Any active duty Air Force CRNA's?

Nursing Students SRNA

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I am considering joining the active duty Air Force, using the HPSP to pay for school. I am prior service AF reserve and love it. I have heard negative experiences from my AD nurse corp friends. So, I am wondering,

1. Do CRNA's fall under the NC(nurse Corp) still?

2. How is the actual work schedule? Panama?

3. Is moonlighting allowed?

4. How is the scope of practice actually work. I have heard that in AF MTF's you have more freedom, but most of the time we would work in Army MTF's and follow their rules?

Thanks to anyone who could help

MN_nurse, it wont let me because I haven't made enough posts. I need 15 to enable to function to private message.

Specializes in ICU.

Does the Air force allow nurses to attend civilian CRNA school after I have already joined?

Specializes in Anesthesia.

Does the Air force allow nurses to attend civilian CRNA school after I have already joined?

No, there isn't a provision to allow AD USAF nurses to attend civilian NA schools on active duty.

Specializes in Emergency / Trauma.

Can I contact you about AF CRNA? I am finishing my BSN in April, and currently have my MEPS paperwork in for the Nurse Corps Apprentice program. I have questions about being a CRNA in the AF. Thanks!

Specializes in Anesthesia.

Just send me a PM when you can. I will answer what questions I can.

Specializes in Anesthesia, ICU, OR, Med-Surg.

[quote=wtbcrna;6683505

2. Yes, you would receive a little more training, but military nurse anesthesia training is overall probably the best nurse anesthesia training there is.

Hi WTBcrna

I'm just wondering how you came to the conclusion that the military CRNA program is overall the best nurse anesthesia training there is as you did not attend a civilian anesthesia program? My school has a 100% pass rate on boards the last 5 years and our attrition rate is less than 8% whereas we both know the military program has a much higher attrition rate. At my clinical site, we even have block rotations where the SRNAs perform all of the peripheral nerve blocks and we are doing heart cases whereas most military programs don't have heart programs except Travis AFB. At my clinical site, we have CRNAs on the heart team and they are the ones actually floating Swan catheters.

The only difference between civilian anesthesia practice and the military practice is the ability to practice autonomously. The training in school is the same while some programs may place more emphasis on some areas while others may not. Also, our patients in the civilian sector are a lot more sicker than what you see in the military population. As you train and work in the military sector, most of your patients are ASA 1 and 2s unless you have a retiree with some co-morbidities. The patients I am taking care of in the civilian sector are ASA 3 and 4s. You all don't get experience with patients who just used crack cocaine or marijuana the morning of surgery. We also do a lot of kidney and liver transplants whereas transplants are not routinely performed at the military hospitals except at Walter Reed where we were still doing kidney transplants.

I'm in the inner city training in a Level 1 trauma facility that is also the designated stroke center for the region and I am getting a real good anesthesia experience that the military crnas are not exposed to and I think my anesthesia program is doing a great job in preparing me for practice.

So do I think the military program is the best for anesthesia training, I would say no. The only difference is you don't have to consult an MDA for anything but I love the collegial relationship I have with my MDAs and we always bounce ideas off of each other in caring for the patient. I also like the acuity of the patients I am getting and the complex cases I'm seeing everyday.

I'm halfway done with my anesthesia program and have 4 job offers including returning back to active duty AF but the civilian experience is much better including pay and benefits.

Specializes in Anesthesia.
Hi WTBcrna

I'm just wondering how you came to the conclusion that the military CRNA program is overall the best nurse anesthesia training there is as you did not attend a civilian anesthesia program? My school has a 100% pass rate on boards the last 5 years and our attrition rate is less than 8% whereas we both know the military program has a much higher attrition rate. At my clinical site, we even have block rotations where the SRNAs perform all of the peripheral nerve blocks and we are doing heart cases whereas most military programs don't have heart programs except Travis AFB. At my clinical site, we have CRNAs on the heart team and they are the ones actually floating Swan catheters.

The only difference between civilian anesthesia practice and the military practice is the ability to practice autonomously. The training in school is the same while some programs may place more emphasis on some areas while others may not. Also, our patients in the civilian sector are a lot more sicker than what you see in the military population. As you train and work in the military sector, most of your patients are ASA 1 and 2s unless you have a retiree with some co-morbidities. The patients I am taking care of in the civilian sector are ASA 3 and 4s. You all don't get experience with patients who just used crack cocaine or marijuana the morning of surgery. We also do a lot of kidney and liver transplants whereas transplants are not routinely performed at the military hospitals except at Walter Reed where we were still doing kidney transplants.

I'm in the inner city training in a Level 1 trauma facility that is also the designated stroke center for the region and I am getting a real good anesthesia experience that the military crnas are not exposed to and I think my anesthesia program is doing a great job in preparing me for practice.

So do I think the military program is the best for anesthesia training, I would say no. The only difference is you don't have to consult an MDA for anything but I love the collegial relationship I have with my MDAs and we always bounce ideas off of each other in caring for the patient. I also like the acuity of the patients I am getting and the complex cases I'm seeing everyday.

I'm halfway done with my anesthesia program and have 4 job offers including returning back to active duty AF but the civilian experience is much better including pay and benefits.

Best Nursing Anesthesia Programs | Top Nursing Schools | US News Best Graduate Schools

Attrition rates of the military programs varies significantly from year to year. The largest percentage of students that don't make it in the Army program have historically been the direct-entry civilian applicants, which makes sense if you add in the stress of being new to the military and the stress of being in NA school at the same time.

Any CRNA has the chance to practice autonomously. There are autonomous jobs for CRNAs all over the U.S. The military just expects that their CRNAs will practice autonomously from the day they graduate.

