Reasons NOT to be CRNA

Sheri257 · Apr 15, 2007

"average CRNA salary $164,172".......
http://www.crnajobs.com/crna-careers/2006-CRNA-salary-survey-report.pdf

That's great but, for me at least, the numbers didn't look all that good, at least in my area. Kaiser is the biggest employer of CRNA's in my area and they pay CRNA's $120,000 a year with benefits and covering malpractice insurance.

Now, I live in California where you can make pretty good money just with an RN. I just accepted a job where I'll be making nearly $100k base salary with benefits.

If I went the CRNA route, that means I'd have to work an ICU job at $55-60K for a couple of years so I'd lose $80K in income just from that. Assuming I'd get into CRNA school, I'd also have to borrow somewhere around $100-130K when I could be making nearly $200K during those two years instead.

With only a $20K a year salary difference, you can see how it would take a good ten years or more just to make up for the lost income and debt ... not to mention interest on the debt and four years of lost pension income with the $100K a year RN job.

Add to that the recent Medicare anesthesia cuts which could affect future income and ... it just seemed like a pretty dicey proposition to me. However, it could be totally different for people in other markets where the CRNA route may be much more advantageous than my particular situation.

:typing

Alpha13 · Apr 16, 2007

That's great but, for me at least, the numbers didn't look all that good, at least in my area. Kaiser is the biggest employer of CRNA's in my area and they pay CRNA's $120,000 a year with benefits and covering malpractice insurance.
Now, I live in California where you can make pretty good money just with an RN. I just accepted a job where I'll be making nearly $100k base salary with benefits.
If I went the CRNA route, that means I'd have to work an ICU job at $55-60K for a couple of years so I'd lose $80K in income just from that. Assuming I'd get into CRNA school, I'd also have to borrow somewhere around $100-130K when I could be making nearly $200K during those two years instead.
With only a $20K a year salary difference, you can see how it would take a good ten years or more just to make up for the lost income and debt ... not to mention interest on the debt and four years of lost pension income with the $100K a year RN job.
Add to that the recent Medicare anesthesia cuts which could affect future income and ... it just seemed like a pretty dicey proposition to me. However, it could be totally different for people in other markets where the CRNA route may be much more advantageous than my particular situation.
:typing

To say the least your numbers are a bit slanted.

Are you talking about becoming a travel nurse for that $100k/year figure as a regular RN? Because if not, I don't see how you would make only 55-60% of other RN jobs as an ICU nurse. In So Cal. ICU pays the same as any other field.

As for using $120k as the salary for CRNAs, first of all this is on the lower end of the pay scale. Second, obviously this figure is not static and will rise quickly as CRNA gains experience.

More accurate figures would be something like this:

New grad ICU RN salary: ~65k-75k from year 1, up to 90k on year 5.

CRNA school costs: 100k/2 years

New grad CRNA salary: $130k from year 1, $140k-$150k from year 3.

If a new CRNA was to pay off his debt as quickly as possible, he'd catch up to the regular RN in about 2 years. But numbers don't tell the whole story. The CRNA has vastly greater earnings potential than the RN, enough so that he's gone from "decent middle class bloke" to "upper middle class yuppie." If he's smart with his finances and career prospects, he can go even higher. The RN has very little upward potential in comparison. Sure, he can move into traveling or management, but that's about it.

Honestly there's no comparison here in terms of earnings potential.

ali anesthesia · Apr 16, 2007

Lizz,

You did a nice financial analysis of opportunity loss in regards to nurses and nurse anesthesia education. However, you left out a few very important considerations. Most nurse anesthetists practice for many years--well into their 70's, while most nurses leave nursing at a much younger age. Also, there is very little "burn-out" in anesthesia and most CRNAs love their work and profession. That is something I can not say about nursing.

My decision to be a CRNA had to do more with having a professional career than just a job.

I have a very good friend who works in California, not Kaiser and makes around $250,000 a year in a private practice setting. It is a cash business and she does have to pay her own malpractice insurance and other expenses.

I do have to agree that if money is the main motivation to be a CRNA, you are going to be disappointed, because anesthesia education is very competitive and difficult, which is necessary because anesthesia administration is stressful and demanding and we earn every penny we make.

