Complete 1 yr ICU req. in the first year of CRNA Schoo?l

Happy Halothane · Oct 26, 2008

In her opinion...if you want to learn anesthesia, go to anesthesia school. If you want to be an ICU nurse, stay in the ICU. Her recommendation was to go to anesthesia school ASAP. Don't wait for the one year requirement to apply. Apply as soon as you can. Of course you will have to work in the ICU for a year before you can attend school but that is a requirement that can be met after you apply.

Well if that's the case, don't even bother becoming an RN...and go to AA school....and be the "assistant" all your life.

Anesthesia does more than ICU experience...it requires an aptitude to learn totally new and advanced concepts. I personally feel that more than 3 years of a "high acuity" ICU should be the minimum. This is more than to get your foot in the door...its to provide a solid foundation to survive in the program.

CRNA's are expected to be every bit as competent as anesthesiologists. I don't care how smart you are...without a strong background, you can't learn in 2.5 years what someone does in 8 years (+ optional fellowship). The 2 years of RN training are meaningless without the clinical application afterwards.

When you, or a family member need surgery, would you rather a med-surg nurse...or an ICU nurse stay by your side? Medical surgical nursing provides excellent time management skills, but doesn't prepare you for 1-1 training.

Don't lower the bar of standard. It would disparage the profession and compromise the quality of anesthesia care that is currently being applied.

loveanesthesia · Oct 27, 2008

In her opinion...if you want to learn anesthesia, go to anesthesia school. If you want to be an ICU nurse, stay in the ICU. Her recommendation was to go to anesthesia school ASAP. Don't wait for the one year requirement to apply. Apply as soon as you can. Of course you will have to work in the ICU for a year before you can attend school but that is a requirement that can be met after you apply.
When I asked her, I was told she only had six months of med surg nursing experience before attending anesthesia school.

In the past, many CRNAs had no nursing experience prior to attending their anesthesia program, but times have changed. In many cases, you have to give an ICU patient an anesthetic. When they roll in the OR with 7 of PEEP, a levo gtt, and a a-line, CVP that need trouble shooting, I honestly don't think I would know where to start without my ICU background. And you can't plan for these cases, they pop up in the middle of your nice day of 'healthy' patients and you have 5-10 minutes to prepare. The only thing I can think of in regards to the above comment is they are working in an outpatient center or are relying on a supervising MD. I have found my ICU experience absolutely necessary on a regular basis.

Josh L.Ac. · Oct 28, 2008

Well if that's the case, don't even bother becoming an RN...and go to AA school....and be the "assistant" all your life.

Or if you plan on working in a major metropolitan center where most midlevels practice under the ACT model, then the term assistant is just semantics and rhetoric.

CRNA's are expected to be every bit as competent as anesthesiologists. I don't care how smart you are...without a strong background, you can't learn in 2.5 years what someone does in 8 years (+ optional fellowship). The 2 years of RN training are meaningless without the clinical application afterwards.

To be honest, do you really think a couple of years of ICU plus 2.5 years of CRNA school makes the average CRNA the equivalent of an anesthesiologist?

loveanesthesia · Oct 29, 2008

CRNA's are expected to be every bit as competent as anesthesiologists.

the average CRNA the equivalent of an anesthesiologist?

These are not the same things, CRNAs must be competent and have been proven to be competent for well over 100 years. The issue of debate is whether ICU experience contributes to, or is necessary, for that compentence. In my opinion, ICU experience does contribute to the competence of CRNAs.

Happy Halothane · Oct 29, 2008

Competence and equivalence are barely tangible. With the proper training (hearts, trauma), CRNAs provide anesthesia for any form of surgery--and should be just as competent as anesthesiologists. The practice of medicine vs the practice of nursing is not equivalent.

All CRNAs are not the same, and neither are all anesthesiologists. What makes the difference in competence is the clinical training and aptitude...the point relevant to this thread.

