This is my first post (obviously) on this forum, and I'm glad to be here. I've gleaned quite a lot reading the threads here, and now feel ready to seek advice on my situation.
I worked for a few years as an executive-level healthcare administrator for a primary care clinic for the uninsured. My experiences there convinced me that I wanted a clinical career, as I longed for the patient contact. I took the normal sequence of coursework to apply to medical school and did quite well, while taking additional courses to broaden my knowledge base and application credentials (patho, micro, A&P, pharm, numerous psych classes, med terminology, etc.). Well, once the time came around to apply to medical school last year, I decided it wasn't for me.
I'm an older student, and didn't like the idea of leaving my family in the trenches for 10+ years while I trained to become a physician, no matter how cool I thought the career would be--my family just matters more to me, and I don't want to miss my children's childhood.
After doing much research, having many discussions with personal friends, some who are MD's, some NP's, and others PA's, I have decided I want to seriously consider nurse anesthesia.
I have called programs, looked through brochures, and emailed program directors. What I am seeking from this community is help from those out in the field (as SRNA's or CRNA's) to guide me through the quick-route, if one exists.
There is a local ABSN program that I am going to apply to for next May. I am also looking at UPenn's direct-pathway BSN-MSN program as an option, but I haven't heard back from anyone there despite an email sent and a phone message left. And then I know I need a minimum of one year in ICU to even be considered for CRNA programs.
Realistically, what is the fastest track to CRNA? Is it possible to get an ICU job as a new grad BSN? Is it possible to get into a CRNA program with the one-year minimum work experience in ICU?
Ideally (yes, I realize few things ever work out ideally), I would like to go through the process systematically, and in the shortest required time frame (13 months ABSN, 12 months ICU, 24 months accelerated CRNA) and be out by the time I would have had I gone to medical school (minus residency).
I did a 16-month absn program. if you are going to attend an absn program, you probably cannot work. The schedule will be very tight. You don't want to sacrifice your GPA over NA/clerk experience. But, if you can somehow manage both, by all means go for it! It will definitely help.
After I graduated, I could not get an ICU job right away. So I took a job at ER (level 1trauma center). Stayed there for a year, then moved to CV ICU.
I applied to crna schools when I just had one year of experience. I got accepted, & will start this fall. So I will have two years of ICU experience in the end.
My GPA is high (like many other applicants, my class average GPA is 3.7)
Had multiple certifications
Precepted students & participated unit based committes.
Most importantly, you gotta sell yourself well during interview.
Especially, if you lack ICU experience, you need to show them you have a great potential.
1. All CRNA schools are moving to a 36 minimum program.
2. The quick route is not necessarily the best route, especially if you want to work in an independent rural practice.
3. CRNA and APNs are not physician extenders. CRNAs have never been physician extenders nor will they ever be. Physician extender and mid-level provider is insulting to many APNs/CRNAs. The only thing CRNAs extend for physicians is their paychecks.
1. All CRNA schools are moving to a 36 minimum program.
2. The quick route is not necessarily the best route, especially if you want to work in an independent rural practice.
3. CRNA and APNs are not physician extenders. CRNAs have never been physician extenders nor will they ever be. Physician extender and mid-level provider is insulting to many APNs/CRNAs. The only thing CRNAs extend for physicians is their paychecks.
1. I know this. The schools in my area are going to have 36-month programs in 2020. I actually prefer the 36-month program option, since I believe extra training in such a specialty is a very good thing.
As an aside, I think it would actually make a lot more sense to have all programs as 3-4 years in length without requiring ICU experience ahead of time. Allow students to have the BSN to get the beneficial health-related knowledge, and then use the extra year(s) beyond year 2 to teach students advanced monitoring, advanced pharmacology and pathophys, or whatever it is programs believe a student learns in the ICU during the required minimum 12 months. This is basically how all other medical training programs function.
2. I don't necessarily disagree. Nevertheless, I am still interested in the shortest distance between two points (which is a straight line); even if I cannot achieve my goal in the shortest timeframe that is theoretically possible, I would like to know what that timeframe is, and shoot for it.
