Why Shouldn't I Tell?

[kmchugh]

Frequently on this board, we have posters who are not yet in nursing school (or have just started) who want to become CRNA's. I often advise these people, among other things, to keep their ultimate goals pretty much to themselves. I have further advised them when asked what they want to do in their nursing careers to keep the answer to "When I graduate, I want to work critical care."

Recently, I have received a few PM's asking me why I give this advice. Rather than repeat myself in numerous PM's, I thought I'd just post a thread on the topic. Also, this will give me a thread I can point to for others who may ask the question. So, here it is.

You will run into some nurses who have a prejudice against CRNA's. When I decided to apply, I had one nurse actually ask me why I was "leaving nursing." Some of the nurses who don't like CRNA's are instructors in nursing schools. Nursing school is tough enough without having instructors frown on your personal plans. Additionally, I have heard of an ICU manager or two who avoided hiring nurses who wanted to become CRNA's because "I don't want to just get them trained up, only to have them leave."

So, why does this prejudice exist? I'm not entirely sure. I personally think a lot of it has to do with jealousy. Some nurses are jealous of the salary we get, or the perceived respect we get, or I don't know what else. A recent poster to this board asked why so many nurses wanted to be CRNA's. He "didn't want anyone to take it personally, but perhaps it was just because they didn't really want to be nurses, but they wanted to be pseudo-MD's." The reasons are legion. But, they are out there, and there is no reason to make your life any tougher than it needs to be.

I will say that those who are prejudiced against CRNA's are a very small minority. But they are out there, working as staff nurses, nurse managers, and instructors in nursing schools. The problem is figuring out who they are. Better to be safe than sorry.

I welcome any comments, agreeing or disagreeing. This is based solely on my experience.

Kevin McHugh

[BarbPick]

JC,

Like ER is not a critical ACLS needed area???????

[Brenna's Dad]

ER is definetly a high acuity area.

What the schools are looking for however, is experience titrating gtts, ventialtors, etc. You'll need this in anesthesia.

[angelbear]

I had a lap gallbladder surgery in early oct. I had a nurse CRNA she was awsome I woke up not in pain and with no nausea. She controlled my post op pain as well and i will be eternally grateful. On the other hand I had to have a rather unexpected and hurried TAH/BSO that time I had an anesthesilogist(sp) He was horrible. He gave me nothing preop to calm me as the crna did and i woke up in horrible pain and very nauseas. He was in charge of my post op pain and just let me say it was horribley inadequet. I will always insist on crna for any further surgeries. JMHO

[CougRN]

while i think it is great that the crna provided great care for you. it is up to the pacu nurse to provide you with good pain management after surgery. if the mda didn't write for enough pain meds then the nurse should have asked for more. as a current pacu nurse i bother all of my mda's for more meds if need be.

[traumaRUs, MSN, APRN]

I guess I live under a rock. We have three ER RNs in CRNA school now and I am very interested in their education. I'm in school also (BSN/MSN combo) and not the least bit jealous. Personally, standing still for hours at a time isn't my cup of tea. However, that's the cool thing about nursing - there are many settings in which to practice. Good luck...

[Sheri257]

Originally posted by kmchugh

So, why does this prejudice exist? I'm not entirely sure. I personally think a lot of it has to do with jealousy. Some nurses are jealous of the salary we get, or the perceived respect we get, or I don't know what else.

Excellent advice. It's always better to keep your mouth shut.

And I'm sure it's about jealousy and the money, more than anything else.

If doctor's are threatened by CRNA's and what they make, certainly other nurses (who make much less) won't be happy either.

[loisane]

The tension between mainstream nursing and nurse anesthesia is real. In addition to the accurate comments by many posters here, there is a history to this tension.

In the 1930's, when nurse anesthetists first proposed to organize into a specialty group, the ANA rejected them. So they institutied their own group, and the AANA was formed. How different would our world be if the nursing leadership of that time had been more forward thinking in their philosophy, and more inclusive in thier decision making? Watchful Care: A History of America's Nurse Anesthetists by Marianne Bankert tells this story, among others.

