Likleyhood of a critical care placement is first year of Air Force service?

as1013 · Sep 26, 2013

Wtbcrna,

Do you have any more advice for new AF nurses pursuing the CRNA career field?

allnurses Guide · Sep 26, 2013

Wtbcrna,
Do you have any more advice for new AF nurses pursuing the CRNA career field?

There is not a quick route to get into AF CRNA school. As a new nurse your options are either come in as a fully qualified ICU nurse, come in as a med-surg nurse then go through the critical care fellowship, or come in the AF and work prn as a civilian ICU nurse (this is probably the hardest option to complete).

When doing your application you want to make yourself as attractive applicant as possible i.e. good grades (overall and science), good officership (you need to look like a good officer on your performance reports), you have to remain a deployable asset, competitive GRE scores, when possible do things that will set you apart (volunteer in pertinent activities to critical care i.e. teach ACLS/PALS/BLS, be an ICU preceptor), and get your CCRN.

SRNA4U, BSN, DNP, RN, CRNA · Sep 26, 2013

By the way I am an adjunct faculty at USUHS and the clinical coordinator at our base for SRNAs that rotate through for speciality training.

Congrats on your new appointment at USUHS. I am still working in the SICU at Bethesda. I'm down to about 8 shifts left there. Still maintaining a 4.0 GPA in my anesthesia program. Just got selected to interview with an anesthesia group for my clinical rotations. Have fun in your new role and please lighten up when people post their comments. Sometimes you come across as the be all and end all to everything in this forum.

SRNA4U, BSN, DNP, RN, CRNA · Sep 26, 2013

Wtbcrna,
Do you have any more advice for new AF nurses pursuing the CRNA career field?

It is a lot easier to get accepted into a civilian CRNA program than through the Air Force. I'm a Major in the Air Force and I work in critical care (4 years) and currently in a civilian anesthesia program. The Army nurses have a much easier time of getting accepted into CRNA school than Air Force nurses. Currently on our unit, we have an Army nurse who works in the PACU who is doing on-the-job training in the ICU because he was selected for CRNA school in January with the Army. The Army will often take nurses who have no critical care experience, accept them for CRNA school, and then place them in the ICU for about 40 shifts of training and then they are on their own for about a couple of months before heading to CRNA school.

The Navy is pretty hard on GRE scores but they don't have a formal ICU course for their nurses. We often get Navy nurses from the med-surg floor and they transfer to the ICU where they get 40 shifts of OJT and then they are on their own. If you want to get to CRNA much easier, the best branch would be the Army. Also, if you get into a civilian CRNA program, the Army has the Bootstrap program where you will go into the Reserves and you get paid $2100/month as a stipend. You don't have to do any drills or anything. You just go to school but you owe them 1 year for every 6 months of school.

The only thing you have to worry about military CRNA school is the politics of dealing with Phase II of the clinical portion. Clinicals are where you are humbled and if you are not liked, there are ways of getting you out the program since the grading during clinicals are either pass or fail.

If you are AF and flunk out of the clinical portion, then you will be assigned to Walter Reed to the ICU where you will stay for a 4 year tour. I've been working in the ICU here for 4 years now and we have about 3 people that didn't make it through the clinical portion and they are now working in the ICU. We have one guy who was kicked out 2 weeks prior to graduating last year. The attrition rates are higher in the military than some civilian program despite the high rankings, which most schools know that some schools do not participate in the US New and World report.

I chose the civilian sector for CRNA school because they are genuine about helping you to succeed in school without any hidden agendas. Also, the civilian population prepares you much better than the military population, who are generally healthy except for retirees and dependants. Even in the ICU, most of the patients in the military ICU are majority step-down patients. We still do 1:1 nurse to patient ratios. In the civilian ICU we get 2-3 patients and they are really sick with a great deal of drips and our patients tend to be a lot sicker than the military. I would rather train in a civilian CRNA program where I am getting exposed to ASA 3 and ASA4 cases on a regular basis. Also, some CRNA programs actually have CT training programs where CRNAs can get TEE certified and work on cardiiac teams.

The positive I would say about the military training is the tuition is free and the bonuses are nice. Hopefuilly we will have an approved budget before Oct 1. As a nurse on the outside, you have options on the best course of action to take for CRNA school. If you want the best ICU experience with really sick patients, civilian ICU is much better than the military.

allnurses Guide · Sep 27, 2013

By the way I am an adjunct faculty at USUHS and the clinical coordinator at our base for SRNAs that rotate through for speciality training.

