dead people don’t try to help you like ...

    24 min

  2. FEB 24

    #115 – The NBCRNA MAC Program: How CRNAs Recertify

    Hey y’all! First of all: thank you to those of you who have subscribed to the website and get these posts right to your email inbox. That’s all that happens: the podcast is free and subscription to the show just means you get the content straight to you as soon as it’s live. I never sell or use your contact info for any other means. I’m just simply thrilled to have your support and interest in the show as the whole thing is geared to support you and help you thrive in your career as an anesthesia provider. Thank you! This podcast covers a run down on the NBCRNA’s Maintaining Anesthesia Certification (MAC) Program. The MAC Program is how CRNAs maintain and rectify their license with the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA). The MAC Program launched in 2024 as a revamped version of the old CPC (Continued Professional Certification) Program. There are some substantial changes that CRNAs should be aware of. First off, you need to know if you’re in the MAC Program yet. Most CRNAs (new grads and those who’ve re-licensed after 2024) ARE in the new MAC Program. This show will coach you on how you can log into NBCRNA’s website to see where you’re at and what you need to know about MAC Ed (Class A) & MAC Dev (Class B) credits and the quarterly MAC Check exam questions that you can take on an app on your phone. All the details are in the show! For the truth of what’s up with the MAC Program and your license, as always, check with NBCRNA! Things change over time. Be sure NBCRNA has an updated email for you. 30% of the emails they send to CRNAs bounce back as invalid addresses. That’s insane! Updatechur email! You can follow along with the podcast by checking out the attached PDF that outlines the show with lots of helpful graphs and more info than what I spoke about in the podcast. Two last points: First: Overall, I think the MAC Program is a really healthy and needed evolution to the CPC Program. NBCRNA has listened to CRNAs and made needed adjustments to the continuing education/relicensure program. We have to have a continuing education/certification program for the CRNA license to have meaning and value. The current iteration is the best it’s been, so there’s that. Second: Remember that your STATE Board of Nursing may require additional steps for you to re-license as a CRNA. For instance, NBCRNA does NOT require pharmacology-specific continuing education credits (MAC-Ed/Class A); however, the State of Maine (where I’m at) does! For example, Maine CRNAs must obtain 60 MAC-Ed/Class A and 40 MAC-Dev/Class B credits for recertification with NBCRNA every 4 years but we have to have 50 credits every 2 years, 15 of which (every 2 years) must be pharmacology credits, to re-license as CRNA in the State of Maine. So the requirements to re-license as a CRNA in the State of Maine are slightly more stringent (and more frequent) than to maintain the national license with NBCRNA. Follow along with the powerpoint for more details: MAC Program Overview – Anesthesia GuidebookDownload

