CRNA Doctorate??

millkay · Mar 19, 2006

This is the first I've heard about a possibility of a Doctorate in Anesthesia Nursing. It had crossed by mind, though. How hard will it be to get into one of these programs?!!!

See Virginia Commonwealth's explanation of this degree.

http://www.sahp.vcu.edu/nrsa/

Nitecap · Mar 19, 2006

I have been told that you wont necessarliy have to have the clnical doctorate to teach. Maybe in the far future you will of course. Right now here is the deal. For the program to award the clinical doctorate a certain amount of faculty and the directors have to have phd. My program directors are have begun the phd route to prepare for a possible transition.

As far as it being more difficult to enter a programs not so sure about that. I doubt the requirements will be increased. It will however prolong programs length as costs which may steer people away.

There are also issues with the MS programs that do not award a MSN and how they can award a Clinical Doctorate in Nursing. I understand their has been a good bit of debate and bickering over this but that is common place when major changes lume no matter what we are talking about. Bottom line is that if the details can get hammered out it can and may be a really good thing for the status of advanced practice nurses.

SigmaSRNA · Mar 20, 2006

I have been told that you wont necessarliy have to have the clnical doctorate to teach. Maybe in the far future you will of course. Right now here is the deal. For the program to award the clinical doctorate a certain amount of faculty and the directors have to have phd. My program directors are have begun the phd route to prepare for a possible transition.
As far as it being more difficult to enter a programs not so sure about that. I doubt the requirements will be increased. It will however prolong programs length as costs which may steer people away.
There are also issues with the MS programs that do not award a MSN and how they can award a Clinical Doctorate in Nursing. I understand their has been a good bit of debate and bickering over this but that is common place when major changes lume no matter what we are talking about. Bottom line is that if the details can get hammered out it can and may be a really good thing for the status of advanced practice nurses.

You attend baylor right Nitecap? I talked with Baylor's program director at length about it (since he was the speaker on the subject) and he said he quit the PhD program to get his DNP. He did some some of the other faculty were getting Phds though

sonessrna · Mar 23, 2006

I just glanced over the conversation here. I think there needs to be a differentiation in this conversation about a PhD vs a DNP. They are two different degrees with two different objectives (from what I understand). The AACN and AANA are not even discussing a PhD option, they are discussing a DNP option. Just for clarification. Hopefully I clarified correctly ;)

SigmaSRNA · Mar 23, 2006

I just glanced over the conversation here. I think there needs to be a differentiation in this conversation about a PhD vs a DNP. They are two different degrees with two different objectives (from what I understand). The AACN and AANA are not even discussing a PhD option, they are discussing a DNP option. Just for clarification. Hopefully I clarified correctly ;)

Yeah...we pretty much already knew that. The point was if you have a PhD before the DNP is set as the entry level for nurse anesthetists, can you teach or be the director of a program. The answer I received from the program director at baylor at the TANA meeting in early march was no. This is the debate.

Focker, CRNA · Mar 23, 2006

Are they thinking about making the DNP a requirement for all new CRNAs to practice in the future?

Personally, if they are, I think that would be a bad idea. Since that would extend the length and cost of any CRNA program significantly, I would think requiring a doctorate to become a CRNA would seriously decrease the amount of applicants. There are many people, including myself, that started nursing school with the eventual goal of becoming a nurse anesthetist. If you tacked, say, two years onto the length of CRNA school, I dont think there would be a significant enough difference between med school/residency and nursing school/experience/CRNA school to make it worth going the CRNA route when you could just become an anesthesiologist, given the pay difference.

I'm no expert on this stuff, so someone fill me in if I am missing something.

MmacFN · Mar 23, 2006

Hmm

Such a tough thing to think about.

I am PRO education. I believe in inceasing the requirements for nursing and its specialties in order to strengthen the profession (Min BSN entry like in Canada).

However. One poster made an excellent point. We dont want to educate ourselves out of jobs. While i dont think a BSN entry for RN's is an obstacle, A PhD for the CRNA may very well be.

