Becoming a CRNA - From One Who Did It

lauralew · May 2, 2002

Hi Kevin, thanks for the informative posts. There are many reasons one does not get through a CRNA program. As one who left a program, let me share some general reasons that I did what I did. I certainly was expected to not only get through a program, but excel, since I was a CCRN with 8 years' ICU experience, an asst nurse manager, excellent grades in undergrad, etc. The program I attended was front loaded with academics for 12 months with 15 months of clinical. The 15 months clinical was sponsored by the military, while the academics took place at a civilian institution in the south. I did very well in academics but totally floundered in clinical, due to having very thin skin as far as my instructors' comments were concerned. The timing of when I went to school was horrible, looking back--I had just gotten out of an extremely abusive marriage immediately before starting the program and was not healed enough emotionally to deal with the head games many of the instructors played. I think had I been able to wait a year or two prior to starting the program, I would have been fine.

I guess my take home message is that besides being strong academically and having the financing in place, make sure you as a person are emotionally stable and strong. Then you should do well.

pauly · May 2, 2002

Kevin,

First I would like to thank you for putting yourself out there to help others who are interested in becoming a CRNA. It is all to often now a days that people won't make time or are not interested in making time to help others.

A little about myself. I am a first year nursing student with a goal of being a CRNA. I have talked to a couple recruiters, and all have mentioned the one year experience in ICU. My question is will I be able to get into ICU right out of college? Most nurses I have spoken to have said that I will find it very hard to get placed in that environment right out of school due to my lack of knowledge and experience in the field. If you don't mind me asking, what was your GPA when you graduated from undergrad school? How old were you? Thanks again for all you help.

Paul

zinacef · May 2, 2002

Dear Sir,

I have been in nursing for about six years and have been toying with the idea of going into nurse anesthesia as I've worked in ICU's before, though on an on-off basis. Now I am in psychiatric nursing and know that if I want to become a CRNA I must return to the ICU area to get the experience which I know is one year. My question is would the nurse anesthesia school take me with just one year's experience over someone else with let's say four to five years experience? Would the one year experience be enough to make it?

jenep · May 2, 2002

Thanks, Kevin, for your informative posting. I have only been a nurse for 1 year, but I am thinking seriously about going in the direction you have. I've started an online BSN program and work on a respiratory unit that has telemetry and is a step down from the ICU but also has some med-surg patients. I was thinking about going to the surgical ICU or PACU to get ICU experience. I want to know if you feel very stressed as a CRNA- the act of anesthesia is a bit intimidating to me but I am very interested. Thank you!

kmchugh · May 2, 2002

First, Lauralew makes a very good point. CRNA schooling is not only demanding physically and academically, but emotionally as well. Unfortunately, there are CRNA's out there who believe the way to train a student CRNA is to put them under as much artificial stress as they can. Their reasoning is "if they can't handle the fake stress I'm giving them, there is no way they'll handle the stress of being alone doing an anesthetic." Unfortunately, we seem to keep reinventing the wheel by adding corners. The military (who were masters at this kind of training) decided long ago that this theory was wrong. Added stress does nothing, but increase the stress of everyone involved. It proves nothing and improves nothing. But, these CRNA's exist, and everyone who goes through a program will run into some of them. Not much you can do about it but "show up, shut up, and suck up." But I would recommend to anyone considering a CRNA program who has had a recent, life altering event (death in the family, divorce, etc) to wait AT LEAST a year to get their mental and emotional state back in order before beginning school.

Paul

I went right from nursing school to an SICU at a level one trauma center. Yes, it was stressful, but it can be done. Personally, I don't believe in the old dictum that says you must have a year (or whatever) of med-surg before beginning to work in an ICU. The time management, assessment, and reaction skills required for these units are completely different, and I believe you essentially force yourself to start all over when you leave the med-surg unit to go to the ICU. If you want to work in an ICU right out of school, then go for it. If your school offers a Capstone program, or something of that nature, get as much clinical time prior to graduation in the ICU where you would most like to work. To your other questions, I graduated from a BSN program with a 3.9 GPA at 37 years old, and started my CRNA program one month shy of turning 40.

