Seriously considering CRNA - Need input

armynse · Dec 30, 2007

IMO, you should get your year of critical care experience as a civilian and then apply as a direct accession to the USAGPAN. If you go active duty without any prior nursing experience it could take 3 yrs or more before you would be able to attend CRNA school. Nurses are deploying damn-near as often as the infantry, especially critical care nurses (I am a critical care nurse, 66H8A), ER nurses, and OR nurses. The Army is facing a severe shortage of CRNAs, but it is also facing that same shortage of bedside nurses. You would surely deploy within your first year!!

Do yourself and your family a favor...wait until you get that one year of civilian experience. You could enter CRNA school in as little as two years as opposed to 4 or 5 years. I am entering active duty, again, as a direct accession to the CRNA program. I was initially commissioned in 2004 as a 66H8A. I got my one year of critical care experience before I spoke with a recruiter. Good luck in your endeavor... It's nice to pin on that butter bar after wearing stripes, I did the same thing...hooah!!

AG08 · Dec 30, 2007

armynse,

Thank you for that critical advice! Those are some life-affecting decisions right there -- for me and my family. I have considered the path you informed me about but the recruiters (yeah I should have known... recruiters) told me that it was better to get my experience as a nurse in the Army. They have some really nice financial incentives to sign up before even finishing nursing school, though.

So if I do get my CC experience in the civilian sector are my chances for being approved for direct accession pretty good with only one year of CC experience directly after graduating nursing school (that is if I can find a job in CC fresh out of school)? Or do you recommend staying in the civilian sector longer and get more experience before applying for direct accession?

I am very excited that you replied... I have so many specific questions that no one would be able to answer unless he/she actually went through the Army CRNA program.... Thank you.

beedog13 · Dec 31, 2007

AG08,

I will take a little different angle on your options than ArmyNurse...the Reserve option.

I was enlisted for 15 yrs in the Army Reserves (68WM6--formerly 91C). I have been commissioned for 5 yrs (all Reserve as well). I start CRNA school in Sept. '08 and will be using the Reserve STRAP program.

1)I agree with her that you should not not even consider accession until you are ready to apply to CRNA school (AD or Reserves)--in fact, I would take it a step further and say do not get commissioned unit you are ACCEPTED--and yes, get your critical care experience as a civilian--period. The op-tempo is not going to be changing any time soon--you will get deployed for 12-15 months a pop on the Reserve side--bank on it. And because of the frequency of deployment on AD you can very likely "get screwed" from going on AD and applying from there--the are enough excuses they can hand you to load a C-5 transport plane..."according to the needs of the Army" should ring a bell...

2)Another thing to consider when crunching numbers--I will assume that you completed an enlistment and have at least 4 yrs AD--that means you get commissioned as an O-1E (not an O-1), then you get your yrs in service--look at the payscale at DFAS, it is a significant diference. If you have 1-2 yrs RN experience when you accession, you will get credit for some of that time and that means you will subsequently spend less time as a butter-bar (called "Constructive Credit"--it is basically time in grade[not service])--this applies to AD or Reserve.

3)Here's the difference--getting into the Army's CRNA program would surely be a an honor and privilege (they are always ranked very high). The short-term financial advantages are obvious (free school, a paycheck, Tricare). But it is easy to get short-sighted about financing CRNA school--bear in mind that for how ever many years you are on AD to pay back your obligation you will be making considerably less in the Army as opposed to having a gig in the civilian sector (most civilian employers are paying $120K-130K or better)--even with the "pro-pay" in the Army, you are not gonna come close to that. The point being that after you add up loans etc. to pay your own way (there are schools that offer scholarships, plus the Reserve incentives I will outline next) vs. having a "free ride" it can honestly end up as almost a wash--not to mention you cannot put a price tag on the autonomy and self-determination of being a civilian (or at least one most of the time).

4)That's why I would offer you this: In the Reserve Strap Program you are getting $1609/month (taxed), your drill pay once you complete 40hrs school/month (without going to drill--use a form 1380) $420/month for you (taxed), $50K in student loan repayment ($20K/yr x's 2 yrs, then a $10K installment the 3rd, current $30K bonus for 66H, 66H8A, 66HM5, 66E with BSN. You belong to APMC (Army personnel mgmnt command) while you are in school (this makes you teflon from deployemnt while in CRNA school by the way). It's current and ages-old DA policy to deploy Reserve CRNA's 90-days boots on ground (so maybe 110 days in actuality) at a time with about 18mos to 24 mos between deployments. You can also now buy Tricare for your Family for $253/month in the Reserves--that is better/cheaper than any university health plan. You may not need it anyway since alot of SRNA's with families qualify for Medicaid (don't be too proud--you have paid alot of taxes and you will be paying a crapload more after you are a CRNA).

