On this episode of the medical podcast Scrubbing In, SpecialtyCare’s Chief Marketing Office Lee Pepper interviews Andy Stasko. Andy is the Director of Operational Performance for perfusion at SpecialtyCare. Lee and Andy discuss how a friend inspired him to enroll in perfusion school, what a smart career choice perfusion is, and how Specialty Care is offering financial assistance to students with the Brown-Brukardt Perfusion Scholarship.

Lee Pepper: Great, it’s my pleasure to welcome Andy Stasko to Scrubbing In Podcast this morning. Andy, thank you so much for coming over.

Andy Stasko: Thank you very much for having me.

Lee Pepper: You know, it was fascinating before we went on air getting a little bit more about your background as a Respiratory Therapist. And I was wondering if you would share with our audience a little bit of your journey from college, into respiratory therapy, and then into perfusion.

Andy Stasko: Sure, be happy to. As a Respiratory Therapist I was working in Pittsburgh. I was, part of my respiratory therapy curriculum was also to be a instructor to the students that rotated through that hospital. So I got to know one of those students fairly well, [inaudible] remain nameless, but this individual ended finishing his clinical rotation with us in this facility, and he came to work for us short time afterwards and then within a few months he said “I’m gonna take a different career path”, and he says “I’m going back to school”.

We wished him well, and off he went. It was one year later, I saw this individual back in our operating room, excuse me, in our cafeteria. And I looked down and I said “Mike”, I said, “you’re in scrubs, what are you doing?”.
He says, “I work here”, I said “where?”.
He says “In the operating room.” He said “I’m a perfusionist.” And I said “what’s a perfusionist?”.
He says “Well you have to come in and see what we do.”
So, I at the time was working two weeks day shift, two weeks night shift was my full time job. So, when I finished my night shift job in the hospital I would go to the OR. to watch a morning heart. So, he invited me in, and it was absolutely a fascinating career path.

Lee Pepper: Wow. Now how long from the time you saw him in the cafeteria, how many weeks or months went by before you decided to go and pursue perfusion?

Andy Stasko: It was a almost entire six months that I was exploring perfusion, and I was also very interested in getting more familiar with the cardiac surgeons that I got to know in our intensive care unit when they would make rounds on their post op hearts. So, one of the particular surgeons invited me to consider going to Perfusion School cause they were starting one up in the City of Pittsburgh.

So, it was very intriguing, and it was a six month window to learn about perfusion in terms of speaking to others, looking online what perfusion was, and it took me six months to get five applications out the door and interviewed two places.

Lee Pepper: Now, how long was the program when went through perfusion school?

Andy Stasko: What the criteria of the school that I got accepted into, they wanted a master’s degree and a minimum of two years of critical care experience in a health care environment. So, with that, I [inaudible] 480 plus applicants into the school that I attended. But with that, it narrowed the academic world. Meaning, it was a 12 month program.

Lee Pepper: Okay, okay.

Andy Stasko: So I had a lot the academics upfront and the bulk of it was lab work and clinical time once I completed by program in Boston.

Lee Pepper: Now today, correct me if I’m wrong, but today’s environment most of the students going to one of the 17 schools in the U.S. and three in Canada, they’re coming out of school with a bachelor’s degree and then they are spending two years pursue… you know going through perfusion school and may or, that maybe a master’s or maybe a certificate of some type?

Andy Stasko: Correct. A bachelor’s is mainly their starting spot. And they go to a perfusion training program over and above their bachelor’s degree and they end up with either a certificate on top of their existing bachelor’s degree or they end up with a master’s degree. And a few are actually coming out with doctorate’s.

Lee Pepper: Now, when you went through perfusion school it seems like, and we had Tom Coley on recently, and he was kind of explaining to us, kind of the history of perfusion, and we had kind of these spikes and valleys with training. So, do, you know, now we’re kind of in this situation where we’re back in a valley where we have a shortage. I was wondering, what would you say to folks that are in college right now getting ready to finish up their bachelor’s degree? I mean, seems like there’s a lot of opportunity right now for perfusionists.

