Why can't you go straight to CRNA School from BSN?

WVUturtle514 · Jan 17, 2006

Being a CRNA requires the use of critical thinking skills everyday. Although critical thinking skills are taught in a BSN program, it is not easy to apply these skills until you're out "in the real world". Having bedside experience is crucial in multiple ways including putting your critical thinking to the test, becoming familiar with the physiology of critically ill patients, becoming comfortable with actually taking care of patients at the bedside and learning to deal with situations that arise while the patient is in your care (such as titrating medications and running a code). I was told in my interview that CRNA programs do not have the time to teach us basic things you learn in an ICU, such as patient monitoring, familiarization with monitors, equipment and medications. CRNA programs expect us to come in already posessing these skills in order to expand on them. Basically, programs do not want to spend time or money teaching us how to take care of an art line, how to interpret Swann-Ganz numbers and teaching us how to take care of a patient on a ventilator. We should already know these things. This is also one of the reasons that most CRNA programs will not accept OR, ER or PACU as "critical care" experience, because a lot of nurses in these units are not familiar with the equipment, ventilators and medications that ICU nurses are exposed to everyday. Hope this helps. If you have any questions feel free to PM me. Good luck!!!

Tracie

SRNA, Georgetown University

Nitecap · Jan 18, 2006

I agree with the above. Though working in the ICU is extremely undesirable you do take home some pretty valuable learning experiences for it. You have an extremely solid foundation to further build upon with the education and experience you get in school. Im sure you are a bright guy, just do your time, 31 is not that old. Half of my class in 30 and up. As an engineer you will like anesthesia, plenty of equipment used all in arms reach. As a nurse your scope of practice maybe limited by the monitoring skills you have laid will help you a ton. Try to work in a busy urban cvicu/sicu or trauma unit and learn as much as possible. I promise you after your stent of a year you will respect ICU nurses much more. It can be way more stressful than you think. Pt's are sick as shiznit with tons of issues, managing a pt sick as such is not all that easy. Yeah you dont decide on treatments as a nurse but once the treatment is decided upon by attendings you carry it out which is not gravy, believe me. Like yeah please keep cardiac index greater than 2.0, as well as pull 150/hr on the CVVH and keep the sats greater than 90, but I dont want to start anymore drips and dont want to increase the fio2 anymore. Oh and by the way, please give him an enema as well while all this is going on.

Being a RN will def. help you prioritize interventions. It will also teach how to comunicate with both family and other health care professionals in a clincal setting.

suzanne4, RN · Jan 18, 2006

I have an M.S. in Industrial Engineering and have worked in healthcare (operations improvement) for several years and now know that I want to be a CRNA. I have worked with nurses and respect them, but I just see myself more as a CRNA (with the knowledge that I have between the two). I am planning to return to an accelerated BSN program in the fall. I know that there is a requirement of at least one year of acute care nursing before even applying to CRNA programs. I am already almost 31 so I'm "late", but I am really just trying understand the reasoning behind this...is it really more for experience? Why can't I get experience from being a CRNA?
Thank you,
KVY

Nursing school only gives you the basics to be a safe learner, your learning curve will not actually begin until you start your first job. There will be so much for you to absorb, not onl yhow the equipment works, but how patients respond to it, as well. And the training that is required is actually "critical" care, not acute care, that is what general hospital wards are actually called.

I understand that you have decided that CRNA is the route that you wish to take, but have you actually shadowed one for a few days to see if it is actually something that you really, really want to do? It is quite different from standard nursing in all respects, and many do not have an adequate idea of what to expect. It is actually harder to get into a CRNA program right now than it is to get into medical school.

Good luck to you with whatever you decide, but make sure that you go into it with open eyes.........................:)

And there are many in their 50s that are in programs, so age really has nothing to do with it.

caroladybelle, BSN, RN · Jan 18, 2006

Nursing School, even BSN programs, give you extremely limited clinical time in a very protected environment. It is not remotely like "real life" in even the best of schools. You must have strong "real life" skills to even contemplate CRNA school. And most prefer 2 years of ICU experience with very good evaluation.

Your first year out of Nursing School you are "still learning".

Think of it this way, a med student gets a Bachelor's, graduates from ,med school with an MD, and is stll required to be an intern for a while, before they can work on their own. And for specialties, they must have further rotations.

Consider that your year or two in the ICU is in effect, your internship/residency.

And another degree while helpful, and imprassive means very little in the nursing/medical environment. Sad but true. Your age, also means very little. There are many 30, 40 years old getting a late start.

Sheri257 · Jan 19, 2006

Though working in the ICU is extremely undesirable ....

Is it extremely undesirable because the patients are so sick and difficult to take care of? Or is it extremely desirable because the real goal is to become a CRNA?

It's funny to hear this because I've always heard RN's say they prefer ICU because they only have two patients to take care of. I've personally never heard an RN say they disliked ICU or that it was "extremely undesirable." But maybe that's because they previously worked in Med Surg which, by most accounts, is more undesirable.

:confused:

athomas91 · Jan 19, 2006

the fact that you ask that question is your answer.

