[apaphoenix]

Okay guys,

I saw it hit a couple of times in a few different threads, but I wanted to ask anyway. I'm starting the clinical phase of my program and like many at this point, I spend hours looking over the career opportunities that may be available to me upon graduation. I just want to know what the experienced CRNA's out there think about where it is appropriate for new grads to practice when they are fresh out of school. There are many opportunities in large urban facilities that would provide excellent clinical experiences upon which a new grad could build a great foundation. In comparison with the rural areas, however, big city jobs don't always offer comparable compensation. Rural jobs on the other hand seem to offer a lifestyle that is more family friendy and laid back along with substantial salary and benefit incentives.

My questions are:
Would it be prudent for a new grad to begin at a rural facility?
Would it severely limit one's mobility in the future if he did so (meaning could I easily go from rural to large facility without much complication)?

Many of the recent grads from my program say that they felt confident that their experiences were adequate enough for them to meet most of the challenges they encountered after school. (The ones that I know all work at large facilities)
Because of this I wonder if I would be hurting myself if I just skipped over the large facilities. My ultimate goal was to do rural anyway!!

Just wanted to get some input from those who may have crossed this hurdle in the past. Thanks guys.

Phoenix

[apaphoenix]

bump

[gaspassah]

well im not yet (i start in august)a CRNA but in general i would suggest going where you are going to be
1. most comfortable in a new environment
2. able to build on clinical foundations
3. be offered support/able to request support for times when the $#$% hits the fan
some CRNA's i know explained it like this "just pay your dues and gain the most experience possible before going out on your own."
i would think it's all based on your feelings towards your own skills. how much responsiblity you are willing to take on. what kind of cases you'll be doing in the rural area, (ob, general, cardiac, neuro etc). and the level of autonomy in general.
just my thoughts.
d

[loisane]

You've probably already read my opinion on this, so I will try not to be too wordy <g>

My suggestion to new grads is to start out in a busy, tertiary, urban center. You want some place that does everything-hearts, OB, neuro, etc, etc. A place you will work your behind off for the first couple of years.

I beleive there are lots of benefits to this. You will more likely have lots of backup and support. You will be exposed to lots of serious, difficult, complicated cases. When you first get out of school is the best time to be exposed to this type of working environment, and develop these skills. They will last you a lifetime. If you start your career in a smaller, more limited, rural workplace, you will not get the chance to develop to your full potential, and--yes, I do think it would be harder to later transition to a large urban center.

Yes, the rural jobs offer more money. Very often they have a limited number of staff. You may be the only CRNA, or one of only 2-3. It takes a great committment to work in these places, and it takes a good salary to get that kind of committment. And they will want their money's worth. A rural CRNA usually needs to have a very high level of independent decision making ability.

I understand that some graduates may feel that their education was so rigorous, that they already meet this criteria. I do not believe this is true for any new grad I have ever been involved with. (Of course, there may be regional variation, and maybe there are some programs that do produce such graduates)

No matter how hard you have worked, you always had that safety net. There was always a clinical instructor available. Every graduate I have ever talked to has commented on the difference they feel without that safety net. To know your decisions are truly your own, and you have to live with the consequences. It is something that just doesn't happen until after graduation.

The best CRNAs are those that realize that graduation is when the real learning STARTS. If you pay your dues for the first couple of years, you will not only maximize your own abilities, you will be making an investment in your future marketability, and making your services that much more valuable in the rural environment.

OK, maybe that was wordy after all. Thanks for listening.

loisane crna