Reading the forums in greater depth has shown me that there are many people who have been accepted into CRNA programs with the minimum required ICU experience. It can be done. There is even another profession that nearly identically mirrors nurse anesthesia (that I won't name for fear of nurse rage), where the students are not required to have any previous healthcare experience at all before getting trained. Students are accepted to medical schools without previous healthcare experience, and there are some PA programs that don't require it. The real training should come from the specialty program itself, not necessarily from a background in an ultimately unrelated discipline.
This is all to say I'm not personally convinced that ICU experience is a critical (pun) component to make for an effective and excellent SRNA, and, ultimately, CRNA. CRNA programs wax in great detail about the excellence of their training. If these program descriptions are to be believed, I think an intelligent and motivated student can be brought up to level in the amount of time given, and with the accepted and approved number of required clinical cases.
Unlike others on this website, I look forward to advanced and prolonged mentoring by physicians once I am in practice. I see it as tantamount to residency training/apprenticeship, and I think oversight by an anesthesiologist is a verygood thing.
Though I eventually want to practice in a rural setting, with increased independence as time goes on, I have no desire to be independent right away, and I can see how such a setup would be problematic.
3. As a healthcare administrator by trade, and public health professional by training, I use "physician extender" because it is an apt term, that is essentially globally accepted, and only in nursing circles have I ever found it to be considered inappropriate. I didn't mean it to be offensive, but, frankly, if you find it offensive you must walk around feeling offended in perpetuity, since this is the standard industry language used for PA's and NP's.
I did a 16-month absn program. if you are going to attend an absn program, you probably cannot work. The schedule will be very tight. You don't want to sacrifice your GPA over NA/clerk experience. But, if you can somehow manage both, by all means go for it! It will definitely help.
After I graduated, I could not get an ICU job right away. So I took a job at ER (level 1trauma center). Stayed there for a year, then moved to CV ICU.
I applied to crna schools when I just had one year of experience. I got accepted, & will start this fall. So I will have two years of ICU experience in the end.
My GPA is high (like many other applicants, my class average GPA is 3.7)
Had multiple certifications
Precepted students & participated unit based committes.
Most importantly, you gotta sell yourself well during interview.
Especially, if you lack ICU experience, you need to show them you have a great potential.
I really appreciate your feedback, and the details you provided. Your final two points are where I believe I stand out. Having worked in healthcare administration for a few years, and being on track to have an MPH in less than a year, I believe my application is remarkable in ways that are probably uncommon among the typical CRNA applicant pool. Please correct me if I'm wrong.
My science GPA is 3.8, and includes around 80 hours of upper-level science coursework, such as advanced chemistry, biology, and physics classes, as well as graduate coursework in biostatistics, epidemiology, healthcare management and policy, and so on. I have 150 hours of shadowing physicians and PA's. I have worked closely with NP's and RN's from my clinic management days, and I have lots of close connections in my local medical community. I have worked in disaster relief, program management, clinical research, and humanitarian efforts. I have the nurse aide certification and BLS.
I have definitely hit a wall as I've read and learned more about CRNA. I do feel some inertia with going back to get another bachelors degree (100% out of pocket expense), and taking an entry-level job as an RN--knowing it is a distinct possibility that I won't be able to land an ICU job as a new grad--just so I can meet the minimum requirements for the programs. It feels like taking several steps back to take one step forward.
Anesthesiology assistant programs are tempting, though they have such a limited number of states where they can practice, and, by and large, seem to represent a dying profession. Since CRNA's are the nationally recognized and accepted anesthetists among health systems and with physician groups, as well as having a much better public relations department, I don't really see AA as a solid longterm bet.
Right now, I'm waiting to hear back from the handful of direct-entry MSN programs for non-nurses that have linkages with CRNA programs (such as UPenn, Columbia, etc.). These seem to be the best suited for someone, such as myself, looking for the most direct path.
Thanks again for your thoughtful post. I appreciate it.
1. I know this. The schools in my area are going to have 36-month programs in 2020. I actually prefer the 36-month program option, since I believe extra training in such a specialty is a very good thing.
