Experienced CRNA...ask me anything

Specialties CRNA

Updated:   Published

Okay...If you've read my posts you know that I will be retiring soon.

Now is your chance to ask a practicing CRNA anything.

12 years of experience from solo rural independent to medical-direction urban ACT. Former Chief and Clinical Coordinator of SRNAs.

I will not reveal my identity, specific locations, employers, or programs.

Anything else...ask away.

Hi,

Thank you for volunteering yourself to be asked questions. I have been working in adult ICU for 2 years and want to get my CCRN too. I have 2 young kids and have been thinking of going to CRNA school. I am neutral about OR or anesthesia, I like interacting with patients. But my question is , how doable is anesthesia school with young kids? Now I hear its more than 2 years. I have also heard that getting admission is very hard too.

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Brent -

My best advice re: schools is to look for programs that offer the best value - not necessarily the cheapest, but the one that will offer you the best education and clinical experience at a price that will not leave you drowning in debt. Look closely at how long the program has been established, the longevity of their Dean, their ties to the medical community, their pass rate, the location of their clinical sites, and their accreditation status. Speak to enrolled students and new graduates. Move if you must.

It is difficult to recommend specific schools because choosing a program is an intensely personal decision involving many factors.

I know a few CRNAs who have degrees like you mention, but that education was something they picked up along the way. If there are CRNAs I know that obtained degrees specifically to enhance their application, I don't know about it. For many programs, entry can be quite formulaic. GRE + GPA + experience + recommendations + interview. Keeping your GPA high and aceing the GRE are probably smarter strategies than pursuing a health-related minor.

That said, I strongly believe in educational "options", because life is what happens when you are busy making other plans. The minors you listed, especially those related to management/informatics/admin, would serve you well in nursing in case you decide that anesthesia is not the right choice.

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Specializes in CTICU.
ThePrincessBride said:
I actually know of a couple cases in which it happened. Both moms died, one almost immediately. The other was in a vegetative state for months afterward and then died in LTC. She was 34 years old.

Makes me never want to get pregnant...ever.

I mean, do you not drive in case you have an accident? Do you not fly in airplanes or cross the road in case something happens? All of life is risk vs reward, and that's a pretty low risk-reward right there.

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Hero -

One thing you will find in anesthesia is that the meek wallflowers get eaten alive. So be bold.

If you have a specific program in mind, contact them and ask if they maintain a list of alumni or contacts for shadowing.

3 months is a long time. Go to the OR and ask to meet the Chief CRNA. Ask for a few minutes of his/her time, explain your background and goals, and request a shadowing experience. Done.

If the Chief says no, find a workaround. And then explain the effort you made to research the CRNA role and job-shadow in your interview. CRNA programs select those with drive. So show them you have it.

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Yorker -

Given what you wrote, I strongly suggest you reconsider a career as a CRNA. Here's why:

1. With time pressures and anesthesia care team models, there is very little time for patient interaction. You will spend most of your time away from patients, whether that's a call room in OB, behind the drapes in an OR, or a break room on standby.

2. Your primary focus for 3 years is school and clinical. You will miss many, MANY bedtimes, birthdays, holidays, family and social functions, most of which will be completely beyond your control. Your children only grow up once.

3. Admission is hard - there are only so many slots - but not ridiculous. Staying in is much, much harder.

4. Part time jobs as a new CRNA are extremely rare. You will more likely be working 8-12 hours per day, plus call, to start. ORs need 24/7 coverage and that's where new CRNAs start in the vast majority of cases. I think many students fail to realize this is not a clock-punching job. Unless you are in a larger practice with fixed shifts, you will not be working an easy 2 or 3 12's per week.

So. Is it doable? Totally. Anything is possible with the right combination of drive, determination, motivation, and resources. We had a pregnant mother with young children in my program. She delivered on a Friday, handed off her newborn to her live-in mother-in-law on Sunday, and went to clinical on Monday. Is it right for you and your family? Only you can answer that question.

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06crna said:
Yorker -

Given what you wrote, I strongly suggest you reconsider a career as a CRNA. Here's why:

1. With time pressures and anesthesia care team models, there is very little time for patient interaction. You will spend most of your time away from patients, whether that's a call room in OB, behind the drapes in an OR, or a break room on standby.

2. Your primary focus for 3 years is school and clinical. You will miss many, MANY bedtimes, birthdays, holidays, family and social functions, most of which will be completely beyond your control. Your children only grow up once.

3. Admission is hard - there are only so many slots - but not ridiculous. Staying in is much, much harder.

4. Part time jobs as a new CRNA are extremely rare. You will more likely be working 8-12 hours per day, plus call, to start. ORs need 24/7 coverage and that's where new CRNAs start in the vast majority of cases. I think many students fail to realize this is not a clock-punching job. Unless you are in a larger practice with fixed shifts, you will not be working an easy 2 or 3 12's per week.

So. Is it doable? Totally. Anything is possible with the right combination of drive, determination, motivation, and resources. We had a pregnant mother with young children in my program. She delivered on a Friday, handed off her newborn to her live-in mother-in-law on Sunday, and went to clinical on Monday. Is it right for you and your family? Only you can answer that question.

