Crna

[walrustooth]

I just have to get this off my chest. I have a couple of courses that have some nursing students in my class and all I hear about is CRNA this and CRNA that.

It seems like everyone and their mother wants to be a CRNA. My wife is in nursing and says the same thing about the people around here all talking about becoming a CRNA. It is like there is a mad rush to become a CRNA.

In the back of my class they're always talking about that $160,000 salary, then another comes along and says no no, my friend said you can make $250,000 via locum tenum and their eyes get big and they start screaming with delight.

I am not kidding, I witnessed one female student start quivering when someone mentioned CRNA and she talking about getting a tatoo with CRNA on it.

It just really gets to me...

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[fab4fan]

I just have to get this off my chest. I have a couple of courses that have some nursing students in my class and all I hear about is CRNA this and CRNA that.


It seems like everyone and their mother wants to be a CRNA. My wife is in nursing and says the same thing about the people around here all talking about becoming a CRNA. It is like there is a mad rush to become a CRNA.

In the back of my class they're always talking about that $160,000 salary, then another comes along and says no no, my friend said you can make $250,000 via locum tenum and their eyes get big and they start screaming with delight.

I am not kidding, I witnessed one female student start quivering when someone mentioned CRNA and she talking about getting a tatoo with CRNA on it.

It just really gets to me...

So, you're a pre-med? Which means one day you'll be making more money than a CRNA. So...?

Nursing students taking the same courses as pre-meds? I feel a great disturbance in "The Force."

 

[walrustooth]

So, you're a pre-med? Which means one day you'll be making more money than a CRNA. So...?

Nursing students taking the same courses as pre-meds? I feel a great disturbance in "The Force."

I've read a number of your posts and never seem to comprehend or understand your tone, yet there is an intensity lurking. I'm not taking any position or side here, just merely inquiring as to what all the hype is regarding the CRNA. How does that pertain to income? It is freakishly bizarre for a nursing student to enroll in English composition?

 

[Plastyc]

Many people going into medicine do not like the idea that a nurse will be making the same...and in some cases more than a physician. It is childish I know....but I see it often.

why does it bother you that ther is hype about CRNA's?

 

[fab4fan]

I've read a number of your posts and never seem to comprehend or understand your tone, yet there is an intensity lurking. I'm not taking any position or side here, just merely inquiring as to what all the hype is regarding the CRNA. How does that pertain to income? It is freakishly bizarre for a nursing student to enroll in English composition?

Here's an idea--why not ask your classmates why they're so interested in becoming CRNAs? Or is this just a vent thread?

It's not bizarre for any college student to take an English Comp. class.

 

[foreverLaur]

Great job. Great pay. Lots of responsibility and autonomy. No med school. No massive debt. No residency. Great hours.

 

[kronickm]

CRNA is one of the "end-game" positions for nurses. It is one of the highest "achievements" you can get as a nurse.

It is sort of different for docs as there is really only 1 degree. Think of it like striving to be a dept. chair at a university hospital, or something else that is basically the plateau of your career.

 

[Yourmother]

ooops..error....there is another file I had that has CRNA only incomes....can't find it.

 

[ralegen]

I agree it's annoying. Especially, when they "say" that they're going to do it, but they don't have the slightest idea of the preparations (i.e. GRE, GPA requirements, expectations etc.). Oh! and, they can't even pronounce it! Hahaha. "Nurse.. ...anna...thesi...olog...the...tist." Ah NEST tha TIST you idiot. LOL

It usually comes from the women; not to be sexist or anything (oops too late). JK.

In all seriousness, I think some of it comes from self esteem issues where they're simply all talk.


-RN student.

 

[johnny500]

As a current CRNA student, I am in agreement with the original post. I went into this because, after a period of several years working in several different fields in nursing, I found that I was most passionate about critical care: CRNA school was the logical continuation of my career. Several folks in my class are of the screaming, "quivering" type that the original poster described, but I think the majority of those people tend to get weeded out in the interview process. You'll find that the majority of people interested only in the money are much the same as anybody interested in any career only for the money: they don't have the intellectual fortitude for the education. I can only imagine that it's similar to med school, in that you have to have a passion for what you're doing in order to persevere through the academic rigors. In answer to the question of why does everyone want to go the CRNA route: Tons of intellectual challenge and stimulation, lots of autonomy, lots of respect, and yes, a good salary to boot.