Dude, weigh it all out and really study the options objectively. Examine geographic considerations, costs of living, family dynamics, your age, and your short/long-term goals. In the meantime, do whatever you can to keep your application base broad and keep as many options open as possible until you have to say "yes" to someone. Pick a good ICU to work in for 1-2 yrs--the ICU experience is tantamount to your success in interviews and for application in general. And of coursee, in short, maintain your military bearing. Hope that helps...

Bryan

armynse · Dec 31, 2007

I gave serious consideration to the Reserve STRAP program, but in the end I obviously decided to re-enter active duty. For me, it was all about the money. I am a Captain with over 15 years time in service. As I may have mentioned, not sure, I enlisted in the Army way back in 1985. I left the Army all together (total of 7 yrs) in pursuit of the two B.S. degrees that I now hold.If I didn't have a break in service I'd be retired or worse, ineligible to attend the Army's Anesthesia program. That being said, my pay and allowances on active duty will be six figures. That's right, I will earn just over $100,000 each year while I am in school. After that, I will receive an annual bonus that will make my pay and benefits very competitive with the civilian sector. And, the biggest catch of all is that I will not have to pay upwards of $2000/mo in student loan payments. No loan payments!! I get to keep what I earn!!

Now, who is making more...the civilian CRNA or me?? I realize that I may be throwing your brain into overdrive, but I feel strongly about the military. Active duty or Reserves, you can't go wrong. I'm sure you will consider which works best for you and your family. Keep your spouse engaged in the decision-making process.

To answer your question, the active duty component will absolutely accept you with only one yr of cc experience. Believe it or not, that yr of cc exp has actually been waived many times in the past but only for RNs on active duty. Also, keep in mind that for every yr of experience that you have as a civilian RN you will receive 6 months of constructive credit towards promotion. In other words, it would take 3 yrs of civilian nsg experience to get commissioned as a 1LT. I was just shy of that mark when I was commissioned as a 66H8A (critical care nurse) and I was on active duty for six months before I was promoted to 1LT.

Feel free to hit me with more questions...I can talk about the Army all day. Army life has been good to me. Good luck to you...hooah.

beedog13 · Dec 31, 2007

AG08,

Once again, Armynse makes several valuable points. I will be CPT 0-3E when I start. There is a huge difference between O-1E and O-3E--even in drill pay. Which brings to mind there is a pay/benefits calculator @ http://www.defenselink.mil/militarypay/pay/calc/index.html.

It really has to do with the number crunch. It is easy to skew numbers. Again--any pricetag on autonomy? Self-determination? You have been AD--I don't need to go on about that aspect of things. Try skiing/snowboarding on the weekends @ Ft. Bragg...try whitewater rafting/kayaking @ Ft. Bliss...try building equity in a nice home when you get moved around alot...it is really not the same.

Like she said, make sure you have a good dialogue with the spouse etc.--you will make the best decisions when the time comes.

Bryan

armynse · Dec 31, 2007

AG08,
Once again, Armynse makes several valuable points. I will be CPT 0-3E when I start. There is a huge difference between O-1E and O-3E--even in drill pay. Which brings to mind there is a pay/benefits calculator @ http://www.defenselink.mil/militarypay/pay/calc/index.html.
It really has to do with the number crunch. It is easy to skew numbers. Again--any pricetag on autonomy? Self-determination? You have been AD--I don't need to go on about that aspect of things. Try skiing/snowboarding on the weekends @ Ft. Bragg...try whitewater rafting/kayaking @ Ft. Bliss...try building equity in a nice home when you get moved around alot...it is really not the same.
Like she said, make sure you have a good dialogue with the spouse etc.--you will make the best decisions when the time comes.
Bryan

Better yet, try whitewater rafting/kayaking at Ft Lewis on the weekends. Fort Lewis is by and large the best duty station if you're an outdoors person. I was stationed there in 2004-2006. I miss the year-round snow-capped mountains, having Mount Ranier towering over my front lawn. I cannot wait to go back. On the active duty side, you will be able to choose your clinical site. MAMC in Tacoma, WA is an excellent clinical site. I was also stationed at TAMC in Honolulu, Hi...twice. Tripler is also a CRNA clinical site.

