Becoming a CRNA - From One Who Did It

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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

Monitoring

Well, of course there are the "big three," heart rate (and rhythm), blood pressure, and pulse ox. Depending on the patient status and type of surgery, I may also monitor CVP and PA pressures, I may monitor BP with an art line instead of a cuff. We also have a BIS monitor that allows us (sort of) to measure depth of anesthesia. Generally, I only use that for carotid endartarectomies. There are other monitors as well, but some of them can get pretty esoteric, and I question their value.

Generally, no, I don't monitor continuous cardiac output, though if a swan is in, I will shoot CO's and CI's. That often gives me a pretty good indication of what I might need to do to correct a problem. Today, for example, cardiac outputs seemed to indicate that the pump was having a problem. But, looking at CI, as well as CVP, we knew the problem was volume. Loaded up the patient, and stability soon followed.

I do give a lot of my meds based on what I am told by vitals. I also base some meds just on what the patient looks like. Often, a sweatty patient is telling me that they are feeling pain, and need more narcotic. I also monitor the train of four stimulator to ensure that the patient remains paralyzed (if the surgery calls for it). Bottom line? I monitor whatever the patient, surgery, situation demand I monitor.

Kevin McHugh, CRNA

This thread has really taken off with invaluable info, thanks to all, especially Kevin, I would like to mention that the GRE has changed format. They have dropped the previous analytical section in favor of an analytical writing section consisting of two essays. Now the format, (as of Oct 2002) consists of; Verbal Reasoning, Quantitative reasoning, and Analytical writing. Check the latest bulletin or go to http://www.gre.org.

I do have one question that I hope may benefit the board as a whole. Can anyone recommend a trade journal for student or working CRNAs?

Thanks everyone!

Yes, the AANA Journal is a pretty good magazine. Check at the AANA website to subscribe. Can't help much more than that, since I get the magazine as a CRNA.

Kevin McHugh

Can you tell me more about Newman as this is my first choice. How many people apply and how many get in?

Can you tell me more about Newman as this is my first choice. How many people apply and how many get in?

Originally posted by Want2Bgasman

Can you tell me more about Newman as this is my first choice. How many people apply and how many get in?

Just this year, Newman increased their class size from 10 to 12, so that's how many get in. The class that Newman started this year was their third class to be admitted. As I recall, they had something like 200 applications for those slots, and interviewed something like 40 or 50 applicants.

Kevin McHugh, CRNA

Originally posted by Want2Bgasman

Can you tell me more about Newman as this is my first choice. How many people apply and how many get in?

Just this year, Newman increased their class size from 10 to 12, so that's how many get in. The class that Newman started this year was their third class to be admitted. As I recall, they had something like 200 applications for those slots, and interviewed something like 40 or 50 applicants.

Kevin McHugh, CRNA

Kevin--

I spoke with Dr Chipas today on the phone regarding my application and he suggested I come to the school in the next couple weeks to set in on some classes. I know this is not and interview but I know I had better be on my toes. Any sugestions? Should I dress casual? Any help would be appreciated.

Jimmy

Kevin--

I spoke with Dr Chipas today on the phone regarding my application and he suggested I come to the school in the next couple weeks to set in on some classes. I know this is not and interview but I know I had better be on my toes. Any sugestions? Should I dress casual? Any help would be appreciated.

Jimmy

Originally posted by fence

Kevin--

I spoke with Dr Chipas today on the phone regarding my application and he suggested I come to the school in the next couple weeks to set in on some classes. I know this is not and interview but I know I had better be on my toes. Any sugestions? Should I dress casual? Any help would be appreciated.

Jimmy

I'd probably dress semi-casual, slacks, button down shirt or polo. I don't think a suit is necessary, but perhaps a shirt and tie combo would be OK. We had a couple of people visit our class, and generally, they dressed semi-casual. Being "on you toes" won't be a big deal, no one is going to quiz you at an informal visit. Relax, take a look around, get a feel for the school. Enjoy yourself.

Kevin McHugh, CRNA

Originally posted by fence

Kevin--

I spoke with Dr Chipas today on the phone regarding my application and he suggested I come to the school in the next couple weeks to set in on some classes. I know this is not and interview but I know I had better be on my toes. Any sugestions? Should I dress casual? Any help would be appreciated.

Jimmy

I'd probably dress semi-casual, slacks, button down shirt or polo. I don't think a suit is necessary, but perhaps a shirt and tie combo would be OK. We had a couple of people visit our class, and generally, they dressed semi-casual. Being "on you toes" won't be a big deal, no one is going to quiz you at an informal visit. Relax, take a look around, get a feel for the school. Enjoy yourself.

Kevin McHugh, CRNA

Kevin--

Thanks for the advice. I am probably gettng nervous for nothing. I do appreciate the calming voice of experience...lol

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