Active Duty CRNA v Guard , HPSP, and Autonomy

[silvrsnoflake]

Hello,

My husband is currently a flight nurse in the Air National Guard. He is a Captain and has been in for almost 11 years. He is now 1 year into CRNA school (3 year DNP program) and has researched his opportunities for jobs after graduation. He is not planning to get out of the military until he retires, but is trying to make a decision about active duty versus staying in the guard after graduation. Currently he is trying to balance school and still attend drill weekends, which is becoming increasingly difficult and I'm sure will be harder in the thick of clinicals over the next 2 years.

Here are our options for after graduation:

1. Take a civilian CRNA job and stay in the Air National Guard (probably just as a flight nurse, which will be a big pay cut on the weekends). This option will require considerable loans and will require balancing drill and school over the next 2 years.

2. Go active duty and get the HPSP scholarship for the next 2 years. This would require two years of active duty after graduation, but would mean no loans and no drill while in school. Currently he is going to drill one weekend a month while in CRNA school, but with the HPSP option, he would have no military requirements until after he graduates. (We already know he qualifies for the HPSP).

Making the decision to go active duty versus stay in the guard is very challenging. The biggest question we have is:

If he goes active duty, we are aware that active duty CRNA's are very autonomous. Being a one year SRNA, this makes him very nervous. Any active duty CRNA's, do you wish you would have been LESS autonomous upon graduation? My husband is very hard working but doesn't want to graduate and feel lost or unsupported as a new CRNA. He's in a very good program, but I'm concerned that it may not prepare him for that level of autonomy, as it is preparing students for civilian CRNA jobs. We also were informed the case load for active duty AF CRNA's is very high, which makes him nervous as well. Did anyone feel prepared after graduating from a civilian CRNA school to be an active duty CRNA??

I'm a nurse and educator and we have 2 little kids. My job is flexible and I would be okay with the 6 month active duty deployments. I'm actually pushing him to do active duty, not only for the money from the HPSP, but I've always wanted to be active duty. I feel like he's on a deployment right now since he's so busy with school, so it would mean 2 more years of sacrifice from a family perspective, but it also means I could quit my 2 current jobs I'm working to put him through school and we would come out of CRNA school with no loans at all.

Anyone who can help, we really appreciate it!

Janelle, MSN, RN, CEN

[wtbcrna, MSN, DNP, CRNA]

I recommend avoiding taking the HPSP or student loan payback if you/he decide on active duty. You will likely do better financially taking the 4 year bonus at 50k a year after entering versus the HPSP or loan repayment.

Active duty CRNAs are independent practitioners, but that doesn't mean you work without help or consultations. We work as a team without the unneeded direction/supervision of anesthesiologists.

He will get orientation and help building his skills to make him an independent practitioner. I have worked with several civilian trained CRNAs that came on active duty with some of the same concerns, and they all made the transition to active duty/independent anesthesia providers just fine.

[silvrsnoflake]

Thanks for that perspective. I didn't really think about it that way. The main reason we would go the HPSP route is because it would help with our current situation. It would relieve him of his guard duties while in school and I would be able to quit my two jobs. So it would definitely decrease our current level of stress. That is a good point about the bonuses though. Not to mention after he finishes his 2 year requirement, he's not sure what the next action would be. He would probably try to get a CRNA reserve position after active duty. Do you know anything about CRNA's in the reserves?

[wtbcrna, MSN, DNP, CRNA]

Thanks for that perspective. I didn't really think about it that way. The main reason we would go the HPSP route is because it would help with our current situation. It would relieve him of his guard duties while in school and I would be able to quit my two jobs. So it would definitely decrease our current level of stress. That is a good point about the bonuses though. Not to mention after he finishes his 2 year requirement, he's not sure what the next action would be. He would probably try to get a CRNA reserve position after active duty. Do you know anything about CRNA's in the reserves?

I know very little about CRNAs in the reserves. There are a few reserve units with CRNA slots. There is occasional IMA slots for CRNAs that provide more flexibility at some of USAF hospitals.

The reason I would suggest not doing the HPSP is that even though you only be using 1-2 years of funding since HPSP won't back pay school costs. You would still have a 3 year automatic commitment for HPSP, and you would be ineligible for the 4 yr 50k bonus during the payback period.