Congrats on your new appointment at USUHS. I am still working in the SICU at Bethesda. I'm down to about 8 shifts left there. Still maintaining a 4.0 GPA in my anesthesia program. Just got selected to interview with an anesthesia group for my clinical rotations. Have fun in your new role and please lighten up when people post their comments. Sometimes you come across as the be all and end all to everything in this forum.

My posts/writing is always on the abrupt side. Warm and cuddly has never my better half, but my students seem to like me none the less.

I am confused are you doing an ICU rotation for your anesthesia program?

SRNA4U, BSN, DNP, RN, CRNA · Sep 27, 2013

I'm finishing up my last 8 shifts on active duty and then switching over to the Reserves. My anesthesia program allows students to take some of the science and core courses online. We start full-time in January and clinicals in April. I meet the Lt Col boards this year and when I finish CRNA school, I may probably return back to active duty to finish out my time since I will be close to 20 years. Currently the anesthesia group I have an interview with takes the top 10% of students in the class. We are provided free housing by the group and will train exclusively with their group of hospitals (they have about 12 facilities they cover) and then upon graduation, we are hired directly by the anesthesia group. I'm doing a Post-Masters program since I already have my MSN so I was already exempt from a majority of the core and support courses. Only need to take my anesthesia classes and then I will be done. Looking at possibly doing an EdD or PhD program afterwards so I can become a Program Director. Already have 2 job offers from Chief Anesthesiologists at facilities where I moonlight as an OR nurse.

allnurses Guide · Sep 27, 2013

It is a lot easier to get accepted into a civilian CRNA program than through the Air Force. I'm a Major in the Air Force and I work in critical care (4 years) and currently in a civilian anesthesia program. The Army nurses have a much easier time of getting accepted into CRNA school than Air Force nurses. Currently on our unit, we have an Army nurse who works in the PACU who is doing on-the-job training in the ICU because he was selected for CRNA school in January with the Army. The Army will often take nurses who have no critical care experience, accept them for CRNA school, and then place them in the ICU for about 40 shifts of training and then they are on their own for about a couple of months before heading to CRNA school.
The Navy is pretty hard on GRE scores but they don't have a formal ICU course for their nurses. We often get Navy nurses from the med-surg floor and they transfer to the ICU where they get 40 shifts of OJT and then they are on their own. If you want to get to CRNA much easier, the best branch would be the Army. Also, if you get into a civilian CRNA program, the Army has the Bootstrap program where you will go into the Reserves and you get paid $2100/month as a stipend. You don't have to do any drills or anything. You just go to school but you owe them 1 year for every 6 months of school.
The only thing you have to worry about military CRNA school is the politics of dealing with Phase II of the clinical portion. Clinicals are where you are humbled and if you are not liked, there are ways of getting you out the program since the grading during clinicals are either pass or fail.
If you are AF and flunk out of the clinical portion, then you will be assigned to Walter Reed to the ICU where you will stay for a 4 year tour. I've been working in the ICU here for 4 years now and we have about 3 people that didn't make it through the clinical portion and they are now working in the ICU. We have one guy who was kicked out 2 weeks prior to graduating last year. The attrition rates are higher in the military than some civilian program despite the high rankings, which most schools know that some schools do not participate in the US New and World report.
I chose the civilian sector for CRNA school because they are genuine about helping you to succeed in school without any hidden agendas. Also, the civilian population prepares you much better than the military population, who are generally healthy except for retirees and dependants. Even in the ICU, most of the patients in the military ICU are majority step-down patients. We still do 1:1 nurse to patient ratios. In the civilian ICU we get 2-3 patients and they are really sick with a great deal of drips and our patients tend to be a lot sicker than the military. I would rather train in a civilian CRNA program where I am getting exposed to ASA 3 and ASA4 cases on a regular basis. Also, some CRNA programs actually have CT training programs where CRNAs can get TEE certified and work on cardiiac teams.
The positive I would say about the military training is the tuition is free and the bonuses are nice. Hopefuilly we will have an approved budget before Oct 1. As a nurse on the outside, you have options on the best course of action to take for CRNA school. If you want the best ICU experience with really sick patients, civilian ICU is much better than the military.

