Any civilians entering the Air Force for the first time as a new grad CRNA? - page 2

Hi. I am currenly in CRNA school with hopes of joining the Air Force after graduation. I have no military background but it has always been a dream of mine to enter the AF as a medical professional. A lot of posts seem to... Read More

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    Quote from SRNA4U
    1. In general we stay about in the low 80% as far as manning goes. It will generally dip at the end of summer and be the highest around January. This correlates to when school commitments end and when new CRNA from the military schools graduate. Manning numbers are very fickle and rarely represent the true picture with USAF CRNAs, and since there is less than 200 of us it doesn't take many to skew the numbers one way or the other.

    2. The highest attrition rate in the Army program is from the direct entry candidates. My understanding is that it can be as high as 50% in that group.

    3. Only one CRNA out of approximately 9 in three years has missed a deployment since I have been at my base. USAF CRNAs are the highest deployed nurses in the USAF.

    4. All military CRNAs practice independently. We got rid of the consult clause for ASA 3+ in the CRNA scope of practice, but we are the first service to do that so far.

    5. As a senior Major that is CRNA in the USAF you would more than likely be put in supervisory position within the first year out of school. Once you make LTC supervisory position would be mandatory.

    My response:

    1. 100% manned is what came directly from the mouth of the Assignment Officer. Unless you work in the assignment section of AFPC, I would rather take what they say as golden versus the opinion of someone who works in a clinical position nor who has the ability to decide what numbesr will be accessioned into the AF. Also, a lot of CRNAs are deciding to stay in the AF because of the economy as well as the increased supply of CRNAs that are flooding the market in some states. Experienced CRNAs are seeing the pay substantially reduced due to the increased supply of new CRNAs, who can be paid at a much lower rate based on the shear numers. I remember hearing around the earlier part of the year that many experienced CRNAs from Florida were moving to Texas and areas north of that state due to the better pay. Florida and Pennsylvania are one of a few states that have a great number of anesthesia programs. Texas Wesleyan accepts over 150 students/year in their program. Also, with the incentive special pay given to AF CRNA's the overall pay is pretty comparable to the civilian CRNAs.

    2. The acceptable attrition rate for CRNA programs is <20% whereas the Army's proram was well over 20%.

    3. In addition to CRNAs, critical care nurses are equally the highest deployed nurses in the USAF.

    5. Most Majors that are CRNAs in the Air Force are NOT routinely placed in supervisory positions. There are not a lot of supervisory positions in the anesthesia department since most "official" supervisory positions are either filled by a CRNA or MDA. As an officer, in general yes, you will supervise people junior to your rank, but as far as suerpvisory positions (element chief, chief of anesthesia, and deputy positions), there are few and far between. Most Majors in the AF, CRNA included, do their primary job of providing anesthesia, especially if you work in a major medical center. The positions of Chief Nurse Anesthetist and Deputy Chief are usually filled by Lt Cols, unless there are a shortage, which there is not in the AF.

    When I was stationed as an OR nurse at Landstuhl, there was a separate Chief Nurse Anesthetist position filled by a Lt Col and the Chief of Anesthesia was a Major. We also had full bird Colonels, who were CRNAs, who also worked in the OR doing their own cases. When I was at Wilford Hall, we had a Lt Col that was the Chief CRNA. At Andrews, we had Lt Cols that were Chief CRNA and Chief of Anesthesia.

    Most Majors are normally working the rooms. Some are picked up for teaching positions at USUHS or CSTARS. Since the AF is manned very well, you will continue to see Maj and Lt Col in clinical positions versus administrative positions based on the shear number of people trying to get command and other leadership positions. From many of the CRNAs I have worked with as an OR nurse, many would prefer to work the rooms instead of being in an administrative position.

    Thank goodness for the creation of the Master Clinician, which has helped many Lt Cols to make the rank of Colonel. As you know, prior to this, the AF did not have any full bird Colonel CRNAs before they came out with the Master Clinician concept, unless that Lt Col CRNA was a Squadron Commander or Group Commander. I will be meeting the board for Lt Col in 2014.

    Time is going by so fast.
    1. I get my information on manning from the Chief CRNA of the AF that determines AF CRNA assignments and deployment sites. She is the one that tells assignments where each CRNA in the AF will PCS to. We often know months ahead of assignments where we will be going as CRNAs. The Chief CRNA knows months ahead of time what the manning should be and that is what is used to determine AFIT slots future openings etc.

