Seeking your advice on the best way to approach becoming a CRNA from your own path...

offlabel · Aug 21, 2016

Enter critical care nursing without giving a thought to a future in anesthesia.

Learn the bedside trade of caring for the critically ill and injured. Read medical textbooks in critical care and trauma. Become an expert in mechanical ventilation, coagulopathy, fluid and electrolyte resuscitation, critical care pharmacology and hemodynamic/cardiovascular physiology. Become the go to person in your ICU.

Don't ever do or not do anything because that's what the protocol says to do. Know where the protocol comes from and why someone thought it was important enough to write down.

All of this takes at least four years to do, and a busy, ambitious motivated four years at that.

Lastly, understand that there are people smarter than you that will never go beyond being a paramedic or flight nurse and that there are things that they will know far better than you ever will. Accept that and listen to what they have to say to you. They certainly will have no idea or indication that they are smarter than you are, so be very respectful and kind to them.

Take this and any other anonymous advice with a grain of salt. But I'll tell you that I can spot CRNA's from a mile away that did not take this type of approach in their life before anesthesia. These folks are the CRNA's that make the egregious errors that make us all look like idiots. And yes, some are those "independent" CRNA's. For all of the chest beating about "independent" CRNA's that goes on around here, this is curiously and conveniently ignored.

And finally...understand this...when a doctor makes a mistake or has a bad outcome, it was unable to be helped because it was a doctor. When a CRNA makes a mistake, it's because he wasn't a doctor. This is the bias you will live with your entire career, so the bar for you as a CRNA vs. you as an anesthesiologist. It's not fair but it will be your reality. Do everything you can to be better.

Bluebolt · Aug 24, 2016

I'm in CRNA school now and I agree with offlabel about the approach to get into school.

Get in the ICU and practice then you'll see if CRNA is really for you. I have plenty of friends that changed paths between ICU RN and CRNA once it came time to make their move. Sometimes life changes your path for you, many of my colleagues couldn't get the prereqs done, couldn't afford to not work for 3 years during school or couldn't seem to get accepted into a program.

Focus on getting in an ICU, get your BSN done maintaining a good 3.4 or higher GPA when you're finished to be competitive. Then after a couple years practice in the ICU get your CCRN, try out charge nursing (the program will ask about it probably), precept students or new hires to the ICU, get on committee's and nursing councils to improve VAPs or other healthcare improvement topics. Show that you are a leader. Shadow in the OR's or outpatient clinics with some CRNA's, make friends and ensure they'll be willing to write you letters of recommendation. Make friends with a couple intensivists or critical care physicians, critical care nurse managers who will write you a glowing letter of recommendation. Obtain your BLS, ACLS and probably PALS and TNCC. I didn't have the TNCC but they did ask about it and other trauma experience. Look up Wake Forests program specific requirements because some CRNA schools have gotten even more selective than others, requiring you to go back and take a specific physics course and a specific organic chemistry course. In my undergrad I took a blended organic and inorganic course that was very difficult, I managed to make an A in it but this one program wanted to scrap it and have me go back to undergrad and take a diff Chem class, just an example. There are other things but I don't want to overwhelm you this early in the process. I'm just giving you an idea of the path in front of you if you do choose to do CRNA and this is just getting you ready to interview to try and get in.

Good luck to you and hopefully whatever you decide on you'll achieve.