Andy Stasko: There is a tremendous opportunity. It is a very rewarding career. If healthcare and helping a patient in an OR setting is something that is a call to that individual for a career path. It is a wide open career. Not only in treating an adult patient, but there’s a pediatric arm of this. And then there’s also another world called ECMO, an ECMO Specialist.

So there are multiple variations, but adult cardiac surgery is the bulk of what we do as clinicians, cause that’s the majority of the locations where we work.

Lee Pepper: When you go through the perfusion school program the first year, my understanding is that, you have quite a bit of traditional course work, and in the second year is when you’re actually going out and working, observing, or scrubbing in and assisting on cases. Is that…

Andy Stasko: That’s Correct.

Lee Pepper: …accurate?

Andy Stasko: Yes.

Lee Pepper: About how many cases would a perfusion student be exposed to during their two year program?

Andy Stasko: I would say on an average about 150 hearts for adult. And that’s them being a primary clinician, in the room sitting behind the Chair, what we call the captain’s chair. The perfusion student is being treated as a primary perfusionist with a mentor in the room. Their faculty member or an associate perfusionist who is certified governing the care of that case. So, the perfusion student learns as the second chair. They first watch, listen, take notes, chart. Then they shift over into the clinical seat as the primary perfusionist. Of that case, they’re mentored, they’re completely monitored for the entire operation.

At times, the surgeon begins to gain comfort and confidence in that student and there’s a lot more autonomy given to that individual. So there’s space between the faculty person and the student. But they’re close by.

Lee Pepper: Can you remember the first time that you scrubbed in, and you were in that chair?

Andy Stasko: I was absolutely petrified. My Knee was shaking, my hands were shaking, and you get this deep pit in your stomach, and it’s called the “pucker factor”. Your sphincters get really tight, because it’s, you’re about to put somebody on pump, and… [crosstalk]

Lee Pepper: Wow..[crosstalk]

Andy Stasko: you’re about to stop their heart. And that’s a frightening experience until you kinda get into the swing of things. And it usually, in a lot of people’s cases it takes about a years time to gain that personal confidence.

Lee Pepper: And how important is it to have that, to build that rapport with that surgeon? It seems like, you know if anything, the surgeon is leading that surgical team and you’re now a new person being put onto that team. I mean, it seems like that’s gotta be a big hill to overcome.

Andy Stasko: It’s a monumental task.

Lee Pepper: Yeah.

Andy Stasko: And you gotta gain that surgeons’ trust and confidence, and it’s done slow. It’s done repetitively. You have to listen and watch. A lot of times there’s very little conversation between you and the surgeon, but you’re 100% focused on that case. And the surgeon wants to know that, that individual that’s behind them or in front of them managing that heart-lung machine is completely engaged on where they are in the operation. And if there’s anything that goes different, or what’s not expected, that there’s an immediate communication shared with that surgeon so that it can be addressed and corrected if there’s something that needs adjusted. There’s a cannula that’s getting malpositioned, or there’s something happening that the surgeon is not queuing us for. It’s his request that we advise him “hey, there’s something going wrong here”. Or, we’re training for those “what ifs”. And a good portion of our cases there’s very little “what ifs”. Cause it’s routine, it’s done every day the same way, you know the surgeons’ protocol.

Lee Pepper: How much has the software changed, the interface that the perfusion is using today versus 20 or 25 years ago [crosstalk]

Andy Stasko: Dramatically. In the computer, the computer technology world, the interfacing, the physiologic programing that goes into some of the heart-lung machinery is built into the platform of our knobs and tools that we turn on. It kinda gives us some guidance, it gives us parameters. It helps us driver perfusion performance when we’re on pump. There’s all kind of bells and whistles and there’s flashing signs when it tells us to let the surgeon know, in certain time intervals, all of that was done by watching the clock on the wall or watching your wrist watch, or making notes on your scrub pant legs. All of that’s been morphed into technology, is very perfusion friendly.

Lee Pepper: In today’s school, will students get the opportunity to train on the different hardware, or do most schools kinda pick one?

