NP or CRNA

  1. Hi all:

    Wondering about grad school now. I have a heavy background in science-minor in chemistry, grad coursework in anatomy/physiology. Am debating about NP v. CRNA

    I am very autonomous, have an entepreneurial background and like responsibility. I have doubts about both...NP as a feel like I would be unchallenged treaty runny noses, earaches, etc. each day, plus, I can't see myself working for someone else such as under a doctor! CRNA cons to me include the ultra sterile environment, lots of machines. Please help! Thanks and bless.
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  2. 21 Comments

  3. by   OB/GYN NP
    I have a few things to offer that you might want to consider. What settings have you worked in? CRNA will be most likely hospital work. Some cosmetic surgeons use CRNA's for office procedures like conscious sedation, but I would think that the vast majority of opportunities would be hospital-based. Although many NP's are utilized in Emergency Departments in hopsitals, the majority of NP's do work in office settings, which definitely can get a little monotonous, like you said with the every-day "boring" stuff. If you like action and fast-paced work, I would say that CRNA would be your best bet. But don't forget that many CRNA's will tell you that there is a fierce rivalry between CRNA's and Anesthesiologists, and just because you're not working in an office setting doesn't mean there won't be a Doctor to consult with, take direction from, and sometimes take criticism from. I would probably recommend taking some time to work in surgery, or in a doctor's office (one that employs NP's) to help solidify your choice. Also, most NP's would probably tell you that when you have a good working relationship with the Doc in an office, and you trust each other, there's not many times when you lose any of your autonomy, except when you need or want to. Good luck in whatever you choose!
  4. by   np2b
    That's funny that the both of you thought that NP-hood would be more boring than CRNA-ness. I actually have chosen to become an FNP because it seemed to have the most variety! Sure, there will be a lot of runny noses and ear infections, but I will also see people of all ages, with the opportunity to see all sorts of illnesses. I'm not super-familiar with the field, but on the outside, the role of CRNA seems like pretty much the same thing day-in and day-out. (This person needs to go under for this long; that person needs to go under for that long.) It gives me something to think about.

    I thought the suggestion of shadowing/volunteering in these respective settings was a great one. Other things you might want to consider as you make your decision are:

    *How much do you like talking with people, specifically patients? I'd imagine you'd see a lot more people in the course of your day as an NP than as a CRNA, and they'd be a lot more lively when you saw them. (Depending on who you are, this can be a plus or a minus.)

    *As was mentioned previously, where do you want to work? (Hospital vs. Clinic). Very different settings, each which have their own personalities (and working hours) and level of autonomy. (By the way, it's not unheard of in some states for NPs to have their own practice. In California, I used to work at a free clinic where the doc is nowhere to be seen for most of the time...she comes in once or twice a month to review and sign charts, as required by law, but the NPs are on their own for the most part. It's my understanding that in some states, the only "oversight" that an NP needs is a collaboration agreement with an MD...meaning that they can call them if they have any questions...but that's about it.)

    *How much do you want to get paid? My understanding is that CRNAs make quite a bit more than an NP.

    It sounds like you're looking into direct entry programs in nursing. If you're interested, I'd be more than happy to pass along a bunch of info that I have about them. Feel free to send me a private message if you care to!

    Hope this helps,

    Kelly
    Last edit by sirI on Dec 17, '05 : Reason: delete private email adddress
  5. by   Tim-GNP
    A lot depends upon your financial aspirations as well... if you want the cash, go for the CRNA.
  6. by   lalaxton
    Something else to consider, most CRNA schools require you to be a full time student, whereas you can go to NP school part-time/full-time and also work(tight but doable)
    No one has mentioned yet that there are many NP specialties that can be very demanding and offer lots of variety. I work as an ACNP and have lots of variety/change/challenges every day. I work very independently, usually with minimal input from the docs. I know other ACNP's that also work with surgeons as First Assists in the OR, follow-up patients in hospital and see patients in the office, so get alot of variety in their work.
    I also considered CRNA when looking to go back to school, but ultimately I like to talk and teach too much to work with patients who spend most of their time asleep! I also know that the OR can be a stressful environment so I opted for the NP role and I'm not sorry I did.
  7. by   Espresso girl!
    Thanks to all of you. I'm overwhelmed by what good people there are out there...those that just want to unselfishly take their time to help another person that they don't even know. It completely gives me faith in this world!

    Geez you guys have all touched on some important, thought provoking issues.

    I am a true people person and love talking with just about anyone. I also thoroughy enjoy science, biochem.