    34 min

  3. FEB 17

    #114 – Leadership: how to get stuff done

    This podcast is for leaders, clinicians, residents & students who need to get wildly important things done. It’s about how to prioritize when so much of your work seems important. How to find balance when so much seems to be coming at you. How to get started at achieving your biggest goals. This episode will walk you through the 4 Disciplines of Execution by Chris McChesney, Sean Covey & Jim Huling.  I have no financial relationship with these folks, the book or their publishers. It’s just a great concept that will help you get organized, identify your wildly important goal and figure out the work you actually need to do and CAN do to accomplish your goals. The 4 Disciplines of Execution (4DX) model will ask you to identify your wildly important goal. You’ll then create several lag measures (subgoals) and several lead measures (objectives) for each lag measure. These lead and lag measures are where the real work is. The wildly important goal may seem out of reach. Even the lag measures (which lag behind the work you’ll do in the lead measures) may seem a bit ambitious. That’s ok. The lead measures should be the specific actions you will take on a daily or weekly basis that will chip away at the lag measures. As you put the work in on the lead measures, your lag measures will come into sight and slowly be realized. As you stack up achieving the lag measures, your wildly important goal will become within reach. The next components of the 4DX model is the scoreboard where you track your progress on each lead & lag measure. This can be any relevant metric on any kind of progress tracker: a list on a whiteboard, a data point in an Excel file, the pounds on the scale, dollars in the investment account or left on the loan. Whatever. Lastly, is the cadence of accountability. You need to either personally set up a check in on your progress with yourself or you need to set this up with your team, mentor or coach. The authors of the 4DX model recommend this be a short weekly meeting where you review progress from the last week and plan actions for the coming week. Accountability is about follow through, taking steps (as small as they might be) and slowly, setting up the cadence of consistency. I was on the Peloton last night and heard Matt Wilpers say that the order of priorities in exercise is developing consistency, then duration, then load. You can’t go out hard all of a sudden and expect big results. Develop consistency. Show up a little bit each day or each week. Then put the time in. Build the duration of your investment towards your goals. Then you’ll know when to put the extra effort in. Check out the show and if you want to dig deeper, definitely check out the 4 Disciplines of Execution. McChesney, C., Covey, S., & Huling, J. (2012). The 4 disciplines of execution: Achieving your wildly important goals. Simon and Schuster. What’s your Wildly Important Goal?

    38 min

  4. FEB 9

    #113 – Sabbatical in Spain with Matt Moody, CRNA

    Matt & Alison Moody took a year off of working as CRNAs to live and travel in Spain with their then 4-year old daughter. This is part of that story. Matt & Alison Moody in Granada, Spain The two were living and working as CRNAs in Asheville, North Carolina when they caught the idea to take a year off of work and live in Spain. Their journey to Spain went from the fall of 2023 to the fall of 2024 and over the last few months, they’ve been re-integrating back to the United States and Western North Carolina and back to their careers as CRNAs. Part of their inspiration to take a year off work came from listening to the episode I did with Kyle & Jen Steen on their decision to sell everything, build out a sprinter van and hit the road. That story is in episode 73. Side note: Kyle & Jen took about 18 months off from work before Kyle returned to his career in anesthesia through locum assignments. They’re still in the van full time and still crossing off new places to live & explore. I hope to have them back on the show soon! Matt & Alison wanted to head to Spain to work on their Spanish language skills and take time to connect with each other as a family. What they discovered along the way may surprise you. In this conversation with Matt, he walks us through what they set out to do and how that changed over time – from before they left through how their experience evolved while they were over in Spain. I think you’ll enjoy this story and hopefully find some inspiration for yourself to think outside of the box and consider what might be possible in your own life. It doesn’t have to be taking a sabbatical or selling everything and hoping in a custom built Sprinter van. It might be about re-prioritizing your work-life balance in other ways. It might be going back to school or picking up pottery like my wife, Kristin. It might be about moving to that area of the country you’ve always wanted to live in or finding a new way to explore your passions. Finding a way to prioritize your own story, dreams and aspirations along the way is possible and I loved chatting with Matt to hear how he & Alison arranged their life to pursue their goals. Matt grew up in coastal North Carolina; went to college and nursing school at UNC Chapel Hill; and then received his CRNA degree at Wake Forest. His heart and soul have always belonged in the Pacific Northwest, so after graduate school he moved west and started his career at the University of Washington Medical Center in Seattle, WA. Eventually, the pull of family brought him back to NC, and he has called Asheville home since 2017. Thus far in his career, Matt has had the fortune to gain experience in many practice areas – from major trauma hospitals to small surgery centers – and has experience in many subspecialties of anesthesia. In his free time, Matt loves to spend time being active outdoors, but he’s especially passionate about rock climbing and skiing. Lately, he and his wife, Alison, have been experiencing the joys (and frustrations!) of introducing their 5 year-old daughter to these activities. While in Spain, Alison created an Instagram page that they invite you to follow. It’s @ La Moody Aventura. @lamoodyaventura Matt also offers his email to anyone who might have questions about how they did what they did. In the show, he talks about how they felt like they were the only ones crazy enough to do something like this but then actually met several folks abroad – including another CRNA family from the States –...

