Reasons NOT to be CRNA

roxy48 · Oct 30, 2006

Hi,

Although I am not a CRNA, I have worked in PACU for over 12 years in a variety of settings from outpt to high acuity level 1 trauma centers, and I am amazed at the number of new nurses who want to "become CRNA's" without knowing anything about the field. It isn't for everyone, yet it seems that there is a trend for fairly new nurses to "get their year of ICU experience " just to get into CRNA school. I also think you should work in a PACU, preop, or OR area as a nurse to see if it is for you. Surgeons can be extremely arrogant ( especially to the anesthesiologist and anesthetist), the stress can be high and it takes a certain personality type to handle it. The liability is great... when things go wrong they can go dreadfully wrong. I really think that new nurses should work in the perioperative area before contemplating a CRNA program.

Lisa

deepz · Oct 30, 2006

traumaRUs said:
....... CRNA's bring to the playing field more than just anesthesia, they are nurses too!

You may not be a CRNA, traumaRUS, but you do understand perfectly well the vital differences between nurse anesthetists and the other anesthetists. I applaud your insight.

Anesthesia is an arcane, a cloistered world. Closed to outsiders. CRNAs must learn to be quietly satisfied with their own work each day, with each patient they care for, satisfied with a Job Well Done: compassionate, efficient, with the accuracy of Science, and even with the elegance of hands-on Art -- satisfied to pat oneself on the back, so to speak, and not requiring external kudos, because no one else can truly appreciate such an arcane process *except* other anesthesia providers, and the doctors in anesthesia all too often do not recognize or they refuse to acknowledge superior care.

Which brings me back around to the *single* major drawback of being a CRNA: the politics. The playing field traumaRUs refers to is NOT a level playing field. Very frustrating.

When Nupe4sleep says in the Very Unhappy With My Career thread ".....I'm tired of the arrogant surgeons, condescending and controlling anesthesiologist and the constant rushing in the OR at the expense of patient safety......" I hear lack of autonomy; I hear a CRNA prevented from giving nurse anesthesia care, required instead to provide just Anesthesia. CRNAs have survived political attacks for over a hundred years because we put our hearts into our work. Hands-on care for us is not just manual labor.

IMHO

Trauma Columnist · Oct 30, 2006

deepz - thanks! My experience with CRNA's has been in military medicine when we lived overseas and my family's medical care was provided by the military.

When I was looking at APN roles, I really was initially quite interested in the CRNA role. However, once I talked with a couple of CRNAs, I realized that I'm not a person that stands still well. I was also fortunate to be able to shadow two CRNA's on a couple of different shifts and realized that this type of job wouldn't fit me well. I did like the intenseness of the work though.

deepz - I too would not like the politics of it either...I'm pretty apolitical.

apaisRN, RN, CRNA · Oct 31, 2006

ApaisRN - you are right. However, most APN's have a much higher stress level than a staff nurse.

I think anesthesia is intrinsically more stressful than the job of most NPs and CNSs, although not perhaps of midwives. Your decisions have to be instantaneous, with no time for a friendly consult or room for error. No time to mull it over. No second chances.

micugirl · Oct 31, 2006

mspcrna said:
You have an interest in becoming a CRNA? I had a strong passion for it many years ago and followed my dreams. I have no regrets what so ever. I have been a CRNA since 1979. Yes the road is hard and requires a strong investment in time and money.

Here's my thing ... I am in clinicals right now as SRNA, and I absolutely hate it. It is my first week, ...well, this will be my 2nd. But, the people that I was with were so cruel with their verbal & nonverbal, that I just cried the rest of the day after I left. I don't know why they have to be so mean. We are in a program that throws you in after 2 months of class, and they have other SRNA's that are front-loaded, so I am not sure if this is where the frustration is coming from...some insight or tips on how not to get on the CRNAs' nerves that have been doing it for a while. The new grads are great teachers to us, so I've heard, but it is though the one's that have all the knowledge want to keep it to themselves, and "eat their young". I was ready to quit--now I am going back this week for more abuse, b/c I've dedicated so much of my family's & my time into getting here, that i have to give it another shot. Plus, this is what my "dream-job" was, you know ... the parts I liked about ICU care.

Any insight here guys?

deepz · Oct 31, 2006

...... in clinicals right now as SRNA, and I absolutely hate it. ......not sure if this is where the frustration is coming from...some insight or tips on how not to get on the CRNAs' nerves .........

My sympathies, micugirl.

My insight as an oldtimer to your stressful situation would be a joke I often tell the students I work with: Think of MY stress; doing the case with a student is like doing the hands-on anesthesia with a puppet, and some of the strings to control the puppet are loose or broken or work only erratically, making for a nerve-wracking experience ... for mentors as well as for SRNAs.

Hang on, you still have a long ride ahead!

deepz

endorphinrush · Oct 31, 2006

I understand what you are asking but not why. And I wouldn't beat myself up over it either. Maybe it isn't something that you are meant to do. Personally, I've been an RN for 15 years and I have finally made the attempt at it. I have 2 interviews next month. I'm nervous as I can be. Academically, I am solid. Professionally, I feel like I am solid, I just hope the interviews go well. There are a lot of other APN options available to you as a nurse. Look at them all. Then decide. Honestly as a student nurse, I was strongly discouraged by CRNA's. I was told the hours were long, the school was brutal and that the job was frightening. The only perk, I was told, was the pay. That never discouraged me for a moment. I just "knew" it was what I eventually wanted. I have a strong passion for this particular area and I hope it reflects in my interviews. You're still in school though. Take time, look around. Work for a bit. Then decide.

