Best "fast-track" advice for an older career changer.

[guest897350]

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).

Thanks in advance for your input and advice!

[kreizyidiot]

Hmm... Interesting thread...

Here are some basic comments:

1. There's no fast track... and I think what the OP meant was... Is there a way to do well in life....have a good career...and not go to medical school.... Well, CRNA requires a lot of time and commitment.... I suggestion getting into a nursing school first. VERY FIRST STEP is getting into a nursing school. Second step is SURVIVING the nursing program. Third step is GETTING A GOOD ICU JOB.

You will realized that in today's world... ICU jobs are like Hunger Games.... It's definitely possible to get one... but there are tons of people wanting to work in them.

2. CRNA's are independent practitioners... Sure we will work collaboratively with MDAs...surgeons...physicians..etc... But we are trained to be independent practitioners.... I don't know any SRNA or CRNA who will want "advanced and prolonged mentoring by physicians..." Sure we can share knowledege... but to have them on your back... I'm not sure if you have shadowed a CRNA in action...there's a lot of drama and politics involved int he work place.... .... I mean c'mon.

3. Critical care ICU experience is CRUCIAL... I mean it's NOT AN OPTIONAL thing... It's required. Beside nursing is different with school nursing. I understand when you said to offer additional information on advance hemodynamic monitor in schools...." But book nursing is not the same as situations happening in real life..... Book nursing is perfect.....this BP drops...this HR...does this..etc... But in real world nursing..all sorts of crap goes on.... and you would need...at least a solid year if not more to really understand.

In addition, I have had tons of people telling me the performance of a SRNA and in relations to ICU experience. The more background (real world) experience you have, the better you will do in school and as a NA.

[kreizyidiot]

Oh and I want to elaborate on this:

"(13 months ABSN, 12 months ICU, 24 months accelerated CRNA)"

Yes you may get into an accelerated BSN program....But trust me...there's a lot of non productive time...and the timing of finding the right ICU job matters as well.... So from graduating from a nursing program (not to mention getting in first) to the time on getting a job... Can easily be 6 months to a year of wait.... 1 year of ICU is minimal (some places do not count your orientation and training).... And you'll get accepted and rejected by tons of places... So you cannot count on getting into a good school right after working there for a year.... (not to say it's impossible).

There are only a handful of programs that offer 24 months.... The rest are 27-30 months (MSN)...and a chuck of schools are transitioning to doctorate level... Let's say it's been 3 years (from now since you will finished your BSN).... Even more programs are transitioning over.... so 24 month programs and slowly dying off.....

[lady_stic]

You seem like a reasonable, level-headed person.

Even the most reasonable person can get pissed off by ignorance sometimes. You have absolutely NO idea what a CRNA does and that is evident by your remarks. Considering the political battles that I'm already fighting as a SRNA, your comment really got under my skin. We already have anesthesiologists denouncing us and lying to the public about our capabilities. We also have apathetic CRNAs that only want their check. The last thing we need are pre-CRNAs that are coming into the profession with FALSE beliefs that we NEED supervision. It's CRNAs like you that weaken our profession. You seem like a fairly intelligent person...shadow a CRNA before you try to comment on what you don't know. I wouldn't shadow at a teaching hospitals with residents where the CRNAs have absolutely no autonomy.

[lady_stic]

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.

AA is certainly not a dying profession. The ASA is actually very aggressively attempting to get them licensed in other states with Texas being one. If it were up to the ASA, they would replace all CRNAs with AAs. I'm sure you know why.

[guest897350]

Even the most reasonable person can get pissed off by ignorance sometimes. You have absolutely NO idea what a CRNA does and that is evident by your remarks.

How's this?

A CRNA is a registered nurse and advanced practice nurse who works in collaboration with anesthesiologists, surgeons and other physicians and medical professionals to deliver anesthesia for medical and surgical procedures.

A certified registered nurse anesthetist cares for a patient before, during and after a medical procedure or surgery by performing a patient assessment, preparing the patient for anesthesia, administering and maintaining the anesthesia to ensure proper sedation and pain management, overseeing patient recovery from anesthesia and caring for the patient's immediate post-operative needs. CRNA's work in the same environments as anesthesiologists, including hospital operating rooms, labor and delivery units, critical and intensive care floors, outpatient centers, offices of dentists, ophthalmologists, plastic surgeons and podiatrists, pain management clinics and in management. In many military and government medical facilities, including Navy ships, nurse anesthetists are the only providers of anesthesia. CRNAs work closely with patients and their families to ensure proper care and comfort and, as such, are regarded with respect by nursing and medical personnel.