AA's are assistants....very highly trained, but without a proven history of safety and ability. Basically a crash course in anesthesia without the required 4+ years of nursing training/experience. With the proper clinical experiences, a PA-anesthetist could become extremely strong.

The difference is, CRNAs can practice on their own (besides the issue revolving in individual states). AA's require an anesthesiologist attending. The ACT is designed for cost-effectiveness and resource availability. Your term "mid-level" is in itself rhetorical.

The point to this thread: diverse, advanced clinical experiences provide a solid foundation to learn anesthesia. Without these, you'll be very far behind a steep learning curve, and might never catch up.

MerrittSRNA · Nov 8, 2008

I have to agree with Happy Halothane. This is one of my peeves, too.

What is it with everybody's rush to get into anesthesia school with the bare minimum? I think that everyone who applies must think about what it is that they are trying to accomplish by shortcutting the rules. What exactly do you think you are going to do as a CRNA? Do you think that you are better than spending a couple of years in the ICU acquiring the must have knowledge that will only crack the surface of what you are going to learn in anesthesia school? And if your program is front-loaded, you will barely have time to keep up with the material let alone work. And when are you going to work? Nights?

Do you realize that all practitioners delivering anesthesia are held to one common standard of care? That's right, we have to know it as well as the docs! There are no more order sheets to go by, you're "writing the orders"!

I was fortunate enough to spend 10 years in the OR working side-by-side with CRNA's and MDA's. I witnessed first hand what could and DOES go wrong with an anesthetized patient. Therefore, when it was time for me to get my ICU experience, I sought out the sickest patients I could find in order to see what happens and how to treat it. AND I spent time there....I didn't rush. I gave the profession the respect it deserves! When things go wrong in the OR, your reaction must be automatic. How are you going to learn that in a textbook?

GIVE THE PROFESSION AND YOUR PATIENTS THE RESPECT THEY DESERVE!

anesthesia_insomniac · Nov 9, 2008

3 yrs experience minimum? Are you kidding me happy halothane? People who think you need tons of ICU experience is actually a pet pieve of mine. If anesthesia schools felt multiple years was needed it would be required as such. Its not like there is a lack applicants. There is obviously reasoning that the usual "1 year minimum" is the standard. I am currently attending one of the top anesthesia programs in the country with 1 year of high quality ICU experience under my belt. There are a couple of us with only a year experience and we are doing just as well as people with years and years of experience. I actually feel I had a step up on some of those people because I was still in a school mode at the start of the program. School seemed to be much more of a life altering experience the longer people have been out of it. Plus, there is only so much that is in common between ICU and Anesthesia. Once you conquer drips, hemodynamics, vents and codes the rest is redundant. I definitely feel my 1 year experience was helpful and would feel it would be extremely difficult without ICU experience, but people should pursue what they truely want to do. If iyou are able to get in with just the "minimum", then good for you. I trust the people who set the minimum, not others who judge what it SHOULD be.

just_cause, BSN, RN · Nov 9, 2008

I agree with the previous poster - if the organization felt the standards should change in order to support and promote the organization - then it is their responsibility and in there best interest to do so.

Schools are not responsible... students are not responsible for the certification standards. Schools and students have their own agendas and are keeping with all prescribed measures they have been provided.

Happy Halothane · Nov 10, 2008

I personally have never met an RN that could conquer "drips, hemodynamics, vents and codes" in 1 year's time. You'll probably have mastered anesthesia by the time you're done with school too.

ICU/Critical care provides a foundation for learning anesthesia. A diverse foundation helps put pieces together in an unfamiliar environment. If an SRNA has never recovered a fresh heart, or an unstable trauma...how are they going to be proficient at keeping them alive when you are the Intesivist? Aggresive CVICUs and Surgical ICUs consider 1 year as "new"...you don't routinely see the really unstable patients, let alone know how be proficient.

