Becoming a CRNA - From One Who Did It

  1. Looking over this bulletin board, I noticed that there were few CRNA's posting, and a large number of people interested in becoming CRNA's posting. There seem to be a lot of questions. I had a lot of help from others in becoming a CRNA, and this is a good chance to pay some of that back. I graduated from Newman University (Wichita, Kansas) just last August. For now, I'll try to answer some of the questions I've noticed are most commonly asked about becoming a CRNA, and what it is like when you are done. If anyone has other questions, I'll try to check this board every so often, and answer those questions, if I can.

    First, if you are in school now, nursing or otherwise, its time to start working hard. Pay particular attention to your nursing and science classes. When considering applicants, most schools look not only at the overall GPA, but at the grades the applicant received in the science and nursing courses. Anesthesia school is tough, with heavy emphasis on science. They need a yardstick to determine whether an applicant can handle the heavy course load they will be required to take. Past performance is always a place they begin.

    Look around, do some research on the various schools of Nurse Anesthesia. There is a great deal of variation in programs. For example, length of these programs range from 2 to 3 years. Narrow the possibilities down to two or three schools. Then, contact the Program Director or Advisor to find out what requirements you must meet to be accepted to the program. If you have a chance, talk with the Director, and find out what you can do to make yourself a more attractive applicant. While there is currently a shortage of nurse anesthetists, there is no shortage of applicants for the relatively few school seats each year. The competition is stiff, and you must make yourself as attractive as possible.

    Every program that I am aware of requires at least one year of experience in an ICU. I am aware of no program that accepts ER, OR, or any other type experience. This may frustrate you, it may not seem fair, and it may not make sense, but trust me, there are good reasons for this requirement. Not all programs require adult ICU experience. One of my classmates' experience was in NICU. Check with the programs you intend to apply to about what specific experience they require.

    Once you have applied and been accepted, get ready. Every anesthetist I have ever talked to has said that anesthesia school was the toughest, most demanding thing they had ever done. (The most stressful was taking boards, but that is another story.) My own life is a good example. Before becoming a nurse, I was in the US Army, and attended the Defense Language Institute to study Russian. This was a full year, total immersion program. It was not even half as tough as anesthesia school. Brush up on your anatomy, particularly the anatomy of the airway and nervous system. Know the autonomic nervous system as well as you can. Be ready to study, study, and study some more. Plan on at least two hours study time for every hour you spend in class.

    Working while in full time anesthesia school is difficult, at best. Working full time is impossible. Don't try it, you will only harm yourself.

    So, what is life as a CRNA like? That depends on where you work. I work for an anesthesia group with both Nurse anesthetists and anesthesiologists. My average work day begins between 6 and 6:30 am, and I work until anywhere from 3 pm to whenever (the longest day I have had was 19 hours). I do anesthesia for all kinds of cases, from simple general surgery to open heart surgery, vascular surgery, and neurological surgery. Nurse anesthetists perform anesthesia, pure and simple. I see my patients before the surgery, plan the anesthetic, and perform all phases of the anesthetic. I put in arterial lines, central lines, and Swan Ganz catheters. I am also able to do regional anesthesia (spinals, epidurals, and regional blocks), but the group where I work does few of these. The only kind of anesthesia I don't currently do is obstetric, because the group I work for does not do OB.

    I think the average starting salary for a nurse anesthetist is $85,000 to $110,000 annually, not including benefits, which can be, and usually are substantial. Many places not only have the salary, but also pay overtime. (Do the math. It makes staying late a whole lot easier.) Someone on this board said that some CRNA's only earn $60,000. I am not aware of any full time position with a salary that low.

    I am extremely satisified with my career choice. I love doing anesthesia. I find it fun, interesting, and challenging. I have more independence and more responsibility than any other advanced practice nurse I know.

    As I said earlier, I'll be happy to answer any specific questions I can. I'd prefer those questions be posted here, so I don't have to repeatedly answer the same questions. Rest assured, you won't be the only one with that question.