    1h 38m

  5. JAN 25

    #112 – How to Transition from Clinician to Chief CRNA

    What’s up y’all! This is Jon Lowrance and this is episode 112 – How to Transition from Clinician to Chief CRNA. Y’all are going to love this conversation. So… I almost don’t know where to begin cause there’s so much to talk about… This is an episode about chief CRNAs but so much more. It’s like when you watch one of those food documentaries about the best pizza kitchens in the world and you’re like: oh, a documentary about pizza, but then it’s really about the experience of chefs, small business owners, friendship and passion. This episode is like that. It’s about chief CRNAs. And we have a couple of guests that are going to talk with us about an article they published on the research they did into the professional experience of chief CRNAs. But this story is really about the transition that most healthcare providers take when they take the step from expert provider to clinician-leader, practice manager or owner. You’re going to see this through the lens of what these 2 researchers saw when they did a qualitative analysis of chief CRNAs across the state of North Carolina. But you might take something away from this about the physician who leads your team or the CMO or health system president that runs the show where you’re at. If you work in healthcare, cause you probably do – again, unless you’re my mom, who listens to all these podcasts – hey Gail! But for the rest of you, if you’re in healthcare, this episode will likely help you understand your clinical leaders better. I never set out to be a chief CRNA or practice manager. I wanted to be the best clinician I could. I wanted to stand in the gap between the chaos and the outcome. I wanted to master my craft as an anesthesia provider and take the best care of patients possible. Literally, like 6 months before our chief CRNA announced that he was going to step down after 8 years in his role, I had the opportunity to become a daily shift supervisor – like a board runner in the OR. I was like: I’m never going to do that. It seems way too hard. Then our chief stepped down and his role opened up and I was like… wellllllllll… This episode hopefully will be relevant to any clinician who, like me, has stepped into a role or is thinking about taking on a clinical practice leadership role that maybe they’re not totally ready for. You’re not alone. So we’re going to talk with Austin Cole and Robert Whitehurst, co-authors of an article about the competencies & professional development needs of chief CRNAs that was published in April 2024 in the AANA Journal. Austin framed his doctoral project at Duke University around this study. Austin Cole, DNP, CRNA began his career after graduating from the school of nursing at UNC-Chapel Hill. Following graduation, he spent two years as a Registered Nurse in a cardiothoracic critical care unit. He received his DNP and nurse anesthesiology training at Duke University and currently practices as a CRNA at Duke Regional Hospital in Durham, NC. Robert Whitehurst is the President of Advanced Anesthesia Solutions, a CRNA practice providing anesthesia services to a variety of outpatient practices. He graduated in 1997 from East Carolina University School of Nursing with his Bachelor of Science in Nursing and in 2004 from Duke University School of Nursing with his Master of Science in Nursing. Bob Whitehurst is also the Chairperson for the North Carolina Association of Nurse Anesthetist’s Political Action Committee and he’s passionate about patient access to high quality anes...