    I am also an entepreneur and former business owner. It's very difficult for me to work for someone else. I am a chief! I found it very demeaning to work as a floor nurse, the way they are treated by the doctors. I'm afraid I would experience more of this being an NP. Tim, I'm also referring to your post about NP's being in a gray zone, not a nurse, not a doctor.

    I felt that CRNA would allow talking time pre-surgery. It is also performed in many outpatient settings and is moving increasingly in that direction to outpatient centers, dentist offices, etc. Also, you have the option to contract yourself to wherever, not worrying about overhead. And one of the biggest issues for me? Respect! This means more to me than money.

    Yes, you could be an entepreneur as an FNP. That was my original goal, to blend complementary medicine with traditional as an FNP. I would have 5-8 yrs I figure before I could do this, as I would need to build a knowledge base out of school. I have become jaded being in the system since I started the BSN, and now think most people just don't want to change their diet, they just want the fries and the coke and if they get diabetes, oh well. No one really seems to care. Hence the healthcare issues we see like lung ca and heart disease. So I figured hey, they want to pay me well to help them sleep during their open heart surgery, sure, I'll do it.

    For the time being, I plan on going to cardiac ICU when I graduate in May. But as you can see I still have a raging debate in my mind.

    Any more insight, send it my way!!!
  8. by   lalaxton
    Espresso,
    Much of your dilema may clear up once you finish school and start working in the 'real' world.. Opportunities may open up, you may be able to talk and observe many diferent people in their roles, maybe even shadow a CRNA or NP to see what it is they do on a day to day basis. Remember also that in some states NP's can practice completely independently from MD's. This sounds to me more of what you are looking for.
  9. by   npkae1
    I am a FNP and my brother in law is a CRNA. There is a world of difference in our practice. I teat acute and cronic illness, and can prescribe any and all drugs in my state. I have a knowledge of all systems and see all type of patients. My brother in law (also in the same state) only sees 1 kind of patient, only has to really know about sedation, and he makes almost 3x the money I do. I have total autonomy. He works directly under a MD. I can prescribe for my family and friends. He can't. It depends on what you want. I do hate all the controversy over NP's. It seems that physicians are threatened by us and try to force all kinds of legislation. They also have a lot of low blows "pseudo doctors" "dumb-doctors" My brother in law doesn't experience any of this. NP's are a threat to all primary care family physicians. We do the same thing for a lot less. They can't accept that and want to put a lot of regulations on the NP. It's funny, if you are in a very rural setting, MD's are all for you doing anything (because they don't want to go there) If you are in their town, they don't want you to do anything without their supervision. (which by the way, we don't need, only their consultation if we NEED it) They want to call it supervision.
    It's still a tough road as a NP, but I think with increasing medical expences, insurances will be forced to accept us.
    Good luck!!!
  10. by   brownrice
    NPKael:

    (I was formerly espresso girl, and am now brownrice)
    You answered my post almost 4 years after I posted!!! So here's what I decided....NP school for the FNP program. I just finished Advanced Patho. It was tough, and many students did not pass and have to take it over. I feel like I made the right decision over CRNA. Have you enjoyed working as an NP, and do you have a specialty?

    Thanks for answering my post!
  11. by   Papadoc
    Quote from Espresso girl!
    Thanks to all of you. I'm overwhelmed by what good people there are out there...those that just want to unselfishly take their time to help another person that they don't even know. It completely gives me faith in this world!

    Geez you guys have all touched on some important, thought provoking issues.

    I am a true people person and love talking with just about anyone. I also thoroughy enjoy science, biochem.

    I am also an entepreneur and former business owner. It's very difficult for me to work for someone else. I am a chief! I found it very demeaning to work as a floor nurse, the way they are treated by the doctors. I'm afraid I would experience more of this being an NP. Tim, I'm also referring to your post about NP's being in a gray zone, not a nurse, not a doctor.

    I felt that CRNA would allow talking time pre-surgery. It is also performed in many outpatient settings and is moving increasingly in that direction to outpatient centers, dentist offices, etc. Also, you have the option to contract yourself to wherever, not worrying about overhead. And one of the biggest issues for me? Respect! This means more to me than money.

    Yes, you could be an entepreneur as an FNP. That was my original goal, to blend complementary medicine with traditional as an FNP. I would have 5-8 yrs I figure before I could do this, as I would need to build a knowledge base out of school. I have become jaded being in the system since I started the BSN, and now think most people just don't want to change their diet, they just want the fries and the coke and if they get diabetes, oh well. No one really seems to care. Hence the healthcare issues we see like lung ca and heart disease. So I figured hey, they want to pay me well to help them sleep during their open heart surgery, sure, I'll do it.