You make a lot of polarizing, absolutist statements and claims. Because of this--and likely due to your anger--you put yourself in the position of saying things that are untrue, and, thus, in the position of being called out and made to look like you, in fact, are the one who doesn't know what she is talking about.

For the record, I do have some idea of what CRNA's do (and probably a better idea of what they do than you care to admit), contrary to your accusation that I have "absolutely no idea..."

It's CRNAs like you that weaken our profession.

Ummm....

I'm not a CRNA.

You seem like a fairly intelligent person...shadow a CRNA before you try to comment on what you don't know. I wouldn't shadow at a teaching hospitals with residents where the CRNAs have absolutely no autonomy.

I'm already scheduled to shadow at a critical access hospital.

[lady_stic]

How's this?

A CRNA is a registered nurse and advanced practice nurse who works in collaboration with anesthesiologists, surgeons and other physicians and medical professionals to deliver anesthesia for medical and surgical procedures.

A certified registered nurse anesthetist cares for a patient before, during and after a medical procedure or surgery by performing a patient assessment, preparing the patient for anesthesia, administering and maintaining the anesthesia to ensure proper sedation and pain management, overseeing patient recovery from anesthesia and caring for the patient's immediate post-operative needs. CRNA's work in the same environments as anesthesiologists, including hospital operating rooms, labor and delivery units, critical and intensive care floors, outpatient centers, offices of dentists, ophthalmologists, plastic surgeons and podiatrists, pain management clinics and in management. In many military and government medical facilities, including Navy ships, nurse anesthetists are the only providers of anesthesia. CRNAs work closely with patients and their families to ensure proper care and comfort and, as such, are regarded with respect by nursing and medical personnel.

You make a lot of polarizing, absolutist statements and claims. Because of this--and likely due to your anger--you put yourself in the position of saying things that are untrue, and, thus, in the position of being called out and made to look like you, in fact, are the one who doesn't know what she is talking about.

For the record, I do have some idea of what CRNA's do (and probably a better idea of what they do than you care to admit), contrary to your accusation that I have "absolutely no idea..."

Ummm....

I'm not a CRNA.

I'm already scheduled to shadow at a critical access hospital.

Rhetoric is not my priority right now especially when I'm typing a response on my iPhone in a doctor's office. "Potential CRNA", current CRNAs with your mentality, whatever...you very well get the point. What was your purpose of posting that definition? I know what a CRNA does and I've seen CRNAs practice is various settings with various levels of autonomy. I've already said my $.02. Best of luck to you.

[holycow00]

How's this?

A CRNA is a registered nurse and advanced practice nurse who works in collaboration with anesthesiologists, surgeons and other physicians and medical professionals to deliver anesthesia for medical and surgical procedures.

A certified registered nurse anesthetist cares for a patient before, during and after a medical procedure or surgery by performing a patient assessment, preparing the patient for anesthesia, administering and maintaining the anesthesia to ensure proper sedation and pain management, overseeing patient recovery from anesthesia and caring for the patient's immediate post-operative needs. CRNA's work in the same environments as anesthesiologists, including hospital operating rooms, labor and delivery units, critical and intensive care floors, outpatient centers, offices of dentists, ophthalmologists, plastic surgeons and podiatrists, pain management clinics and in management. In many military and government medical facilities, including Navy ships, nurse anesthetists are the only providers of anesthesia. CRNAs work closely with patients and their families to ensure proper care and comfort and, as such, are regarded with respect by nursing and medical personnel.

You make a lot of polarizing, absolutist statements and claims. Because of this--and likely due to your anger--you put yourself in the position of saying things that are untrue, and, thus, in the position of being called out and made to look like you, in fact, are the one who doesn't know what she is talking about.

For the record, I do have some idea of what CRNA's do (and probably a better idea of what they do than you care to admit), contrary to your accusation that I have "absolutely no idea..."

Ummm....

I'm not a CRNA.

I'm already scheduled to shadow at a critical access hospital.

You just got that paragraph from a non reputable site (I did a cut paste Google search), please visit the AANA site, or professional organization for better insight into the profession.

