CRNA vs AA

[NoRNshortage]

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Hello all,

First, a little introduction. I just graduated from nursing school in Texas 2 months ago, and passed my state boards a few weeks back. I had done all the proactive things while in school like busting ass at clinicals, trying to network, going to fairs, etc. A couple unit managers said to keep "checking with them." I did. After much checking, no jobs, so sorry. One outpatient clinic that clearly said, "call us when you graduate, we'll hire you," is now not answering any of my calls or e-mails. Not just, "sorry, no jobs," but not even a reply! All the grad interns jobs? Applied to all, not a bite. I graduated at the top of my class but many wanted only BSNs (I received an ADN degree). The hospital where I did my clinicals? No jobs. The few new grad jobs went to some people with some serious people connections it seems. I guess my networking "skillz" were not mad. Job fairs? Open House? HR is happy to talk, but that's it. "Try in a couple months. Hang in there. No experience right? No, clinical experience doesn't count." I've done cold calls. I've walked directly into units and spoken with nurse managers and nurse directors. "Have you tried our online system." Yes! I'm already in your friggin' system! I'm just coming in to see you in person and show you that I'm going to go that extra mile. Some of my former classmates who are also newly-minted RNs are in the same boat. They've been searching everywhere. Even getting a job at a nursing home is a challenge. But then I am warned by some hospital HR people that if I take a job a nursing home, they won't even look at me down the road because "it's the wrong kind of experience. You'll develop bad habits." I know from my clinicals that some floor nurses of several years experience still don't have their ACLS. So I got ACLS-certified on the first try and am now working on PALS. I'm doing CEs everyday even though I don't need them for the first 2 year of my license, just so I can show an potential employer a long list of my accomplishments. It just plain doesn't matter to these people. They are not going to hire me. They look at their watches when I seek them out.

OK, so that's my introduction. My original intent was to become a CRNA. I got perfect grades on my prerequisites. I graduated at the top of my class as mentioned above. I have killer recommendation letters. I wanted to get into an ICU and commit 2-3 years to learn the art and become a hemodynamics guru. I wanted to work in the highest acuity are where patients threaten to code every minute of the shift, so I would be most well prepared for CRNA school. I planned to pass the CCRN after the first year on the ICU. Well, didn't get the ICU job. Can't even get a med-surg job. On the fence about nursing homes and LTACHs. Printing a fresh batch of resumes for private doc offices.

My question to you who have more life and professional experience to me is, should I broaden my scope and think about attending AA school? So I take 2 courses in general biology, 2 courses in organic chem, 2 courses in physics, score well on the MCAT and I'm good right? I took engineering calculus and got an "A," so that's covered. I am confident I can rock all of these out. I've been doing that all the way up until now.

Working nurses, mid-levels, PAs, and MDs, please provide with your thoughts and feedback, please.

Nursing students ahead of me warned me of this. One of my own friends was just accepted to nursing school. I wonder what I should tell her.

 

[Narnian]

Well in either case if you go MD/DO or CRNA/NP/PA you will need a 4 year degree.(in most cases) I am not sure about AA school. You could get your BSN and take the med school pre-reqs at the same time. Also there are various online BSN programs that are reputable. There are three ICU nurses that I know that were ADN and just wanted to get the BSN because they wanted to climb the "nursing ladder" and they finished in about 1 year. If you need a job right away, take the nursing home gig and start working on your BSN either online or taking classes. If you get your BSN you can do public health, school nurse, and other state jobs that require a BSN (in most cases)

 

[Smb8041]

OP: I like your screen name..lol nothing upsets me more than when a person tries to tell me that there is a nursing shortage!

I graduated nursing school last May. Like you, I want to go to CRNA school, so I was looking for ICU positions ALL summer. All of May, June, July, and August I contacted hospitals all over my city and I heard nothing from anyone. Finally, late August I got a position on a med/surg ICU. I got hired with another girl who has her ADN. So it is possible. I would not give up hope yet. Unless you are strapped for cash and need a job ASAP, I would wait until at least April. The next hiring period for new grads is coming up soon, so positions might be opening up. You seem like a very intelligent determined person, hospitals are sure to see this in you.
A website I really liked to use when looking for jobs was Washingpostjobs.com I even found job postings on there that I didn't find on the hospital's actual websites. In fact that's where I found my current new grad Internship ICU position.