    Kevin McHugh, CRNA
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  2. 146 Comments

  3. by   SERENAde
    I was just wondering ....how you were able (how anyone for that matter) is able to support themselves throughout crna schooling???...i am very excited about becoming a crna in the near future but not sure how i would make ends meet. Any suggestions.....
    thank you very much...
    seri
  4. by   lgcv
    Is the salary you quoted true in Wichita as well? What did you think of the program at Newman University? When in your educational process did you start seriously looking for employment, or did you know where you were going to work from the beginning? What do you consider to be the most important things to look for in a job? I think that is every question I have, thank you for taking the time on to answer questions on this board.
  5. by   kmchugh
    SERENAde:

    Loans, loans, and more loans. I am also fortunate to have a very supportive wife who is an RN, and she worked her tail off while I was in school. But several of my classmates were single, a couple of them were even homeowners. We all made it through with loans, grants, and scholarships. You can get the usual government subsidized and unsubsidized loans, plus there are a number of private companies that will give out school loans. One such company I dealt with was P.L.A.T.O., and they have a web site:

    http://www.plato.org/

    Yes, you will be in debt when you graduate. But your salary will be sufficient to cover these loan repayments, and then some. Additionally, many anesthesia groups are offering some kind of loan repayment assistance as part of their contract. Read my answer to Igcv below for more on that.

    Igcv

    Yes, Wichita falls in the salary range I quoted. You will find that in most places, the salaries offered from group to group will be pretty comparable. Often, the difference will lie with benefits. So, when looking for a job, first decide where you want to live. Then look at the salaries offered there, to see if you are willing to work for that salary. The more popular places, such as Florida or Colorado will have salaries that are usually on the lower end of the scale, because a lot of people want to live in those places, hence more applicants for the same job. When you have decided on where you want to live, compare benefits offered by various employers. Look at paid time off, and what medical and dental plan is offered. Does the employer pay for your medical and dental plan, or do you have to contribute? (Most pay for them with no contribution from you.) Also look at retirement benefits, payment for continuing education, and loan repayment assistance. There is a lot of variation in benefits. Look at what type of anesthesia the group does, and whether that fits with what you want to do. Find the average number of hours CRNA's in the group work each week. Does that fit into your lifestyle? In the end, it is a work of comparison. Find the group whose salary, benefits, and work best fit your desires. There are also places where the CRNA's are hired and paid by the hospital. I have found that anesthesia groups tend to be more flexible than the larger hospital corporations.

    I was offered a very attractive contract as soon as I found out I had been accepted into school, so I had a job lined up before I even attended my first class. It has worked out great.

    As for your question about Newman, I was in their first class, so the program was going through some growing pains at the time, which were often frustrating. Many of these problems have since been resolved. The program is a two year program, so it is very intensive and stressful. The up side is that I finished and started working for a paycheck six months to a year earlier than most programs. I felt it was, and is, a good program. My class started with 10 students, and graduated 8. Of the 8 graduates, all 8 passed boards on their first try, so they must have done something right.

    Kevin McHugh
  6. by   kmchugh
    Igcv

    One other thing to think about when looking for a job. I know a number of SRNA's who have been offered contracts, but did not immediately sign. Generally, this is because they felt like they had not yet done enough anesthesia to know what did or did not interest them. They wanted more time in their clinical rotations before signing anything. You have to weigh which is more important: Do you want the security of knowing you have a job when you finish, or do you want to wait to see what interests you have in anesthesia? For example, I love to do (occasional) open heart cases. There are a number of places where all open heart cases are done by the MD's, and only general surgery is done by the CRNA's. I personally would not go to such a place.

    Kevin McHugh
  7. by   jperry25
    kmchugh,

    I was wondering if you knew much about KU or Truman/UMKC's programs. I'm from Kansas also and have been looking at these programs. I graduate in May and have a job in the surgical ICU at KU Med which I think will give me a good foundation if and when I do go to anesthesia school. Just curious why 2 students didn't make it through the program. Did they fail a class or did they have something in their personal lives happen and have to drop out? Also wanted to say thanks for your post. It was very helpful.
  8. by   SERENAde
    Thank you soo much for responding...it was very kind of you....