Andy Stasko: No, they should get exposure to all of the leading manufacturers that are out there. Now when a student comes out of school, in their schooling, they get affiliated with certain clinical sites. It’s a relationship that’s built over time with the faculty of that institution with the clinical sites. They have to [inaudible] the student to the program, and then during that it is the hope that the student has exposure to multiple sites. Usually it’s two to five clinical sites that they’ve done their training at. Which does include pediatrics, cause they have to get pediatric experience and exposure. So that is even a different level of technology, because it’s smaller, it’s different than an adult. So you go from different clinical sites using different equipment under different faculty. And you, again, it’s the process to gain the confidence of that surgeon and comfort. Then you move to a different clinical site. So that’s the difference in extending someone’s clinical education as a perfusionist, is the number of sites and cases they pump.

Lee Pepper: Are most of today’s students, when they’re going through the perfusion school, are most of them also working a part-time job somewhere or somewhere else in the hospital and then going to their perfusion school or doing their clinicals or are they 100% focused on their school?

Andy Stasko: I would say it’s, I wouldn’t say it’s 100%, but I would say it’s a very high percentage. Greater than 90. They completely focus their education on school. They usually take out large loans and they go in debt, so that their school pretty much asks of them to be completely committed and focused on their education. Not only learning in the book but coming in and providing that in the clinical setting. It’s very distracting and disturbing if you’re conflicting with running a household, or maintaining a job outside of work. There’s always constraint, [crosstalk] your primary responsibility is school and your clinical time. And in an OR you cannot predict when a case starts and when a case ends and when you need to be somewhere else because of a job, that doesn’t shine very well on the relationship that the student has with that institution or the school.

Lee Pepper: It’s very much like going to medical school.

Andy Stasko: Correct, it very much is. You’re completely committed, you’re indebted to that institution and to that faculty. And to that faculty member to mentor and guide them while they’re in the OR learning, it’s a critically important time during their career. And they’ll have the means to pay that debt back if they do take out loans and school debt.

Lee Pepper: In my understanding that the range for perfusion schools are somewhere around the 40 to 50 thousand dollar range to go those programs. Is that, do I have that number right?

Andy Stasko: That’s correct. By the time the…[crosstalk]

Lee Pepper: So its not an insurmountable amount of money that somebody’s looking to finance their education for those two years?

Andy Stasko: That’s correct. I mean, when I went to school it was, I took out a one year loan through the State of Massachusets it was a funded school loan, but it was $15,000.00. I was married with a family, and I did have to work. I worked on the weekends. But I was able to make it work for us. And we took a loan, I was able to pay that loan back in a 10 year payback period, so that was a great day when I signed and sent in that last payment.

In today’s environment, the cost is higher, but I think a relative term. It was a debt that I felt that I could overcome to change my career path. And, it provided, it has provided me the means to be a very happy individual both at work and away from work.

Lee Pepper: Well, that’s one of the things that I wanted to discuss with you too, because you also, in your role at Specialty Care, you also are the Chair for the Brukardt-Brown Scholarship which is an annual scholarship that Specialty Care awards to students who are going to be attending perfusion school next year, and I want to take the opportunity for you to share a little bit of information with our audience because there are probably people listening that aren’t even aware that there are scholarships available for this kind of training that could potentially go through that process here in the next month when the application process opens.

Andy Stasko: Sure. 2016 we launched the Brown-Brukardt Scholarship Program. And there is a deep commitment by the leadership of Specialty Care to support perfusion education, and we try to offer something of substance. It’s a substantial award. For the two previous years, we had two winners selected each year. And we covered quite a bit of their debt. And their debt load was, we offloaded that burden and we were able to work with them and they are now associates working for Specialty Care in a relationship that is very favorable monetarily for them.

It’s a substantial award. And it is a award that this organization and leadership team has increased the number of applicants this year from a total of two to four. We’re expanding the number of scholarship recipients, we’re reaching out to a larger audience, both perfusionist and clinical technicians working in a perfusion type setting in an OR with exposure to open heart surgery and blood recovery using what we call autotransfusion. So, clinical technicians who wish to go to perfusion school now have a mechanism to at least apply for a substantial award to help them get over the hurdle of finding initial funding to go to school.

