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So I am super interested in CRNA and really like the autonomy and the ability to have independence within the field . I currently work in a medical icu and my ideal patients are intubated sedated with multiple drips, crrt, bronchs, procedures etc. with a crna degree I was wondering is it possible to have the job equivalent of a Intensevist? Or the person that is the pulmonary intensevist that response to rapid responses etc.

I also have a passion for palliative care (weird combo) but I’m wondering if crna ever work in palliative clinics or pain management clinics independently ?

as much as I love what I’ve heard with crna I’m wondering if what I have in my head for a job is what crna are actually allowed to do within their scope of practice .

I have shadowed one crna and plan to shadow more in the future as well as palliative NP but I am torn on what to do! Any comments are welcomed !!

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Specializes in SRNA CEN CCRN-CMC.

I'm not a CRNA but if you want a job similar to an intensivist then I think you want to pursue acute care nurse practitioner. On a side note one of the NP's in my ICU recently got certified in palliative care and left to do that.

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Specializes in CVICU.

Also not a CRNA here. Though I have worked a lot with CRNA's in arrest situations and they are generally the primary responders for airway in a code situation. Though, their role typically ends after the airway has been established.

Also, MDA's are branching out into the pain management world more and more. I have not heard of many CRNA's working much in this scope, as at the time it is kind of a MD niche. However, as things continue to grow in this field I would imagine CRNA's supporting this role as well. I would think it would be a long time before they could practice independently in this role. (However this is just my speculation).

Having researched the CRNA role myself and working toward that goal, I also have interest in this area of practice, but would like to get settled in the current role and then receive advanced training after further years of feeling confident at that level of practice.

Cool aspirations though! You sound like some of the pain management MDA's I have talked to about this! They work a lot with palliative patients in the pain management clinics. Definitely a cool niche, and it will be interesting to see where it goes in the future!

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Specializes in ICU, Anesthesia.

I'd advise you to spend some time on AANA.com

CRNA's provide anesthesia in all kinds of environments.

Some facilities do utilize CRNA's in emergent situations for their airway/hemodynamic management skills but this is always for something acute. You wouldn't round on septic patients and adjust vents etc.

CRNA's do provide acute pain management services using regional techniques and in some states, chronic pain.

The HHS Pain Management Best Practices Inter-Agency Task Force recommends a greater use of CRNA's in pain management roles to help combat the opioid epidemic. Their final recommendation was released May 9th.

Since Pallative care is more than just pain management it would be outside the scope of practice as well.

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Specializes in CVICU.
2 hours ago, RicRock said:

I'd advise you to spend some time on AANA.com

CRNA's provide anesthesia in all kinds of environments.

Some facilities do utilize CRNA's in emergent situations for their airway/hemodynamic management skills but this is always for something acute. You wouldn't round on septic patients and adjust vents etc.

CRNA's do provide acute pain management services using regional techniques and in some states, chronic pain.

The HHS Pain Management Best Practices Inter-Agency Task Force recommends a greater use of CRNA's in pain management roles to help combat the opioid epidemic. Their final recommendation was released May 9th.

Since Pallative care is more than just pain management it would be outside the scope of practice as well.

This is awesome to hear! I have seen the advanced pain management and acute surgical pain management fellowship programs on the AANA website and I think these would be awesome programs!

https://www.aana.com/ce-education/pain-management/advanced-pain-management-fellowship-program

https://www.aana.com/ce-education/pain-management/acute-surgical-pain-management-fellowship

I also liked the resource you mentioned from the HHS Pain Management Best Practices Inter-Agency Task Force. I think you were referencing section "3.3.3. Workforce" when speaking of it (draft report attached below). I would be excited to see the nurse anesthesia profession grow in this role.

https://www.hhs.gov/ash/advisory-committees/pain/reports/2018-12-draft-report-on-updates-gaps-inconsistencies-recommendations/index.html#3.3.3-workforce

I have seen CRNA's putting in epidurals and performing axillary nerve root blocks and other things of that nature. The regional anesthesia and pain services team at my hospital seems to be comprised of MDA's and I got to talk with them about pain management services. They mentioned that pain management services is expanding, but seemed hesitant when I asked them about the CRNA's role in this setting. I am just wondering your or anyone else's opinion on this? Is there push back/tension from MDA's? How is that expanding currently? If CRNA's are functioning within these roles, is it in more rural settings or are they able to practice in more urban environments?

Not trying to stir the pot, I am just interested to see where things are going!

I hope this is not too far off the OP's post, but I thought it seemed applicable.

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Specializes in ICU, Anesthesia.

As far as who does what is facility dependent.

Some CRNAs practice independently, doing all the blocks and lines. Some are never allowed to do blocks or even push their own drugs for intubation.

As you stated, especially in university hospitals, crnas will do no regional.

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On 5/24/2019 at 9:13 PM, ptier_MNMurse said:

This is awesome to hear! I have seen the advanced pain management and acute surgical pain management fellowship programs on the AANA website and I think these would be awesome programs!

https://www.aana.com/ce-education/pain-management/advanced-pain-management-fellowship-program

https://www.aana.com/ce-education/pain-management/acute-surgical-pain-management-fellowship

I also liked the resource you mentioned from the HHS Pain Management Best Practices Inter-Agency Task Force. I think you were referencing section "3.3.3. Workforce" when speaking of it (draft report attached below). I would be excited to see the nurse anesthesia profession grow in this role.

https://www.hhs.gov/ash/advisory-committees/pain/reports/2018-12-draft-report-on-updates-gaps-inconsistencies-recommendations/index.html#3.3.3-workforce

I have seen CRNA's putting in epidurals and performing axillary nerve root blocks and other things of that nature. The regional anesthesia and pain services team at my hospital seems to be comprised of MDA's and I got to talk with them about pain management services. They mentioned that pain management services is expanding, but seemed hesitant when I asked them about the CRNA's role in this setting. I am just wondering your or anyone else's opinion on this? Is there push back/tension from MDA's? How is that expanding currently? If CRNA's are functioning within these roles, is it in more rural settings or are they able to practice in more urban environments?

Not trying to stir the pot, I am just interested to see where things are going!

I hope this is not too far off the OP's post, but I thought it seemed applicable.

Since this thread has been created, there’s been a lot of new released new articles and journals about CRNA opening their own ketamine clinics for pain management, ketamine has always been such an underused drug in my opinion, but with the opioid epidemic it will be very interesting and exciting to see where this drug falls in place with practicing CRNA

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