Direct entry CRNA programs

[love-d-OR]

Just out of curiousity, do you see a future for direct entry CRNA programs? I have heard and know of direct entry NP programs and was wondering to my self if the CRNA programs are close to getting there. Some of those graduates have argued that being an RN first does not determine how well they practice as an NP, can that be said of CRNA practice?

~I am not for or against DE programs though I tend to think that advanced practice nursing degrees are for RN's to gain advanced nursing positions. On the other hand I have heard APN's say that being an NP or CRNA is nothing like being an RN, so is the RN experience necessary before the APN??

[DMSRN]

Georgetown offered a direct-entry program for CRNAs in the past, although I'm not sure if they are still doing it. Of course no direct entry program can be the same as those offered to NP's because of the 1 year ICU experience requirement, unique to CRNA certification. Acceptance to the DE program at Georgetown allowed you guaranteed admission to the CRNA program after completion of the nursing cirriculum and the ICU requirement. Additionally, since the applicant already had their bachelor's in another field, they weren't required to complete the full "BSN" if they didn't want to (I think it was only an extra course or two) and they didn't have to take the GRE. I know Georgetown was very selective with who they accepted into the program - the applicant had to be demonstrate a very strong science background and genuine interest in becoming a CRNA. To date, I only know of 2 such people who were admitted under this program, and I know one never went on to anesthesia school. The other was one of my best friend's in my class. She was orginally a Chemistry major at UNC Chapel Hill, who ended up working for 2 years before starting the NA program.

I'm not saying I'm necessarily a proponent of the idea, and not so much because of the lack of ICU experience, but I just don't think anyone can possibly know what kind of advanced degree program is best for them, without having any exposure to nursing. Even when I started in the ICU as a new grad I had no idea what type of Master's degree I wanted to pursue. I initially chose the ICU because of my experiences as a nursing extern and my desire to work with critically ill patients. After exploring all the different APN options, I realized nurse anesthesia was the best match for me, and fortunately, I already had the ICU experience I needed. However that was not a decision I could have made back when I applied to nursing school.

[love-d-OR]

Thanks for your replies guys. The topic had me thinking as I had a roommate who was in a DE program and once she graduated,she did not feel confident working as an NP, so she got an RN job. Well I was talking to one of the nurses at my job and I had told her about my ex-roomie. Well she was appalled that anyone would hire a DE student to work as an NP's, because as she claimed if they could not recognise the signs of an MI, how could they treat it (if they have not worked as a RN how can they work as an advanced RN). She felt that only the best should go to get their masters (if they would be handling ppl's lives) and they could only reach that level after at least 5 years of practice. To cut the story short she went on to say that she sees a day when CRNA schools will have a DE program and that will be the day nursing will loose all it has worked for becasue it will have nothing to set it apart from PA and NA programs.

Oh, someone suggested I do not post this question here as I might offend some of you CRNA's, I hope I did not offend anyone.

~love-d-OR

[loveanesthesia]

I don't think CRNAs are offended by the question, but I do think that we are very committed to our educational standards. Some in nursing leadership have questioned the standards and wanted to change them so they can take more CRNA students and get more tuition dollars into their college. They point to the NP programs and state that it works just fine, new grad RNs make great students, so nurse anesthesia should do the same. That's what gets CRNAs a little hot. Well, I bet new grad RNs do make great students, do well on tests, don't ask too many questions, and graduate. But, do they make great NPs? They problems I've heard of first hand, from a NP, is that they are not socialized into an advance practice role, (they have difficulty taking charge of a situation, asserting their authority) and in general are missing patient assessment skills. Really seems to be what your roommate was saying as well. As for DE nurse anesthesia programs, the accreditation standards would need to be changed, and why would CRNAs do that?

[JoeAnaesthesia]

Actually, it's all based on supply and demand. I just spoke with the dean of nursing in a huge med/nursiing university here. She told me that they've got 18 open seats every year in the CRNA program and that they get around 200 RN applicants every year for those 18 open seats. They want 5-10-15 years of rather elite experience in say a burn ICU, cardio ICU, etc.....THE ONLY REASON THEY CAN GET AWAY WIITH THESE OVERKILL REQS IS SIMPLY SUPPLY AND DEMAND - 200 APPLICANTS AND ONLY 18 SEATS. And that's at a large med/nursing university in the New York area with lots of resources and lots of demand. It has nothing to do with medical competence or expertise. It's all market supply and demand and the fact that they can get away with it because so many are knockng on their door.

[loveanesthesia]

The reason there are limited seats is because of access to clinical experience in almost every program. It takes a lot of clinical experience to become a safe CRNA, and the SRNAs need to get a wide variety of experience. MD residency programs also need the clinical experience, so that limits the number of SRNAs that can be admitted to programs. Other factors such as outpatient surgery centers, and for profit heart and orthopedic hospitals that have moved a large percentage of cases out of the community hospitals plays a role.That particular program may have chosen to get down to the 18 by ranking on years of ICU experience. Most SRNAs apply to more than one program so it's a little difficult to know how many applicants there are for each seat. The number of seats nation wide is at an all time high, at close to 2000. Programs are doing everything they can to admit and graduate more well educated CRNAs, and have doubled the number in the past 12 years.

[stanman1968]

The requirment may be a bit stiff but the reason requirments are so high are

1. the high degree of clinical knowldge and skill REQUIRED to be a CRNA.

2. supply and demand

try another school, if you want the major change that will occur with becoming a CRNA gotta make a big change.

[nurseman78, BSN, RN, NP]

University of Pittsburgh offers a direct entry program that will allow you to complete both the BSN and then the MSN, and you can choose NP, CRNA, CNP, etc.

[elkpark]

University of Pittsburgh offers a direct entry program that will allow you to complete both the BSN and then the MSN, and you can choose NP, CRNA, CNP, etc.

I looked at this link, and I didn't see anything about a "direct entry" MSN program for non-nurses. I only saw an "early admissions" program for licensed RNs to complete a BSN with the MSN program, and the anesthesia major specifies that you have to have at least 1 year of critical care experience to be eligible -- so, the same requirements as everyone else (as required for accreditation).

[nurseman78, BSN, RN, NP]

Ah, good that you noticed that. I figured it was too good to be true. I had known that it was for RN's, but I didn't know it still required ICU experience. Oh well, just do it the hard way, I guess. :)

[elkpark]

Ah, good that you noticed that. I figured it was too good to be true. I had known that it was for RN's, but I didn't know it still required ICU experience. Oh well, just do it the hard way, I guess. :)

The minimum required ICU experience is a requirement established by the organization that accredits CRNA programs -- every program is required to abide by it, and there's no way around it. Also, because CRNA programs are so competitive these days, the bare minimum of experience does not make one a particularly appealing or competitive candidate in most programs.

[1287PennEMT]

Here, the CRNA program will allow BSN students to "sub-matriculate" to MSN programs. Many of them accept directly in but here's my understanding basically of how it works. You can take a few non-clinical courses as an undergrad. You are provided a "preliminary" acceptance if accepted to the submatriculation program. They will use connections to try to help you get an ICU job (like making your last clinical in an ICU, maybe trying to help get a job?) and then you come back after your year's experience. They STILL can, however, determine that you have not learned enough in your year and send you back. The preliminary acceptance is good basically over 5 years.

BTW I believe out of ...150ish? BSN students, they accept I think 2 or 3?

[nurseman78, BSN, RN, NP]

In other words, give it a shot, but don't put all your eggs in that basket.