AA student contemplating CRNA track...advice?

Nursing Students SRNA

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Hi all,

I have been accepted into a AA program starting summer 2011, but I am also seriously contemplating the traditional CRNA track. Above all, my goal is to become an anesthesia provider. However, I want to gauge my options, and figured this would be a good place to get informative and helpful feedback. While I am already guaranteed a spot in the AA program, I do notice that there are a lot less positions available for AA grads vs. CRNA's. I imagine this is mostly the case because it is a fairly newer profession and many hospitals "don't know how to hire AA's, even when they really like them", etc. I also notice that CRNA's generally make more money for doing essentially the same job function (in hospital settings, or course) and I feel like this would bug me getting paid less for the same job duties. However, if I chose to go the CRNA way, I would need to go back to school as I am not a RN - my degree is pre-med, focus in nutritional sciences. I am thinking the fastest route would be to get an ASN, then do a bridge MSN program to CRNA school. However, realistically, what are my chances of landing a good critical care position as a fresh grad in Florida? Already taken my GRE, scored around a 1200, and my cum GPA is 3.5. I am assuming this would all take me another 2.5 years to complete. Im 24, no kids or marriage so I am still flexible, and looking to make the right investment in my future. AA school isn't cheap! What recommendations would you all have in this case?

Thanks in advance :) And I hope everyone can remember to be nice and honest in their responses!

Thank you all for your responses!!

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Thank you all for this great information. I am just curious what attracks nurses to the CRNA specialty, other than the obvious pay raise. I am a bit of a science geek and the nervous system amazes me, but when I think about what I know (the key phrase here) about the job responsibilities of a CRNA it seems like one would do a lot of watching people sleep. Again, I will be the first to admit I have never worked next to a CRNA, so I obviously don't have the complete picture. I appreciate any advise/insight anyone can offer.

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Specializes in CT-ICU.

My limited experiences in shadowing a few CRNA's helped me realize that although the job may look "easy" from an outsider's perspective (i.e. watching people sleep), all the advanced knowledge and critical thinking that they are constantly doing is what makes it look so "easy."

Shadow a CRNA and ask them why they'd choose one drug over another for a particular patient and they'll spew out tons of information and rationale that will blow your mind :) All that knowledge and decisiveness is what makes the job of watching people sleep look so easy haha

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I am curious, as this thread is about 3 years old, what path you chose.

I'm almost 43, and I have been practicing AA for almost 5 years now.

For myself, being such a late in life career change, and already having a degree in Chemistry, AA was the clear choice based on time and the region I live in. However, even still, I get tired of being the "red-headed step-child" of the anesthesia world. My biggest gripe: my inability to be able to obtain licensure in states where I would like to live.

As one nurse noted, AA's have been around for over 40 years and we haven't really gained any traction. This is, of course, has everything to do with money and politics and NOT clinical variables, and, I believe any objective anesthesia practitioner at any level who has worked with AA's and CRNA's would agree. But this lack of equality at the policy-making level is not a surprise with the AANA fighting us every step of the way, the PA's not wanting anything to do with us (even though we're officially known as PA-A's in GA), and the MD's basically being their usual complacent, apathetic selves not interested, REALLY, in our "plight". So, combine all that with the fact that AAAA, AA's national association, only represents about 2500 VOTES nationwide in any given election and you can see why any policy maker is not too concerned about what AA'

If I were 24, I would choose a CRNA route. I wouldn't be an MD because I don't want to live at the hospital. Also, I believe that with the changes in healthcare coming in this country, I would not be surprised to see nurses actually better politically positioned than doctors in the future. Furthermore, as a nurse you still have many different career paths and options.

Am I proud to be an AA? Absolutely. I believe the training I received at Emory in Atlanta was outstanding

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to finish up my last post:

However, if there was a bridge between AA and CRNA, I would HIGHLY consider it, because I am tired of the political BS.

I wonder if the AANA would ever consider some sort of bridge program for AA's? I think it would be a political Win for them.

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Probably not. Because AA's to CRNA's may still carry with them an alternative agenda. Can you imagine, not that it would happen, but an AA becoming a higher up in the AANA? Much like CRNA's who become MDA's and end up biting the hand that fed them... an AA might do the same. The CRNA is already a middleman fighting the fire at both ends.

Your post is very informative and hope my statements elsewhere don't detour your discussions here. The more we all know, the better!

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Specializes in Anesthesia.

AAs have no proven track record, because there are no studies showing that AAs are safe and effective independent anesthesia providers. AAs are stuck working in ACT practices, and ACT practices are themselves inefficient. In a healthcare economy that is looking to be the most cost-effective it leaves very little room for a provider that is totally dependent on another type of provider and actually decreases the amount of operating rooms that can be run at one time d/t that type of anesthesia practice.

IMHO there won't be a bridge program from AA to CRNA anytime soon, because the AANA agenda is to make full-service providers that can work in any type of practice. That would make it very hard to transition a provider whose whole training and clinical experience has been devoted to working under direct supervision and making them into an independent provider.

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Specializes in CRNA.

A 'bridge' program is not possible because CRNAs are nurses first, and advanced practice second. And there may not be recognized differences in CRNA and AA functions in an ACT-but that is far from the entire picture. I appreciate your input here. It seems a shame you didn't go for nurse anesthesia. Mid 30's is not a late transition.