Another note: "works in collaboration with anesthesiologists, surgeons and other physicians.." Read up on CRNA supervision and opt-out laws.... Also read up on CRNA autonomy and independent practice...

This thread will not get you anywhere in life. Let this thread die because you are making statements about the profession without first shadowing (yeah you may be scheduled, but shadow first then post), being a SRNA, or CRNA. You are on your own on this fight with people in the profession. They may not know as much as you with regards to hospital administration or other health care outlets, but they sure know a heck more about the anesthesia community and the profession as a whole.

Metaphorically speaking: From what I am seeing in your post, it seems as though you are trying to teach surgeons about surgeries based on what you read and heard "online."

[wtbcrna, MSN, DNP, CRNA]

Certified Registered Nurse Anesthetists Fact Sheet

Nurse anesthetists have been providing anesthesia care to patients in the United States for more than 150 years.

The credential CRNA (Certified Registered Nurse Anesthetist) came into existence in 1956. CRNAs are anesthesia professionals who safely administer more than 34 million anesthetics to patients each year in the United States, according to the American Association of Nurse Anesthetists (AANA) 2013 Practice Profile Survey.

CRNAs are the primary providers of anesthesia care in rural America, enabling healthcare facilities in these medically underserved areas to offer obstetrical, surgical, pain management and trauma stabilization services. In some states, CRNAs are the sole providers in nearly 100 percent of the rural hospitals.

According to a 1999 report from the Institute of Medicine, anesthesia care is nearly 50 times safer than it was in the early 1980s. Numerous outcomes studies have demonstrated that there is no difference in the quality of care provided by CRNAs and their physician counterparts.

CRNAs provide anesthesia in collaboration with surgeons, anesthesiologists, dentists, podiatrists, and other qualified healthcare professionals. When anesthesia is administered by a nurse anesthetist, it is recognized as the practice of nursing; when administered by an anesthesiologist, it is recognized as the practice of medicine. Regardless of whether their educational background is in nursing or medicine, all anesthesia professionals give anesthesia the same way.

As advanced practice registered nurses, CRNAs practice with a high degree of autonomy and professional respect. They carry a heavy load of responsibility and are compensated accordingly.

CRNAs practice in every setting in which anesthesia is delivered: traditional hospital surgical suites and obstetrical delivery rooms; critical access hospitals; ambulatory surgical centers; the offices of dentists, podiatrists, ophthalmologists, plastic surgeons, and pain management specialists; and U.S. military, Public Health Services, and Department of Veterans Affairs healthcare facilities.

Nurse anesthetists have been the main providers of anesthesia care to U.S. military personnel on the front lines since WWI. Nurses first provided anesthesia to wounded soldiers during the Civil War.

Managed care plans recognize CRNAs for providing high-quality anesthesia care with reduced expense to patients and insurance companies. The cost-efficiency of CRNAs helps control escalating healthcare costs.

In 2001, the Centers for Medicare & Medicaid Services (CMS) changed the federal physician supervision rule for nurse anesthetists to allow state governors to opt out of this facility reimbursement requirement (which applies to hospitals and ambulatory surgical centers) by meeting three criteria: 1) consult the state boards of medicine and nursing about issues related to access to and the quality of anesthesia services in the state, 2) determine that opting out is consistent with state law, and 3) determine that opting out is in the best interests of the state's citizens. To date, 17 states have opted out of the federal supervision requirement, most recently Kentucky (April 2012). Additional states do not have supervision requirements in state law and are eligible to opt out should the governors elect to do so.

Nationally, the average 2013 malpractice premium for self-employed CRNAs was 33 percent lower than in 1988 (65 percent lower when adjusted for inflation).

Legislation passed by Congress in 1986 made nurse anesthetists the first nursing specialty to be accorded direct reimbursement rights under the Medicare program.

Nearly 48,000 of the nation's nurse anesthetists (including CRNAs and student registered nurse anesthetists) are members of the AANA (or, greater than 90 percent of all U.S. nurse anesthetists). More than 40 percent of nurse anesthetists are men, compared with less than 10 percent of nursing as a whole.

Education and experience required to become a CRNA include:

• A Bachelor of Science in Nursing (BSN) or other appropriate baccalaureate degree.
  
• A current license as a registered nurse.
  
