SRNA4U

@kjd321. I didn't know you were in NYC. Since you're graduating wiith your ADN, I would encourage you to go straight to ICU once you pass NCLEX. Definitely don't tell your manager about your desire to attend CRNA school. While you're working in the ICU, you can take your BSN courses in the evening. By the time you finish your BSN, you will have the 2 years ICU completed along with your degree. Then, depending on the school, you should be able to apply to CRNA school at least a year out from finishing your BSN. My nursing career was spent on active duty Air Force and for the life of me, I could not get the required score for the GRE. I ended up getting my MSN degree, left the military applied to civilian CRNA post-masters certificate programs, and was able to bypass the GRE requirement since I already had my MSN. You should not pursue the ACNP program if you want to be a CRNA. I did an assignment at Northwell in Long Island and was assigned students from Hoftstra's nurse anesthesia program which is also combined with an ACNP degree. Those students were so stressed. They would come to clinicals with me for their anesthesia rotation and then in the evening would have a practicum on doing physical exams on patients for their ACNP portion and they were working on the DNP project as well. I think their program director figured out how insane that was and I was told there were talks to remove the ACNP from the CRNA program. Their intention was to have CRNAs who can function like ACNPs as a response to COVID. Also, there are many anesthesia programs out there that do not require GREs anyway, but since you want to stay in the NYC area, your options may be limited. The good thing about PA is they have the most CRNA programs in that state followed by Texas and Florida. I had a colleague who went to Columbia but is and has been stuck with a lot of debt from that Ivy League education. I know the SUNY Downsatate program closed a few years ago. I know Buffalo has a program. Rutgers has a good program too in NJ. Good grades from your BSN will get you in but its really competitive. Even though most schools say they accept a 3.0 GPA, many students far exceed that minimum. Some programs will also compute your science GPA. And last but not least, learn as much as you can in the ICU. Try to get into one of those nurse residency or new grad programs for ICU training. When the time comes for you to apply to CRNA school, reach out to me and I can write a recommendation letter for you. So far 100% of the people I have given recommendations for have received acceptance into a program. Best of luck!

@kjd321 Life is great after CRNA school. I started my own anesthesia corporation and work as an independent contractor. I finished my doctoral degree in nurse anesthesia a year after I finished Drexel's program. Drexel's program is one of the best programs in PA. The reputation of the program says it all within various anesthesia departments in PA. In my opinion, the two best nurse anesthesia programs in PA are Drexel and Villanova. Having completed my peds rotation in Philly, students from Penn and Jefferson were not left alone during their peds rotation because many anesthesiologists felt those students were not prepared for clinical. Drexel and Villanova students we were left alone after intubation to provide anesthesia care for the peds cases. Have confidence. Drexel will prepare you to be an excellent CRNA but you will have to put in the work. Drexel has some of the best clinical sites to ensure you will succeed as a nurse anesthetist. My primary clinical site was in Delaware and after our 1st year, we were doing our own cases and worked like CRNAs. I was with a CRNA my 1st year and if you made it to the 2nd year at that particular site, you were then advanced to do your own cases. You were no longer working with CRNAs. It was just you and your attending. The anesthesiologist would come in for induction and that would be it. You would manage the case by yourself and you extubated the patient by yourself. Loved my clinical site. When we graduated, we were totally confident in doing our own cases. I graduated and went straight to NYC and ended up staying there for 7 years. Now I'm working as a travel CRNA and I work for my own company. Another great thing about Drexel's program is once you're accepted into the program, which they normally interview 2 years in advance, you are allowed to take some of your classes online before you officially start the program to lighten your load. For example, you're allowed to take advanced physiology, advanced pharmacology, and I believe the research courses online before the program starts. Another thing, Drexel will allow you to interview without meeting the 2-year ICU experience. You just need to have the 2 years in by the time you start the program. When I interviewed, I only had been in the ICU 6 months but had 2 years when I started the program. I don't want to discourage you from applying to Jefferson or Penn but go where you will get a top-notch education and trust me, based on where you went to school, hospitals, anesthesia departments, and fellow CRNAs will know based on the program you attended, if you will be a great clinician. I'm currently working in central PA and people are always asking what program I attended, When I say Drexel, that says it all. There is no question regarding my clinical experience. The name speaks for itself. In January, I will be working in Chicago for a year at a Level 1 adult and peds trauma hospital. Life is great. Pursue your dreams and give Drexel a try.

