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ACNP vs CRNA

NP Students   (1,384 Views 21 Comments)
by Flightmed123 Flightmed123 (Member)

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I'm a fairly new nurse with >10 years Paramedic Field and ER experience. I'm currently trying to find my choice of practice and decided to begin my RN-start on a step down unit with anticipation of staying 1-2 years max prior transition to CVICU or MICU. I'm basically putting myself in the position/path for CRNA or ACNP. Please don't add here to choose CRNA because its financially rewarding due to this is not my drive for a career choice. -I'm wanting the career to reflect my personality,-research-bedside manners and beginning foundation from EMT to now. Im-guessing-I want really be able to make a ultimate decision until after ICU experience and shadowing both career choices, however, I'm hoping to get good insight here to ponder on and help steer. My interest for CRNA is basically from others perspective in regards to autonomy and skill that mirrors the Paramedicine field, however, I like my nursing counterparts at the bedside, teaching, understanding labs and relationship to patho. as well as the fact ACNP skills also mirror Paramedicine skill set without the gas aspect but with prescription privilege's and the fact they can also practice independently. I know reading this implies why not go to medical school and I want to stop that idea because Its not in my path of decisioning in comparison to time and expectation on personal life. All in all, I believe either path is a great-career choice and I will ultimately choose between the two within the next 2-3 years and want- all my-experience to have the reflection my reason for advisory here.

I have entered topics previously directing my approach strictly for-CRNA or SRNA. I'm now hoping to here from Acute Care NPs who may have been where I am now prior making a decision to what career path to choose. I know a few nurses have stumbled with this idea due to not being able to work in CRNA school, or similar to my reasoning. I believe this because-majority worked ICU at the bedside and typically these two are the grad school choices in critical care. I hoping to read many comments from Nurse Practitioners due to I'm steering more that direction but not positively sure.

Also provide pros and cons about the job NPs. CRNAs welcome to chime in as well if you stumbled between a decision prior CRNA. Thanks in advance!

Edited by Flightmed123

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JBMmom is a MSN and specializes in Long term care; med-surg; critical care.

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I'm not yet an AGACNP, but I will be when I'm done with school. I have a background in biochemisty and a couple professors encouraged me to consider CRNA school (also touting high salaries), but while in nursing school I paid attention to that role and don't find it's where my interests lie. The CRNAs that we work with in my ICU basically come in to intubate patients, or they're in the OR with intubated patients. The anesthesiologist generally gets the informed consent, so there's very little patient contact, as you noted in your pros and cons. I think it's the kind of job that 10% of the time stuff is going down and you're on, but the majority is sitting around monitoring. Not something that I could stay awake doing (which would be quite an occupational hazard). I chose AGACNP, although I also know I want to specialize in palliative and hospice care, because I want to maintain my patient care/education/support role in my career. I'm not as interested in hospitalist or procedural acute care practitioner roles myself.

You seem to have a pretty solid understanding of the two roles and your own motivations. It sounds like you're more of a fit for AGACNP based on what you shared. Good luck figuring out your best plan.

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JBMmom, MSN:

Thanks for sharing your perspective. Also sharing the different roles help me a lot for research and supply/demand. I wish you the best of luck in your new soon to be career. You seem to be very knowledgeable and by saying this u will rock in this profession.

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juan de la cruz is a MSN, RN, NP and specializes in APRN, Adult Critical Care.

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I am an Adult ACNP working in Adult Critical Care for over 10 years. Although I don't work closely with CRNA's, our intensivist team is quite multidisciplinary with physicians who are double-boarded in Anesthesioloy-Critical Care, Pulmonary-Critical Care, and various other combos (i.e., Nephrology-CC, Neuro-CC, Trauma-CC).  Working alongside intensivists who are also anesthesiologists has given me an appreciation of their specialty.

They do have patient interaction before and after the case when they follow up with patients in the ICU and wards. There is also a procedural element to the role not only in terms of intubations but also with central and arterial lines or even epidurals. They are great with sedation and pain management which is very useful in non-OR settings. They have to be well versed with physiology to know what they are doing.

That said, I love Critical Care and I'm lucky enough to find a job in it in an institution that performs advanced medical care, fosters interdisciplinary collaboration, and nurtured my learning through the years. As an NP in a hospital ICU setting, I accept that I'm not going to be independent - there will always be a physician above me but having that highly trained resource is a great benefit to me in caring for the sickest of all patients in the entire hospital. 

I find my role as a Critical Care NP as a middle ground that hits the right spot between being involved in the cerebral and problem solving approach to medicine and managing patients yet still being able to maintain close working relationships with fellow nurses at the bedside without having to perform the busy tasks that goes along with the bedside nursing role. I find that as a bedside nurse, sometimes those tasks can sometimes take away from being able to sit back and analyze what's really going on with the patient.

I am not knocking the bedside nurses' role by saying that and implying that what they do is beyond my skills. We all contribute to patient care overall and nurses take a big share of that contribution but I just prefer the time I spend in the provider role better.