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wtbcrna and loveanesthesia: i appreciate your responses.

actually, loveanesthesia has it correct, in the setting of the ACT, there is no difference in our functions in the workplace. I work at a level 1 trauma center in the southeast with CRNA's, AA's, and resident MD's. There is no difference in the amount of supervision I receive versus one of my CRNA colleagues. NONE. We both still run on a 1:4 supervision ratio MD:AA/CRNA, so there is no decrease in the amount of available OR's because of AA's. There may be differing ratios in other states. The attending is here at the beginning and the end of the case (sometimes) and is available if I need them for anything, just like the CRNA's.

wtbcrna, "independent" is a relative term. I think you all are also required to be under "medical supervision" as well (the MD doing the procedure, PLEASE CORRECT ME if that's incorrect), its just that we, being a profession created by anesthesiologists, are specifically "saddled" to the Anesthesiologist MD as our supervising MD. I was never taught in anesthesia school to not be an independent thinker or practitioner, like, "oh, don't worry, the doctor will do that". It was stressed that we be prepared no matter what the situation and I think our course work and clinical rotations speak for themselves in the regard.

Also, the Kentucky Study (how many eyerolls just happened?? :-) ), did show that we were just as safe as anyone within the ACT. To disregard that study based on your reasoning wtbcrna, with all due respect, is misleading as I think you are misinterpreting and misrepresenting the meaning of "independent" in that setting. It is in the ACT setting. In practice, it seems that we are just as independent as the CRNA, in that setting.

I appreciated your responses about the AA to CRNA bridge idea. I wish you would expand a little of what you mean by your "far from the entire picture" statement loveanesthesia.

Thanks!!

By the way, I really enjoy having meaningful, civil dialogue regarding AA's and CRNA's in practice. I believe that many of the factions that exist are due to misinformation and ignorance, on both sides. I enjoy hearing different perspectives and learning to create a more hospitable work environment for everyone, such that we all can bring our "A" game and patient benefits from our combined expertise.

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Specializes in Anesthesia.
wtbcrna and loveanesthesia: i appreciate your responses.

actually, loveanesthesia has it correct, in the setting of the ACT, there is no difference in our functions in the workplace. I work at a level 1 trauma center in the southeast with CRNA's, AA's, and resident MD's. There is no difference in the amount of supervision I receive versus one of my CRNA colleagues. NONE. We both still run on a 1:4 supervision ratio MD:AA/CRNA, so there is no decrease in the amount of available OR's because of AA's. There may be differing ratios in other states. The attending is here at the beginning and the end of the case (sometimes) and is available if I need them for anything, just like the CRNA's.

wtbcrna, "independent" is a relative term. I think you all are also required to be under "medical supervision" as well (the MD doing the procedure, PLEASE CORRECT ME if that's incorrect), its just that we, being a profession created by anesthesiologists, are specifically "saddled" to the Anesthesiologist MD as our supervising MD. I was never taught in anesthesia school to not be an independent thinker or practitioner, like, "oh, don't worry, the doctor will do that". It was stressed that we be prepared no matter what the situation and I think our course work and clinical rotations speak for themselves in the regard.

Also, the Kentucky Study (how many eyerolls just happened?? :-) ), did show that we were just as safe as anyone within the ACT. To disregard that study based on your reasoning wtbcrna, with all due respect, is misleading as I think you are misinterpreting and misrepresenting the meaning of "independent" in that setting. It is in the ACT setting. In practice, it seems that we are just as independent as the CRNA, in that setting.

I appreciated your responses about the AA to CRNA bridge idea. I wish you would expand a little of what you mean by your "far from the entire picture" statement loveanesthesia.

Thanks!!

By the way, I really enjoy having meaningful, civil dialogue regarding AA's and CRNA's in practice. I believe that many of the factions that exist are due to misinformation and ignorance, on both sides. I enjoy hearing different perspectives and learning to create a more hospitable work environment for everyone, such that we all can bring our "A" game and patient benefits from our combined expertise.

No, I work totally independent. There is no state requirement or federal requirement for me to work with an anesthesiologist or be supervised in anyway. I pull solo call and work with mixed group of MDAs and CRNAs. The CRNAs and MDAs are totally interchangeable where I work in our job duties. There are actually few restrictions on CRNAs to work independently in any state. What most people confuse about CRNA independence is the ability to bill Medicare without "supervision" i.e. opt-out states. This "supervision" requirement in CRNA only hospitals to my understanding is often accomplished by simply having a surgeon signing an order form requesting anesthesia services by the CRNA staff.

In an ACT practice AAs most often are interchangeable with CRNAs, but you can never have true study on AA safety versus CRNA safety when only one of them can work independently. CRNAs are the only type of anesthesia provider that have studies showing comparable safety/effectiveness when compared to MDAs. This type of study that can never be replicated with AAs. The restriction of AAs working in ACT practice is the biggest limiting factor for AAs, and always will be.

I appreciate that you want to have a civil dialogue about AA and CRNAs, but I think JWK has ruined many of those conversations long ago.

My personal view is that AAs are intelligent people that are being used as a political tool by the ASA. AAs no matter what the public premise of their start was have been used specifically by the ASA for many years to restrict and control CRNA independence.

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