• At least one year of experience as a registered nurse in a critical care setting.
  
• Graduation with a minimum of a master's degree from an accredited nurse anesthesia educational program. As of Nov. 1, 2014, there were 114 accredited nurse anesthesia programs in the United States utilizing more than 2,500 active clinical sites; 32 nurse anesthesia programs are approved to award doctoral degrees for entry into practice. Nurse anesthesia programs range from 24-36 months, depending upon university requirements. All programs include clinical training in university-based or large community hospitals.
  
• Pass the National Certification Examination following graduation.
  

In order to be recertified, CRNAs must obtain a minimum of 40 hours of approved continuing education every two years, document substantial anesthesia practice, maintain current state licensure, and certify that they have not developed any conditions that could adversely affect their ability to practice anesthesia.

Certified Registered Nurse Anesthetists Fact Sheet

[guest897350]

You just got that paragraph from a non reputable site (I did a cut paste Google search), please visit the AANA site, or professional organization for better insight into the profession.

Was the information incorrect though? Doesn't matter the reputation of the site according to you. Just comment on whether or not the information posted is correct.

Another note: "works in collaboration with anesthesiologists, surgeons and other physicians.." Read up on CRNA supervision and opt-out laws.... Also read up on CRNA autonomy and independent practice...

This thread will not get you anywhere in life. Let this thread die because you are making statements about the profession without first shadowing (yeah you may be scheduled, but shadow first then post), being a SRNA, or CRNA.

Lots of people do this. It's one of the utilities of this forum, I believe: to gain information, to have discussions, to learn, to get advice, etc.

This thread has actually been very helpful for me. I have no reason to stop participating in a three I started, one which has had many insightful and productive posts, because a handful of posters have taken issue with a couple comments made. Closing the thread or moving on because of this seems like a disproportionate response.

You are on your own on this fight with people in the profession. They may not know as much as you with regards to hospital administration or other health care outlets, but they sure know a heck more about the anesthesia community and the profession as a whole.

I don't have a problem standing up to people when they are acting irrationally. I agree with you that most (probably all) of the people here know more than I do re: anesthesia. That's why I'm here, after all. However, much of the disagreement has had nothing to do with the actual practice of anesthesia, and more to do with semantics.

Metaphorically speaking: From what I am seeing in your post, it seems as though you are trying to teach surgeons about surgeries based on what you read and heard "online."

Nah. I'm not trying to teach anyone about their profession. I merely responded to someone accusing me of knowing, "absolutely nothing" about the profession of nurse anesthesia. This was a false accusation, so I countered it. Moreover, I got into a kerfuffle with someone who has rather extreme views, and expressed them in an adversarial way. I've never been an NP, PA, or MD/DO, but I have been the boss of them, and someone working in my clinic acting like that particular poster would have been called into my office and given her walking papers, to hell with what she thinks she knows about her profession. She exhibited unhealthy and unprofessional behavior, and, I apologize, but I would never stand for that behavior in my clinic, so I' not great at dealing with it here.

I get it, this is not a professional setting, but, rather, an anonymous, online forum, so I should expect people to act out more here than they probably do in real life. I know people use these forums to vent a lot of times, so I can handle it better in the future perhaps.

Again, I have been given great advice here from more people than otherwise, so, ultimately, this thread has been a success.

[guest897350]

Certified Registered Nurse Anesthetists Fact Sheet

Nurse anesthetists have been providing anesthesia care to patients in the United States for more than 150 years.

The credential CRNA (Certified Registered Nurse Anesthetist) came into existence in 1956. CRNAs are anesthesia professionals who safely administer more than 34 million anesthetics to patients each year in the United States, according to the American Association of Nurse Anesthetists (AANA) 2013 Practice Profile Survey...........

Certified Registered Nurse Anesthetists Fact Sheet

Thanks for posting this--maybe now I can say I know something about the profession. And if anyone questions me, I'll just say that @wtbcrna taught me everything I know

[wtbcrna, MSN, DNP, CRNA]

Anesthesiologists, Surgeons, and CRNAs all collaborate with each other that does not imply that one supervises or directs the other.

[guest897350]

Anesthesiologists, Surgeons, and CRNAs all collaborate with each other that does not imply that one supervises or directs the other.

I see what you're saying. Do anesthesiologists supervise or direct CRNA's ever?