Zinacef

You don't say how long you have been out of the ICU, or how long your total ICU experience is, but to be blunt, you are in EXACTLY the wrong place to do well in anesthesia school. Not to say psych nursing experience isn't valuable, and might not help, but the drugs you give and the problems you deal with can not prepare you for anesthesia. Anesthesia deals with mental problems about 0.01% of the time, and physical assessment and evaluation about 99.99% of the time. One year's experience in an ICU is enough to prepare you for CRNA schooling. But, if that one year is all you have, it better be recent (like just before attending school). My best advice to you is to go back to the ICU right away, and get that year's experience. As to who would be accepted, if two candidates were completely equal in all other respects, but one had five years to the other's one year's experience, the more experienced nurse would probably be accepted. But I know one CRNA who graduated from nursing school in May, and went immediately to work in an ICU. The following November (six months later), he applied to CRNA school, and was accepted in January or February, after his interview. He finished his required one year experience while waiting for a late August class start date. So, experience is important, but not everything.

JENEP

I don't always feel stressed as a CRNA, anymore than I always felt stressed as an ICU nurse. Anesthesia is about 97% routine, and 3% sheer terror. The more experienced you get, the less the percentage of terror. You just never know, and have very little warning when that sheer terror is coming. So, you must be vigilent. When you first start doing anesthesia clinicals, you spend most (all) of your time terrified. I can remember the first two months I felt like I was constantly on the verge of wetting myself. But, as you do more anesthetics, your confidence grows, and you get more used to handling unusual situations. That's when you really start to enjoy doing anesthesia.

You mentioned you were getting your BSN online. Fair or not, some programs may look at those with less favor than a resident (full or part time) ADN to BSN program. Look around, try to find what CRNA programs you might be interested in attending. Check with the directors of those programs to see if there would be any prejudice against a BSN who earned the BSN online. Not all programs have this prejudice, but it might be helpful to know up front. You also mentioned that you were considering PACU for ICU experience. In my experience, only a few schools consider PACU experience as meeting the one year ICU requirement. Again, check with program directors to see how they feel. My best recommendation here is to work in the SICU. That's my background, and I feel strongly that it better prepared me for school than PACU. I have a good basis for comparison, since I also worked PRN in a PACU and in an ER prior to attending school. In this case, you don't want to set yourself apart, or give a selection committee something to hang their hat on to accept another candidate over you.

Kevin McHugh

meandragonbrett · May 2, 2002

Paul,

From what I hear, you should be able to get into just about any unit you would like. At the local hospitals here in my city, they are screaming for nurses in ANY unit new graduate or not.

Brett

BTW- Kevin thanks for all of your posts, and making this board come Alive!

meandragonbrett · May 2, 2002

Kevin,

Would you say that you get different things out of working in the MICU V. SICU?

brett

kmchugh · May 5, 2002

Brett

Absolutely different experiences working in an SICU over an MICU. Much of the core technology and experiences will be the same, but the focus is different. In an SICU, you generally will see post surgical patients, with surgical problems. In my experience, you will have more exposure to technology, such as swan ganz catheters, central lines and arterial lines in the SICU. You will also have much greater exposure to the folks from anesthesia and surgeons working in the SICU, which will give you contacts for when you do apply to anesthesia school.

If you work at a larger hospital, with trauma services, you will also have exposure to trauma patients. Never underestimate the value of these kinds of learning experiences.

Kevin McHugh

Rhon1991 · May 5, 2002

Originally posted by Othcakotcha
Craig,
Just read your journal and must say it is very intresting.... I start CRNA school at Virginia Commonwealth University in August and can't wait. I'll stay in touch so we can compare experiences.

Othca,

I hope you share it with all of us too! Im very interested in hearing about these experiences so that when the time is right for me to pursue this avenue, I will have somewhat of an idea of what it will be like. Thanks!

Rhonda:cool:

braden74 · May 5, 2002

Pauly,

Just to let you know I just graduated or actually will in 5 days from a BSN program. I had 3 offers for ICU jobs and that is because I only applied to 3 places. You will have no problems finding an ICU job as a new grad. I'm starting an internship in a combined Medical/Surgical ICU and hope to begin applying to CRNA school in a year or two.

Good Luck

Kim S. · May 6, 2002

Thank you very much for sharing your story and advice. It's a true inspiration! I have been accepted into a Nurse Anesthetist program starting this August. I have been searching on the web for scholarships and stipends, as I see many others are doing. I recieved an offer from a local anesthesia group for $500 a month and I would be obligated to work for them when I am certified for the amount of time that they provide money. 2 1/2 years paid = 2 1/2 years time at a "competitive rate". I have spoken to a few students who feel that I should not lock into anything just yet, despited however tempting any money can be. I have reviewed quite a bit on this website and it sounds like we will basically have our pick when we are out. What is your opinion? Take the loans and worry about it later, or secure a job and have a little money in the pocket (however little it may be)?

Thank you for any info!!!

