Pennsylvania CRNA vs NP

Jules A, MSN · Jan 21, 2017

It sounds like you have the background for CRNA and so there would be no comparison imo. CRNAs, so far, have been far smarter than NPs who have lowered our standards and schools are accepting anyone who is able to pay tuition. The NP market is becoming saturated again my opinion and what I'm seeing in the Maryland/Washington DC area. It is my understanding CRNA programs are still limiting admissions to qualified applicants with appropriate RN experience, kudos and color me severely jealous.

Independent practice unless you want to open your own business is overrated, imo. I fought to get it for our state but haven't found that it does much more than give us chest thumping rights, sort of like the smug NP holistic care BS. It has not increased our wages because schools have done nothing to educate students on how to actually behave like a business person and it hasn't changed my practice one bit. Overall I'm glad we have it on paper but in the big picture, overrated.

Neuro Guy NP, DNP, PhD, APRN · Jan 25, 2017

I still think independent practice is great. I practice in NJ and PA. NJ is semi autonomous, meaning there is no collaborative agreement but there is a prescriptive agreement for opioids (though the crazy thing is that once you sign the agreement you keep it in your own files! The state doesn't collect it!)

Pennsylvania on the other hand is a doozy. If you change jobs you CANNOT work until the state APPROVES your new collaborative agreement with your new physician. As you can imagine it can be a nightmare.

Anyway,

Jobs outlook - there are more NP jobs out there from my search

Salary - generally CRNA (though not always, such as in my case, especially if you know how to hustle)

Advise - follow your heart on what you want to do!

flipper628 · Jan 25, 2017

I believe the accrediting body for CRNA's is going to require a DNP by 2021. My last semester in NP school I was at the open house and the director of graduate studies was speaking about it. I think its an extra 18 months of schooling and since most CRNA schools are full until 2019 this would probably pertain to you.

Acute Care NP may be another route for you as well with your background.

Good luck!

guest769224 · Jan 27, 2017

since most CRNA schools are full until 2019 this would probably pertain to you.

What? Not true.

flipper628 · Jan 27, 2017

In my area anyway, they are admitting people to start in 2019. I'm sure it varies by region, my mistake.

Nursepennsylvania · Jan 30, 2017

Thank you for your advice everyone! I'm still debating, unfortunately I currently don't agree with the DNP for CRNA's if the practice isn't independently. Both sound like such great options

Jules A, MSN · Jan 30, 2017

I'm still debating, unfortunately I currently don't agree with the DNP for CRNA's if the practice isn't independently.

Although I agree the DNP is unnecessary as it stands now I disagree the independent practice thing has much if anything to do with its value or that it even has much value at all as it stands. In any event I'd foresee both NP and CRNA at some point in the near future requiring DNP or the greedy schools will have simply done away with the MSN so if you are more than 10 years out from retirement my advice would be brace yourself for the reality you will probably be best served by eventually playing along with the games and getting a DNP. :wtf:

babyNP., APRN · Feb 2, 2017

Although I agree the DNP is unnecessary as it stands now I disagree the independent practice thing has much if anything to do with its value or that it even has much value at all as it stands. In any event I'd foresee both NP and CRNA at some point in the near future requiring DNP or the greedy schools will have simply done away with the MSN so if you are more than 10 years out from retirement my advice would be brace yourself for the reality you will probably be best served by eventually playing along with the games and getting a DNP.

Actually, Jules, all CRNA new grads will require a DNP in the year 2025 in order to be certified, so it's already a thing for them. I learned about this in school and it's why my alma mater finally decided to do a DNP program (one of the last hold outs amongst brick and mortar schools as the dean didn't support the DNP), although it's only offered for CRNAs, not the NP programs.

ETA: link from the folks that accredit CRNA programs- COA Position Statements

Jules A, MSN · Feb 2, 2017

Actually, Jules, all CRNA new grads will require a DNP in the year 2025 in order to be certified, so it's already a thing for them. I learned about this in school and it's why my alma mater finally decided to do a DNP program (one of the last hold outs amongst brick and mortar schools as the dean didn't support the DNP), although it's only offered for CRNAs, not the NP programs.
ETA: link from the folks that accredit CRNA programs- COA Position Statements

Yup and I think it would be an excellent idea to add additional education to APRN requirements if it offered anything clinically worthwhile but we've agreed to disagree on that before. :) It sounds like they forced your Dean's hand although the truth is financially its a winner so hard to argue with that. Regardless of your opinion on the issue I'd imagine you have to respect her for attempting to question what the masses are so willing to blindly accept without questioning. I'd like to buy her lunch.

missnurse01, MSN, RN · Feb 7, 2017

OP, do what you think will satisfy you for the next 40 years. Things can really change in that time frame! Also don't discount the idea of moving out of PA for work. Many of us do. It may sound difficult but people go home for visits. Everyone's situation is different of course. We have moved states many times with kids in tow. Good luck with your decision!

Riburn3, BSN, MSN, APRN, NP · Feb 10, 2017

OP, I was in the same boat as you earlier in the decade. All of my RN training is in CVICU and Trauma, and I also have my CCRN. I strongly debated going to CRNA school and thought it was what I wanted, so much so that I got into TCU's CRNA program. Before even having my interview though I shadowed some CRNA's and anesthesiologists and slowly started to realize that I couldn't imagine doing what they did, over and over for the next 30-40 years of my life. While excited at first, the repetition quickly became boring to me. I went to the interview anyway to keep my options open and was accepted, but in the end didn't go.

A year later I applied to NP school at a local state public university, was accepted, and haven't looked back. My first NP degree is as an FNP, and I'm currently wrapping up my AGACNP cert as well. I work for a large hospital in their cardiology department seeing inpatients and managing heart failure outpatients and I love it. I also work on the side for an internal medicine practice rounding in rehab facilities. Even though Texas is a collaborative practice state, the individuals I work for really let me do my own thing, but they're also there if I have any questions.

Independent practice is a great thing if your state implements it well. I am also licensed in New Mexico which is independent practice, and the amount of headache to be licensed and allowed to prescribe was tremendously less than it was in Texas. Whenever I work up there once in a blue moon, its nice being able to operate freely and not have all my hospital notes cosigned by another physician.

My best advice would be to shadow or follow around a CRNA and a NP, and get a taste of what it's like for them, and see if you like it. A LOT of people on here are very jaded with both practices, so take whatever you hear in the CRNA or NP forums with a grain of salt. Go off what you see and experience with your own eyes, and most importantly, do what you think you would enjoy more. The internet is a place where sad people like to gather an wallow in their own sick.