Not sure CRNA is for me

jimgardner1 · Jul 20, 2017

I realize this is an old thread, but I am a crna and wish I would have dedicated my life to something else. Its been ok, but the politics suck and Job stability is hard to come by now a days. You may join one group and then they lose the contract and due to non compete in your contract you have to leave the hospital. Totally sucks and in 10 years I have had to leave 3 hospitals due to this, I have friends who are in the same boat and have the same complaint. I would say the number one complaint is job stability. As far as "big bucks", its not there. You work a crap ton of hours and if you do the math, you can make better money as an agency nurse or go to california and make the big nursing bucks in the union. My friend lives in sacramento, which is not a high cost of living area and makes 85 an hour as a floor nurse! Plus he's not even in the top tier in the union, he's only been there for 10 years. Right now I am in a group that can't even afford to pay my pension contribution because of mismanagement. What you need to realize is that most of the time you don't work for the hospital or surgical center you work for a "group", which is usually just some dude with minimal business management skills. Scary stuff to me. Anyways, before you jump head long into student loan debt, realize that the money dream is not here. Plus did I mention that anesthesiologists hate crna's and depending on what state your in, most of the doctors you work with will have no respect for you, on top of that RN's a lot of times have a chip on their shoulder with you and treat you like crap as well. Plus, you take a million dollars worth of liability for every case that you perform, odds are you will have a case go bad in your career and end up in court. The odds of that happening when your a nurse is not nearly as high, usually they sue the hospital. Good luck with your career choice but seriously take off the rose colored glasses before your jump in.

06crna · Jul 26, 2017

Just curious if anyone out there is not happy as a CRNA. Just curious if anyone has become a nurse practitioner, gone to medical school, or left the field of medicine entirely. What did you not like about being a CRNA? I have been a CRNA for 5 years and I am tired of the job. I would like to talk to my patients more and I am not happy sitting in one room for hours. I like to get out and about and see the light of day sometimes. Just hoping to hear if someone feels the same way and what you did about it.

I KNOW THIS IS A DATED THREAD...but I'm working with SRNAs, aspiring SRNAs, and unhappy CRNAs who ask me this question on a daily basis, so I am answering here.

I have been a CRNA for 12 years and have never been happy in this career. I am retiring from anesthesia within a year. I am geographically limited due to my spouse's career, so I plan to take a few months off completely after retirement to thoroughly consider my options. It is probable that I will leave health care entirely. I was admitted to a post-baccalaurate premedical program that guaranteed admission to medical school upon completion of the few credits I was lacking, but I decided not to attend. I realized I would dislike being a physician as much, if not more, than being a nurse, with 200k and 8 years of my life spent becoming one.

I attempted to semi-retire a couple of years ago, but part time CRNA work is difficult to find in my area, so I had to travel out of state for full-time periodic work to maintain my skills. When I was home, I worked independent per diem for a couple of hospitals & clinics where I hold privileges, but the shifts were so sporadic that I found I didn't have the same quick familiarity in the OR that I needed to practice safely (in my mind). I returned to a medically-supervised ACT setting managed by a very large AMC.

Anesthesia has changed in the time I have been practicing. You asked "what do you not like about being a CRNA?" Well, the list is long, but here goes:

Much has to do with the anesthesia care team model and anesthesia management companies. I do not like being a machine monkey, stuck in an OR for hours, with no control over the cases I do, the surgeons or anesthesiologists I work with, or when I eat/use the restroom/arrive & leave. I am just any anesthetist sitting at the head of the bed. At my current job, the only role I perform on induction is intubation - then I rarely see the anesthesiologist again. No regional, no OB, just general anesthesia or MAC all day, every day. There is no critical thinking, no "best practice" case management, just versed-fentanyl-lidocaine-propofol-paralytic. It is mind-numbing.

Surgeons are often quirky personalities, but even the ones with good attitudes are increasingly short-tempered, undercompensated, and overworked. And, in a certain subset of high-reimbursement specialities (ortho, cardiac, spine) they tend to become egomaniacal and demanding as administration praises them for the money they bring in to the facility.

