NP to CRNA?!

Nursing Students SRNA

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I'm currently an NP student who worked only med surg looking for an ICU job to possibly consider CRNA. Has anyone been an NP and made the transition to CRNA?

Specializes in Anesthesia, Pain, Emergency Medicine.

You do understand that there are many NPs that work as intensivists? You do understand that there is a particular type of NP (ACNP) that is trained from the get go in Critical care? I'm talking about all the various procedures, diagnosing and treating intensive care patients? Even a primary care NP is way ahead of the ballgame in regards to understanding disease pathophys and treatment. So who would you want doing anesthesia for your mother who has prior MIs, CHF, diabetes and HTN? A new CRNA who had 2 years of critical care experience or NP who actually diagnosed and treated many patients with those issues? It is a no brainer. :)

If Juan(ACNP) went back to CRNA school. I would pick him the day after he graduated for the above patient over the vast majority of experienced CRNAs.

I would take an ACNP or FNP (to CRNA program)over a regular RN who has 2 years of critical care experience with all else being equal.

While many schools may admit students with ER experience or NP experience, those students are competing with a LOT of nurses that have true critical care experience.

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The COA has now define what is acceptable experience. The requirement for critical care is that you have experience as a Registered Nurse in a critical care area, on a daily basis, managing invasive hemodynamic monitors (such as pulmonary artery catheter; CVP; arterial), cardiac assist devices, mechanical ventilation, and vasoactive drips (such as norepinephrine; epinephrine; dobutamine; nicardipine; nitroglycerine). The critical care areas include the following: Surgical Intensive Care, Cardiothoracic Intensive Care, Coronary Intensive Care, Medical Intensive Care, Pediatric or Neonatal Intensive Care, and Neurosurgical Intensive Care.

DM

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nomadcrna said:
You do understand that there are many NPs that work as intensivists? You do understand that there is a particular type of NP (ACNP) that is trained from the get go in Critical care? I'm talking about all the various procedures, diagnosing and treating intensive care patients? Even a primary care NP is way ahead of the ballgame in regards to understanding disease pathophys and treatment. So who would you want doing anesthesia for your mother who has prior MIs, CHF, diabetes and HTN? A new CRNA who had 2 years of critical care experience or NP who actually diagnosed and treated many patients with those issues? It is a no brainer. ?

If Juan(ACNP) went back to CRNA school. I would pick him the day after he graduated for the above patient over the vast majority of experienced CRNAs.

I would take an ACNP or FNP (to CRNA program)over a regular RN who has 2 years of critical care experience with all else being equal.

While many schools may admit students with ER experience or NP experience, those students are competing with a LOT of nurses that have true critical care experience.

I guess it all depends on the individuals involved. We've all known NPs who were so jam-up-and-jelly-tight with their skills and knowledge that you'd rather have them handling your care than any MD in the town. We've all known NPs who you know you will have to help make decisions about your patient in a manner that allows them to think that they are coming up with the pt care decisions on their own, because they are too proud to take advice from a lowly nurse and too ignorant and ill-prepared to figure things out on their own. Of course, the same can be said about nurses. I doubt, however, that the critical care RNs with two years experience are going to get the type of recommendation letters that they need if they aren't the cream of the crop in their respective units. I don't know where NPs would get recommendation letters that speak to their ability to titrate drips and do hand's on management of critically ill patients in a feces-hitting-the-wind-machine situation. Having the knowledge and book smarts is important, but it is not the same thing as having the knowledge and book smarts AND applying those qualities at the bedside while multitasking in a crisis situation. I'm sure that there are many CCNPs that have and use those bedside skills, but the majority I've worked with either did not possess that ability and/or never applied that ability, so how do you know? I've never met a CVICU or STICU nurse with 2 years experience in their unit that did not have the skills and knowledge necessary to do this work if they wanted to. Again, it really comes down to the individuals being compared, but if I had to play the odds, I'd take an RN with 2 years CC experience over an ACNP or FNP with two years experience. It really does not matter, though, because if they get into and through CRNA school, they will be ready and able to handle the job.