    52 min

  6. 11/24/2024

    #111 – How to do Medical Mission Trips with Stacey Such, CRNA

    What’s up yall! This is Jon Lowrance and this is episode 111 – How to Prepare for Medical Mission Trips with Stacey Such, MSN, CRNA. (Stacey pronounces her last name, Such, like “Suke/Duke.”) Before we get to this show, I’d like to give a quick shout out to the CRNAs, SRNAs & physician anesthesiologists who made it to Encore’s conference in Bar Harbor back in October as well as the Maine and Arizona State Association of Nurse Anesthesiology conferences, which were also in October. I had the privilege of speaking at all three of these conferences and really loved getting to see some of you out there. We had 2 SRNAs in Bar Harbor from different programs who came to that conference because they heard about it right here on the podcast, which is awesome! Somebody else in Bar Harbor let me know that after they listened to the episode on how ondansetron prevents spinal induced hypotension – which I recorded way back in 2021 with Jenny Li in episode 16, this guy went and did his own deep dive on the topic, ended up presenting on it at his group and they changed their whole practice as a group in managing c-sections. That’s amazing. I have so much respect for yall out there on the front lines, working to master your craft and make a difference for your patients. So, it’s always a blast to get to hang out with you in person at these conferences. On that note, for 2025, I’ll be back with Encore Symposiums down in Hilton Head, South Carolina in May and back at the Cliff House in October. That’s May 19-22 at Hilton Head Island in South Carolina and October 20-23 at the Cliff House Resort in Cape Neddick, Maine and those are with Encore Symposiums. All right, in this episode, Stacey gives us a run down on how healthcare providers can prepare for short term medical mission work. Stacey has been a CRNA since 2012 when she completed her Master of Science at Middle Tennessee School of Anesthesia. She worked as a CRNA for just over 10 years prior to returning to graduate school to complete her Doctorate in Nurse Anesthesia Practice at Virginia Commonwealth University. She framed her doctoral project around short term medical mission trips, their impact on global health and how healthcare providers can prepare to engage in this work. In this show, you’ll hear what motivate Stacey to engage with this work following a deeply personal tragedy. You’ll hear stories about her time serving with Mercy Ships, Samaritan’s Purse and the World Health Organization. Stacey walks listeners through her 8-step guide for how to prepare for medical mission work. This is an excellent introduction to short term mission work and will hopefully inspire you to get involved in serving others in new ways and give you a guide for where to start. Stacey included her 1-page guide to preparing for medical mission work in the show notes to this episode. She’s titled this Global Anesthesia Outreach: A Comprehensive guide To Preparing for Medical Mission Work. Global Anesthesia Outreach: A Comprehensive guide To Preparing for Medical Mission Worka href="https://anesthesiaguidebook.com/wp-content/uploads/2024/11/Global-Anesthesia-Outreach_-A-Comprehensive-guide-To-Preparing-for-Medical-Mission-Work.

    52 min

  7. 10/30/2024

    #110 – How we do interviews with Alison Kent & April Bourgoin

    What up yall. This is Jon Lowrance with Anesthesia Guidebook. This is episode #110 – How we do interviews with Alison Kent, MSN, CRNA & April Bourgoin, DNAP, CRNA. In this episode, April, Alison & I talk about how we conduct CRNA interviews as a leadership team with our Department of Anesthesiology at MaineHealth – Maine Medical Center. Maine Med is the only level 1 trauma center in the state of Maine with 700-licensed beds. We run around 60 anesthesia sites of service a day with a staff of just over 130 CRNAs, 50 physician anesthesiologists, a physician residency & fellowship program and have clinical affiliations with 4 different nurse anesthesiology training programs. Alison Kent is the Manager of CRNA Services at Maine Medical Center and completed her Master of Nursing in anesthesia at the University of New England in 2006. She’s been at Maine Medical Center as a CRNA for nearly 20 years and has served in the Manager role since 2017. April Bourgoin is one of two Supervisors of CRNA Services at Maine Medical Center and completed her Master of Science and Doctor of Nurse Anesthesia Practice degrees at Virginia Commonwealth University in 2017.  Prior to becoming a CRNA, she served for eight years as an active duty commissioned officer in the Army as flight nurse with the 82nd Airborne Dustoff medevac team. She served two combat tours prior to transferring to the Army Reserves at the rank of Major. April joined me on episode 93 of Anesthesia Guidebook where we talked about OR fires and this is Alison’s first, but certainly not last, appearance on the show! These 2 folks are part of the core CRNA leadership team at Maine Medical Center. Together, they truly make the world go round for our team and are like the glue that holds everything together. It’s an absolute privilege to get to work closely with these folks on a daily basis and I couldn’t be more thrilled to have pulled them in on this podcast about how we do interviews. So, let’s tee this up a bit. In today’s anesthesia market, you can go anywhere and make a great money and do interesting cases but the thing that will differentiate your experience with a group is the culture of the team. And your experience of that culture begins with your interview. It actually begins a little earlier than that, even, with how the reputation of the team reaches you – maybe through things like this podcast, or when you reach out to inquire about a group or talk with friends & colleagues who may work or have worked with a particular group. But a really important deep dive into the culture of the team will come on interview day. You should meet some core folks on the team – CRNAs, physicians, trainees, administrative specialists. You should get in the operating rooms and actually see the staff do the work that you’re looking to join them in. You should leave the interview with a very clear idea of what you’re potentially getting yourself into, both in terms of culture and with a thorough run down of the benefits and compensation package. If you’re listening to this and you’re a practice manager or thinking about getting into a role in which you support your team as a leader, hopefully you find this podcast super helpful. Alison, April & I talk through our process & structure for interviews, what kinds of questions we ask, what we look for in candidates and how we work to both recruit folks and protect our culture by making sure we’re bringing in people who are a good ...