Please hang in there, I know it's tough out there, but give it a few more months if you can. Also, have you thought about med school?

 

[NoRNshortage]

Thank you for your encouragement.

It's funny that you mention med school. I talked with 2 of my former professors that I took A&P and microbio under. They are both former MDs as well. They encouraged me to go directly for med school then and that was their advice again most recently. Perhaps their position at the very top of the healthcare food chain makes it difficult for them to see me pursue any other path except medicine.

But the thing that makes me balk is 4 + 4. Med school and residency. I'm 40 right now. After physics, bio, & org chem, I'd be 50 before I could start practicing. One of my former teaches suggested I go the MD/PhD route to get funding all the way through. I'd be 52-54 then!

Right now I feel like I'm in my prime. I had my first career, did reasonably well but am not rich enough to retire. I feel that if I knock out CRNA school by 44-45 or so, I'm still fresh and can still turn that wheel. But another 10 years of school? I really don't know. I love the mental stimulation, but I don't know how I will be physically. I have several physicians in my family, and they can tell me from first hand experience that the devotion to medicine is total. School, cadaver lab, clerkships, or clinicals. Nothing else. No working out, no hanging with the family. Nada. Maybe if I had worked out 2 hours every day like a martial arts movie star I'd be confident about being tip-top shape until age 80. But right now, I don't know. Just finishing nursing school has taken a lot out of me.

 

[Smb8041]

I don't think your professors in school told you to do med school because they were the "top of the food chain". I think they saw potential in you and didn't want you settle for anything less. However, I completely understand that you are older and feel that CRNA/AA will be the quickest route to get where you really want to be. Just remember, you are going to have some sort of regret either path you take. If you go the CRNA/AA route, you will spend many days wishing you would have gone to med school so you can have complete autonomy and control. On the other hand, if you go to med school, you will spend many nights on call wondering why in the heck you decided to put yourself through this horrible process. Just try to decide which decision you will regret less and stick with that one 🙂

 

[jwk]

The AA route would cut out the one or more years of critical care required for CRNA school. However, you can also do your critical care work while you're going to school and finishing pre-reqs. You need to bear in mind that neither one guarantees you'll get in if you meet the pre-reqs. AND there's a lot of education between now and then. Biology is generally a piece of cake, but organic and physics can be an absolute bitch regardless of how smart you are. And a lot of smart people take the MCAT assuming they'll do well - and don't.

 

[NoRNshortage]

You are of course right about that. I'm originally not even a science guy. I did very well in math in high school, reasonably well in chemistry, and abhorred physics and biology. That's probably what steered me towards a liberal arts major many moons ago.

So I faced doing the prerequisites for nursing a couple years back with great trepidation. Each course was a monumental struggle, but I busted through it and made an "A" on every single one. It hasn't gotten easier for me, and I'm sure it'll be even more of a struggle for what's coming up.

Even though I got "A"s in 2 semesters of college chem and lab some 20+ years ago, it's been a long time since I messed with Avrogado's Number and whatnot so I might just see if I can scratch up some time and do the basic chems again.

Anyhow, the whole med school thing would take a great deal of consideration. I did the nursing thing full-time while still working full-time and busting out the clinicals on the weekends. There was a period of about 4 months where I pretty much ignored my family, and I regret that. I made the grades, but sometimes I think that perhaps getting "B"s or even "C"s would have been better. You just don't get do-overs with family time. It might not look good for the ad-coms when you get a B/C and then re-take and get an A, but you could at least make a passioned verbal defense ("You want know about Cushing's Syndrome? Hit me! Yes sir, hand me that whiteboard and I'll draw you that Kreb's Cycle. Arachdonic acid cascade? Bring it!") while laying out your knowledge directly from your dome right then and there.