Nonetheless, I will have to pay a price for my "free" education. I will likely deploy to the desert within 3 mos of graduatiing. Bring on the sand...hooah!

BTW, Army CRNAs have absolute autonomy. In fact, at the majority of MTFs MDAs are few and far between. Army CRNAs administer >90% of all anesthesia. This is why USAGPAN is ranked #2 in the country, second only to VCU. There is tremendous responsibility placed upon the shoulders of Army CRNAs...you would not have to work for a group or facility that uses the ACT model (CRNAs are supervised by MDAs). In the OR(stateside or battlefield), it would be you and the surgeon(s). If that appeals to you...give USAGPAN serious consideration.

Isn't it nice to know that you have options?? I feel for civilian-trained CRNAs who face so much debt upon graduation. At my age, there's no way I'd be willing to take on that kind of debt. Debt-to-income ratio will no doubt limit your spending power. I wish you all the best, young soldier...

allnurses Guide · Dec 31, 2007

Better yet, try whitewater rafting/kayaking at Ft Lewis on the weekends. Fort Lewis is by and large the best duty station if you're an outdoors person. I was stationed there in 2004-2006. I miss the year-round snow-capped mountains, having Mount Ranier towering over my front lawn. I cannot wait to go back. On the active duty side, you will be able to choose your clinical site. MAMC in Tacoma, WA is an excellent clinical site. I was also stationed at TAMC in Honolulu, Hi...twice. Tripler is also a CRNA clinical site.
Nonetheless, I will have to pay a price for my "free" education. I will likely deploy to the desert within 3 mos of graduatiing. Bring on the sand...hooah!
BTW, Army CRNAs have absolute autonomy. In fact, at the majority of MTFs MDAs are few and far between. Army CRNAs administer >90% of all anesthesia. This is why USAGPAN is ranked #2 in the country, second only to VCU. There is tremendous responsibility placed upon the shoulders of Army CRNAs...you would not have to work for a group or facility that uses the ACT model (CRNAs are supervised by MDAs). In the OR(stateside or battlefield), it would be you and the surgeon(s). If that appeals to you...give USAGPAN serious consideration.
Isn't it nice to know that you have options?? I feel for civilian-trained CRNAs who face so much debt upon graduation. At my age, there's no way I'd be willing to take on that kind of debt. Debt-to-income ratio will no doubt limit your spending power. I wish you all the best, young soldier...

Not to start an argument, but autonomy of CRNAs has nothing to do with Ft. Sam Houstons ranking or any other CRNA school. It is mainly to do with subjective feedback and the research they produce. The same goes for all the schools ranked by US News.

The USN is considered have the greatest autonomy of all the services, and the AF policy on CRNAs closely resembles that of the Armys. Actually, the Army doesn't have total autonomy stateside. You are supposed to consult an MDA for anything above an ASA III (correct me if I am wrong but I am pretty sure that is correct from what I have heard from the Army CRNA instructors).

There are good and bad to both the military and civilian sides. Don't forget about 75% of the Army's CRNAs get out after their initial pay back. This is mainly d/t deployments which can range for the Army 6-15+ months. Six months doesn't sound that bad until you consider you can be redeployed almost as fast as you get back home... I am expecting deployments to drastically change for the better within the next year, but for now it is what we are stuck with.

As far as debt...if you can keep from starving while going to civilian CRNA school then the debt compared to making 140,000+ a year shouldn't even be a consideration. I personally didn't want to starve while going to school that is why I chose the military route, and the benefits are great. I will be able to retire in 20 yrs, work prn for the rest of my career, not have to worry about medical benefits, and I will still be getting half of my base pay for the rest of your life. Those are the things that really entice me to want to stay in the uniformed services/military.

Capt E, USAF, SRNA (USUHS)

armynse · Dec 31, 2007

There can be no argument...the rankings speak volumes as to the quality of education and the caliber of the program's graduates. Simply stated, graduates of USAGPAN are trained to function autonomously. The ability to think/function independently is an absolute must...

I can certainly understand why the majority of CRNAs(with less than 10 yrs svc) leave the Army as soon as their committment is up...their pay and benefits are in no way competitive with their civilian counterparts. I, on the other hand, have the benefit of time in service which makes my military salary dwarf what I currently earn as a civilian RN. Also, I say let all of the CRNAs leave after their initial ADSO...just makes the pot sweeter for those who stay the course. Take note of the fact that each branch of the military has the discretion of increasing bonuses for company grade officers in critically short AOCs almost at-will.