ORs can be a difficult environment in which to work. It is usually cold, if not frigid. Hazardous cautery smoke, inhalational agent contamination, cords everywhere, fire risks. OR nurses and techs are often dissatisfied with their jobs (rightfully so - they are treated poorly by administration, surgeons, and peers and are not paid enough for putting up with a lot of abuse). They are also a "closed culture", so disruptive behavior from staff is not uncommon and often takes time to resolve. If it is a disruptive surgeon that brings money to the hospital, it may never be addressed. There tends to be a lot of gossip. Relationships occasionally become personal, and when issues arise, they inevitably come to work with the couple. I cannot think of a setting in which I haven't worked with MD-CRNA, CRNA-RN, MD-Surgeon pairs. It gets very awkward when infidelity occurs, I must say.

I thought the salary would be fantastic, but truthfully, I had far more freedom, fewer hours, better benefits (stock options and profit-sharing) and a higher income working in medical device sales. With more than a decade of experience, two graduate degrees, I will make 125k for 5 week days swing shift plus weekend coverage of about 12 days per year totaling 80 hours per pay period. My highest-grossing year I made just over 180k for 50 hours of work weekly plus in-house weekend call coverage Friday 1900 - Monday 0700, but I had 1099 out-of-pocket travel expenses that decreased my actual pay significantly.

Bluebolt · Jul 26, 2017

I KNOW THIS IS A DATED THREAD...but I'm working with SRNAs, aspiring SRNAs, and unhappy CRNAs who ask me this question on a daily basis, so I am answering here.
I have been a CRNA for 12 years and have never been happy in this career. I am retiring from anesthesia within a year. I am geographically limited due to my spouse's career, so I plan to take a few months off completely after retirement to thoroughly consider my options. It is probable that I will leave health care entirely. I was admitted to a post-baccalaurate premedical program that guaranteed admission to medical school upon completion of the few credits I was lacking, but I decided not to attend. I realized I would dislike being a physician as much, if not more, than being a nurse, with 200k and 8 years of my life spent becoming one.
I attempted to semi-retire a couple of years ago, but part time CRNA work is difficult to find in my area, so I had to travel out of state for full-time periodic work to maintain my skills. When I was home, I worked independent per diem for a couple of hospitals & clinics where I hold privileges, but the shifts were so sporadic that I found I didn't have the same quick familiarity in the OR that I needed to practice safely (in my mind). I returned to a medically-supervised ACT setting managed by a very large AMC.
Anesthesia has changed in the time I have been practicing. You asked "what do you not like about being a CRNA?" Well, the list is long, but here goes:
Much has to do with the anesthesia care team model and anesthesia management companies. I do not like being a machine monkey, stuck in an OR for hours, with no control over the cases I do, the surgeons or anesthesiologists I work with, or when I eat/use the restroom/arrive & leave. I am just any anesthetist sitting at the head of the bed. At my current job, the only role I perform on induction is intubation - then I rarely see the anesthesiologist again. No regional, no OB, just general anesthesia or MAC all day, every day. There is no critical thinking, no "best practice" case management, just versed-fentanyl-lidocaine-propofol-paralytic. It is mind-numbing.
Surgeons are often quirky personalities, but even the ones with good attitudes are increasingly short-tempered, undercompensated, and overworked. And, in a certain subset of high-reimbursement specialities (ortho, cardiac, spine) they tend to become egomaniacal and demanding as administration praises them for the money they bring in to the facility.
ORs can be a difficult environment in which to work. It is usually cold, if not frigid. Hazardous cautery smoke, inhalational agent contamination, cords everywhere, fire risks. OR nurses and techs are often dissatisfied with their jobs (rightfully so - they are treated poorly by administration, surgeons, and peers and are not paid enough for putting up with a lot of abuse). They are also a "closed culture", so disruptive behavior from staff is not uncommon and often takes time to resolve. If it is a disruptive surgeon that brings money to the hospital, it may never be addressed. There tends to be a lot of gossip. Relationships occasionally become personal, and when issues arise, they inevitably come to work with the couple. I cannot think of a setting in which I haven't worked with MD-CRNA, CRNA-RN, MD-Surgeon pairs. It gets very awkward when infidelity occurs, I must say.
I thought the salary would be fantastic, but truthfully, I had far more freedom, fewer hours, better benefits (stock options and profit-sharing) and a higher income working in medical device sales. With more than a decade of experience, two graduate degrees, I will make 125k for 5 week days swing shift plus weekend coverage of about 12 days per year totaling 80 hours per pay period. My highest-grossing year I made just over 180k for 50 hours of work weekly plus in-house weekend call coverage Friday 1900 - Monday 0700, but I had 1099 out-of-pocket travel expenses that decreased my actual pay significantly.