After 4 + 4 to become an MD, my kids who would be off to college would not even know who I am. That said, I've dropped a couple trial balloons recently with the spouse and kids and they completely support me ("Being poor for 8 years? Hey, we're down with that, as long as it's what you want.") I just don't know if I can put them through that.

I have shadowed an AA and a couple CRNAs, but these guys and gals were already pretty established and had schedules that had good work/life balance. No telling what the stars have in store in 5 years' time. Everything might change.

 

[PrinceVersed]

Just an anecdote, my hospital could probably use 10 new RN's between its CVICU and ICU. We are that short. Most of us, working 12s, have to work 5-6 days a week because we are so short. However, the brilliant minds that own our hospital are so narrow sighted, money grubbing, and have no regard for patient safety, that they will not hire any new staff. Why would they? When we work a nurse or 2 short per shift they are making a killing. Pure profit.

To your problem. CRNA is another bag of worms you have to worry about even if you get in. Unchecked numbers of CRNAs are flooding the market every year. You might have an even harder time getting a job as a CRNA than you are having now, unless you are willing to relocate. Also, you have to deal with all the ACT crap and what not that sometimes comes up with MDAs.

AA, I have no idea. JWK is your source on that.

 

[fab4fan]

Just an anecdote, my hospital could probably use 10 new RN's between its CVICU and ICU. We are that short. Most of us, working 12s, have to work 5-6 days a week because we are so short. However, the brilliant minds that own our hospital are so narrow sighted, money grubbing, and have no regard for patient safety, that they will not hire any new staff. Why would they? When we work a nurse or 2 short per shift they are making a killing. Pure profit.

To your problem. CRNA is another bag of worms you have to worry about even if you get in. Unchecked numbers of CRNAs are flooding the market every year. You might have an even harder time getting a job as a CRNA than you are having now, unless you are willing to relocate. Also, you have to deal with all the ACT crap and what not that sometimes comes up with MDAs.

AA, I have no idea. JWK is your source on that.

Work smarter, not harder.

(Or insert your own health care middle-management cliche of choice.)

 

[PrinceVersed]

Work smarter, not harder.

(Or insert your own health care middle-management cliche of choice.)

It's all about safety. It's tough to manage an immediate post op CABG on a vent who is waking up and pulling at the tube and a crazy old ba$**** with an IABP who is trying to sit up at the same time. Now add another patient or two to this mix and wait until the $hit hits the fan.

They really just don't get it. sigh..

OP, sure you really want to work as a nurse? haha

 

[NoRNshortage]

It's all about safety. It's tough to manage an immediate post op CABG on a vent who is waking up and pulling at the tube and a crazy old ba$**** with an IABP who is trying to sit up at the same time. Now add another patient or two to this mix and wait until the $hit hits the fan.

They really just don't get it. sigh..

OP, sure you really want to work as a nurse? haha

Yes, I'm sure. I've already gone through hell and rivers of feces to get here with license in hand and my certs, and am banging on the castle walls for any way to get inside.

In terms of it getting crazy, I think any job with "money shots" will have this element. Like my wife always says, "If it's completely safe, you have absolutely no issues with it, you are immune from being fired, and the pay is sky-high...well, that kind of job just simply does not exist!"

I'm getting in. Period.

 

[PrinceVersed]

Yes, I'm sure. I've already gone through hell and rivers of feces to get here with license in hand and my certs, and am banging on the castle walls for any way to get inside.

In terms of it getting crazy, I think any job with "money shots" will have this element. Like my wife always says, "If it's completely safe, you have absolutely no issues with it, you are immune from being fired, and the pay is sky-high...well, that kind of job just simply does not exist!"

I'm getting in. Period.

Just wait until you are there, sir. You will understand when that licenses that you worked so hard for and all the rivers of feces you went through is purposefully put on the line everyday/night just so your hospital can squeeze out an extra $200 bucks.

IF you do get a job, I am sure you won't have a tough time getting into CRNA school. So, chin up. If you have any specific questions about getting into school, you can always PM me.