Terpole · Nov 1, 2006

enorphinrush said:
I understand what you are asking but not why. And I wouldn't beat myself up over it either. Maybe it isn't something that you are meant to do. Personally, I've been an RN for 15 years and I have finally made the attempt at it. I have 2 interviews next month. I'm nervous as I can be. Academically, I am solid. Professionally, I feel like I am solid, I just hope the interviews go well. There are a lot of other APN options available to you as a nurse. Look at them all. Then decide. Honestly as a student nurse, I was strongly discouraged by CRNA's. I was told the hours were long, the school was brutal and that the job was frightening. The only perk, I was told, was the pay. That never discouraged me for a moment. I just "knew" it was what I eventually wanted. I have a strong passion for this particular area and I hope it reflects in my interviews. You're still in school though. Take time, look around. Work for a bit. Then decide.

I can say that I was very naive when I first starting my nursing education. I had a plan, but now my plan needs revision. I'm the type of person who likes to have a plan for the future and follow it religiously. Now I'm not sure. Now it's about me making a decision with objective info, not the "he said, she said" or "it was heaven/hell for me". Although that stuff is great because it can give you a heads up, I made my decision a few weeks ago that I just don't know enough yet make a plan for my entire career. Now I have a new goal...learn as much as I can about everything and wait until I have a broad and defined knowledge base to make a decision about the next phase of my career. Besides a little work as an R.N. for a few years wouldn't hurt the cause of paying off these student loans...:chuckle :chuckle

Before all of that, I still have to graduate....

heartICU · Nov 1, 2006

micugirl said:
Here's my thing...I am in clinicals right now as SRNA, and I absolutely hate it. It is my first week, ...well, this will be my 2nd. But, the people that I was with were so cruel with their verbal & nonverbal, that I just cried the rest of the day after I left. I don't know why they have to be so mean. We are in a program that throws you in after 2 months of class, and they have other SRNA's that are front-loaded, so I am not sure if this is where the frustration is coming from...some insight or tips on how not to get on the CRNAs' nerves that have been doing it for a while. The new grads are great teachers to us, so I've heard, but it is though the one's that have all the knowledge want to keep it to themselves, and "eat their young". I was ready to quit--now I am going back this week for more abuse, b/c I've dedicated so much of my family's & my time into getting here, that I have to give it another shot. Plus, this is what my "dream-job" was, you know...the parts I liked about ICU care. Any insight here guys?

It gets better. It does. These are new skills to learn, and a new environment to learn it in. What you need is simply more experience with the OR environment. The routine cases, setup, etc will get better with time. Especially if you have only been doing it a few weeks. I am finishing up an integrated program in a month (started clinicals the first week of class!) and I didn't feel comfortable in the OR for a few months. Always felt stupid, always felt like I was in the way. I swear, I think my vocabulary for the first few months was "I'm sorry." I constantly was in everyone's way, taping IVs wrong, putting EKG leads in the wrong place, missing IVs, missing intubations, etc. It gets better with practice and time. This truly is a great profession...just gotta give it time to acquire the skills you will need to do it well.

And as for the CRNAs who give you a hard time...the way I handled it was, at the end of the day, I asked them what suggestions they had for me to read, brush up on, etc. Trust me, it's very hard to gauge whether you are where you need to be in terms of clinical performance. You have to rely on your preceptor for their feedback, so I always tried to solicit something from them at the end of the day. And I thanked them for the day, whether it was good or not. After all, they are teaching, and some (as I am sure you have seen) are terrible at it, but do it becuase they must. There are still things to learn from them, even if it's just how NOT to treat a student.

It does get better - I promise!

medsurgnurse, RN · Nov 1, 2006

roxy48 said:
Hi,
Although I am not a CRNA, I have worked in PACU for over 12 years in a variety of settings from outpt to high acuity level 1 trauma centers, and I am amazed at the number of new nurses who want to "become CRNA's" without knowing anything about the field. It isn't for everyone, yet it seems that there is a trend for fairly new nurses to "get their year of ICU experience " just to get into CRNA school. I also think you should work in a PACU, preop, or OR area as a nurse to see if it is for you. Surgeons can be extremely arrogant ( especially to the anesthesiologist and anesthetist), the stress can be high and it takes a certain personality type to handle it. The liability is great... when things go wrong they can go dreadfully wrong. I really think that new nurses should work in the perioperative area before contemplating a CRNA program.
Lisa

Thank you. Thank you. Thank you.

micugirl · Nov 4, 2006

Just know that they are very nice to you while you shadow,but it's a different world when you come in there to persue the CRNA career. They eat you alive!

micugirl · Nov 4, 2006

I see your point deepz, and I think it must be stressful to have a student that knows so little throwing a wrench in your plan. Just maybe recommend to the schools that are sending their students to you, that maybe their students need certain guidelines before coming. This will lighten both your stress & theirs. It's not their fault for not being taught as well as some others. Try to remember that we are usually in a strange place without support, without the proper tools to take care of a person that needs a CRNA, and feel insecure enough. I found that one of the people that was with me was great--he actually gave reasons for the things he did: See one ...do one type, and not constantly yelling. We are already stripped of any ounce of dignity before we get to your bedside. Basically, you've been there, but there used to only be a few drugs & volatiles--now there are much more we have to learn.