Invaluable advice that could save many people a year or so of hell and $60,000 or more in debt. I just had a friend and classmate withdraw from the program about a year in because she just couldn't manage CRNA school and her family. I think the straw that finally broke the camels back for her was she was going to have to send her 3 year old daughter to be raised by a relative for a couple years if she had any hopes to pass the courses. She withdrew finally and now she's got all that debt to pay back.

Another student withdrew because she was having to be away from her husband a lot more than she ever thought, even living in other cities during the week for school/clinicals then the weekends become 16 hour study sessions locked in a room. I don't know the dynamics of their relationship but it came to a breaking point where apparently she had to choose either school or her marriage.

You really have to go into the program ready to sacrifice just about anything to get through. Along the way you'll have many moments where you'll question if anything is ever worth all this effort and sacrifice. The professors will remind you constantly to "remember your why" which means to remember why you came to CRNA school.

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06crna said:
I was 34.

No criticism taken. It is long enough for me. I had to work today with an anesthesiologist with an attitude and CRNA hatred who was demeaning and critical for no other reason than she is the physician and I am the nurse.

I am done...and I am totally, completely okay with my decision.

So that makes you 46 now... did you get in on the ground floor of Amazon or are you going into another field?

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Hello,

I am currently a RN in the CVICU. I have been on the unit for 1 year now and I am finishing up my BSN (June 2018). Our unit is kinda an odd unit. We are a split unit broken up into recovery and CVICU. I think all of it was split up due to staffing issues. For example, fresh hearts will come up from the OR and they stay in recovery for 4 hours one to one. Then after that they are paired with an ICU nurse. My question is will this be enough experience for me to be successful in CRNA school? I just got checked off on IABP and I have had 2-3. I am working towards being able to take CRRT patients and every now and then we get an impel patient which I am not checked off on. I feel like we in some ways are a step down unit but that just may be the nature of CVICU as patients progress and improve after surgery. After I get my BSN I have also considered applying for a SICU position at the Mayo clinic. I just want to be prepared and successful in CRNA if I get in eventually. My unit also does vascular cases open AAA, endo AAA, thoros, and other vascular stuff.

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06crna,

Your years of experience and insight are truly appreciated. Thank you for that. What would be the number one piece of advice you would give to all prospective SRNA's looking into applying to graduate school in the near future?

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ThePrincessBride said:
I actually know of a couple cases in which it happened. Both moms died, one almost immediately. The other was in a vegetative state for months afterward and then died in LTC. She was 34 years old.

Makes me never want to get pregnant...ever.

Then you really must not want to ever get behind the wheel of a car...

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Specializes in Critical Care.

Yorker-

I'm almost done with school and have a small child. It makes things MUCH more difficult, at least for me. We don't have any family in the area, so my wife and I are paying out the nose for daycare. Additionally, I'm basically an absentee parent and deadbeat husband. I'm missing out on so much with my kid growing up. When you hear people complain about how much time they spend studying, imagine doing that with kids running around, or having to wait until they're asleep until you can get work done. Imagine having an exam in the morning and then waking up multiple times in the middle of the night. Imagine leaving for clinical at 4:45 am having little sleep. If you have family that can help with babysitting, I'd highly recommend looking into a program near family that can help. Otherwise, wait until they're a little older. Just my 2 cents.

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06crna said:
"Anesthesia awareness" is a lengthy and complex topic, and the term means different things depending on setting, anesthesia type, situation, etc. . I am going to assume that you are referring to the case in which a patient is awake, aware of the surgical procedure...but cannot move or communicate.

Despite what Hollywood and sensational media may portray, these cases are exceedingly rare. A likely scenario would be a patient under general anesthesia, paralyzed by drugs, intubated and ventilated, but not anesthetized by either IV infusions or inhalational gases.

There are so many failsafes in anesthesia that a competent and vigilant CRNA would recognize the situation. Even if the patient was given beta-blockers or medications to lower heart rate and blood pressure, anesthetists are constantly "sweeping the field". That is to say, we are constantly scanning the patient, the machine, the surgery, etc. Even if we don't look like we are looking, we are. And listening. It becomes second nature and automatic.

Off the top of my head potential causes: medication swaps/errors, inhalational agent vaporizer failure, empty vaporizer, IV pump failure, loss of IV access, lack of recognition/vigilance, anesthesia machine technical issues.

Prevention: standard monitoring that is part of every anesthetic, optional depth-of anesthesia brain monitoring (BIS), NEVER disable or zero-volume anesthesia machine and monitor alarms. But the best prevention is a competent, experienced, vigilant anesthetist.

Re: suffering. That is not a term we typically use in anesthesia. We note responses to stimulation, which may be painful, by increases in heart rate, blood pressure, and respiratory rate (if the patient is breathing spontaneously). We then process the information we have at hand to decide how to treat it.

A separate, but related, issue to awareness is recall - and this is not uncommon. Some specialties are more likely to experience this than others (cardiac, neuro, OB) due to the type of surgery and anesthetic. Some patients even report that they remember going to sleep or waking up with a breathing tube. These are normal and expected experiences. Some patients are not undergoing general anesthesia, but sedation, and we specifically counsel them that recall is a a distinct possibility. They must accept that risk prior to signing the anesthesia consent.

Thank you. Lots of good information.

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