Latest Comments by BigPappaCRNA

Latest Comments by BigPappaCRNA

BigPappaCRNA 876 Views

Joined Jan 13, '13. Posts: 50 (62% Liked) Likes: 79

Sorted By Last Comment (Past 5 Years)
  • 1
    ICUman likes this.

    The job prospects are so limiting if you go the AA route. You would be eligible to work in less than a third of the states. You would never be able to be independent in any way. Your compensation would not keep up with a dynamic, independent CRNA. Your ability to actively pursue and work 24 hour shifts would be far, far more limiting as an AA. There is just no comparison for someone in your situation. AA is great for someone with no choices or options. You have both, and it would make no sense at all to choose the limiting path of AA.

  • 2
    Asclepius86 and ICUman like this.

    Quote from AndersRN
    That statement will change if you go to med school and decide to become an anesthesiologist...
    No. Actually, it won't. We learn the same facts. We use the same textbooks. We do the same job. We have the same results. Unless the subject is about advanced appreciation of break room Java, and stock portfolio performance, the two educations provide the same level of knowledge and understanding.

  • 1
    twinsmom788 likes this.

    Quote from offlabel
    So, a flight medic of 4 or 5 years with a BS in Chemistry or Biology is less qualified than an L and D BSN nurse with the same time on her unit?

    I would love to have the flight medic as a student. They would be great. They would still need to be nurses, we we practice under our nurse license. And, they would need a BSN if the program to which they were applying were MSN or DNP programs. But those are not my rules, or even program rules. That is University rules. But one does have to be an RN, to be a CRNA.

  • 0

    Truth be known, the CC requirement is more of a hurdle than anything. Placed there to slow down the candidate and force them to get their experience in critical thinking, prioritizing, and communication. Some, but not too many, can start directly into an ICU. Most have to put in some time first, and then do their ICU time. This makes for a better, more well rounded candidate.

  • 2
    cocoa_puff and ICUman like this.

    Quote from offlabel
    Whoa...I have no reason to doubt this statement, but if its true, there has to be way more to the story....Just at face value, this is an endorsement of AA equivalency to CRNAs by USGPAN...not doing any favors to CRNA's if this isn't just an outlier in their admissions. That's an off the street admission into anesthesia training, unless, like I said, there's more to the story.

    That said, as an in the trenches provider, it isn't hard to tell those CRNA's with strong CC backgrounds. If a candidate doesn't bring that to the table and the program accepts them, that's on the school. But they're not the ones that have to work with them.

    So what I'd say to the OP is, be as strong as possible for the sake of your future patients and the CRNA's you'll ultimately be working with.

    No AA equivalent. Just that fact that experience is experience is experience. It is about decisions and critical thinking and priority setting and communicating and achievement. You can and do get that in most any unit. As a CRNA educator for over two decades, I love ER nurses. They are very good at situational thinking. All those things I mentioned up above. There is nothing magical about ICU experience, and, in fact, 95% of what we do is quite boring, mundane, and routine. But ICU experience does give a little bit of an edge up on worst case scenario kind of patient presentations that we see once in a while. A full nursing education and 4-5 years of any type of acute care RN experience and you are light years ahead of any AA.

  • 2
    cocoa_puff and ICUman like this.

    Quote from offlabel
    ER and PACU experience alone are non starters for most programs. CC experience is a non negotiable for any worthwhile program, generally speaking.
    You are partially correct. Most programs want to see at least some critical care experience, but not all. Your comment about any "worthwhile" program requiring it is not accurate. Just the opposite is actually true. The crappy programs all puff up and posture and try to tell you how competitive they are (really program x, with a class size of near 200?). While the better programs are actually far more open minded and flexible. Hell, the assistant director of the Army Program had exclusively OB experience, and I think that is a "worthwhile" program.

    Bottom line, don't guess, and don't take anyone's word here, including mine, just research the programs. Call them. They are very happy to help.

  • 1
    Nurse Cookie Swirl likes this.

    Quote from Nurse Cookie Swirl
    I've been accepted into a CRNA program that offers an MNA degree. I still have 2 interviews lined up for other schools. One is a DNP and the other school is a MSNA. I might want to teach in the future and I see most CRNA teaching jobs require an MSN. Do you think they'd hire me with a MNA degree?

    Any input would be appreciated!

    Thanks,
    -Swirl

    That all depends. If the school in which you want to teach is in a school of nursing, your MSNA may keep you from getting the job. They might not be able to hire you, even if they want to, with an MNA or MSNA.

  • 0

    Spoken like a true troll, probably from SDN. "It takes the whole team to get a job done" may very well be true. But....by your very own admission, that whole team does not need and MDA, ever. And of course, facts supports this.

  • 0

    I don't know that it will hurt you, but it may. I can't really see how it would help you. If CRNA is your goal, stay a clinician.

  • 1
    ICUman likes this.

    Quote from kLPantera
    What about the school rankings given by Search for Top CRNA Schools in Your Area which they claim to be ranked by actual data and not subjectiveness?
    Well, I just reviewed several programs on that website. It is highly inaccurate and woefully outdated. Of the first three programs at which I looked, they still have a program director listed who has been gone for over 5 years. They have a program listed in California which does not exist in California, and never did!! They have some listed which no longer exist. They don't even have any program listed in Arizona, even though there are two. Several reviews still list score requirements for the GRE with the old criteria.