    2. I know the current nurse anesthesia program director of USUHS. I just had dinner with him this month, and met with him in June to discuss the current students. I help precept the USUHS SRNAs at my facility. I am fully aware of each class at USUHS attrition rate. I also personally know the two of the former USUHS nurse anesthesia program directors. I have spoke in person and on the telephone with the former Army nurse anesthesia program director, Col Garrett, and I friends with one of the professors at the Army program. I have fair understanding of the attrition rates at both programs. The acceptable attrition rate is <20%, but the COA has let the military programs go above that for many years d/t the unique nature of the students.

    3. Approximately 75% of the AF CRNAs get out after their initial commitment, and there is only one larger surgical hospital for the AF anymore (Travis). We can also go to Landstuhl, BAMC, and Bethesda (those positions are few and far between for AF CRNAs though being usually assigned to Andrews instead). Element Chief and Flight CC generally goto CRNAs, and considering that most CRNAs in the AF get out around the time of Major or work in smaller hospitals most Majors that our CRNAs will end up at one time or another at the majority of AF hospitals will be at least element chief at sometime or another.

    4. There were 0-6 CRNAs in the AF before the master clinician. This is d/t LTC Austin the former nurse anesthesia director at USUHS who did not make 0-6 initially, but filed a congressional complaint and won. He retired right after he won and was selected for 0-6. The policies concerning promoting CRNAs in the executive track changed after that. No matter which track CRNAs are promoted into you still have to spend most of your time as LTC in the executive track to promote to an 0-6.

    5. Someone can elect to listen to one of my OR nurse colleagues or they can choose to listen to one of the AF CRNAs that is in active communication with Chief CRNA of the AF, current DNAP student (who will be moving into instructor position for SRNAs if he stays in), and current clinical preceptor for USUHS SRNAs. There is a big difference in knowledge base from current AF CRNAs and current AF OR nurses on what is going on in the AF CRNA community.

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    The 75% would depend if the CRNAs were picked up for AFIT as a LT or junior Capt. Most people that have more than 10 years of service normally decide at that point if they're going to stay in after they pay back the 5 year commitment. You don't see too many LtCols separating after their initial commitment since Lt Cols normally have on average around 16-17 years of service. Three more years they are able to retire. You do see a good number of young Captains separating since they have on average anywhere from 10-12 years after their 5 year commitment is completed. In smaller facilities, CRNAs are competing for element chief and other positions in the OR with OR nurses, CRNAs, anesthesiologists, and other Majors from other departments based on how the surgical service is setup. I have seen OR nurses as Flight Commander over an OR Dept, which includes the anesthesia dept in some organizations. Korea, Japan, and Turkey are setup like that and these are very small facilities. Anethesia departments normally don't have element chiefs. Element chief is normmally filled by OR nurses. Chief Nurse anesthetist positions are filled by a CRNA and Chief of Anesthesia filled by a doc. Overall flight commander positions, are opened up to a greater variety of nursing specialties and not just anesthesia personnel.
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    I know quite a bit of USUHS faculty as well such as Col Schoneboom (sp), Col Perry, Lt Col Larry Todd and I are very good friends. He is actually one of the clinical instructors at USUHS, who also works at my hospital, which is right beside USUHS. I also know many of the people that teach in the Periop CNS program, such as Col (ret) Wanzer, when she was in the Army.

    Actually, the Chief CRNA of the AF, does not decide on assignments. Since all retirements and separations are coordinated and approved by AFPC, they know well in advance what the target numbers should be for the AFIT CRNA program, with consultation from the Surgeon General Consultant for Anesthesia. The Chief CRNA does have input into the deployment cycle, such as who gets deployed, but as far as deciding who determines the numbers for AFIT, it is AFPC. You know sometimes its ok to admit you don't know everything. You would be surprised of the many CRNAs I know in the AF having worked as an OR nurse with 12 years in and over 8 assignments. I am well connected with leaders from the Army CRNA program as well. So you are not the only one, who knows people in certain positions within the AF anesthesia community. Not just counting them, I know a lot of regular CRNAs as well who are just ordinary people that are not looking for a titiel or position, who just love doing anesthesia.
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    Actually, I am a critical care nurse, who also works as an OR nurse.
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    Congrats on working on your DNAP. I have a MSN already and have been accepted into a post-masters nurse anesthesia program and will continue on to get my PhD. Best of luck to you. Just remember humility goes a long way and we all don't know everything. We all know people but one of the differences is that I know the administrative side since I have experience as an Element Chief and Deputy Flight Commander. Only having clinical experince only gives you a one-sided view but once you operate in the administrative aspects of the military, you get a much better picture of how things work operationally. Keep up the good work.
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    I know all those same people that work at USUHS including the current CNS director. Yes, there is nothing wrong with admitting that you are wrong, but not being a CRNA you do not know how AF CRNA assignments work or our deployments. People on here can choose whose advice they want to utilize an AF critical care nurse that works part-time as an OR nurse or an AF CRNA....

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