To both sides credit, there have been tremendous strides in more recent history. I can see a real improvement, compared to when I first entered nursing. I believe our leadership now recognizes the value of working together, with combined strength.

Under this vision, our group professional attitude should trickle down to all educators and managers. I hope there will come a day when experiences, such as Kevin describes, no longer occur. Unfortunately, that day is not quite here yet.

loisane crna

[LilgirlRN, ADN, RN]

So, why does this prejudice exist? I'm not entirely sure. I personally think a lot of it has to do with jealousy. Some nurses are jealous of the salary we get, or the perceived respect we get, or I don't know what else.

Only speaking for myself... the prejudice comes from the attitude that some CRNA's project. You kinda expect doctors to think they are God, we're used to that, but not from another nurse.

[jdpete]

I used to feel as an RN that CRNA's were the ones that belittled people, but I found the reverse to be true more than the way I originally thought. You are exactly right about keeping it to yourself. I had people discourage me the whole time. How will you live when you are in school? What does your wife think about you "quitting" work to go back to school? You will have so much debt it wont be worth it. I swear, I never had more people suddenly worry about my living arrangements and expenses until I said I was going to school. There are some people who cant go to school for various reasons, and most will not want to see you go either. And now working as a CRNA, to finish my first thought, I have had RN's telling me about how some of the older CRNA's, that are kind of bossy at times---"well they are an RN just like me." I always let this stuff slide off of my back, but it can be insulting. The answer is yes and no. I never claimed to not be an RN, I am with pride, but to go to 27 grueling months, to make life impacting decisions throughout the day, to work in an extremely stressful enviornment for a much nicer income, and to have a much broader-based knowledge about Anatomy and pharm than I ever did before (sometimes I would like to work in the ICU again with what I know now) we really dont deserve treatment like this. The sword cuts both ways with attitudes towards one another. So I highly advise not telling people----most will not be happy for you.

And to answer the question on ER---I worked in both dept (ER and ICU) ICU is what clearly helps you more because you are an extension of an ICU nurse more than an ER nurse. Granted, I am sure you are completely qualified from the ER, but actually working in the ICU and dealing with SWANS, monitoring preload, afterload, and placing A-Lines, monitoring people with hemodynamic changes, giving Dopamine/Dobutamine and actually seeing what it does to Swan readings---this is what you do as a CRNA---you dont just stabilize like in the ER----just an opinion about what dept "makes" you ready the most----You will be clearly qualified from the ER, no doubt, but I think ICU prepares you the most-----IMO----Good luck

[AnesthesiaBound]

In my experience, the majority of negative attitudes toward my decision for a career in anesthesia was found in the "older nurses". Most younger nurses were excited for me and showed no negative feelings about the career change.

In my opinion, they seem to be upset that you haven't chosen the same career path as they have. I have had many people say, "what, regular nursing isn't good enough for you?"

As to advice, if you are in a position where decision-makers are older and you think they hold these views, it is better to keep your goals to yourself. Otherwise, you could be facing biased assignments, worse shifts, etc.

And definitely, if you are looking for a change into a unit for experience, don't let them know you are planning on going to school a short time later. This can only hurt your chances of getting the job.

BJ

[Sheri257]

Originally posted by jdpete

I swear, I never had more people suddenly worry about my living arrangements and expenses until I said I was going to school.

I had to laugh when I read that.

I always love the jealousy disguised as "concern" bit. :chuckle

Let's face it: CRNA's are at the top of the heap, and people are going to be jealous.

(P.S. I'm just a lowly nursing student. Not a CRNA although, like everybody else, I wish I was )

[Rapheal]

As a floor nurse I have no jealousy of CRNA nurses or any other nursing roles that someone has chosen (and undoubtedly worked hard to achieve). I say -rock on hbscott.