Anesthesia is critical care. Every case, you put the patient into a critical care state. ICU is as redundant as you make it. Anesthesia can be treated the same way...turn on the gas, give some ephedrine vs neo, wake them up. Repeat.

Life can be redundant too, if you want it to be.

I personally don't want someone providing anesthesia on my family if they are the "minimum" kind of person. I would also be embarrassed to admit lack of experience, let alone be someone that proselytizes it.

mammothsnw · Nov 10, 2008

Insomniac I totally agree....At this point in my anesthesia school education...I can say with confidence that the only instance where I could imagine that spending MORE than 1 year in the ICU would be of any benefit to my future career as a CRNA is if there happens to be a emergent leaky flexiseal in the OR.

Now maybe we feel this way b/c our one year was spent in a busy level 1 where we didn't have 2-3 years to figure out/master multi-tasking, frequent codes, drips, swans...we learned these fundamentals quickly or we didn't make it past orientation...and this happened frequently on my unit.

I'm not making this point to say that 1 year is sufficient for everyone...it depends on the individual and where you work..1 year may be enough, it may not be enough for everyone.

But to make statements like people should have "3 years in the ICU, or people are taking a short cut, or would you want your loved one taken care of by someone with only 1 year in the ICU"...that is just as lame as saying 1 year is enough for everyone.

That's why the AANA has made the 1 year minimum...then the schools can figure out who meets the requirement but has also shown excellence in other areas that will make them outstanding anesthesia providers.

So to answer a previous question...I'm actually in school with Insomniac...and I would choose him to give my family member anesthesia before several people in our class with 5-10 years ICU experience...:bowingpur

anesthesia_insomniac · Nov 10, 2008

You must be joking Happy Halothane...Once again, now your predicting what experience I got in "just" one year. Fresh heart transplants, Bi-vads, unpredictable aneurysm's etc...fresh CABG's and valves were the "easy" patients and noone went to the PACU they came straight to our unit. With high staff turnover, new grads get the same patients as everyone else (except pediatrics). I'm sure you'll still knock this experience but I still felt it needed to say where I came from after your "fresh heart" comment...

You seem to be making your statements mainly on quantity of ICU experience. I believe its strictly quality. A person can get years of experience in just one year depending where you work. I agree with mammoth, schools aren't just going to accept a one year experienced ICU nurse unless they had great experience. If they made a mistake by admitting me, I would expect not to be able to keep up right about now.

CRNA's are mostly that certain type A personality, and I'm not different. A student nurse anesthetist who strives for the minimum grades in school does not mean its the same person who got admitted with the minimum experience. I agree, I wouldn't want an anesthetist who wants the "minimum", but my example is in regards to their work ethic, not years of ICU experience.

mammothsnw · Nov 10, 2008

Happy Halothane....I see that your M.O. is to make broad generalizations, snide remarks, and provide the rest of us with an education regarding the necessity of being an 3rd degree blackbelt in the ICU in order to be an acceptable SRNA.. so I'll make my point and get back to studying.

If it makes you feel better I can assure you that where Insomniac and I worked prior to anesthesia school (#1 teaching hospital in the West), recovering fresh hearts and taking the sickest patients was not reserved for the experienced 3 years plus crowd...we did it...and we were good at it, and no it wasn't mastered over night...or mastered at all..why?? because learning...especially in critical care is constant....I think you're arrogant if you believe you had it mastered in 3+ years...Most intensivist MD's don't feel THEY have it mastered...my point is as long as you master the basics that have been mentioned...you have the foundation to move on and be successful in anesthesia school if you work hard at it...no shortcuts here despite what you believe. Take you beef with the 1 year requirement up with the AANA....it has obviously not resulted in unsafe CRNA practice over the long history of our great profession (BTW..your statements re 1 year not being sufficient only gives credibillity to the opponents of CRNA's being SAFE to practice independently...way to go). My advice to you is don't place so much confidence in your ICU skills..as I'm sure you've noticed by now...ICU nursing is NOT anesthesia nursing...good luck in your studies