I_am_Julia · Apr 16, 2007

what crna school alone cost 100-130k?

piper_for_hire · Apr 16, 2007

UPenn

Sheri257 · Apr 16, 2007

To say the least your numbers are a bit slanted.
Are you talking about becoming a travel nurse for that $100k/year figure as a regular RN? Because if not, I don't see how you would make only 55-60% of other RN jobs as an ICU nurse. In So Cal. ICU pays the same as any other field.
As for using $120k as the salary for CRNAs, first of all this is on the lower end of the pay scale. Second, obviously this figure is not static and will rise quickly as CRNA gains experience.
More accurate figures would be something like this:
New grad ICU RN salary: ~65k-75k from year 1, up to 90k on year 5.
CRNA school costs: 100k/2 years
New grad CRNA salary: $130k from year 1, $140k-$150k from year 3.
If a new CRNA was to pay off his debt as quickly as possible, he'd catch up to the regular RN in about 2 years. But numbers don't tell the whole story. The CRNA has vastly greater earnings potential than the RN, enough so that he's gone from "decent middle class bloke" to "upper middle class yuppie." If he's smart with his finances and career prospects, he can go even higher. The RN has very little upward potential in comparison. Sure, he can move into traveling or management, but that's about it.
Honestly there's no comparison here in terms of earnings potential.

No, it's really not slanted: as I said before, it is probably worth it in the long run but, this is how the numbers broke down for my particular situation. I wasn't trying to speak for everyone else. Unfortunately new grad ICU base pay in my particular area of SoCal is not $65 to $70K, unless you're counting overtime but ... I was comparing base pay benefited positions.

The most I can possibly make as an ICU new grad with benefits where I live in the Inland Empire is $30 an hour and the average is really more like $28 so ... the base pay is more like $52 to $56K. With night differentials you can get up to about $60K base. I could make up to $38 an hour in some ICU jobs, but that's without benefits. As far as ICU pay in five years, I'm not sure why that matters since you'd hopefully be in CRNA school by then.

What job pays nearly $100K a year as a regular RN? The CA state department of corrections and mental health are now paying that much because a federal judge has taken over the medical system and is forcing them to pay higher salaries. The first year is nearly $90k with bonuses and the second year is $98K. And, that's with full benefits and not counting OT. The pension benefits are also better than Kaiser's: 50 percent of your base pay after 20 years versus 30 percent with Kaiser.

Those numbers have actually been posted on this board many times. After you put some time in and get promoted to various supervisory and other positions, the pay can get up to $10K a month or $120K in 3-4 years. So, the income loss at least in the initial four years is quite substantial, especially when you add the $100K+ debt and lost pension benefits.

As for the $100 to $130K for CRNA school, obviously that includes the cost of living, not just tuition, etc. since you also have to pay bills during those two years. Those figures have also been widely quoted on this board. As far as future income potential, I'm sure it would get a lot better but, the recent Medicare anesthesia cuts was another concern, at least for me ... since there's no guarantee on that front.

Even if you make up to $250,000 a year as a CRNA, how much do you actually net after health and retirement benefits, malpractice insurance, other expenses, etc. if you have to pay for all of those things yourself? Retirement alone is extremely expensive if you're self employed and don't have employer contributions ... and retirement is a very big issue for me personally.

I was just pointing out that these are some of the things people might want to look at. That's all.

:typing

I_am_Julia · Apr 16, 2007

not true @ appox 31k per year. check their website for further information.

upenn

Alpha13 · Apr 17, 2007

The most I can possibly make as an ICU new grad with benefits where I live in the Inland Empire is $30 an hour and the average is really more like $28 so ... the base pay is more like $52 to $56K. With night differentials you can get up to about $60K base. I could make up to $38 an hour in some ICU jobs, but that's without benefits. As far as ICU pay in five years, I'm not sure why that matters since you'd hopefully be in CRNA school by then.

I was being generous when quoting the RN salary so there wouldn't be any dispute there. I believe that salary could be made in the more popular areas, but yes if you want to live out in the more rural areas the RN pay goes down even further. And from what I've read, CRNA salaries do just the opposite, in more rural areas they go up.

I was quoting the 5 year salary for RN because this is obviously a rough comparison between an RN and CRNA salary.

What job pays nearly $100K a year as a regular RN? The CA state department of corrections and mental health are now paying that much because a federal judge has taken over the medical system and is forcing them to pay higher salaries.

...

Those numbers have actually been posted on this board many times. After you put some time in and get promoted to various supervisory and other positions, the pay can get up to $10K a month or $120K in 3-4 years. So, the income loss at least in the initial four years is quite substantial, especially when you add the $100K+ debt and lost pension benefits.

I doubt very much that a new RN can get to that salary level in 4 years. Additionally you are quoting figures from perhaps the best paying RN jobs in the entire country. I'd be willing to bet that less than 1% of the RN population makes that kind of salary. When you quote from positions like that you need to stick in some kind of disclaimer because otherwise you ARE slanting numbers.