It's great that you're saying this. So often people hear only from the many CRNAs who really enjoy their careers. For the many high school and college students clamoring to get on the path to CRNA it would be great for them to hear your side of the path. I know of some physicians who say similar things about not enjoying the reality of being a physician and wanting to take a different path. I believe it's called "golden handcuffs". Most students have no idea until they're in the program that 1 out of 10 anesthesia providers end up with substance abuse problems.

I'm thankful for the new doctorate requirement because I know I can always teach at a university if I need a change of pace.

06crna · Jul 26, 2017

Bluebolt, I think you'd be surprised by the number of dissatisfied CRNAs. Private practice anesthesiologist-owned groups and hospital-employed CRNAs are rapidly being bought out by anesthesia management companies. So, not only do you have the usual stresses of anesthesia (some cases cause a phenomenal amount of stress, either because of the type of anesthetic or the patient's co-morbidities or both) but you also have the feeling that you are just a part of a money-making corporate system.

And even with a DNP, there are no guarantees that a teaching job awaits once you have had enough of clinical anesthesia. Anesthesia is a small world and very political. Jobs in education, sales, industry, and state/national level associations are almost always obtained through connections and highly competitive.

06crna · Jul 27, 2017

A couple more things to note:

Anesthesia is physical in a way I did not appreciate until I worked full-time. Night OB call, emergency intubations on the floor, moving obese patients from the preop gurney to OR table, patient positioning, working in a confined space - all takes its toll. I am fit but petite, and patients are often double or triple my body weight. There is rarely enough moving and lifting help.

The politics amongst AAs, CRNAs, and physicians are very distasteful to me. I am not a member of the AANA and have not been for several years. I have worked alongside AAs and - honestly - found their anesthesia practice to be without fault. I also found that AA-anesthesiologist interactions seemed more collegial and collaborative than CRNA-anesthesiologist interactions. I would not want to be an AA, because your practice is always restricted to working with an anesthesiologist, but I respect them. It is not my place to judge their choice.

Juanito, BSN, MSN · Jan 20, 2018

I'm a CRNA. 3 years and I hate it. Never thought about going back to the bedside, but I guess I could. I'm going to rent out my house and move. Try something different. Maybe do anesthesia on the side. It is boring now. It used to be fun. Tired of just existing behind the curtain. No other opportunities for advancement in most places. I cannot spend the rest of my life doing this. If necessary, I will go back to the bedside just to keep my sanity.

Juanito, BSN, MSN · Jan 20, 2018

That is definitely a component of my unhappiness. Much rather do endo or ambulatory surgery

Trauma Columnist · Jan 25, 2018

Several posts have been removed. Per our terms of service, we seek NOT to be divisive.

ICUCCRNPA · Mar 29, 2018

I've never met a miserable or unhappy CRNA in person

Ruby Vee, BSN · Mar 29, 2018

I've never met a miserable or unhappy CRNA in person

I have. Several, actually, although two of them weren't CRNAs when I met them. They had already come back on staff as bedside nurses.

goodgrief · Jun 9, 2018

I read a statistic the other day that said only 27% of college grads have a job related to their major beyond 5 years of graduating. It seems like 5 years out of school is the magic number where people question their decision of careers. For me a job is a means to an end. I get it, you're sick of doing the same thing everyday, sick of the strong personalities in the OR, the call and weird hours, the sick patients who don't care about their health who have poorly managed medical conditions, dealing with PACU nurses, clipboard carrying nurses who come up with ridiculous policies that make no sense, being surrounded by 4 walls without windows all day, coming in to work when it's still dark and not leaving until after the sun has set and it's dark again, etc. I get it! I know money isn't everything, but tell me what other profession you can jump right into and make the amount of money you're making as a CRNA? The jobs are few and far between. Most likely what you need is a good hobby or vacation more, something to look forward to when you're not at work. I just figure my job is a job and it's what enables me to have the lifestyle that I want. I'm saving like a mad man, investing and trying to grow my wealth and live off of passive income alone so I can get out of the medical field as soon as I'm able. Until then, I'll continue passing gas for a very well-paying job, enjoying my hobbies, outside-of-work activities, vacations and watching my wealth grow.

Oklahoma 1 · Oct 31, 2018

Good grief I agree with you, if I'm going to invest the time and effort and money to get the degree I'm going to stick it out. I think you get out of your job what you put in, and I do agree a poor work environment can create a toxic work area, but if it does explore other options using your specialized skill set. Good luck to all. Make what you can save all you can and enjoy life.