    Maybe, maybe that site was relevant and valid at some point, but right now it is horribly outdated. Buyer beware.

  • 3
    ICUman, GordonIsSoCool, and elkpark like this.

    The rankings are highly, highly subjective. But they do look at certain benchmarks, and these are not really important. Let's look at 1st time board pass rate. Sure it is nice, but it tells you nothing about the program. It could quite literally be the worst program in the country, but have a high rate, because they have taught their students how to pass a test, rather than how to administer an anesthetic. I have seen some programs get cited by the COA for low rate, and the programs plan is to make the students attend 2,3, or 4 board review programs, all on the students dime. Then they actually have someone teaching their students, and their rate goes up, and now they look like they are "highly successful" even though it is a joke.

    This is is just one example of the rankings meaning nothing. But I will say, that those in the bottom third really are there for a reason. No matter the metric, there is no reasonable case that they should be in the top third. So, what does that mean? Well, is the 5th highest rated school better than the 12th? Probably not. But is the 20th highest rated program better than the 93rd? Most likely, yes.

  • 1
    cocoa_puff likes this.

    Quote from cocoa_puff
    I know Gonzaga University in Spokane WA offers CRNA only clinical in smaller, rural facilities, in addition to clinicals at a level II trauma center and a community hospital. Franciscan Skemp also offers CRNA only clinicals.

    As for the minimum one year ICU experience, it is the minimum for a reason. In that first year, you're not only learning how to be an ICU nurse, but you're also learning how to be a safe and competent nurse. It takes awhile to become proficient. Also, even with certification and leadership, you would be competing with more experienced ICU nurses for spots. When I apply for CRNA school, I plan to have at least 3-4 years of ICU experience. I want to get to the point where I can expertly handle anything on the unit, and I want to be seen as someone the other ICU nurses can come to for help. I want to do RRT, charge nurse, precepting, serving on committees, possibly even do a publicized research study. While you could probably get in somewhere with one year, a few extra years will make you a stronger candidate for CRNA school.

    Thank you thank you thank you. Finally someone gets it. Someone that is listening. It takes more than one year to be an adequate ICU nurse let alone to then move on to the challenges that lay head in a CRNA program. The smaller the program the more competitive, the more competitive the better you need to be, the better you need to be you need some ICU experience.

    The two schools you mentioned are excellent examples of small class size and outstanding clinical opportunities. Others are, of course, any of the military programs, Midwestern, Kaiser, National University, Arkansas State, Samuel Merritt. There are others, this list is hardly all of them. Just the ones that pop into my head right now.

  • 0

    Quote from rjh2013
    Thank you! That's great advice. As far as anesthesia models go, are there CRNA only clinicals in all states? Or should I look for schools in opt out states? I'm a little fuzzy on the whole "opt-out" concept.
    "Opt-out" is actually about billing, and does not actually have anything to do with actual anesthesia practice. It is a little confusing, but at this point in your careers, you should not get too hung up on whether or not your potential program is in an opt-out state.

    You our can absolutely find CRNA only practices in all states, however not all schools utilize them. Some schools, especially in larger urban areas, especially in the NORTHEAST do not utilize them. The program's exist to make money, or staff medical centers and groups. They do not exist to produce full service, independent, full scope of practice providers.

    I do do not and will not call out any schools as poor, nor will I say some are good. But a general trend of training exists in most east coast programs that is far more ACT based, than exists out west. The programs that are the most restrictive generally keep telling you how difficult they are, and tout irrelevant stats like first time board pass rates, all the while leaving out the fact that you placed the absolute minimum labor epidurals to graduate.

  • 2
    cocoa_puff and ICUman like this.

    1. Small class size. Can a school possibly clinically educate 50, 100, 150 students a year? You have to know this.

    2. At least half of your clinicals a need to be CRNA only. If all your clinical are tightly controlled ACT areas with anesthesiologist a and residents, don't do it.

    3. You need to get experience with nerve blocks and regional anesthesia. Not holding the syringe and watching the MDA placing the block. YOU need to be the one doing the block. Same for central lines, spinals, and epidurals.

    4. The more your potential program tells you how hard and demanding and challenging is, the more you need to raise an eyebrow. The more a program tells you that you need to study for your interview, the more an eyebrow should be raised. The less access they give you to current students, the more an eyebrow should be raised.

    5. If they will even look at you as a candidate, with only one year experience, you just have to ask yourself why, you have to raise an eyebrow.

    Few, if any exceptions, to these guidelines. If a program is close to where you live, or will take you despite you not being strong, or has lame reasons why they don't meet the above guidelines, please, please, please ask yourself why?

    Good Luck.

  • 0

    A student should have no expectations that moral considerations will be considered. You are there to learn. Everything. You also should have no expectations that doing one of those procedures is avoidable. It might just not be avoidable. As horrible as one may or may feel about those cases, if you are on call you would be expected to do your duty. By all means work at places where you just won't have to decide, if it is the important to you. But to choose not to do a legal and indicated case on moral grounds can and will get you terminated


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