Lets take myself for instance. Im a 32 year old fellow. Started as a medic then got a taste for what medicine would be like and went to NSG school. Ive been an RN for almost 10 years. I kept moving up to the next challenge, now im ready for the next step CRNA.

On average, the MIN req for CRNA is 4 years BSN, 2 yrs experience in the ICU (while this used to be after a few years on a floor thats no longer the case) and about 2.5 yrs of CRNA school for masters. A total of 8.5 years of education and experience at a minimum. That is exactly .5 years longer than medical school and residency.

Now if you make PhD the typical CRNA then you have to say that an MSN is minimum entry. So now add 2 years for an MSN at a minimum. Most of us simply couldt take off work to do a MSN for a pre req so we would probably be doing it online or night classes. LEts say we are go getters and managed to finish it in 2 years while working full time (near impossible). So now we have added 2 years. The CRNA school would be the same length of time as you would simply replace the masters core classes with the PhD classes (which are often self directed and hellish). Now we are talking a min of 10.5 yrs to be a crna.

So, none of that takes into account that the average RN entering CRNA school is 5-7 yrs of experience before they are ready. Thats potentially makes it (lets say 5 yrs) 13.5 yrs of experience and education. To be an MDA = 8 yrs. and the pay is 2-4 times more than the average CRNA.

I totally see how we could be screwing the pooch. an entry PhD CRNA would be this

- At least an extra 15K in school cost for a masters program pre req

- At least an extra 2 yrs of time (more likely 3-4)

- A major deterrant to potential students who have families.

The other side is one not mentioned but purely political. If you increase the requirements people will be calling for an increase in wages. CRNAs have fought for a speciality niche in the Physician world that is unparalelled in Nursing, Full scope of practice of an MDA without legal limitations. Really, thats something special. There are 2 factors which are what keep CRNAs in good graces with hospitals and what cause team approach anesthesia and independance they are:

1) CRNAs can do the same job for 1/2 the cost (or more)

2) Research has proven that CRNAs have the exact same pt outcomes as their physician counterparts.

Hospital systems will be on the side of the CRNA because the same service can be offered for a decreased cost and no increase in liability. Plain and simple. Change the cost, and why not have a physician.

Secondly, there is a major issue in regards to AAs encroaching upon CRNA practice. While this isnt a big deal now, if it takes 10+ yrs to be a CRNA and all of 4-5 total to be an AA eventually hospitals will start to look at them when there supply of CRNAs is signifigantly depelated between an increased time for education, decreased enrollment and increase in retirees without replacement.

Its a catch 22. Im my opinion now isnt the time for the PhD role unless its done post CRNA education.