    54 min

  8. 09/01/2024

    #109 – Leadership 101 – Why it Matters

    What’s up yall! This episode dives into fundamental concepts related to leadership and casts a message for why it matters to all of us. Whether you’re primarily a clinical CRNA/physician anesthesiologist, resident/SRNA, a practice leader/manager, business owner, educator, researcher or policy advocate, leadership has a fundamental role in your day to day life. In this episode, we talk about: The art & science of leadership Position, power, influence Leadership & management  Leadership & followership Culture, and how we influence it  The Servant Leadership Model  Jocko’s leadership principles I’m pulling from my time as an instructor with Landmark Learning and NOLS (National Outdoor Leadership School), both outdoor education schools that thread leadership principles through their risk management and wilderness medicine programs. I’m also pulling from my experience as the chief CRNA at Maine Medical Center, a level 1 trauma center with over 200 staff in the anesthesia department. And some of the content is coming from the work I’m doing as I pursue a PhD in organizational leadership with a research focus on how high performance teams operate in emergencies. Hopefully you’ll find something you can hang your hat on here. Leadership is the art and science of influencing others to achieve shared goals. There’s a ton of different leadership styles & theories out there and I’ll touch on some in the podcast. My personal approach is the Servant Leadership Model, which flips the traditional organizational chart – a pyramidal/triangular structure – on its head and puts the leader at the bottom of the triangle and the most important staff up at the top. The most important folks in any organization are those who are doing the front line work to deliver on the mission and vision of the organization. In the Servant Leadership Model, these folks are the top and the leaders and managers are positioned below them. The job of leaders and managers is to support and empower the folks above them to do their best work in robust and resilient environments where the capacity for the right thing to happen flourishes. No big deal right? To find out more, check out the podcast! Servant Leadership ModelDownload Leadership Tactics By Jocko Willink Be humble  Don’t act like you know everything  Listen, ask for advice & heed it Treat people with respect  Take ownership of failures Pass credit for success up & down the chain of command Work hard  Have integrity – do what you say, say what you do Be balanced – avoid extreme actions/opinions Be decisive  Build relationships = this is the main goal of a leader

    39 min
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    About

    Anesthesia Guidebook is the go-to guide for providers who want to master their craft. We help anesthesia providers thrive in challenging, high-stakes careers through our relevant, compelling guides. You’re on a path to becoming a master anesthesia provider. We’re your go-to guide for deepening your anesthesia practice.

    Information

    • Creator
      Jon Lowrance
    • Years Active
      2020 - 2025
    • Episodes
      116
    • Rating
      Clean
    • Copyright
      © Except where otherwise noted, the content on this site is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License
    • Show Website
      Anesthesia Guidebook

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