Hello, I am a CRNA in New York City and yes, the COVID pandemic is real here. I work in a 525 bed level 1 trauma facility and we are seeing high volumes of patients. We have ICUs on 5 different floors with all patients on vents. Everyday, there are RRTs called on the med-surg floors where we must intubate patients and place them on vents. Its sad when family members are not present when these pts go on vents because they know there is a high probability they will not come off. The rates of multisystem organ failure is sad to see. As a result of the hypoxemia, these pts end up on CVVH with the kidneys showing the first signs of failure. The hypercoagulable state of these pts also cause lots of CVA and MIs because of the rapid forming clots. IVs would stop flowing because of the rapid clot formation with the need for most of the pts to be placed on Heparin drips. I have seen so many pts go into shock and then we call their family for video face time so they can see their loved ones while we get consent for DNR orders. As a CRNA, some days I am assigned to the ICU where I practice my ICU and anesthesia skills. Some days I assigned to the airway where I go throughout the hospital intubating patients. Other days, I am assigned to the OR where I wait for an urgent or emergent case that requires surgery. If your wife believes this is a conspiracy theory, she should come to any hospital in NYC and see the patients here. We have even converted some of our ORs to negative pressures room with 3 ICU beds in each room so we can take care of COVID pts. Our cafeteria dining area has been converted to a COVID unit with a wall that was constructed and is now a 20 bed unit. This virus is no joke.

We know in anesthesia e4very drug has its side effects and unfortunately, Sux is one of them. I try not to use it unless I have an obese patient with a questionable airway or if I am doing a case where neuromonitoring of motor evoked potentials is being used. We know that guys who are very muscular experience myalgia and should be avoided. I work in the Bronx NY area and at my trauma center job most of the docs routinely like to use Sux but at my per diem ambulatory surgery job, we like to use Roc since most of our cases tend to be ASA 1 and II type patients. Thank God for Suggamadex in our aresenal.

There isn't a direct correlation regarding the GRE exam and a person successfully completing an advanced practice nursing program. I completed CRNA school without the GRE exam and did very well.

As a new CRNA, the responsibility of taking care of the patient is on the same level as the anesthesiologist. A regular nurse could not do the same job as a CRNA. What you are observing on the periphery of what a CRNA does, prevents you from seeing what the CRNA is thinking while taking care of the patient. The physiology, pharmacology, pathophysiology, and the anesthesia courses are what separates the RN from an CRNA. You have to know how that patients co-morbidities and medications are affected by your anesthesia medications and gases. Would an RN know how to manage a patient that has Local Anesthetic Systemic Toxicity from the medications injected by the surgeon? Would an RN know what medication is used for this toxicity? Would an RN know how to treat a patient with pheochromocytoma? Would an RN know the differential diagnosis between pheochromocytoma, Malignant Hyperthermia, Serotonin Syndrome, and Neuroleptic Malignant Syndrome. A lot of these syndromes have similar presentations but a CRNA would have the training to differentiate them and the medications used to treat them. So while you may see a CRNA going through the motions, you have no idea of what they're thinking and why they base the decisions of what med to give based on a patients medical history. After having worked as an ICU nurse I thought I knew it all but until I went to anesthesia school and learned how drugs work at the cellular level, I have come to realize that I didn't know as much as I thought I knew. Also, going from the RN role to the CRNA role you are taught to practice as a provider and make decisions on your own, after all, some states allow CRNAs to work independently without an anesthesiologist. As you mentioned about the doc coming to push drugs, where I work, the docs only supervise us 70% of the time so I get to do my own inductions by myself. Every practice is different. So yes, I think I deserve the salary I receive because I have the awesome responsibility of having someones life in my hands and the knowledge and training I have received has prepared me well for my job. Also, RNs can't float swan catheters but I can as a CRNA when doing hearts. Our anesthesiologists do not even gown up. I place the swan catheter myself. So I'm just a little confused on how you can say an RN can do the job of a CRNA. Can an RN manage a patient that has Aortic Stenosis or Mitral Regurgitation. There is so much you just don't know. I have learned so much in 28 months that I know I still have so much to learn. Good luck to you.

