Er experience

FlyingED · Dec 11, 2003

Good Question.

I am in the same boat you are in. I have 6 yrs of ED experience. This year is my first round of applications and I have already had one interview.

OK, here is my view of ED experience. The AANA requires critical care experience, but I have not found there definition of "critical care". So what I did was went to the AANA web page and their programs page and started calling. I probably talked to 10 different program directors and gave them my experience and asked if I met there minimum requirements, as far as critical care experience. Of those ten programs, three said yes and encouraged me to request an application.

The odds are that you will find a program that likes your experience and will look at your application. Doesn't mean you or I will get in, but at leat they will look at us.

cory

TraumaNurse · Dec 11, 2003

As with ICU, not all ERs are created equally. There are only a few programs that will accept ER for CRNA school and for those that do, they usually want to see that the ER is in a large level 1 trauma center and teaching hospital. In that setting, you will see sicker, more critically ill pts. If you are willing to relocate, there are several programs that may accept your ER experience, otherwise, if you are serious about becoming a CRNA, you may have to transfer to ICU.

FlyingED · Dec 11, 2003

I work at two level 2 trauma centers, for what is worth. They still took my applications, but busy is better, high acuity is better, basically the sicker the better.

athomas91 · Dec 11, 2003

i have 5 years ed experience - applied to one school (listed in the top programs u.s news and world report) - have pretty good stats

and got in.....

i did agree to work in the cvicu for 1 year prior to starting my program - they wanted me to be able to concentrate on anesthesia and not how to hook up the swan ganz cath.... and it did benefit me - i was however accepted w/o this experience -there was just a 1.5 yr wait to get in -

when they asked me why i felt the ed was enough i simply told them - we see it all - we never know what is going to hit, yet we have to be prepared and calm - i also told them that working on the front lines gives us better insight into new meds that pts are being rx - as well i relayed my belief that you can teach most anyone anything - but you cannot teach insight,fortitude,or quick response under pressure and that no one but an er nurse knows this better.

FlyingED · Dec 11, 2003

Wonderful post. What a great answer to why ED nurses can get the job done.

SLEEPERJC · Dec 12, 2003

Ive been in the E.R. Level I Trauma for about 10 years. I hope to round out my experience in SICU before applying to CRNA school. Still finishing BSN program. You have nothing to loose by applying.

go for it.

dragonfly954 · Dec 12, 2003

Off the subject but what is the sudden appeal for CRNA by everyone?I admire anyone that can go through all that;don't get me wrong.Is it the money,status?Best of luck to you all!:)

Trauma Columnist · Dec 12, 2003

Dragonfly - I echo your sentiments. It seems this board is really populated by CRNA threads - not criticizing, just curious. I'm finishing a combined BSN/MSN program and figure this will get me a better job. Personally though have never had any interest in standing still for umpteen hours. Much prefer a lively level one trauma center.

sweetdreams · Dec 12, 2003

rmcgrog,

I agree that asking the individual program directors is the best approach. I got in with 1 yr MICU, 3.5 years ER, and .5 PACU;

good luck

athomas,

"we never know what is going to hit, yet we have to be prepared and calm - i also told them that working on the front lines gives us better insight into new meds that pts are being rx - as well i relayed my belief that you can teach most anyone anything - but you cannot teach insight,fortitude,or quick response under pressure and that no one but an er nurse knows this better."

AMEN!

kmchugh · Dec 12, 2003

Perhaps you all will allow a different perspective on the question. This comes up often, and ED nurses feel slighted that most programs will not accept their experiences as valid "intensive care" experiences. Before I even start, let me tell you my experience. Prior to becoming a CRNA, I worked primarily in an SICU, but also worked PRN in the ED of the same hospital. This hospital was a level I trauma center, and no question, our ED saw it all. I also worked PRN in a free standing surgical center in the pre-op and PACU areas. In 1999, I applied to and was accepted for Newman University's first CRNA class. I've been a CRNA for a little over two years now, and there is good reason for the ICU requirement.

Working in the ICU gives you day to day experience with vasoactive drips, central and arterial lines, as well as Swan Ganz catheters. You see patients in the immediate postoperative period, while many of the drugs we give in anesthesia are still having effect on the patients. Yes, I know you see many of these things in the ED, but there is a subtle difference. In the ED, you are present for the placement of these lines, and you start these drips. In the ICU, you are not only present at the start of these therapies, but you are there for the long haul. You see the waveforms, and how they change with different therapies or physiologic changes. You not only initiate the drips, you must titrate these drips. You see the long term effects these drips can have. In short, you get more than the snapshot afforded by ED experience. And an ED nurse never sees open heart patients in the immediate post operative period. And yes, the cardiac experience afforded by these patients is invaluable in your education as a CRNA.

Rather than complain about why most programs don't accept ED experience, my suggestion is that if you truly want to be a CRNA, buck up and go to the ICU. Like it or not, there is a reason most programs require that experience. And even in those that don't, when all other things are equal, most programs that accept ED experience will take an applicant with ICU experience over the applicant with only ED experience. Why hobble yourself?

Off the subject but what is the sudden appeal for CRNA by everyone?I admire anyone that can go through all that;don't get me wrong.Is it the money,status?Best of luck to you all!

Dragonfly - I echo your sentiments. It seems this board is really populated by CRNA threads - not criticizing, just curious. I'm finishing a combined BSN/MSN program and figure this will get me a better job. Personally though have never had any interest in standing still for umpteen hours. Much prefer a lively level one trauma center.

I think the answer to your questions lie in the fact that there are a lot of nurses out there who want to become CRNA's. Its very competitive, and any information you can find is helpful. There are a number of practicing CRNA's out there (as well as at least one program director I know of) who monitor this board, and try to provide some answers and tips to help those people achieve their goal. So, this board has become a bit of a magnet for CRNA hopefuls.

And TraumaRus, if you think anesthesia is about standing still for umpteen hours, then you just don't understand.

Kevin McHugh, CRNA

athomas91 · Dec 12, 2003

Kevin, I do agree - the CVICU was invaluable experience and i feel my comfort level w/ lines/drips/cvp's etc is much, much, much better!

as for the post about "everyone wanting to be a CRNA

all of a sudden????

i do not know how familiar you are with what it takes just to get into a program - but this has been my goal for years that has finally come to fruition - so there is no all of a sudden about it.....

CRNA is the absolute pinnacle of nursing - it requires the most didactic and clinical training available - there are those of us who tend to gravitate towards the most difficult goals - and I think those are the one's who eventually become CRNA's - it offers autonomy in nursing which is soooo needed and welcome - and most would be lying if they told you the money doesn't matter - it pays very well....