Actually, no civilian patients aren't sicker than military patients. That is a misnomer that some civilians like to state when comparing military to civilian practices. The majority of military care goes to retirees and dependents of all ages not just active-duty healthy people, and several of military hospitals have joint care agreements with the local VA facilities further increasing the acuity of our patients. My patients in training were routinely ASA 2 & 3s. ASA 4s weren't entirely uncommon, but you have to ask yourself, if you are routinely scoring patients as ASA 4 is that for billing purposes, because unless they are going to die without that surgery an ASA 4 is a poor surgical candidate by definition.

How exactly does doing organ transplants translate to the types of anesthesia that you will most likely be doing after graduation? Yes, it is a "big sexy" case, but it is also highly specialized. Those cases IMO tend to be very cookbook even if they do have a large fluid management component to them.

I have heard all this before. I got to work at X trauma center. I got to work in the heart room etc.

Well I did rotations at Baltimore Shock Trauma as a student, I routinely took care of patients that had been blown up by IEDs within the last week, I got to work in the heart rooms at my civilian rotations, I got to rotate through a civilian pediatric hospital, I got to do Swans, I got lots of PNBs (cervical, paravertebral, lumbar plexus, TAP, costal blocks, ankle blocks, and all the other normal blocks with and with out US), but the main thing I did and learned through my time as an SRNA was how to work independently. There is huge difference in working with physicians and having your practice dictated to you by physicians.

There is no doubt that some civilian NA schools have the ability to get more "big sexy" cases than military NA programs, but without a doubt those are also the cases most CRNAs will not be doing on a regular basis. Those cases are almost always at ACT practices too.

I am happy that you are proud of your program, and it sounds like you are getting some great experience.

I still stand by my statement that military CRNA training is the overall best training that an SRNA can receive, especially if your goal is to be trained as an independent CRNA.

Specializes in Anesthesia, ICU, OR, Med-Surg.

As well all know there are biases in the U.S. New and world Report and they are not the gold standard for dictating which crna programs are better. Some.schools don't even participate in the surveys from the US News and World Report. If they looked at how many people make it through anesthesia in the military and board pass rates, I'm quite sure the military programs wouldn't be listed in the top.

I think you are more qualified to speak on military anesthesia programs but not comparing which anesthesia education system is better when you didn't attend both of them. We are all trained to provide anesthesia care whether you attend military or civilian anesthesia programs but our patients again tend to be much sicker just as when I worked in the icu in the military, our patients were no where as sicker as patients in the civilian icu. Most of our icu patients in the military were majority step-down patients and the same goes for surgical patients. Are you all doing stroke codes in your anesthesia practice? The consistent acuity levels of our surgical patients are still much sicker than your military population which is why the military leadership allows military crnas to moonlight in the civilian sector as well as when you are preparing to deploy, you are sent to civilian hospitals to train like Baltimore shock trauma for CSTARS. If the military thought your military anesthesia practice was sufficient, then you wouldn't need to come to the civilian hospitals for that training.

As far as the types of cases I will be doing after graduation is the same since I do clinicals with an anesthesia group that has an exclusive contract with the hospital and surgical centers for the organization which is one of the groups that offered me a job. Not sure if you have done transplants or not but they are not cookbook recipe anesthesia and involves a lot more than fluid management. Also the anesthesia practice where I train is not dictated by the docs to the crnas. The ACT model from where I train is not bad. We really work in a collaborative way to care for the patient. I think the military program have you geared to think of ACT as a dictatorship but its not like that where i train. We are able to practice and provide anesthesia the way we want to. If i want to hang a Remi drip i dont have to ask the doc if its ok. I just do it. If the surgeon wants MAC and i feel an LMA is better then the pt gets an LMA and the MDA backs us up. We can consult with our MDA if we have questions and we are not told by our MDA how he wants the anesthetic delivered or what meds we can or can not give. But I will say that during my time in the military, there was a crna from Travis AFB who lost her crna license and her RN license for negligence and she was military trained. Pt went into laryngospasm in the PACU and suffered anoxic brain injury. You can Google the case. According to the case report she had multiple instances of misjudgement when caring for her patient.

Specializes in Anesthesia.

Hey, great you think your school is the bomb! You still aren't going to get me to agree that the vast majority of civilian NA schools are better or even on par with military NA schools.

I am well aware of the reasons why military SRNAs rotate through different facilities, and it is not just a simple fact of low acquities or lack of complex cases. Besides rotating to different sites allows students to have wider breath of experience than staying at one or two facilities for their entire training.

I am adjunct CRNA faculty for one of the military NA schools and one civilian NA school. I have trained with civilian SRNAs and have taught civilian SRNAs, so I have decent understanding of the strengths and weaknesses of each type of program.

When you look at your scope of practice where you want to work, if it states under the "supervision" of the MDA then you are truly never going to have an independent practice. Your practice will be dictated day by day by whichever MDA you are stuck with that day, and if that MDA doesn't want you doing X,Y, or Z then you aren't going to do those things.

I am well aware of what happened at Travis and many other mishaps in anesthesia in the USAF. All of those incidents have to be reviewed by other USAF CRNAs or MDAs.

I am also well aware that a civilian trained MDA killed Joan Rivers and two civilian trained CRNAs were responsible for one of the largest Hep C outbreaks in U.S. Where someone received their training doesn't mean a provider is infallible.

Specializes in Anesthesia, ICU, OR, Med-Surg.

Adjunct faculty meaning you are a clinical preceptor

Specializes in Anesthesia.

Adjunct faculty meaning I was in charge of the SRNAs at JBER. I was in charge of their OB and regional anesthesia rotations plus I did their simulation scenarios with the SimMen at JBER.

hmm, interesting thread thanks guys

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