As an aside, I think it would actually make a lot more sense to have all programs as 3-4 years in length without requiring ICU experience ahead of time. Allow students to have the BSN to get the beneficial health-related knowledge, and then use the extra year(s) beyond year 2 to teach students advanced monitoring, advanced pharmacology and pathophys, or whatever it is programs believe a student learns in the ICU during the required minimum 12 months. This is basically how all other medical training programs function.
2. I don't necessarily disagree. Nevertheless, I am still interested in the shortest distance between two points (which is a straight line); even if I cannot achieve my goal in the shortest timeframe that is theoretically possible, I would like to know what that timeframe is, and shoot for it.
Reading the forums in greater depth has shown me that there are many people who have been accepted into CRNA programs with the minimum required ICU experience. It can be done. There is even another profession that nearly identically mirrors nurse anesthesia (that I won't name for fear of nurse rage), where the students are not required to have any previous healthcare experience at all before getting trained. Students are accepted to medical schools without previous healthcare experience, and there are some PA programs that don't require it. The real training should come from the specialty program itself, not necessarily from a background in an ultimately unrelated discipline.
This is all to say I'm not personally convinced that ICU experience is a critical (pun) component to make for an effective and excellent SRNA, and, ultimately, CRNA. CRNA programs wax in great detail about the excellence of their training. If these program descriptions are to be believed, I think an intelligent and motivated student can be brought up to level in the amount of time given, and with the accepted and approved number of required clinical cases.
Unlike others on this website, I look forward to advanced and prolonged mentoring by physicians once I am in practice. I see it as tantamount to residency training/apprenticeship, and I think oversight by an anesthesiologist is a verygood thing.
Though I eventually want to practice in a rural setting, with increased independence as time goes on, I have no desire to be independent right away, and I can see how such a setup would be problematic.
3. As a healthcare administrator by trade, and public health professional by training, I use "physician extender" because it is an apt term, that is essentially globally accepted, and only in nursing circles have I ever found it to be considered inappropriate. I didn't mean it to be offensive, but, frankly, if you find it offensive you must walk around feeling offended in perpetuity, since this is the standard industry language used for PA's and NP's.
Thanks for your post!
I don't think you know that much about CRNAs at all. It shows in your posts.
1. Critical care experience is considered paramount to offering a basic background in taking care of patients in nurse anesthesia. It is why the CRNA profession has went from requiring no nursing experience, to at least a year of nursing experience, to one year of acute care experience, and to finally one year of critical care experience. It is still being debated whether the critical care nursing experience should be increased to 2 or more years.
2. Anesthesiologists for the most part could care less about CRNAs as a whole. CRNAs increase their salary, and allow them to stay out of the OR. That is all MDAs really care about. MDAs want to be in charge, and do all the "fun/technical" procedures while someone else actually takes care of the patient while they get paid to sign charts. Most MDAs want CRNAs there to work and could care less about mentoring. You can actually see multiple posts by MDAs on other websites where MDAs refuse to teach CRNAs anything and actively oppose training of CRNAs in regional and other types of speciality anesthesia.
3. I am in the USAF and the accepted term for all APNs, PAs, physicians, and all other persons able to directly provide care without being under direct supervision/orders is provider.
4. CRNAs have been around for 150 years. We were a professional organization/AANA decades prior to the ASA. CRNAs have always had independent practice, and therefore we are not physician extenders anymore than an MDA is a physician extender. I know that term is common in billing circles and for people that work around billing and administration.
5. Anesthesiologists Assistants are not the same as CRNAs and there are only a few states where AAs can work, if you want the quickest route by all means go that route. AAs are actively opposed by CRNAs groups in every state. When and if TEFRA requirements change then AAs will be even less of viable option than they are now. A CRNA doesn't need an MDA to practice, but without an MDA present AAs cannot practice. AAs do not practice in the military since the military does not have or endorse ACT practices. IMHO AAs are nothing more than a political tool thought up by the ASA to try to control CRNA practice. AAs are completely controlled by the ASA and will never achieve any semblance of independence.
As an aside, I think it would actually make a lot more sense to have all programs as 3-4 years in length without requiring ICU experience ahead of time. Allow students to have the BSN to get the beneficial health-related knowledge, and then use the extra year(s) beyond year 2 to teach students advanced monitoring, advanced pharmacology and pathophys, or whatever it is programs believe a student learns in the ICU during the required minimum 12 months. This is basically how all other medical training programs function.