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Specializes in Anesthesia, Pain, Emergency Medicine.

No offense but you are thinking like a nurse and not a provider. I see that you are a SRNA. Make the leap to thinking like an independent, skilled provider. Use critical thinking skills here.

A NP comes with another education that trains them to be providers. They can actually diagnosis and treat patients. They can order WHAT YOU DO IN THE ICU. They can also do many of the procedures and even more in some cases than CRNAs can.

You are comparing apples to oranges. The only reason we ask for critical care experience is to give the nurses a bit more experience. It really makes absolutely no difference at all for the end result.

Picking a RN with 2 years experience over an independent practitioner with a graduate degree already is pretty silly, if you stop and think about it. :)

So to make this really plain.

1. RN who takes care of a patient in ICU. Follows the orders of providers.

2. NP who gives orders for the care of the patients in ICU. NP who intubates, places chest tubes, alines, decides what drips to give the patient, I could go on more but I think you get the picture.

NP -> CRNA is lateral education. They are both Advanced Practice RNs already.

Way different than going from an RN to CRNA.

You need to research what the various types of NPs education and functions are. After doing anesthesia for 22 years, I've seen all types of providers. Good and bad and what they did before they became CRNAs did not really matter all that much.

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First, I am a CRNA in autonomous practice. I get your argument, and I agree with your last statement wholeheartedly. I'm referring to the numerous NPs that I've worked with that graduated high school, graduated nursing school, immediately enrolled in grad school, earned their MS degree, became certified as a NP, secured a job, and then fumbled around for years writing orders that made no sense wile not being able to see the forest for the trees. I had two RN classmates who were amazing producers in the classroom and who hid and ducked every patient care opportunity possible during clinicals take this exact route. One actually made the comment at the beginning of a clinical day "that's what I want to do...I want to be the one telling others what to do and not be the one being told what to do." Ok, we all understand that, but maybe you need to actually learn what it is that you need to do before assuming that role. Like I said, there are a lot of NPs out there who know what is going on and have the knowledge and understanding to truly manage critically ill patients. There are also a lot of them that writing orders based on what they think they know, yet could not handle a crisis situation if the world depended on it...the ICU nurses are covering their asses every day. Again, to your last comment, it is spot-on assuming that the admissions boards are doing their jobs well and not letting in the ICU nurses that can't think for themselves and are completely dependent on the protocol sheets in front of them and not letting in the NPs who have never had any true patient care experience and who are relying on the nurses to handle what they do not understand.

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Specializes in Anesthesia, Pain, Emergency Medicine.

You can say the exact same thing and insert CRNA, MD etc into your argument. Of course you will always get people who are not as good as they should/could be. ICU nurses have been helping providers, ALL types of providers for years.

BTW, you can say the same thing about ICU nurses, just insert ICU nurse into your argument as well.

I did not intend to insult you by being a student. I saw a post you made on June 27 about a day in the life of an SRNA. I did not realize you actually graduated in 2012.

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Specializes in ICU, OR.

A friend of mine was an adult acute care NP and went back for her CRNA. She was having trouble finding a job as ANP and was debating Family NP or CRNA. With critical care experience and more $ to look forward to, she became a CRNA.

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Hey Missy89!

I am just curious if you ever ending up switching and going for your CRNA? I am currently and ICU RN who is in school for my FNP but am also considering making the switch to the CRNA route. I would love to hear what you ended up doing and how you feel about that decision! Thank you!

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Not true, I was admitted as an NP, with most recent bedside experiment greater than 5 years ago. It depends highly on what type of NP you are. I am acute so I manage ICU patients all the time. Call or contact the schools, there are some that will consider NP management in the ICU.

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I was recently admitted to the CRNA at UTC. I am an acute NP and have worked in the CU and internal medicine. You have to be able to defend why you should be a good candidate. If you have no ICU experience then it may be an issue.

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