    I just had one more question...what departments could a crna work in other than emergency,open heart...i guess more specifically do crna's work in ob/gyn, pediatrics, neonatal,nicu....i am most interested in working with mothers,babies, children....would a crna be employed in these areas??
    may be a dumb question but i would like to know if becoming a crna would be worth it for me........
    thank you,
    seri
  9. by   kmchugh
    jperry

    To be honest, I don't know anything at all about Truman's program. When I first considered becoming a CRNA, I looked into KU's program briefly. What I found was that KU required you to take several classes (particularly chemistry and physics) before entering their program. These were not required classes for the nursing program, and I found this requirement to be a little disheartening. When Newman opened their program, I found the only requirement beyond a BSN was taking a statistics class (if it was not a requirement of your undergraduate program). Most CRNA programs do not have the heavy pre-req requirement that KU has. There is some chemistry and physics you need to know as a CRNA, but as the director at the Newman program told me, they will teach you what you need to know.

    As it turned out, I was glad I did not go to the KU program. Most SRNA's are required as part of their program to attend the bi-annual state meetings, and I got to meet a number of KU students at these meetings. I found that the KU program would not have been a good fit for me. First, it is a 30 month long program, compared to the twenty four months required at Newman. (If you do the math, you will find that in tuition, books, and lost salary, that extra six months will cost you as much as $30,000 - $50,000.) There are some other reasons I did not care for the KU program, but won't go into those here.

    You asked about the two students who did not make it through the first Newman class. I feel that saying why they did not make it through on a public bulletin board would be a violation of their privacy, and therefore I cannot and will not address that at all. In any event, I was a student at the time, and not involved in the decision making process of releasing the students. Anything I said would be hearsay. I understand your curiosity, but I really cannot say more about it.

    Seri

    CRNA's don't really work "in" any of the departments you listed, with the exception of the labor and delivery department. Primarily, you will find CRNA's in the surgical suites, providing anesthetics for surgery. You will also find them in the LDR, putting in the epidurals for pain management. In some places, particularly rural areas, you will find CRNA's doing these things by themselves, and in others, as part of a team under the direction of an anesthesiologist.

    In some hospitals, CRNA's are on the code blue teams, and will respond to all areas of the hospital for that purpose. Some will respond to the emergency department as part of the trauma team.

    I have performed anesthetics for all kinds of patients, including neonatal, pediatric, adult, and geriatric. From the tone of your letter, interaction with the patient seems to be very important to you. That's a great trait for a CRNA to have, but remember, our interaction is more limited than most nurses. But that interaction can be most important, in calming a patient's fears before surgery, and helping alleviate the patient's pain after surgery. There may be some places where a CRNA might work only in the LDR, but most places will expect you to perform anesthesia in the OR as well.

    One other point: I am a firm believer that the only dumb question is the one you did not ask for fear of looking foolish. So, ask away.

    Kevin McHugh
  10. by   ma kettle
    Are there certain types of experiences that are preferred by the schools acceptance committes? ie trauma verses open hearts. DO they like a variety of experiences? What are the things that these schools are looking for. Iknow they like high QPA and wonderful GRE scores. But are there other experiences and other things that they don't mention?
    Sandy
  11. by   jenn71
    Along those lines, are there things I should be doing during nursing school besides making great grades and spending time shadowing CRNA's in order to build a good application for CRNA school? It seems like everybody who applies to CRNA programs will have great GPA's and GRE scores and also will have spent time with practicing CRNA's.
    I am also wondering, like the last post, what you can do while working in ICU to make yourself a more competitive candidate.
  12. by   alansmith52
    I love this post its just what I need. (raw info from one who knows.)
    funny thing. I was a linquist also. I never went to DLI becaue I had aquired the languae as a civilian. and my wife is an RN also. If its a recipie for success I am all over it. (I am being supersillious of course).
    Drive on.
  13. by   kmchugh
    I've spent some time thinking about how to answer the question "what else besides what everyone says?" Thats a tougher question altogether.

