Quote from AbeFrohman
You're right, I can't give you the name of a group because I can't remember it. But it does exist.
While the CRNA may generate more money in the OR, some anesthesiologists who practice in critical care would probably rather have some time off from the ICU rather than more money. They make enough as it is.
You're not billing for both, your billing as a CRNA while you are in the OR and as an NP in the ICU/Clinic.
It is a huge leap for a CRNA to practice in the ICU because they legally can't. You need your ACNP to do so. CRNA has no prescriptive priviledges to dish out antibiotics, lasix drips, etc, etc.
It's easier to chose one or the other. There are definitely not that many groups hiring for a CRNA and a ACNP. I was just offering a suggestion.
Just one comment. You can't assist in surgery if you don't have your RNFA as well.
I'm also hoping that your friend, while ambitious, has some supervision in the minor care center. He is a new grad after all.
1. Would you care to share more about this group/hospital where they have hired a NP/CRNA to man the ICU? Again if the hospital wants to contract the anesthesia group to cover both the ICU and ORs that is one thing. Stranger things have happened, but I still wouldn't count on an anesthesia group hiring you to do both. I would look for a hospital (or an anesthesia group that specializes in contracting services for ICU) that would hire you directly if you are wanting to do both NP/CRNA roles, and you could probably work out somekind of deal with the hospital than an individual anesthesia group unless you can find anesthesia group that also has a contract to cover the ICU also. I personally haven't seen any anesthesia groups that have contracted to cover ICU outside of the normal anesthesia interactions, but I am sure there is some around since there are quite a few MDAs that do their fellowship in critical care.
2. CRNAs can get prescriptive authority depending on the state you live in. How do you think CRNAs do independent practice running pain clinics(not that I am advocating it one way or the other)? In the hospital setting CRNAs write orders all the time and believe it or not .
3. Would you care to show me the law(s) that state CRNAs can't practice in the ICU? In many states CRNAs are considered under the umbrella of APNs. A CRNAs/anesthesia provider whole practice revolves around providing critical care. The big difference is that it is usually only a short time that CRNAs give critical care. It isn't that much of a leap to convert those skills outside of the OR. Many nurse anesthesia schools
require a rotation through the ICU in order to give SRNAs the opportunity to write orders and manage critical care patients in the ICU setting.
4. By the way what is your expertise in anesthesia? I am a military SRNA and will graduate in December of this year, so I feel my understanding is quite reasonable in most aspects of anesthesia. I am not expert by any means, but I do work in anesthesia everyday and have rotated through several civilian facilities providing anesthesia. I also have 20 semester hours towards my FNP.
You might want to try these links and do a search of www.aana.com
CRNA ACNP combination