    For the time being, I plan on going to cardiac ICU when I graduate in May. But as you can see I still have a raging debate in my mind.

    Any more insight, send it my way!!!
    Hi there!
    It looks like you also enjoy science and did some work which is very well within the realm of premed. Have you absolutely rulled medicine out? Give it a thought. I've been an RN for 15 yrs, and I'm licensed acupuncturist. I also ventured out for med school during most of 2004. Stopped for various reasons. I'n looking at the same options FNP vs CRNA now. But I think neither one will give me a satisfaction. I know I need to suffer through it but do what I really want. Also the autonomy and incorporating complimentary medicine are perhaps the most important things for me. I know all about the debt, long hours,the hell of internship and residency, but it looks as though there is no easy way out for me.

    Good Luck with your decision
  12. by   Papadoc
    Wow, I just realized that I answered almost 4 y.o. post:chuckle
    Oh well ,t's Saturday Night...Live!:chuckle
  13. by   brownrice
    Hey Papadoc!

    I'm very happy that I decided to go to NP school. I have also attended 1 year of grad school at one of the four accredited Naturopathic Medical Schools in the US (in Arizona). I am very preventive medicine minded, but it was just, in my opinion, not in sync enough with mainstream medicine. I decided that being an NP, and blending my passion for natural medicine would be of great benefit to my patients.

    I can understand that you want to go to medical school. I think one must also consider economics when making this decision. What will your debt load be like upon graduation? Consider the interest piled on to that debt, and will it be paid by the time your are 70? An NP can provide primary care, and even develop a specialty. No offense intended, but is it an ego driven need to have the MD behind your name? Do you want to be credentialed to do surgery? What can you not do as an NP, that you can do as an MD, that would make you think you really need to do this?

    Take Care!
  14. by   Papadoc
    Quote from brownrice
    Hey Papadoc!

    I'm very happy that I decided to go to NP school. I have also attended 1 year of grad school at one of the four accredited Naturopathic Medical Schools in the US (in Arizona). I am very preventive medicine minded, but it was just, in my opinion, not in sync enough with mainstream medicine. I decided that being an NP, and blending my passion for natural medicine would be of great benefit to my patients.

    I can understand that you want to go to medical school. I think one must also consider economics when making this decision. What will your debt load be like upon graduation? Consider the interest piled on to that debt, and will it be paid by the time your are 70? An NP can provide primary care, and even develop a specialty. No offense intended, but is it an ego driven need to have the MD behind your name? Do you want to be credentialed to do surgery? What can you not do as an NP, that you can do as an MD, that would make you think you really need to do this?

    Take Care!
    Hey Brownrice!
    Thanks for a quick response
    I really cannot answer those questions when I'm asking myself. Generally speaking, I think that where I am right now (Brooklyn,NY/NYC) public is not ready to accept NPs as an autonomous practitioner. There is definitely a surplus of all kinds of physicians here, and doing a solo practice, or even some semi-independent set up is not very realistic. I'm sure it's quite possible to find your place "under the sun" as an NP, but in Tri-State area it seems like I'd have to go "against the gradient".There is something that bothers many ppl about non-physician thing.Most of the time it's just a stereotypical thinking. The question is "how practical" in terms of business it is being an NP vs MD/DO. I'm not talking about what you could do legally, I know it's very similar if not the same as a doctor.But the public perception of "My Dr. said...Mylanta:chuckle vs my Nurse (practitioner) said....XYZ" Well, you get the point. There is also billing aspect....I know it's getting better, but there is still a lot of misconceptions, and discrimination by insurance companies. Also I really want to practice preventetive/holistic health, and to be as far away from surgery as humanly possible. But I haven't been to find out what limitations does NP have let's say for administering IV highly concetrated vitamin coctails, chealation,glutathion,playing with bioidentical hormones,establishing contacts and ordering from holistic labs, and pharmacies..etc,provided you have the right training for it. There is a site that you may want to visit if you want to be in preventitive health www.ACAM.org, but even there there is a devision for docs, and non-docs. So to answer your question:Yes, absolutely, for me as a guy, ego definitely works as a devil's pick fork .So I'm still not sure, but the thought of "what if" I should have become a physician, and didn't is absolutely daunting I'm really stuck with indecision.
    Have a good one

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