1. Depending on the NA school it is often easier to get into the AF CRNA program. The trick is meeting all the requirements, and not being under the retention bonus. The AF program is smaller than the Army program, but has been having trouble filling all the slots the last couple of years. Pretty much if you have decent recommendations and meet the qualifications you are going to get in.

2. There are now two parts to phase II/clinicals. There is meets criteria or doesn't meet criteria for the clinical portion, but there is also graded didactic portion during clinicals also.

3. You do not automatically go to Walter Reed/NNMC if you are dropped from the program nor do you incur an automatic 4 years for dropping out. There is a minimum of 2 year time commitment just with the PCS to school. Then depending on where you are in school you incur somewhere 2-5 years. When you are dropped from the school you revert back to your primary AFSC/job and are reassigned where the AF needs you. A lot of the phase I students stay in the local area d/t large hospitals in the area, and the costs to PCS.

4. USUHS does not arbitrarily drop students. It is expensive and takes a long paper trail before someone is dropped. There are a couple instantaneous drop reasons i.e. showing up impaired, diverting drugs, severe danger to patients etc. During phase II students that are having trouble and being evaluated for remediation are usually sent TDY to another phase II site for independent evaluation. Students have to consistently fall below criteria, be verbally counseled, and placed on remediation before being they are let go.

5. All services offer HPSP, which gives a stipend to go through civilian CRNA school.

6. I don't know how the Army program is accepting students without a year of critical care experience since that is a COA requirement as of this year.

7. You will see many sick patients in the military NA program. The AF augments all it's civilian clinical rotations. I went to Baltimore shock trauma, DC VA, Dayton's Children's hospital, and another mid-size hospital in Delaware for my out rotations. You probably won't do many or any TEEs in the military, but considering very very few CRNAs do TEEs or hearts on their own it is probably a skill you won't use again.

8. IMHO the best thing about the military CRNA training programs is training their students to be independent providers fully capable to provide all types of anesthetics, and not training "stool monkeys" that cannot function independently while graduating with the bare minimum of cases.

allnurses Guide · Sep 27, 2013

I'm finishing up my last 8 shifts on active duty and then switching over to the Reserves. My anesthesia program allows students to take some of the science and core courses online. We start full-time in January and clinicals in April. I meet the Lt Col boards this year and when I finish CRNA school, I may probably return back to active duty to finish out my time since I will be close to 20 years. Currently the anesthesia group I have an interview with takes the top 10% of students in the class. We are provided free housing by the group and will train exclusively with their group of hospitals (they have about 12 facilities they cover) and then upon graduation, we are hired directly by the anesthesia group. I'm doing a Post-Masters program since I already have my MSN so I was already exempt from a majority of the core and support courses. Only need to take my anesthesia classes and then I will be done. Looking at possibly doing an EdD or PhD program afterwards so I can become a Program Director. Already have 2 job offers from Chief Anesthesiologists at facilities where I moonlight as an OR nurse.

Sounds like large ACT practices...That will make it hard to learn how to be an independent CRNA.

Trauma Columnist · Sep 27, 2013

Hey guys please keep OPSEC in mind when posting on the internet. Personnel PCS's, troop movement probably shouldn't be mentioned. Thanks much.

allnurses Guide · Sep 27, 2013

Hey guys please keep OPSEC in mind when posting on the internet. Personnel PCS's, troop movement probably shouldn't be mentioned. Thanks much.

No, OPSEC or confidential information was given.

The USUHS faculty are all listed with their pictures on a public website, if I posted something else you will have to let me know because I missed it. Graduate School of Nursing- Uniformed Services University

Trauma Columnist · Sep 27, 2013

Mentioning names of personnel and their PCS plans is what I was referring to. I was not a nurse when I was active duty. Security regarding troop and personnel moves is OPSEC. All services have new and strict policies on social media and the use of the internet.

http://www.army.mil/article/103528/Soldiers_must_consider_OPSEC_when_using_social_media

allnurses Guide · Sep 27, 2013

Mentioning names of personnel and their PCS plans is what I was referring to. I was not a nurse when I was active duty. Security regarding troop and personnel moves is OPSEC. All services have new and strict policies on social media and the use of the internet.
Soldiers must consider OPSEC when using social media | Article | The United States Army

We will just have to agree to disagree since all that was posted is public information that is easily accessible through a public website. No other persons were mentioned by name. That is like saying it is breaking OPSEC mentioning who the Chief Nurse of the USAF is and where she currently stationed...