Kim

QUOTE]Originally posted by kmchugh

Looking over this bulletin board, I noticed that there were few CRNA's posting, and a large number of people interested in becoming CRNA's posting. There seem to be a lot of questions. I had a lot of help from others in becoming a CRNA, and this is a good chance to pay some of that back. I graduated from Newman University (Wichita, Kansas) just last August. For now, I'll try to answer some of the questions I've noticed are most commonly asked about becoming a CRNA, and what it is like when you are done. If anyone has other questions, I'll try to check this board every so often, and answer those questions, if I can.

First, if you are in school now, nursing or otherwise, its time to start working hard. Pay particular attention to your nursing and science classes. When considering applicants, most schools look not only at the overall GPA, but at the grades the applicant received in the science and nursing courses. Anesthesia school is tough, with heavy emphasis on science. They need a yardstick to determine whether an applicant can handle the heavy course load they will be required to take. Past performance is always a place they begin.

Look around, do some research on the various schools of Nurse Anesthesia. There is a great deal of variation in programs. For example, length of these programs range from 2 to 3 years. Narrow the possibilities down to two or three schools. Then, contact the Program Director or Advisor to find out what requirements you must meet to be accepted to the program. If you have a chance, talk with the Director, and find out what you can do to make yourself a more attractive applicant. While there is currently a shortage of nurse anesthetists, there is no shortage of applicants for the relatively few school seats each year. The competition is stiff, and you must make yourself as attractive as possible.

Every program that I am aware of requires at least one year of experience in an ICU. I am aware of no program that accepts ER, OR, or any other type experience. This may frustrate you, it may not seem fair, and it may not make sense, but trust me, there are good reasons for this requirement. Not all programs require adult ICU experience. One of my classmates' experience was in NICU. Check with the programs you intend to apply to about what specific experience they require.

Once you have applied and been accepted, get ready. Every anesthetist I have ever talked to has said that anesthesia school was the toughest, most demanding thing they had ever done. (The most stressful was taking boards, but that is another story.) My own life is a good example. Before becoming a nurse, I was in the US Army, and attended the Defense Language Institute to study Russian. This was a full year, total immersion program. It was not even half as tough as anesthesia school. Brush up on your anatomy, particularly the anatomy of the airway and nervous system. Know the autonomic nervous system as well as you can. Be ready to study, study, and study some more. Plan on at least two hours study time for every hour you spend in class.

Working while in full time anesthesia school is difficult, at best. Working full time is impossible. Don't try it, you will only harm yourself.

So, what is life as a CRNA like? That depends on where you work. I work for an anesthesia group with both Nurse anesthetists and anesthesiologists. My average work day begins between 6 and 6:30 am, and I work until anywhere from 3 pm to whenever (the longest day I have had was 19 hours). I do anesthesia for all kinds of cases, from simple general surgery to open heart surgery, vascular surgery, and neurological surgery. Nurse anesthetists perform anesthesia, pure and simple. I see my patients before the surgery, plan the anesthetic, and perform all phases of the anesthetic. I put in arterial lines, central lines, and Swan Ganz catheters. I am also able to do regional anesthesia (spinals, epidurals, and regional blocks), but the group where I work does few of these. The only kind of anesthesia I don't currently do is obstetric, because the group I work for does not do OB.

I think the average starting salary for a nurse anesthetist is $85,000 to $110,000 annually, not including benefits, which can be, and usually are substantial. Many places not only have the salary, but also pay overtime. (Do the math. It makes staying late a whole lot easier.) Someone on this board said that some CRNA's only earn $60,000. I am not aware of any full time position with a salary that low.

I am extremely satisified with my career choice. I love doing anesthesia. I find it fun, interesting, and challenging. I have more independence and more responsibility than any other advanced practice nurse I know.

As I said earlier, I'll be happy to answer any specific questions I can. I'd prefer those questions be posted here, so I don't have to repeatedly answer the same questions. Rest assured, you won't be the only one with that question.

Kevin McHugh, CRNA

Kim S. · May 6, 2002

Hi everyone! I have been reading this website for a few months now, however I have never written anything. Thank you all for your advice, and Kevin thanks for the inspirational story! I have been accepted into a NA program starting this fall. Like many others, I have been on the web in search for scholarships and stipends. I have been offered a stipend where an anesthesia group will pay a few hundred dollars a month and I will owe them time when I am certified. I was wondering if anyone has any input on locking into one of these deals, vs. taking the loans and worrying about it later? The overall feeling I get is to hold out and wait until graduation. What has been your experience???

Thanks for your input!!!