Nitecap · Jan 19, 2006

Is it extremely undesirable because the patients are so sick and difficult to take care of? Or is it extremely desirable because the real goal is to become a CRNA?
It's funny to hear this because I've always heard RN's say they prefer ICU because they only have two patients to take care of. I've personally never heard an RN say they disliked ICU or that it was "extremely undesirable." But maybe that's because they previously worked in Med Surg which, by most accounts, is more undesirable.

Actually i really enjoyed taking care of the sickest of the sick pts because it makes you think, you learn a ton, you make more decisions, it is fast paced and the day flys by. I didnt mind ICU that bad, I wouldnt be a RN in any other area of the hospital.

Ill tell you the things I found undesirable:

Hygenic care - bed baths and butt wipes and cleaning freaking 1 liter of diarrea out of a kinair bed with wall suction and a yanker that stinks b/c he has a GI bleed and I am in the room in a isolation gown sweating my assssses off and about to puke b/c it stinks like shiznit so bad. All while at the same time I have a pt in the next room that is sick, on drips, CVVHD machine alarming b/c is out of dialysate, BP is marginal and I am in here cleaning crap. Then you finally finish and and go in the other room and start your cvvhd again then go back to the first room and the pt has shiiittt again on the brand new sheets and gown you just changed not to mention has pulled out his foley and art line and is bleeding rather profusely from the right radial site. So you then clean him and restrain him b/c he is confused and trying to get out of bed with a ton of lines and drips going. Then at visiting time the family is pissed b/c you have restrained him and he is again laying in shitttt.

Then after visiting hours you have to stop the CVVHD in the other room. And push your 300lb intubated pt from the third to the first floor for a CT. Not to mention he is in a big boy bed, has 3 chest tubes 2 of them needing portable suction, a NGT clamped that he keeps pulling and picking at, a femoral aline that needs transducing during transport as well as a right IJ quad lumen all with fluids or drugs infusing with a quad channel 25lb pump to go along. So you then goto CT with RT bagging, you monitoring and pushing and a 120lb phillipino CNA to help you push this obese pt. Then transfer with to the table hoping not to pull out a ct or line, CT last 5-10min then back to the bed and back up stairs. Then get back to the room, have to restart the CVVHD that means reprimng a new set, not to mention straightening out your bird nest of lines that somehow formed on your roadtrip. You then after 1 hour of not seeing your other pt though someone else was monitoring him go back to his room to find he has craped again confused and playing in the crap.

So again no its not the sick pts , I love the managing the sick pts, they are intense, fast paced ,a real learing experience. Its situations like above that makes the work undersirable. And no that scenario does not happen everyday but it def. can happen more than I like. Face it ICU work, especially if you work in a busy urban fast paced ICU is straight up hard work both physically, mentally and emotionally. You not only care of the pts medical and hospital stay oriented medical issues but also his hygenic, psyc,nursing, feeding, you do it all. You are PT when they cant come to ambulate or do ROM, you are a CNA when they are busy, you are housekeeper if the room needs straightening and you cant find housekeeping. you are the advocate and translator of what is actually going on with the pt in lay terms b/c most docs have no cmcn skills what so ever and pump the pts and families with such false hope its not even funny. again ICU is hard work. You not only learn to manage extremely sick pts but you must learn excellent time management and prioritization skills to be effective and efficient. It is these skills that will assist you to become a more efficient CRNA.

Why do I want to become a CRNA? Way more clinical descision making, more autonomy, more desirable work, just as flexible of schedules, less hygenic and nursing care type stuff, more mental work, better compensation all the way around. I have made the right choice, no doubt about it.

rn29306 · Jan 19, 2006

The neighbors from downstairs are beating on their ceiling because I am laughing so loud. Man, you should write a book or something, if not then at least do standup.

I remember those days, kinda glad they are behind me now.

KVYEng · Jan 20, 2006

Everyone,

This is a great resource for a non-clinical person who wants explore being a CRNA more. I am thankful for the opportunity to read all of your advice and comments. I know, admire, and respect every nurse that I have ever worked with or met. It's not that I don't want to be one, like I said, I respect them. To be honest, my goal is to be a CRNA so I just feel a little fakey--like I am using the position to get to my goal.

Again, thank you for your responses. You've given me a lot to think about.

Sincerely,

KVYEng

apaisRN, RN, CRNA · Jan 20, 2006

To be honest, my goal is to be a CRNA so I just feel a little fakey--like I am using the position to get to my goal.

Don't feel too bad about it. Many CRNAs knew early on that bedside nursing was just a means to an end - I know I did! Even when I started nursing school I already knew I'd go on to advanced practice nursing, and by the time I graduated I was on the anesthesia track.

The thing is, there is a nursing shortage, especially of critical care nurses. If you put in a couple of years, you'll learn a ton and the facility will get the benefit of your work, as well as an RN who is highly motivated and probably high-performing. I feel like my time on med-surg and ICU was my time in the trenches. I cannot imagine doing bedside nursing for life, I would lose my mind, but I sure do know how hard those bedside nurses work!

Ekklesia · Jan 21, 2006

...stinks like shiznit...

Nitecap, that was the funniest stuff I've read in a while!!!!!!!!!!