Lee Pepper: Well, I mean it’s one of the most exciting aspects of Specialty Care that I’ve learned about, and I think it’s a testimony to [inaudible] the 400 plus perfusionists that work here. Because they’ve all, like you, gone through those times where they probably had to take out personal loans from family members, or student loans, and I’m just really proud of the organization, proud of the work you and your team are doing to provide that type of opportunity for students today.

Andy Stasko: We take a lot of pride in developing that relationship and we take a lot of ownership in to vet and deliberate to try to get the applicant pool to increase awareness. Our first year we actually had 9 completed applications that we deliberated against. Last year we had 27. So it tripled. We’re expecting in the neighborhood of 70 to 90 applicants this year that meet the criteria for all of the components to complete their full application. And the committee of eight members will have to deliberate that pool.

Lee Pepper: And let’s share a little bit on this course. They can go to the Specialty Care website to learn more about the details, but the application process, it’s not too onerous when I was reviewing it. It’s basically a six page document with all your contact information and some of your history. It’s providing transcripts, a thousand word essay, your resume or CV. It seems very doable for most people, I think, that are considering this.

Andy Stasko: It does, and it is. We put a lot of weight in the essay because we really want to fell how that individual thinks that they would utilize the funding for. Why they want to be in perfusion, what assets we can look at in term of employing that individual, what would they bring to our organization that would be different from someone else. We’re looking for that outstanding individual that has a very strong voluntary background, that has done things external to the school. You know, leadership roles that they’ve taken in clubs, and in organizations where they’ve taken leadership positions. We’re looking for the best, the brightest, and the individual that wants to come to work for Specialty Care. We’re really trying to enhance that with a healthy scholarship opportunity. And yes, the individuals that have applied, we’ve maintained a relationship with them through communication via email and our recruitment department that we believe that we can monitor and offer them a very, very fair salary and a benefit plan that can out perform, the opportunities are there for us to be attracting those qualified individuals.

Lee Pepper: Well, if anybody’s got questions I’m guessing that you’re open, if somebody in our audience wanted to find out some more information about the realities of being a perfusionist, or information about Specialty Care. I’m guessing you would be open to talking to anybody that might have a question, I know I certainly am if anybody listening wants to get in touch with Andy or I. You can contact us through the Specialty Care website and we’re happy to answer any of your questions about the scholarship, or about perfusion in general.

Andy Stasko: Happy to do that. We have a, we even have a email box specific to the scholarship if there’s any question. It’s [email protected]

Lee Pepper: Great

Andy Stasko: It’s a monitored email inbox that several members of the committee do monitor. We answer questions from people in the U.S. as well as outside of the U.S. But the main thrust is, you have to be a student that’s in one of the seventeen U.S. schools, currently enrolled, and in that enrollment they have to get one of their letters of recommendations has to be from their current program director. And that’s part of the application process that is spelled out on our website.

Lee Pepper: Excellent. And the application process will start sometime in December of this year and applications will be due no later than February 28th of 2019.

Andy Stasko: That’s correct.

Lee Pepper: And what is the, how many months or weeks does it take for the committee to kind of vet the applications and make a decision?

Andy Stasko: On average, it’s been taking us about two weeks to collate all of those finalists, excuse me, the applicants into a semi-finalist pool. And then from the semi-finalist pool we schedule personal phone interviews, Skype meetings, something where we’re talking in FaceTime …

Lee Pepper: Okay.

Andy Stasko: With those individuals, and there’s more than one, there’s usually up to three sometimes five committee members who are on those calls. So we’re getting that personal look into the student’s eyes and their body language and their impression that they leave upon us, for us to narrow that semi-finalist pool down into the winners.

So, at the end of the day, it’s about 14 days from the close of the scholarship. So we hope that by March 15th we’ll have a decision rendered.

Lee Pepper: Excellent, excellent. Well Andy, thank you so much for joining us …

Andy Stasko: Thank you.

Lee Pepper: …this afternoon, I really appreciate you coming in.

Andy Stasko: You’re welcome.

Lee Pepper: Thank you.

Andy Stasko: Thank’s for having me.

Todd S.: Thank’s for listening to Scrubbing In. Please take a second to give us a rating on your Podcast App and subscribe so you wont miss out what we have coming up. See you next time.