Experienced CRNA...ask me anything

Specialties CRNA

Updated:   Published

Okay...If you've read my posts you know that I will be retiring soon.

Now is your chance to ask a practicing CRNA anything.

12 years of experience from solo rural independent to medical-direction urban ACT. Former Chief and Clinical Coordinator of SRNAs.

I will not reveal my identity, specific locations, employers, or programs.

Anything else...ask away.

ICUman said:
I'm curious if MDA's have pushback and high resistance to this happening, as it seems it may make their (MDA's) job prospects more difficult to obtain/retain. Of course I am in favor of CRNA's 100% and am happy about this trend, but I imagine there is some difficulty involved incorporating/replacing those jobs with nurse anesthesia providers.

Seems like nothing but great prospects ahead for CRNA's.

There is a teachable moment here for aspiring and newly-practicing CRNAs. When you work for a physician-owned practice, which is a business model rapidly being replaced by anesthesia management companies and hospital-employed anesthesia provider models, anesthetists are the commodities that generate billable hours - yet they are viewed as economic liabilities. Do you understand what that means? That means every dollar your physician owner pays you is a DOLLAR OUT OF HIS POCKET (certainly if the group participates in profit-sharing). Now imagine the tension that creates in the group.

Think about it.

1 Votes
loveanesthesia said:
Yes there is a lot of pushback from the ASA. It's why they are aggressively supporting AAs. Quality with AAs is not good and they know it, so they will not be replaced with AAs.

I must respectfully disagree. I am currently working alongside AAs and students from two AA programs in a large teaching facility. CRNAs and AAs function interchangeably in this facility.

There are some CRNAs here that terrify me, and there are AAs here whose knowledge base and skillset make me look like a neophyte.

Generalities are....generally...useless.

2 Votes
MHARNP said:
Just entering school this coming May. The thought of traveling down the road (way, way down the road) sounds interesting. My husband works from home, so he would be able to travel with me. Could you elaborate a little more about what you're enjoying about the change? Any suggestions on what to look for or what to avoid?

Congratulations on your acceptance!

Re: change. Well. Frankly? I despised being treated like a halfwit on a daily basis when I was a staff CRNA in an ACT. So, leaving that behind was nice.

I have had my own sole-proprietorship for years, so I simply returned to independent contractor work. As an experienced CRNA with a varied, high-acuity background and management experience, I am valuable. I am firm but fair - and completely unemotional when it comes to business negotiations because the product I am selling is myself. I command a very high hourly rate and a fully-paid housing/living/travel package. How clients choose to implement some/all of the services I can provide is their choice - provided they are willing to pay.

I am making phenomenal money, but the freedom to make my own career choices has been the better payoff.

Sorry. You will have to clarify the question re: look for/avoid. As it pertains to....??

1 Votes
RATMLPN said:
I'm just beginning my studies pretty much, I'm an LPN now on the way to my RN. Is there any advice that you would give a nurse at the beginning of her career to keep in my mind during my studies? Useful electives, courses to really focus on, etc? I've been interested in this since I became an LPN.

Thank you!

One step at a time! Good luck!

1 Votes
offlabel said:

If you simply value procedures and paychecks, locums travelling may be for you. You are the anonymous hired gun technician that shows up and does the work, gets paid and leaves. No one knows you, knows what you are actually capable of or knows if you are dependable when things go sideways. Surgeons could not care less about anything other than the last case you did. That's OK.

Offlabel! Have a care, please. Not all locums providers are carrion-picking money-grubbers. I am well-liked, well-regarded, and well-compensated for good reason.

1 Votes
canookies said:
I've read the entire thread from beginning to current. It has been very eye opening. I am beginning the SRNA journey at the same age that you started. I have all of my life in order so that the only thing I nee to focus is on school. I am also disillusioned with the corporate model of healthcare, but this is the game we have to play now. I appreciate all your honest description and advice regarding this career that many don't see from the inside. Wish you all the best

Kind of you to post. Thank you.

Keep that skepticism of the corporate model of healthcare, but also keep in mind that the vast majority of our patients haven't the slightest idea how our billion-dollar industry works. They often choose their surgeon....but they almost never choose their anesthetist.

I wish you all the best in your endeavor!

1 Votes
ck32 said:
I apologize if this was already addressed. In your opinion, how long do you think a CRNA can safely practice? I understand this is dependent upon several factors and is very individualized. But, for someone whom maintains their physical and mental health, what is a realistic age someone can expect to be able to perform this type of work? I am completing my FNP now but am asking on behalf of my husband? At what age is "too old" to transition into this specialty? Again, I understand that it is all relevant...just asking for your opinion, based upon your experience. Thank you:-)

Decades and decades. I know many anesthetists who are still practicing well into their 60s, though very few of those are working full-time, and none of them are taking call. I cannot think of any who are beyond 70. Anesthesia is a physical job in many ways. Patients are large. Pushing beds is physically taxing. Moving sedated/anesthetized patients is taxing. It is hard work. I am a petite, fit woman and I am physically tired more days than not.

I know several anesthetists who began training in their 40s. I don't know how many of those are still working and/or felt that it was worth the trade-offs at that late stage in their careers.

1 Votes
Specializes in CRNA.
06crna said:
I must respectfully disagree. I am currently working alongside AAs and students from two AA programs in a large teaching facility. CRNAs and AAs function interchangeably in this facility.

There are some CRNAs here that terrify me, and there are AAs here whose knowledge base and skillset make me look like a neophyte.

Generalities are....generally...useless.

In another post you speak about being treated like a halfwit in an ACT. In that setting AAs function the same as the CRNAs. It's a fact that a CRNA can replace a MD, and an AA never can.

1 Votes

How common is it for CRNA's in the hospital setting to be directly employed as a hospital employee, vs. working for a separate anesthesia company that contracts to provide services in the hospital?

1 Votes
06crna said:
Offlabel! Have a care, please. Not all locums providers are carrion-picking money-grubbers. I am well-liked, well-regarded, and well-compensated for good reason.

Those pejoratives are all yours...not a single one is mine and never implied any either. Locums are paid what they are because they endure the hardships of travel and fill a serious need.

I don't doubt that it is possible to have a good reputation as a traveler. There is no way, though, that you can have the kind of relationship with staff and surgeons in months long stints here and there that you can staying put for a long time. That isn't a bad thing. It's just a thing.

1 Votes
loveanesthesia said:
In another post you speak about being treated like a halfwit in an ACT. In that setting AAs function the same as the CRNAs. It's a fact that a CRNA can replace a MD, and an AA never can.

To be clear: the halfwit ACT practice was CRNA/anesthesiologist medical-direction model employed by a large corporate anesthesia management company.

Your two statements are unrelated. What is the salient point? Medical direction is not equivalent to competency.

I am unapologetically supportive of the AA role. We all have our place. I urge you to be one of the open-minded, thoughtful practitioners who recognizes that we will go much farther if we respect one another's choices and work collaboratively.

If you wish to practice independently, then by all means do so! Just don't diminish another's role in the process. It's unnecessary and unkind - and ultimately a reflection of you. Not them.

I work with AAs. Every day. Do you?

1 Votes

Offlabel -

Correct. My interpretation. Not your words.

That said...

This statement of yours is a bit harsh, don't you think? "If you simply value procedures and paychecks"

Otherwise. Agreed.

I concede.

As you say. Carry on.

1 Votes
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