ACNP vs CRNA

[Flightmed123]

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!

[Flightmed123]

Absolutely!!!!!!

[Corey Narry, MSN, RN, NP]

9 hours ago, adventure_rn said:

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!

The one blog quoted by a previous poster is from a nurse who always wanted to be CRNA but went through the ACNP route first, never practiced as an ACNP and is now a CRNA student. That is quite unusual and a long complicated way to get through a goal.

I have a colleague from many years back who went from FNP to CRNA. She worked as an NP actually in the ICU (it was allowed where I was working at the time). She never liked the role, was always brought to tears by how she felt about how surgeons were treating her, and went back to bedside ICU nursing for a year then applied to CRNA school and got in. She is a CRNA now.

I was at a large ICU conference recently and was involved in the planning of the event. I worked with a colleague who started her APRN career as a CRNA (in fact got in to a top CRNA school) and hated the role once she was practicing. She went on to ACNP afterwards and works in the ICU as an NP now, never renewing her CRNA license. I can't divulge any more information as she has quite a public profile in nursing circles.

My point is not to sway anyone to go for one path vs the other. I feel that the ideal situation is for us to research and familiarize ourselves with what each role offers and where we fit in the hope that we don't have to flip to the other role once we find out the one we picked the first time around is not for us. I, however, would be interested in posts from nurses who are able to combine practicing in both roles.

[Flightmed123]

Juan de la Cruz, MSN, RN, NP

Exactly! In regards to your conclude. This is my objective... research, research, listen, and observe practice. I’m interested in hearing those with an combination as well. ?

[murseman24, MSN, CRNA]

13 hours ago, juan de la cruz said:

The one blog quoted by a previous poster is from a nurse who always wanted to be CRNA but went through the ACNP route first, never practiced as an ACNP and is now a CRNA student. That is quite unusual and a long complicated way to get through a goal.

I have a colleague from many years back who went from FNP to CRNA. She worked as an NP actually in the ICU (it was allowed where I was working at the time). She never liked the role, was always brought to tears by how she felt about how surgeons were treating her, and went back to bedside ICU nursing for a year then applied to CRNA school and got in. She is a CRNA now.

I was at a large ICU conference recently and was involved in the planning of the event. I worked with a colleague who started her APRN career as a CRNA (in fact got in to a top CRNA school) and hated the role once she was practicing. She went on to ACNP afterwards and works in the ICU as an NP now, never renewing her CRNA license. I can't divulge any more information as she has quite a public profile in nursing circles.

My point is not to sway anyone to go for one path vs the other. I feel that the ideal situation is for us to research and familiarize ourselves with what each role offers and where we fit in the hope that we don't have to flip to the other role once we find out the one we picked the first time around is not for us. I, however, would be interested in posts from nurses who are able to combine practicing in both roles.

I have seen people post on social media who are both NPs and CRNAs who work in the ICU or the ED as well as in the OR. My point was these people obviously have a unique insight into both roles. I think you would be more likely to find them on CRNA specific blogs as it is my opinion (could be wrong) more go from NP to CRNA than the other way around.

[Corey Narry, MSN, RN, NP]

22 minutes ago, murseman24 said:

I think you would be more likely to find them on CRNA specific blogs as it is my opinion (could be wrong) more go from NP to CRNA than the other way around.

That's still going to be tough route to take. Not all NP's work in the ICU and CRNA programs require "active bedside ICU nursing experience" during application to get in. Remote ICU experience usually won't cut it. If a practicing NP wants to go to CRNA school, the most logical way to increase their chance of acceptance is to go back to the bedside RN role for a few years and apply to CRNA school.

[adventure_rn, MSN, NP]

17 minutes ago, juan de la cruz said:

That's still going to be tough route to take. Not all NP's work in the ICU and CRNA programs require "active bedside ICU nursing experience" during application to get in. Remote ICU experience usually won't cut it. If a practicing NP wants to go to CRNA school, the most logical way to increase their chance of acceptance is to go back to the bedside RN role for a few years and apply to CRNA school.

