SRNA for a day entry for 10/15/02 - page 2

Craig: (aka) nilepoc, Srna for a day. Just read your entry for 10/15/02 and agree with you 100%. Although I am not in crna school yet, I have done all my nurs. edu. AD and BSN at a health science... Read More

  1. by   Roland
    scenario:

    Tim aged twenty five becomes a CRNA. He spends four years as an undergraduate, two years working in the ICU gaining experience, and twenty nine months in CRNA school. Thus, Tim has invested almost nine years in obtaining his goal of becoming a CRNA and goes to work at the age of thirty four. Let's say that Tim earns an inflationally adjusted $140,000 per annum over the life time of his CRNA career working to the ripe old age of sixty five (note Tim's intial earnings may be less but his later earnings might be substancially more. Also keep in mind we are adjusting out inflation driven raises and focusing on 2002 "constant" dollars.) Thus, Tim's life time earnings might be somewhere around $3,720,000 or $140,000 times twenty six years plus $80,000 (or 40K per year) for the two years working in the ICU.

    Lisa on the other hand aspires to enter the regal rhelm of the MDA. She also comes to this realization at the still youthful age of twenty five. However, in her case she invests thirteen years in obtaining her goal (this could vary a year or two in either direction depending upon the exact type of residency Lisa pursues). Specifically, her path consists of four years pre-med, four years medical school, one year internship and four years residency. Finally, a gleeful woman of the age of thirty eight begins practice as an MDA. Let's assume an inflationally adjusted income of $240,000 over the course of her career (again she might earn significantly less initially in her career but substancially more in her later years).

    Thus, if she cashed in her Hippocratic oath at the age of sixty five she would have lifetime gross earnings of six million and two hundred forty thousand dollars or $240,000 times twenty six years (I'm not even counting her pay as a resident or intern. Let's instead apply that towards her medical school debt). This amounts to an additional $2,520,000 in life time gross income. Even when you consider higher costs associated with MDA malpractice insurance (as compared to CRNA insurance) the ECONOMIC choice seems clear. I won't consider tax implications or differential investment opportunities which could substancially complicate any analysis. Consider for instance that if Lisa invested an ADDITIONAL $2,000 per month in tax exempt municipal bonds over what Tim could afford to invest (which earn an effective rate of 3% or so a good deal only if you are in very high tax brackets as is Lisa) she could easily add an additonal million to her life time earnings total. The rich do indeed tend to get richer.

    In short the younger you are the more attractive going the medical school route becomes. If I was even five years younger OR if I didn't have a family that is the route I would pursue. As it is all I want are a couple of days off a week, a decent salary, and a nice surf board to try and catch the perfect north shore wave.
    Last edit by Roland on Oct 18, '02
  2. by   smiling_ru
    Yes a CRNA can make 250000 a year but it is the high end of the scale rather than the average.
  3. by   meandragonbrett
    Originally posted by Roland
    scenario:

    In short the younger you are the more attractive going the medical school route becomes.
    That is not true for everyone. It is true if you're looking at it from a standpoint of who will make more in the long run. If money is one's only motivation to become a physician because they make more and only have 3-4 more years of training, he needs to check his priorities on why he is becoming a physician. Now I'm not saying in anyway, shape or form that you should totally ignore salary when considering which route. Although, money should not be your primary goal.

    Most of you here know that currently I have no desire to be a physician. Now I know that feeling may very well change once I get out of nursing school and if it does I'll have to make a decision then.

    Brett
  4. by   MICU RN
    Brett:
    Wait to you get in out of high school and in the real world of healthcare. There are many other reasons to choose medicine besides more money. wait to you are in nursing school and you learning how to give bed baths and turn the pt. q 2 hours or you are talking to the doctor about the pt. status and all of sudden you have to stop what you doing to go clean up poop. Then you realize that as a nurse you do many task that require very little intellect. And that is what is so crazy about nursing one minute you are help saving someone's life with your knowledge and next you are doing aid work. There is no other profession quite like it.

    I know you do vol. work in the OR, but believe me it not same as once you are in nursing school or out practicing.
  5. by   meandragonbrett
    MICU,
    I was refering in particular to Roland's post only.



    Brett
  6. by   meandragonbrett
    Originally posted by MICU RN
    There are many other reasons to choose medicine besides more money.
    That's exactly the point I was making in my post.
  7. by   Roland
    I start from the proposition that we work to live, and not that we "live to work". Thus, if I won ten million in the Super Lotto although I would engage in various philanthropic activities, I wouldn't work a regular job. I assume that the PRIMARY motivation for people working ANY job is the pay associated with the occupation (this includes benefits such as health care insurance). Indeed, this is the basis for virtually ALL economic analysis in a free market economy. Obviously, it is not the only consideration since abilities and proclivities enter into the equation. No matter how much I WANT to play in the NFL and make ten million per year... It's just not going to happen (for me). On the other hand I do have at least SOME possibility of becoming a CRNA. In addition, being a "science geek" at least some of my proclivities are conducive to my obtaining this goal.