SigmaSRNA · Mar 24, 2006

Hmm
Such a tough thing to think about.
I am PRO education. I believe in inceasing the requirements for nursing and its specialties in order to strengthen the profession (Min BSN entry like in Canada).
However. One poster made an excellent point. We dont want to educate ourselves out of jobs. While i dont think a BSN entry for RN's is an obstacle, A PhD for the CRNA may very well be.
Lets take myself for instance. Im a 32 year old fellow. Started as a medic then got a taste for what medicine would be like and went to NSG school. Ive been an RN for almost 10 years. I kept moving up to the next challenge, now im ready for the next step CRNA.
On average, the MIN req for CRNA is 4 years BSN, 2 yrs experience in the ICU (while this used to be after a few years on a floor thats no longer the case) and about 2.5 yrs of CRNA school for masters. A total of 8.5 years of education and experience at a minimum. That is exactly .5 years longer than medical school and residency.
Now if you make PhD the typical CRNA then you have to say that an MSN is minimum entry. So now add 2 years for an MSN at a minimum. Most of us simply couldt take off work to do a MSN for a pre req so we would probably be doing it online or night classes. LEts say we are go getters and managed to finish it in 2 years while working full time (near impossible). So now we have added 2 years. The CRNA school would be the same length of time as you would simply replace the masters core classes with the PhD classes (which are often self directed and hellish). Now we are talking a min of 10.5 yrs to be a crna.
So, none of that takes into account that the average RN entering CRNA school is 5-7 yrs of experience before they are ready. Thats potentially makes it (lets say 5 yrs) 13.5 yrs of experience and education. To be an MDA = 8 yrs. and the pay is 2-4 times more than the average CRNA.
I totally see how we could be screwing the pooch. an entry PhD CRNA would be this
- At least an extra 15K in school cost for a masters program pre req
- At least an extra 2 yrs of time (more likely 3-4)
- A major deterrant to potential students who have families.
The other side is one not mentioned but purely political. If you increase the requirements people will be calling for an increase in wages. CRNAs have fought for a speciality niche in the Physician world that is unparalelled in Nursing, Full scope of practice of an MDA without legal limitations. Really, thats something special. There are 2 factors which are what keep CRNAs in good graces with hospitals and what cause team approach anesthesia and independance they are:
1) CRNAs can do the same job for 1/2 the cost (or more)
2) Research has proven that CRNAs have the exact same pt outcomes as their physician counterparts.
Hospital systems will be on the side of the CRNA because the same service can be offered for a decreased cost and no increase in liability. Plain and simple. Change the cost, and why not have a physician.
Secondly, there is a major issue in regards to AAs encroaching upon CRNA practice. While this isnt a big deal now, if it takes 10+ yrs to be a CRNA and all of 4-5 total to be an AA eventually hospitals will start to look at them when there supply of CRNAs is signifigantly depelated between an increased time for education, decreased enrollment and increase in retirees without replacement.
Its a catch 22. Im my opinion now isnt the time for the PhD role unless its done post CRNA education.

It wouldn't be a PhD. It would be a DNP. Major difference. PhDs, depending on the area of study takes between 4-7 years to complete, on average. DNP would take approximately 3 years. From the plan of action of the AACN, no dissertation would be requirement and no where near as much research would be required. Also, you can get a doctorate in anything with getting a master's in it first. In other words, we go from BSN to DNP; no master's degree in between. Its the same as any other field of study; you can get a Bachelor's in biology and go straight to your PhD in biology without getting a master's (as long as you meet the requirements). 4 years BSN; 1-2 years ICU; 3 years CRNA...8 to 9 years total. 4 years undergrad 4 years med school 4 years residency....12 years total...

I still like the numbers

Pete495 · Mar 24, 2006

I don't like the numbers in either case. How much can be said for freakin' education if you can't get around the OR without tripping over your own shoelaces? For many, the education was spread out so they could have a life, and perfect their thinking and skills while working at the same time. Increasing the educational requirements means the profession will breed more alcoholics than it already has.

MSN, DNP both = CRNA. Finding educators and increasing research can be done without forcing higher educational requirements.

However, I'm up against a wall on this one.

MmacFN · Mar 24, 2006

Sigma

While that may be true, if DnP has little extra vaule whats the point?

no-pain · Mar 24, 2006

From my point of view, since I am begining to raise a family and dont want the extra stress of anesthesia school right now, I am pursuing an MSN (online) to keep up with what may be the future trend of anesthesia schools. Even when I do apply (in 2 years) and there is no consensus on minimum requirements I will already have the MSN and will only need to focus on the anesthesia courses since I will have already taken the nursing core courses (for an MSN anesthesia program). Basically for me its a good fit if the DNP is going to be the standard. I dont really have an opinion one way or another with making the DNP manditory for entry level anesthesia practice but again for me I plan on getting it anyway.

SigmaSRNA · Mar 25, 2006

Sigma
While that may be true, if DnP has little extra vaule whats the point?

I didn't say there would be any extra value. I was just educating you on the difference of degrees that are going to be offered. I will say this. This argument is probably the same one they had "back in the day" when there was a change from diploma to the bachelor's degree and from the bachelor's to the master's degree.