Also as I mentioned before, 100k in debt is not 100k that needs to (or even should be) paid immediately. Rather it's like a 10k bill for next 10-15 years or so, so if you want to compare salaries with the debt expense included then subtract that off the CRNA salary. As far as comparing benefits again there is no comparison as CRNA benefits are far superior. Signing bonus, relocation bonus, 4-6 paid vacations, 401k match, insurance covered, all are not uncommon.

Even if you make up to $250,000 a year as a CRNA, how much do you actually net after health and retirement benefits, malpractice insurance, other expenses, etc. if you have to pay for all of those things yourself? Retirement alone is extremely expensive if you're self employed and don't have employer contributions ... and retirement is a very big issue for me personally.

Not 250k, but still quite a bit. You're right that managing finances becomes much more challenging for non-salaried positions, but I think someone who can get through a CRNA school and would consider such positions can manage. It's not even that hard with the guidance of a decent financial advisor.

I was just pointing out that these are some of the things people might want to look at. That's all.

It looks to me that you are undermining (perhaps unintentionally) the financial benefits that CRNAs enjoy. I'll say again, there is NO comparision in pay between the two professions. Maybe if you compare a $120k supervisory RN position to a CRNA position in the future discounted for healthcare reforms (that have not happened and are thus pure speculation) then yes, they are comparable. With real world numbers however, they are not.

I don't mean to berate you, I just don't want others to be led astray

Sheri257 · Apr 17, 2007

I doubt very much that a new RN can get to that salary level in 4 years. Additionally you are quoting figures from perhaps the best paying RN jobs in the entire country. I'd be willing to bet that less than 1% of the RN population makes that kind of salary. When you quote from positions like that you need to stick in some kind of disclaimer because otherwise you ARE slanting numbers.

The first thing I said was that I live in California where, most people know that RN's already make a lot more, on average, than RN's nationwide. I also said:

"However, it could be totally different for people in other markets where the CRNA route may be much more advantageous than my particular situation."

So I'm not sure how much more of a disclaimer you want. Less than one percent of RN's nationwide may make that money but, if you live in California, three of the state facilities in my area alone are hiring right now so people have those job opportunities if they want them. To me, at least, that would be lost opportunity costs.

It looks to me that you are undermining (perhaps unintentionally) the financial benefits that CRNAs enjoy. I'll say again, there is NO comparision in pay between the two professions. Maybe if you compare a $120k supervisory RN position to a CRNA position in the future discounted for healthcare reforms (that have not happened and are thus pure speculation) then yes, they are comparable. With real world numbers however, they are not.
I don't mean to berate you, I just don't want others to be led astray.

The title of the thread is: Reasons NOT to be a CRNA. There are upsides and downsides to every career path so, I'm not sure why it's wrong to consider the downside when becoming CRNA is such a big financial investment.

You also seem to be forgetting that I've agreed with you that it's probably worth it in the long run. But, again, for my particular situation, it would take quite awhile to recoup the lost income and debt.

:typing

piper_for_hire · Apr 17, 2007

The only valid general comparison is the average RN vs the average CRNA. You're always going to find specific cases where people make way more than the average, but that really doesn't get us anywhere since those are the exception and not the rule.

Looking at compensation is one thing, but you still have to get out of bed every morning and go to work for the next 30 years (at least I do!). Money is important, but so is the nature of the work. Overall - better pay, better hours, no back breaking lifting, better autonomy, no more arguing with families over brain death criteria, no more code browns .... can't wait till graduation!

-S

suzanne4, RN · Apr 17, 2007

The only valid general comparison is the average RN vs the average CRNA. You're always going to find specific cases where people make way more than the average, but that really doesn't get us anywhere since those are the exception and not the rule.
Looking at compensation is one thing, but you still have to get out of bed every morning and go to work for the next 30 years (at least I do!). Money is important, but so is the nature of the work. Overall - better pay, better hours, no back breaking lifting, better autonomy, no more arguing with families over brain death criteria, no more code browns .... can't wait till graduation!
-S

Every facility where I have worked OR, the CRNA assists in transferring the patient from the OR table to the gurney or bed. General anesthesia means that all muscles are asleep, as well as shincters. And there have been Code Browns in the OR. And usually everyone helps to clean them and then to move them.

And in many facilities, it is the CRNA's responsibility for positioning of the patient. And many times the patient is much larger than the CRNA. There will be quite a bit of "back" work involved if you are planning to work with adults.

piper_for_hire · Apr 17, 2007

I've not seen any of that in the facilities that I have worked in. Big patient? Call the techs! Code brown? Let PACU worry about it! Really bad code brown? Ooops - will have to reschedule this one! Surgeons get away with murder.

-S