PNP or CRNA?

[VanillaTwilight18, BSN, RN]

Hey y’all, I’m a nurse currently considering going back to school in the next couple of years (around 2022-2023, just trying to gain experience and get my finances and things in order through the end of this year and 2021 to prepare) and I’m pretty conflicted on what path to try and take. I worked almost two years in the Neonatal ICU (level 3, we just didn’t do ECMO or cardiac except PDA ligations but we had 22 weekers and a ton of other wide experiences) and I’m about 6 months into the Pediatric ICU at a level 1 trauma center. By time I apply for PNP or CRNA I will have ~2yrs experience at least in the PICU.

In 2021, I’m planning on getting my Pediatric CCRN, my TNCC, and possibly ECMO cert., as well as planning on taking a class to precept new grads. My GPA in school was not phenomenal, but I had a lot of undue stressors and since graduating have been working on some financial stressors and my mental health and some of the other things that were holding me back. I think I graduated with a 3.2 or 3.3? But I’m not sure what my nursing GPA was I’m sure it’s closer to a 3.0 ?‍♀️

I want to either go back to school for my PNP and maybe work in an outpatient pediatric cancer clinic or do CRNA and be a CRNA at a children’s hospital. I just don’t feel like I’m a very competitive applicant for either program, but ESPECIALLY not the CRNA program. Plus, I’m stressed about the CRNA finances because a lot of schools tell you you can’t work during the program. I don’t have a husband or anyone to “live off of” per say besides my parents but they live a little over an hour away from the closest CRNA school and I know some schools are in-class and not online. 
 

So then I wonder about doing PNP school (which my current hospital will pay for as long as I work during the program) and then once I’m more out of student loan debts and am more financially stable I can go back for my CRNA? The CRNA pathway just really interests me and the autonomy looks really nice, I’m just worried it’s not a feasible pathway for me. I’m also worried about job prospects with PNP because several threads on here talk about it being hard to find a job. However, the PNP program I’m looking into is a 3yr dual program acute and primary care which gives me more options and I am not opposed to moving for a job since I’m currently single. 

Just looking for advice, career outlook, recommendations to make myself a stronger applicant, etc?

[Nan1989]

I can give you a little outlook regarding CRNA programs and PNP. But this is just my knowledge so take it with a grain of salt. It's different for everyone and in different parts of the country.

First off, to me, CRNA programs are MUCH more competitive than NP programs. Nowadays it seems that there are so many options for NP programs, I think it's a more accessible pathway for many looking to advance their nursing career. I've never heard of someone looking into getting their NP and then continuing on to a CRNA. To be honest, I'm not sure that would help your application for CRNA school unless you were still working in an ICU setting. Even then, unsure. CRNA programs are super-specific and particular in what they expect and are looking for, and you're right, they're super competitive about school and GPA. Most CRNA programs I've heard of look for a science GPA of at least 3.5. And financially, I've never ever heard of a program where you can work part-time during the program. CRNA school is a full-time job no matter vs. NP programs where you can be more selective with time and work/school loads. 

There is and will continue to be a shortage of both NP's and CRNA's in our world. As baby boomers are retiring, there have been many reports (go back and listen to NPR's specials during nurses week) that there will be a strong need for both. I personally wouldn't worry about finding a job from either path. 

The best advice when you're looking at these programs is to get in touch with faculty, let them know you're interested in applying and that you really want to make sure you have all your boxes checked. This is VERY different for both programs. For CRNA I would definitely recommend more than 2 years of ICU experience but for NP I think you'd be fine. 

Planning for the future is hard! We've all been there/are there. Best of luck! 

[johnjohn1981, LPN, RN, EMT-I]

I have been an ICU nurse for about 4.5 years. Currently travel nursing and have been able to save money that way. School is very very expensive, most programs are 100K. So my goal is to have that much money saved by the time I start CRNA school. 
I started my FNP degree back in 2018 simply because I wanted to make myself more competitive for CRNA school. I also would love to be an aesthetic/derm NP on the side LOL. And because I truly love education and learning, but again, I wanted to make myself more competitive. 
I graduated with a 3.48 nursing GPA /; but my sciences are like a 3.7. I am 60% done with my masters and GPA is 3.8. 

I have my CCRN, CMC, TNCC and other certs. It took me like 3 months of studying like 2-5 hours on my days off to prep for the GRE /: and I have been studying almost every day for 2 months prepping for interviews. It’s A LOT.

Anyhow, CRNA school is very competitive. So far, I’ve applied to 8 schools. I was accepted to a program already but.. I have also been waitlisted for most of the schools. I have a couple of more interviews coming up, but the tuition for that school is 156K.. great program though. 
My GF has also been waitlisted or denied from multiple schools. She is also applying this year. 

It depends on the lifestyle you want.. and where your heart is. if you love children, love having many patients, and you don’t mind working clinic hours then do NP! But if you want more flexibility in schedule, a bit more money, to work in the OR, and have 1 patient at a time, then go for CRNA. I would recommend shadowing both.. and this will also help you during interviews as it’s the #1 question the faculty asks. 

If CRNA is your goal through, then do it. Take a year to save money and take grad nursing classes on the side. Get all the certs you can and join committees. Also, volunteer somewhere. I did like 90 hours at my local physical therapy clinic. I also was involved in shared governance committees while I was a staff nurse.. 3 years ago.  If you want it, you can do it. You May have to apply to many schools and may have to wait a year or so. But, it’ll be worth it. 

Best of luck.  

[johnjohn1981, LPN, RN, EMT-I]

Oh I forgot to mention..... one big difference between NP and CRNA is that.. NPs diagnose and treat a disease. They see IDK.. 20 patients in one day or more. If you work in hospitals, you maybe see your patients for 5 mins, diagnose, and prescribe meds + orders. A bedside nurse carries out your orders.. so it’s not very patient-involved. 
 

But if you love drawing labs, doing arterial sticks, would love to learn to place a lines/central lines/nerve blocks, intubate, give vasoactive meds depending on vitals, and for all of your focus to be on one patient for hours.. then CRNA is the answer. Depending on the hospital, CRNA is very involved w the patient, from drawing labs, to giving blood, Monitoring your sedation/vitals... giving fluids.. very patient involved.