Actually CRNAS can make just as much if not more in the surgicenter or GI clinic. I just finished CRNA school and many of us will be getting second jobs in GI clinic since they are paying over 110 hr in some locations. NPs re not making anywhere what crnas are making.

I did inactive reserves while in anesthesia school. I'm done with school as of next week. Took a job in New York City. Will be taking boards in May. I'll probably stay in NYC for 3 or 4 years and then I'm am hoping to go to either Germany or South Korea as a civilian and work for the military.

Hello, I've been off active duty since Nov 2013. When I was in, CRNAS were getting 50,000 bonuses every year. But now they have too many crnas so I'm not sure if they're still offering it. I just took a job in NYC in the south Bronx where they're are giving me a 10,000 bonus plus a yearly retention bonus. They have a really nice benefits package plus I don't have any call, no weekends, and no OB. The money us in Texas, Michigan , and Boston where crnas are making over 170,000 a year for base pay rate. Not including overtime and call. There are so any options but you have to find the place that suits you. For example, my primary clinical site is a level 1 trauma facility with 32 ORs. The place I'm going to in NYC is only 8 ORs and is a level 2 trauma facility. I'm looking for something of a slower pace.

I live in the suburbs of philadelphia which is way cheaper than living in the city and you get more space and it's much safer. For Christiana, the school selects who will interview and stay there. I'm at chrisitiana and we only rotate out for peds. All of the rest of the rotations are at Christiana. Christiana is the best clinical site Drexel has and you actually interview with the anesthesia group there. Drexel may select 12 people to interview buy they normally select 10 students but it was off this year that they selected 11 students from Drexel and 2 from Jefferson anesthesia program. When you graduate you are offered a job to stay at chrisitiana as long as there are no clinical issues and if you have a good attitude.

When I applied, it was back in Oct 2010 and I got my letter to interview around Dec/Jan time frame for a March interview date. I know the school does interviews in June as well. There were 12 selected for March and 12 for June interviews. They normally accept 20 students. If you get selected for an interview it's more than likely you will get in. I interviewed to start with the 2013 class but was unable to get out the military at that time so I ended up deferring for a year and started in the 2014 class. Being an OR nurse will definitely put you ahead of the class. I was running my own room by the end of my 1st year while the rest of the class started doing their own cases this year of our second year. Post masters definitely make your loaf a lot easier. Im.just doing 1 anesthesia class while.my.classmates still have 2 classes plus clinicals. 1st year is definitely the hardest but the 2nd year us much nicer. During the classes, they will give you study guides for the exams so you'll know what to focus on since there is so I've material. I think the 1st semester we learned over 80 drugs mechanism of action, dosages, and pharmacokinetics such as metabolism and elimination. Good luck to you. Drexel I think is the best school.

I study only 3 to 4 hours a night but mostly I spend the weekends catching up. Every school is different. Im in an integrated program and I worked per diem through out the program as an OR nurse without any problems. I'm a senior now and it definitely is much nicer now compared to the first year. No care plans this year except for specialty rotations. We start running our own room end of this month. Last fall we started doing breaks and lunch relief. Anesthesia is the best job in the world