Based on this, I'd reevaluate your understanding of how this works. Go to nursing school and get a nursing job and see what its like to be a nurse and to work in direct patient care before you decide that those experiences are less valuable than class time. CRNAs work in a highly variable and complex patient care situations and the expectation is that they are able to demonstrate some level of competence in these skills upon passage of the boards. They learn the "C" and the "A" in anesthesia school, and the "RN" part from being an RN.
Yes, the medical education model operates differently. But M.D.s do not graduate from school and immediately begin doing surgery, writing chemo orders, performing invasive procedures or caring for patients at a critical level immediately out of school. It takes them YEARS of residency and fellowship to practice competently, confidently and independently. If nurse anesthesia operated on the same model... it would be a 10+ year endeavor, again, having you leave your family in the trenches.
You can certainly get a job in the ICU straight out of nursing school, I know a lot of people that did, some of them DEFINITELY are not qualified but , a lot of it had to do with timing...who got their applications in when there were openings, who held out of a job in an icu, who was willing to travel further to work in one, etc etc.
Best fast track advice? Start now: enter nursing school now, get the ICU job, get the few years of experience and apply to CRNA school. I know that doesn't sound any faster or more direct... but as programs increase requirements for experience and length of training, the longer you wait to enter the system, the more protracted your educational experience will be.
I don't think you know that much about CRNAs at all. It shows in your posts.
1. Critical care experience is considered paramount to offering a basic background in taking care of patients in nurse anesthesia. It is why the CRNA profession has went from requiring no nursing experience, to at least a year of nursing experience, to one year of acute care experience, and to finally one year of critical care experience. It is still being debated whether the critical care nursing experience should be increased to 2 or more years.
2. Anesthesiologists for the most part could care less about CRNAs as a whole. CRNAs increase their salary, and allow them to stay out of the OR. That is all MDAs really care about. MDAs want to be in charge, and do all the "fun/technical" procedures while someone else actually takes care of the patient while they get paid to sign charts. Most MDAs want CRNAs there to work and could care less about mentoring. You can actually see multiple posts by MDAs on other websites where MDAs refuse to teach CRNAs anything and actively oppose training of CRNAs in regional and other types of speciality anesthesia.
3. I am in the USAF and the accepted term for all APNs, PAs, physicians, and all other persons able to directly provide care without being under direct supervision/orders is provider.
4. CRNAs have been around for 150 years. We were a professional organization/AANA decades prior to the ASA. CRNAs have always had independent practice, and therefore we are not physician extenders anymore than an MDA is a physician extender. I know that term is common in billing circles and for people that work around billing and administration.
5. Anesthesiologists Assistants are not the same as CRNAs and there are only a few states where AAs can work, if you want the quickest route by all means go that route. AAs are actively opposed by CRNAs groups in every state. When and if TEFRA requirements change then AAs will be even less of viable option than they are now. A CRNA doesn't need an MDA to practice, but without an MDA present AAs cannot practice. AAs do not practice in the military since the military does not have or endorse ACT practices. IMHO AAs are nothing more than a political tool thought up by the ASA to try to control CRNA practice. AAs are completely controlled by the ASA and will never achieve any semblance of independence.
*Edited*
Cool story, bro.
I have been encouraged by the feedback from those who have made the fast-track work for them. It gives me hope that it can be done, and I'm eager to hear back from the programs I have contacted. I will look in more-depth at AA's, and will begin completing my application to PA programs this week. Thanks for all the help, everyone!
Based on this, I'd reevaluate your understanding of how this works. Go to nursing school and get a nursing job and see what its like to be a nurse and to work in direct patient care before you decide that those experiences are less valuable than class time. CRNAs work in a highly variable and complex patient care situations and the expectation is that they are able to demonstrate some level of competence in these skills upon passage of the boards. They learn the "C" and the "A" in anesthesia school, and the "RN" part from being an RN.
Yes, the medical education model operates differently. But M.D.s do not graduate from school and immediately begin doing surgery, writing chemo orders, performing invasive procedures or caring for patients at a critical level immediately out of school. It takes them YEARS of residency and fellowship to practice competently, confidently and independently. If nurse anesthesia operated on the same model... it would be a 10+ year endeavor, again, having you leave your family in the trenches.