    As I indicated above this analysis reflects my bias as a free market, conservative orientated individual. In a planned economy such as the former Soviet Union different considerations will take precedence. However, even in that environment subtle issues of class and compensation DO enter into peoples career choices (to the extent they actually HAVE a choice).

    Many people in todays society look disparagingly upon those who openly proclaim money as their primary motivation to do ANY occupation. However, when you consider that your income intrically effects virtually every aspect of your existence this seems illogical. Where you live, the health care and education you are able to afford your children are all in one way or another tied to your income.
    Last edit by Roland on Oct 19, '02
  8. by   Brenna's Dad
    Excellent argument Roland.

    I have to admit, that I doubt many people (including myself) might pursue Nurse Anesthesia if there wasn't a more than nominal economic payoff. There has to be some monetary incentive for the increased responsibility (as if critical care nursing wasn't enough) and the expense of attending school (both in lost wages and loans).
  9. by   MICU RN
    Roland:
    I agree with you; we need more people in nursing who have this attitude. In nursing school if you told an insructor what you just posted you would chastised. We as a profession need to get away from this mentality that nursing is a vocation and treat it more like a profession that requires a college education to become a member of. I have no problem telling people that one of the main reasons I am trying to become a crna is because I want to make more money. Also, I have a burning desire for more autonomy and a job that rquires more intellect. I didn't go back to college and work my tail off, so I could make twenty bucks a hour and have to do nursing aid work on a routine basis. And that is what we as bedside nurses are expected to do in our job description. In smaller hospitals they have CEO's who have just undergrad business degrees. You think they would be surprised to find out that a BSN program is harder than any undergrad business degree curriculum. And yes i am sure there are some stellar programs in the ivy league, however, there are also BSN programs in the ivy league schools too. Then maybe they would realize that new nurses are not going to put up with low pay and crappy work conditions. Pharm., PT, OT, and even resp. therp. wont get their hands dirty like we as nurses are expected too on a routine basis. It really is a shame how nursing in general is treated like the mules of the hospital.
    Last edit by MICU RN on Oct 19, '02
  10. by   g8rlimey
    Originally posted by MICU RN
    Roland:
    We as a profession need to get away from this mentality that nursing is a vocation and treat it more like a profession that requires a college education to become a member of. ... It really is a shame how nursing in general is treated like the mules of the hospital.
    Anthony: I couldn't agree with you more. I have consistently believed since nursing school and upon entering the ICU that nursing education needs MAJOR revision for two reasons.

    1. Nursing has become extremely specialized and needs specific majors within nursing to respect those specialty areas, i.e. Peds, OB/L & D, gerontology, onco., etc. Although, I do agree that all of this information is important to receive, It can be diversified to allow those that know what areas they want to work in to seek that education. In the UK, the nursing education is split into several different tracts: Mental Health, Geriatrics, Peds, and Adult. Students are allowed to chose their route of study and have the ability to cross-train.

    2. As you stated above, nursing needs to grow into it's deserving professional status. Although I may be chastised for this statement, I truly believe that the education should be standardized to only 4-year degrees, and the science req. should be higher. I am not saying ADN nurses aren't good nurses because they are some of the most astute and clinically common sense smart that I have met.
    I realize this a pipe-dream in respect to our shortage, but I truly feel this would advance our chances for professional survival, thus poosibly boosting respect.

    PS: Another way to be a professional is to start "billing" the hospital for the services we provide much like PT, OT, and Respiratory. What would the CEO's do when we started carrying PDA's and billed everytime we titrated vasopressors or hung chemo or held a mother's hand after she delivered a still-born? Just a thought open to any criticism....

  11. by   EmeraldNYL
    I totally agree with you. I am currently in an acelerated BSN program, and it is innovative in the fact that we are being trained to think and act like PROFESSIONALS. Personally, I think if the BSN was required, that may actually help the shortage, because it may improve nursing's image and encourage people to enter the profession. Many people don't enter nursing because they don't consider nurses to be highly educated and intelligent. Improve nursing's image, and people will respect nursing more and want to become nurses. Unfortunately, this debate has been going on since the 70's; how do we all join together and make it happen? Write to your legislators and the ANA and tell them you want the BSN to be the entry level!
  12. by   k123456
    Message deleted. No response necessary.
    Last edit by k123456 on Mar 8, '04

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