 

[NoRNshortage]

You are right and I am aware that hospital admins are running a business. If I, and I alone don't take the precautions to take care of my license, I'll find myself thrown under the bus with prominent wheel tracks on my back. If faced with a sketchy nurse-patient ratio I may have to invoke safe harbor and deal with losing my job even though I should be protected in the face of unreasonable demands--I know that going in.

I see that your description is "pre-medical." May I ask if this is one of your reasons to eventually attend med school, so that you can eliminate some of these dangerous hospital factors by running your own practice?

Thanks for the offer to answer my questions. I will definitely ask some as I come closer to finishing all my prereqs and getting some experience under my belt.

Just wait until you are there, sir. You will understand when that licenses that you worked so hard for and all the rivers of feces you went through is purposefully put on the line everyday/night just so your hospital can squeeze out an extra $200 bucks.

IF you do get a job, I am sure you won't have a tough time getting into CRNA school. So, chin up. If you have any specific questions about getting into school, you can always PM me.

 

[chimichanga]

Nursing instructor here...I get so tired of hearing from short-sighted nurse managers that give the line 'if you work in a SNF, we won't take you' because of _____________ (insert any lame excuse here)

It's a horrible way to think, and you wouldn't want to work for them anyhow...

Unfortunately, the supply is greater than the 'demand' (right now), so they can afford to be picky...

you have the right attitude. be willing to relocate if necessary.

In AZ, new grad positions (in hospitals) are tough to find...so nursing homes, schools, immun. clinics, et al, are popular now...

2 years ago we had one student go to a certain teaching hospital in TX. She made a good impression, and six more students followed (in later semesters), and the hospital now loves our program...It's become an 'official' channel that we can suggest to our grads as another option...

hang in there, and keep doing the cold calls...it'[s a much better way then going thru HR, and I built a career on doing that very thing (basic networking and being assertive)

chimi

 

[PrinceVersed]

I see that your description is "pre-medical." May I ask if this is one of your reasons to eventually attend med school, so that you can eliminate some of these dangerous hospital factors by running your own practice?

Thanks for the offer to answer my questions. I will definitely ask some as I come closer to finishing all my prereqs and getting some experience under my belt.

I was pre med for a variety of reasons. However, I got rejected from med school because I'm too stoopid! So now I am going to CRNA school. Start in the fall. Terrible med applicant, pretty awesome CRNA applicant

 

[fab4fan]

I was pre med for a variety of reasons. However, I got rejected from med school because I'm too stoopid! So now I am going to CRNA school. Start in the fall. Terrible med applicant, pretty awesome CRNA applicant

Congratulations. Don't give a second thought to those you've left behind. 😉

 

[Paseo Del Norte]

Nursing instructor here...I get so tired of hearing from short-sighted nurse managers that give the line 'if you work in a SNF, we won't take you' because of _____________ (insert any lame excuse here)

It's a horrible way to think, and you wouldn't want to work for them anyhow...

Unfortunately, the supply is greater than the 'demand' (right now), so they can afford to be picky...

you have the right attitude. be willing to relocate if necessary.

In AZ, new grad positions (in hospitals) are tough to find...so nursing homes, schools, immun. clinics, et al, are popular now...

2 years ago we had one student go to a certain teaching hospital in TX. She made a good impression, and six more students followed (in later semesters), and the hospital now loves our program...It's become an 'official' channel that we can suggest to our grads as another option...

hang in there, and keep doing the cold calls...it'[s a much better way then going thru HR, and I built a career on doing that very thing (basic networking and being assertive)

chimi

Agreed, I got my start (in nursing) as a LPN at a long term care facility. There are many components of that environment that can apply to the "acute" care environment assuming you are the kind of nurse that strives to do a good job. Assessment, charting, doing large med passes and wound care are all important concepts that can crossover.

I also cannot say enough good things about continuing education and good networking. Having people who know your name and work ethic can make all the difference. Also agree with being assertive. I have gone so far as to approach physicians that I know well and ask for letters of recommendation. Everything can potentially count.