You can certainly get a job in the ICU straight out of nursing school, I know a lot of people that did, some of them DEFINITELY are not qualified but , a lot of it had to do with timing...who got their applications in when there were openings, who held out of a job in an icu, who was willing to travel further to work in one, etc etc.
Fantastic post! Thank you so much. I think your point about getting the "RN" in CRNA by working as a nurse is right on, and makes a lot of sense. I can see how just being in the hospital in a setting of high acuity and having to manage bedside care of patients on the brink would be invaluable. Thanks for making that clear.
Best fast track advice? Start now: enter nursing school now get the ICU job, get the few years of experience and apply to CRNA school. I know that doesn't sound any faster or more direct... but as programs increase requirements for experience and length of training, the longer you wait to enter the system, the more protracted your educational experience will be.[/quote']
This is sobering advice, and I do appreciate the directness of it. The more I read and learn, the more I think what you say here is absolutely correct. I have emails and voicemails out to programs now. I'll see what I hear back and make some decisions.
Good Luck! You can do it... just temper your expectations of how you think everything should and does work because in Nursing.... everything you "know" before you start... always ends up being wrong LOL
*to clarify my snark*
I'm a new grad new nurse working in heme-onc. I wanted to do all of the following when I was in nursing school:
Be a CRNA
Bail on nursing and go to PA school after I graduated
Be an NP
Be an Ortho nurse
NOT work in oncology
Work in the CTICU
Be a clinician
Be an OR nurse
and here I am doing the only "not" on my list. Everything changes... all the time. You'll land somewhere and your nursing career can be very rewarding and take you places you didn't expect... even if the road there took forever and didn't make any damned sense.
"Unlike others on this website, I look forward to advanced and prolonged mentoring by physicians once I am in practice. I see it as tantamount to residency training/apprenticeship, and I think oversight by an anesthesiologist is a very good thing.
You've gotta be kidding me. Become an AA, MDA, PA or whatever but we don't need anymore slave minded CRNAs in this field. Based on your statement, you have no clue what an adequately trained CRNAs skills are like. The best CRNAs don't "need" an ollie and I wouldn't let a lot of ollies that I've worked with even do a MAC anesthetic on me.
You've gotta be kidding me. Become an AA, MDA, PA or whatever but we don't need anymore slave minded CRNAs in this field. Based on your statement, you have no clue what an adequately trained CRNAs skills are like. The best CRNAs don't "need" an ollie and I wouldn't let a lot of ollies that I've worked with even do a MAC anesthetic on me.
How much time have you spent shadowing CRNAs at different types of anesthesia practices? You stated you wanted to eventually work in a rural anesthesia practice, which usually means solo, CRNA only, or independent mixed anesthesia practice. Have you spent anytime shadowing CRNAs in any of those type of practices?
The anesthesia community is full of politics. It invades every anesthesia practice across the country. You can have great working relationships with MDAs, but you will never understand frustration until every MDA you work with is and will be your supervisor dictating your practice from case to case in ACT practice. You can invariably have 2 or more MDAs telling you how to run your anesthesia everyday. I doubt you have ever seen or been involved in something like that since I don't know of any other job that can and does change the rules of how to do things sometimes several times a day in an ACT practice.
glassprn
39 Posts
Here's my story.
I did a 16-month absn program. if you are going to attend an absn program, you probably cannot work. The schedule will be very tight. You don't want to sacrifice your GPA over NA/clerk experience. But, if you can somehow manage both, by all means go for it! It will definitely help.
After I graduated, I could not get an ICU job right away. So I took a job at ER (level 1trauma center). Stayed there for a year, then moved to CV ICU.
I applied to crna schools when I just had one year of experience. I got accepted, & will start this fall. So I will have two years of ICU experience in the end.
My GPA is high (like many other applicants, my class average GPA is 3.7)
Had multiple certifications
Precepted students & participated unit based committes.
Most importantly, you gotta sell yourself well during interview.
Especially, if you lack ICU experience, you need to show them you have a great potential.