I will be a field grade officer prior to the end of my initial ADSO post anesthesia school...perhaps I can earn my PhD on company time. :idea:

allnurses Guide · Dec 31, 2007

There can be no argument...the rankings speak volumes as to the quality of education and the caliber of the program's graduates. Simply stated, graduates of USAGPAN are trained to function autonomously. The ability to think/function independently is an absolute must...
I can certainly understand why the majority of CRNAs(with less than 10 yrs svc) leave the Army as soon as their committment is up...their pay and benefits are in no way competitive with their civilian counterparts. I, on the other hand, have the benefit of time in service which makes my military salary dwarf what I currently earn as a civilian RN. Also, I say let all of the CRNAs leave after their initial ADSO...just makes the pot sweeter for those who stay the course. Take note of the fact that each branch of the military has the discretion of increasing bonuses for company grade officers in critically short AOCs almost at-will.
I will be a field grade officer prior to the end of my initial ADSO post anesthesia school...perhaps I can earn my PhD on company time.

I am glad to see you so hyped about going to school. I am at lull right now. CRNA school has the ability to take the energy right out of you. All the military programs train their anesthesia to work independently d/t the simple fact that we deploy and are required to work independently.

Don't get to caught up in the rankings from US News it is highly subjective. There is no doubt that the Army program is one of the best in the nation, possibly the best!

I have heard of CRNAs with as much 17+ years giving up their retirement and getting out of the Army.

Medical bonuses are decided on as a group between the uniformed services, so each service can then decide if they are going to give up to that max (45,000/yr after payback for CRNAs right now) or tweak it or not...ie... the Army gets more bonus money, $15,000, during payback than does the AF or Navy (we get 6,000).

Do you know which school you will be going to yet( Ft Sam or USUHS)?

armynse · Jan 1, 2008

17+ years and giving up retirement...deciding to leave when so close to the promised land is profound.

I'm not really looking forward to going back to school. What I mean is that I'm not kidding myself...I know I'm gonna get my butt kicked up one side and down the other. I'm more excited about returning to active duty, I need a break from civilians...no discipline, no accountability. There are some real slackers at the bedside. Needless to say, they drive me stupid. I've seen many Army Nurse Corps officers leave active duty only to return within a year or two. My total time as a civilian, this stint, will be 3 mos shy of 2 years.

I feel for you...I know they gotta be stickin' it to you over at USUHS. I'm going to San Antonio...had no interest in going to the east coast because I don't have any family close by and I didn't want to risk having to do clinicals at Walter Reed.

I applied for anesthesia school long after the first round of selections were over. I was accepted at Northeastern and boarded by the Army in late November. However, if I had applied prior to the original deadline, I would have been obligated to apply to USUHS. The word in the Army is that USUHS is the more difficult to get into...I was afraid that I would get accepted. I've been sent TDY to San Antonio many times and I'm comfortable there. Choosing USAGPAN was personal, I suspect that you have the diehard academics(students) in your class which might also contribute the multitude of other stressors that you face.

I consider myself to be the avg grad student with a 3.5 GPA. Students with GPAs greater than mine drive the competition factor to new dimensions. I've been given the impression that USUHS has the bulk of the 3.7 and above crowd.

I know what the SRNAs in phase I at USAGPAN were doing since June (35 exams prior to the Christmas break)and I'm terrified of what awaits my arrival in June '08. Your program must be functioning at the same breakneck speed. Hang in there...it might get worse before it gets better, but keep your eyes on the prize...CRNA.

:smiley_aa:biere:

allnurses Guide · Jan 1, 2008

armynse said:

I know what the SRNAs in phase I at USAGPAN were doing since June (35 exams prior to the Christmas break)and I'm terrified of what awaits my arrival in June '08. Your program must be functioning at the same breakneck speed. Hang in there...it might get worse before it gets better, but keep your eyes on the prize...CRNA.

This semester was supposed to be the worst academic semester for us. USUHS must have been comparing notes with Ft Sam on exams because after about the 1st 3 weeks this semester we were taking 1-2 exams usually every week on top of 1-2 papers every week.

All the Army guys at USUHS do their clinicals at Walter Reed. I don't if it has always been that way. I don't know how they select which school the Army goes to, but I pretty certain GPA is not the main factor. The majority seem to have come from Walter Reed before school.

None of the material is terribly difficult to learn, but the time given to learn it is extremely short in most cases.

I feel your pain about working on the civilian side! There is a lot of problems that we just don't worry about on the military side.

Good Luck! Both schools are great!