Adjunct faculty meaning you are a clinical preceptor

As well all know there are biases in the U.S. New and world Report and they are not the gold standard for dictating which crna programs are better. Some.schools don't even participate in the surveys from the US News and World Report. If they looked at how many people make it through anesthesia in the military and board pass rates, I'm quite sure the military programs wouldn't be listed in the top. I think you are more qualified to speak on military anesthesia programs but not comparing which anesthesia education system is better when you didn't attend both of them. We are all trained to provide anesthesia care whether you attend military or civilian anesthesia programs but our patients again tend to be much sicker just as when I worked in the icu in the military, our patients were no where as sicker as patients in the civilian icu. Most of our icu patients in the military were majority step-down patients and the same goes for surgical patients. Are you all doing stroke codes in your anesthesia practice? The consistent acuity levels of our surgical patients are still much sicker than your military population which is why the military leadership allows military crnas to moonlight in the civilian sector as well as when you are preparing to deploy, you are sent to civilian hospitals to train like Baltimore shock trauma for CSTARS. If the military thought your military anesthesia practice was sufficient, then you wouldn't need to come to the civilian hospitals for that training. As far as the types of cases I will be doing after graduation is the same since I do clinicals with an anesthesia group that has an exclusive contract with the hospital and surgical centers for the organization which is one of the groups that offered me a job. Not sure if you have done transplants or not but they are not cookbook recipe anesthesia and involves a lot more than fluid management. Also the anesthesia practice where I train is not dictated by the docs to the crnas. The ACT model from where I train is not bad. We really work in a collaborative way to care for the patient. I think the military program have you geared to think of ACT as a dictatorship but its not like that where i train. We are able to practice and provide anesthesia the way we want to. If i want to hang a Remi drip i dont have to ask the doc if its ok. I just do it. If the surgeon wants MAC and i feel an LMA is better then the pt gets an LMA and the MDA backs us up. We can consult with our MDA if we have questions and we are not told by our MDA how he wants the anesthetic delivered or what meds we can or can not give. But I will say that during my time in the military, there was a crna from Travis AFB who lost her crna license and her RN license for negligence and she was military trained. Pt went into laryngospasm in the PACU and suffered anoxic brain injury. You can Google the case. According to the case report she had multiple instances of misjudgement when caring for her patient.

Hello, I'm a senior SRNA. It actually does get better by your senior senior year. The junior year does come with challenges but make sure you are confident, prepared, and well versed with your meds. The anesthesia profession love to see confidence portrayed as many will be looking to you for direction when things go wrong and you have to be able to manage and direct people to get things done to care for the patient. We both know there are some people who are not good preceptors and some really don't want to train students and then there are those who act like they came out of the womb born as CRNAs and were never students. In addition to ICU, I also come from an OR background as an OR nurse so I was totally comfortable in the environment. I remember in my class we had one student whose anxiety levels were so high that she actually passed out in the preop area while interviewing her patent. She had to be taken the ER. Of course this raised red flags because the staff felt like how can we leave her in the room with a patent if she's going to keep passing out. The poor girl was also intimidated with the pimping that came from the CRNAs and MDAs. Now she is doing a lot better. The min thing is to get your anxiety under control because patients can also pick up on this and this can make them even more nervous. Make sure to read up on your cases and know the procedure inside out. Portray confidence. Hopefully things will work out for you. I remember when I finished nursing school I always wanted to be an ER nurse. When I went to the ER and I actually hated it. It was just not for me. Hopefully this wont be the case but some people in anesthesia can make it really hard for you when they are trying to weed out people who they think wont be able to cut it. Fortunately for me, I'm with an anesthesia group that has an exclusive contract with the clinical site where I train so I don't rotate out for anything except for peds which is nice because all of the staff know our skills and where we are clinically. The good thing about not rotating out is not having to deal with the new round of pimping by staff who don't know you or where you are clinically. The downside about not rotating is you don't get to see how other sites do things. The first year of anesthesia school is the hardest but now that I am a senior its totally different. No more care plans this year except for specialty rotations and cases I haven't done before. The pimping is no more on medications and basics but now on perfecting your art of anesthesia and timing your wake ups to prevent delays in case turnovers. We're down to 2 classes this semester and in the spring we're down to 1 semester. I'm telling you it does get better but if you really want this, you're going to have to take it but don't let your anxiety get you kicked out of your program. Words of advice from our program director was to never let them see you sweat. Keep it inside and when you get a break, go into a closet and cry or vent or whatever you need to do but never let them see you sweat. One of the MDAs I work with says his big thing is you may not know what you're doing but if you display confidence as if you know what your're doing, it decreases staff anxiety in the room and it goes much further with the docs. I remember when I did my first nasal intubation. I was so nervous on the inside that I was sweating but I never let it show how nervous I was. The MDA said I did an excellent job and that he didn't know that I was nervous after I placed the tube when I told him. You'll do fine but you have to keep the anxiety level hidden because we all know the CRNAs talk about students with each other as well as the MDAs discuss students with other MDAs as far as who's good and who's struggling. I was the only student in my first year to get offered a job with the anesthesia group whereas most job offers are in the senior year. I was told by the MDA that everyone has been talking about how advanced I am with my skills and the confidence I display which let me know they watch everything about you and they all talk. You definitely don't want to get labeled in a negative way.