That is a fascinating idea, though. I'd never thought about it until this forum, but there's a surprising degree of overlap between the role of the PICU NPs I work with and CRNAs. They intubate and manage airways and inhaled gases like nitric, and they manage pressors, sedation and paralytic drips. We do bedside open-chest surgeries fairly often on my unit, and the NPs are the ones functioning in the anesthesia role while the surgeons are in the chest (or rather, the NPs are calling out orders for sedation/paralytics/volume/pressors while the RNs are pushing the drugs and charting, similar to the division of roles in a code). I think an active ICU NP would be exceptionally well-equipped to become a CRNA, more so than many ICU nurses.

Still, like you said, the easiest, most direct, and least expensive path is to figure out what you want to do in advance and just do it, rather than going back and forth.

[CRNAdegSeeker]

The blog from snratips.blog does not recommend going for NP rather she mentioned that she never wanted to be NP and that she only did because of "life situation". I agree that the easiest, most direct and least expensive path is to make up your mind about what you really wanna do.

Thinking about it though, CRNA school is hard, and it's nice to have a back up plan I guess

[Flightmed123]

44 minutes ago, CRNAdegSeeker said:

The blog from snratips.blog does not recommend going for NP rather she mentioned that she never wanted to be NP and that she only did because of "life situation". I agree that the easiest, most direct and least expensive path is to make up your mind about what you really wanna do.

Thinking about it though, CRNA school is hard, and it's nice to have a back up plan I guess

Good points! I agree with gathering research and making the right decision which is my best interest now in terms of where I am currently, seeking path and best interest, however, I think it is huge if you get into a market that requires both that aids financially for family with a emphasis of being impactful to bettering the systems outcomes in terms of Nursing Services for APRN. Than again, we have PhD dissertation for that in terms of researchers so who knows. I guess it’s hard to justify other than hear those who done it speak out.

Speaking for self if I was interested and met the requirements now, I would start shadowing the medicine model if I wasn’t with a system to make it all make sense or justify to self why am spending this amount time from family when I could get a better outcome for myself in terms of not working and compensating for time lost and complicated requirements during the path traveled. ? “Each is on” I would think.

[Corey Narry, MSN, RN, NP]

On 7/14/2019 at 8:22 PM, adventure_rn said:

That is a fascinating idea, though. I'd never thought about it until this forum, but there's a surprising degree of overlap between the role of the PICU NPs I work with and CRNAs. They intubate and manage airways and inhaled gases like nitric, and they manage pressors, sedation and paralytic drips. We do bedside open-chest surgeries fairly often on my unit, and the NPs are the ones functioning in the anesthesia role while the surgeons are in the chest (or rather, the NPs are calling out orders for sedation/paralytics/volume/pressors while the RNs are pushing the drugs and charting, similar to the division of roles in a code). I think an active ICU NP would be exceptionally well-equipped to become a CRNA, more so than many ICU nurses.

Still, like you said, the easiest, most direct, and least expensive path is to figure out what you want to do in advance and just do it, rather than going back and forth.

Our role is similar to the PICU NPs you're familiar with. We perform intubations and insert invasive lines as well. We manage sedation and hemodynamics. I feel that there is a decent amount of job satisfaction in the ICU NP role across the board. I feel like someone in our role would want to be a CRNA only if they also want to work in the OR to provide anesthesia to get a break from the ICU but I've only met one person who left the ICU NP role to go to CRNA school. Not saying that it's not uncommon or rare even, just don't have enough experience on the topic.

This person I knew actually went back to bedside nursing prior to applying to CRNA school as she was given advice that it would help her program acceptance to have a more varied ICU patient experience rather than just CT surgery patients which was where we worked primarily at the time. I did feel like she would have been a strong candidate to go to CRNA school direct from her NP role. She now just works in the OR as a CRNA from her public profile. I'm not sure if it is hospital credentialing that is influencing that decision as I don't work in that part of the country anymore.