    First, there is a reason everyone tells you to get good grades in nursing school, do well on the GRE, work in a busy ICU, and spend some time with a CRNA. These are the fundamental things looked at by ALL school admissions committees. In selecting students, committee members must not only come up with the best possible candidates, but in today's law suit happy society, the choices made must be defensible. So, they must have both objective and subjective means to screen candidates. We all know the things I listed above are the objective measuring sticks. So, what is the subjective measuring stick? The interview.

    After applications are received and screened, the list of applicants is pared down a number that can reasonably be interviewed. If you are selected for an interview, you have passed the first hurdle. So, how do you prepare for an interview? That's tough to say. Interview questions vary from year to year, selection committee to selection committee, even candidate to candidate. Some questions, of course, are pretty standard (in one form or another):

    Why do you want to be a CRNA?
    What do you know about what a CRNA does?
    What have you done to ensure you really want to do anesthesia?
    What steps have you taken to prepare to get through school (generally, though not always, a financial question)?

    Going to the selection board, I'd have answers to these questions firmly in mind, so you may answer them without hesitating or stumbling. I know for my interview, I also wished I'd studied up a bit more on the autonomic nervous system receptors, and the effects on those receptors of the more common vasoactive medications. Most folks tell me some question about dopamine, or some such, was in their interview.

    Every school has its own idea of the perfect student. I've said this before, but it bears repeating. Contact the director(s) of the school(s) you want to apply to. Ask point blank what you can do to make yourself more attractive to the school. This serves more than one purpose. First, you find out what you can do. Second, it tells the director you are willing to do more than the basic application to try to get into school, let's him/her know you are motivated. And finally, if you follow the director's advice, it tells him/her you are willing to actually do extra to be in that program. By doing these things, you bring yourself up on the director's "radar" in a favorable light. Since the director sits on the interview committee, he/she can (and usually will) tell the other members privately that you have "gone the extra mile" in the application process.

    A couple of specific points to questions asked in other posts:

    Sandy: ICU is both the preferred and necessary experience to apply to CRNA school. Generally, time in a larger, busier ICU will look better than (for example) a small, rural ICU. The bigger hospital ICU's will have the sicker patients, and will provide you with more actual experience with vasoactive gtt's and invasive monitoring devices. I think most schools tend to favor adult ICU experience over pediatric or neonatal ICU, though this does not always make a difference.

    Jenn71: The most important thing in nursing school is concentrating on what you are doing NOW. Good grades in undergraduate studies is one of the first, most important things a selection committee looks at. If you got all A's in english, psychology, and interpretive dance, but just barely scraped by in chemistry, microbiology and statistics, that tells the selection committee that you probably won't do well in the strongly scientifically oriented CRNA programs. Generally, CRNA schools won't talk to you much while you are still in nursing school, other than to send you information on what prerequisite classes you will need to apply to the program. This is not being snotty. They WANT you to focus on nursing school. Focusing on what you can do to get ready for CRNA school while still in your undergraduate program is putting the cart before the horse. If you focus too hard on getting ready for CRNA school while in nursing school, you might just cause yourself grief. Your real preparation for your master's program begins the day you graduate from your undergraduate program.

    How's that?

    Kevin McHugh
  14. by   alansmith52
    Isn't that the truth. I wish I would have heard that bit of advise about six weeks ago.
    I am one semester away from finishing my bacholors. I was starting to get kind of "geddy" Like if you've ever ridden a horse you know that when your almost home; the horse knows it. They know that there is food and water waiting for them so they have a tendency to just take off and leave the rider.
    this was me about six weeks ago. while in the midst of a very intensive advanced pathophys class I started studing for the gre needless to say one test paid the price before I got my head back in the game. Luckily I will still be able to pull out an A but I've had to really try and stay on task with whats important now.

    matt RN :imbar :imbar :imbar

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