 

[deleted6669]

Agreed, I got my start (in nursing) as a LPN

many of the best nurses I know climbed the ladder like that; cna to lpn, lpn to rn while working full time.
a few of the best nurses I know never stopped being lpn's.

 

[Green85]

I see your concerns OP, being an ICU nurse at a TMC hospital and being a RN preceptor, I hear first hand from my students about the struggle to get a job, especially the December grads..but hang in there, a new hire cycle will be coming up soon! As far as jobs, you may be limited by your ADN, pretty much all the major hospitals are switching to hiring just BSN as best practice. If I could step into your shoes with your situation, I would do the BSN bridge online, take organic chem in the meantime and prep for the next hiring cycle. The MD route seems pretty long (assuming that you dont have a bachelors yet?), unless that is a lifelong dream...

 

[Jakester]

Sorry for bumping an oldish thread but I don't see where anyone has asked you an important question. You mentioned a liberal arts major - do you HAVE a bachelor's degree? If you do that makes your options much brighter as direct entry BSN/MSN programs ( I don't think there are direct entry CRNA but that is not my area) and AA/PA programs do not require specific degrees to matriculate. You must fulfill certain course requirements and they vary across the country for PA programs but the bottom line is any BS/BA will get you started. Assuming you have the pre-requisites (and the degree) you could be done in under three years. Good luck and humblest apologies if you addressed the degree issue earlier.

 

[greentuna]

So I understand your grief, and I feel bad for all the people I know from semesters after me. I even felt bad for the people I graduated with! The nursing market is inflated and the new grads are not getting jobs. I desparately wanted ICU but I had to settle with what I could get. I got a Ob job where I did pp & nsy, cross trained er and peds. Just being in the hospital was good enough for me, esp when it paid the bills. Well I just got hired on a expanding ICU unit. Dont know where it will take me, but I didnt give up. I hate to say the 2yrs I spent in OB were wasted, bc I see it as a positive with autonomy and critical thinking skills. Them girls are crazy!

 

[NoRNshortage]

Heck, I would go into L&D if they would take me. As unlikely as they are to hire a guy, I even applied for L&D positions at various hospitals. One open house I went to, they said, "We really don't want you there. Just kidding. But seriously, we don't want you there." I remember my L&D rotations with fondness, when patients said, "Right... now where is that part of the release where I get to exclude students? Because I really don't want HIM in here with me while I'm pushing little Joey out." The high point of my clinicals in that unit was the one single time I was allowed to do a vaginal exam and learn something.

Anyhow, just to update the thread: still looking hard. Went to an interview last week where the interviewer had the rudeness to not even show up and had her secretary tell me to fill out an employment form.

 

[The right Path]

Heck, I would go into L&D if they would take me. As unlikely as they are to hire a guy, I even applied for L&D positions at various hospitals. One open house I went to, they said, "We really don't want you there. Just kidding. But seriously, we don't want you there." I remember my L&D rotations with fondness, when patients said, "Right... now where is that part of the release where I get to exclude students? Because I really don't want HIM in here with me while I'm pushing little Joey out." The high point of my clinicals in that unit was the one single time I was allowed to do a vaginal exam and learn something.

Anyhow, just to update the thread: still looking hard. Went to an interview last week where the interviewer had the rudeness to not even show up and had her secretary tell me to fill out an employment form.

It's always irked the crap out of me when people make a big deal out of a male L&D RN- and yet are cool with a male physician all up in their ****. Yeah, yeah people are entitled to their preferences, but sometimes their priorities are seriously jacked.

For my first birth I had 3 students in there with me, one of them male and I can tell you I was so tired and miserable that the Macy's Thanksgiving Day Parade could have come through and I would not have cared.

So anyways, back to the OPs problem finding work- have you tried getting into one of those extended preceptorship (unpaid unfortunately) programs that are sponsored by nursing schools and/or hospitals? It helps you get experience that employers are looking for and the sponsoring hospital gets free labor. It is a good way for you to prove yourself and hopefully get hired on for real when you're through with the program. Just an option to consider if it is available in your region.