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zoidberg is a BSN, RN and specializes in Adult Med/Surg & Critical Care.

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6 hours ago, juan de la cruz said:

 I find that as a bedside nurse, sometimes those tasks can sometimes take away from being able to sit back and analyze what's really going on with the patient.

👆THIS. A thousand times this. Ok carry on. 

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This girl story from ACNP to CRNA school. 

srnatips.blog 

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On 7/12/2019 at 4:58 PM, juan de la cruz said:

I am an Adult ACNP working in Adult Critical Care for over 10 years. Although I don't work closely with CRNA's, our intensivist team is quite multidisciplinary with physicians who are double-boarded in Anesthesioloy-Critical Care, Pulmonary-Critical Care, and various other combos (i.e., Nephrology-CC, Neuro-CC, Trauma-CC).  Working alongside intensivists who are also anesthesiologists has given me an appreciation of their specialty.

They do have patient interaction before and after the case when they follow up with patients in the ICU and wards. There is also a procedural element to the role not only in terms of intubations but also with central and arterial lines or even epidurals. They are great with sedation and pain management which is very useful in non-OR settings. They have to be well versed with physiology to know what they are doing.

That said, I love Critical Care and I'm lucky enough to find a job in it in an institution that performs advanced medical care, fosters interdisciplinary collaboration, and nurtured my learning through the years. As an NP in a hospital ICU setting, I accept that I'm not going to be independent - there will always be a physician above me but having that highly trained resource is a great benefit to me in caring for the sickest of all patients in the entire hospital. 



I am not knocking the bedside nurses' role by saying that and implying that what they do is beyond my skills. We all contribute to patient care overall and nurses take a big share of that contribution but I just prefer the time I spend in the provider role better.

"I find my role as a Critical Care NP as a middle ground that hits the right spot between being involved in the cerebral and problem solving approach to medicine and managing patients yet still being able to maintain close working relationships with fellow nurses at the bedside without having to perform the busy tasks that goes along with the bedside nursing role. I find that as a bedside nurse, sometimes those tasks can sometimes take away from being able to sit back and analyze what's really going on with the patient."

 

Great Perspective!!!!!  

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adventure_rn is a BSN and specializes in NICU, PICU.

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(All of my background comes from PICU/NICU, so please take my feedback with a grain of salt.)

In addition to getting your required ICU hours, one of the great things about working in ICU is that it gives you a better sense for what these two specialties actually do and what you'd enjoy more. I gained a much better understanding of both roles once I began working in the peds CTICU since we frequently interface with anesthesia as well as various acute care NPs. It's great that you're exploring your options right now, but you may find once you're in the ICU environment that your options become clearer. From your post, you seem like a thoughtful, introspective individual; as you gain more and more exposure to the various advanced practice roles in the hospital setting, continue to reflect on the pathway that bests suits your interests.

I'm sure it varies by facility, but the PICU/peds acute care NPs that I work with have a tremendous amount of autonomy. It also seems like there's far more variety in acute care NP roles compared to the CRNA route; you can find the precise niche/specialty that works for you, and you have the opportunity to switch gears down the road if you want a change of pace or scenery. For instance, if you start out in the ICU and want to switch it up, you can go to ED. Or the cath lab. Or an interventional pain clinic. Or about a hundred other specialties. In the CRNA world, you have far fewer options if you get tired of your role. Just my 2 cents.

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You might find some useful information by searching the nurse anesthesia blogs for NPs who then went on to become CRNAs later in their careers.

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adventure rn, BSN

"variety" is one of many pros I have on the list in order to differ prior shadowing in. Thanks for joining the group message. Helpful indeed 🙂

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Murseman24, BSN, RN

Im not sure that I would want to go back for CRNA afterward NP unless there is a dual program and my research of market availability fits. Although I don't have a interest in medicine model with that track and requirements it would make since for me to go to medical school or do CRNA first to compensate time and financial. Good idea though for which market I fall in and work responsibility. Thanks for thoughtful contribution. 😉

Edited by Flightmed123

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adventure_rn is a BSN and specializes in NICU, PICU.

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14 minutes ago, Flightmed123 said:

Murseman24, BSN, RN

Im not sure that I would want to go back for CRNA afterward NP unless there is a dual program and my research of market availability fits. Although I don't have a interest in medicine model with that track and requirements it would make since for me to go to medical school or do CRNA first to compensate time and financial. Good idea though for which market I fall in and work responsibility. Thanks for thoughtful contribution. 😉

Not my area of expertise, but I wonder if the blogs are by people who left NP for CNRA because they were dissatisfied with the NP role? (Although I could be wrong). I figure that even if there are a handful of people who left NP to become CRNAs, the overwhelming majority obviously don't. ¯\_(ツ)_/¯

Still, it would be interesting to check out those blogs for the sake of hearing a different perspective and understanding the various options. I think that CRNAdegSeeker mentioned a specific blog a few posts above mine.

Let us know what you find out!

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