 

[Sehsun]

All I know is that critical care is strongly recommended (required?) to get into CRNA school.

 

[Febrifuge]

Yeah, at the CRNA program at my university, you don't get an interview until you've been an ICU nurse for something like 3 years. All the CRNA's we have are fairly bad-@$$ in that respect.

I don't know how typical that is, but I understand there are not all that many CRNA programs in the US, at least compared to the 140-some med schools and 140-some PA programs.

 

[YouNolesIt]

Yeah, at the CRNA program at my university, you don't get an interview until you've been an ICU nurse for something like 3 years. All the CRNA's we have are fairly bad-@$$ in that respect.

I don't know how typical that is, but I understand there are not all that many CRNA programs in the US, at least compared to the 140-some med schools and 140-some PA programs.

There are currently around 110 CRNAs schools in the US. Although I would not consider it to be as competitive as Med school--none the less it is still extremely competitive. Depending on the program there can be as many as 20-30 applicants per slot. One of the main reasons for lesser numbers than med school relates to the requirement of a BSN--we only recruit from the existing pool of qualified RNs.

 

[Febrifuge]

Ah... my mistake. I must have been thinking of a different program at my school, then. Thanks!

 

[ksahlberg]

what about liability ins? I can imagine it could be through the roof

 

[Trauma Queen]

Anesthesia programs for nurses used to be run/taught by local anesthesiology groups at hospitals in my city. The students were RN's who learned administration of anesthesia during a 3 year program of clinical and classroom learning experience. With the advent of Master's prep as the requirement for Advanced Practice in the U.S., universities and SBON's now require typically the following: 2-3 years critical care nursing (sicu, cticu or the like) followed by a Master's in Nurse Anesthesia at a program recognized by the BON and other regulatory agencies. Just a little background info.

 

[CRNAs]

What does CRNA have to do with critical care?

I don't know who wrote this question, but it is blatently apparent that you have no comprehension of what a CRNA is/does. As a critical care nurse who is both nationally certified in Critical Care and sub specialized in Cardiovascular Surgical Critical Care, as well as a current CRNA student, I am well aware of the qualifications and rigors that are required of a CRNA.

1.) First and Foremost the CRNA is the Ultimate Airway manager. CRNAs (as well as MDAs) are the experts in Emergency management and ventilation, as well as emergency access to patent airways

2.) The CRNA is essentially a hemodynamic badass, or at least that is the intent. This is why CRNA schools require the CCRN certification for school. In critical care, especially cardiovascular critical care you learn in depth hemodynamic control. As a CVSU nurse I have been left alone on thousands of occasions to manage fresh post op hearts. I manage all aspects of swan gang cath care such as SVR, CVP, PA pressures. I have to know normal pressures, how to manage pressures, and patient trends. I have to not onl know what drips do, but how they work. I have to know that dobutamine is a positive ionotrope and that it acts on beta 1 and 2 as well as alpha 1 and 2 andrenergic receptors. I have to know that because it acts on all of these receptor sites there is a potential for many side effects. Such as, bc it is a beta 1 agonist it will increase ionotropy, lusitropy, chronotropy, and dromotropy. If my patient is dry and their CI is low I have to know that dobutrex's influence on chronotropy will probably throw my patient into Sinus tach, and that I should probably give fluid instead of starting dobutrex. The fluid will increase CVP and preload, which is greatly needed in a post op heart that has severe myocardial stunning from beta blockers and cardiapleagia, not to mention the cool 92 degrees that the heart may be. I have to know that giving fluids and rewarming the patient will allow the patient to loosen their Systemic Vascular Resistance and therefore decrease after load and increase CI/COO. I have to know that the formula for SVR is (MAP-CVP*80)/COCO and that if I have an inadequate CVP waveform I will not have an accurate SVR.

3.) Beyond number two, the CRNA is well versed in all areas of Critical Care IE Central line placement, airway management, epidural/pain control, Arterial line placement/management, hemodynamic stabilization, airway management.

In fact there is a really good article written by an MD in a book called Clinical Anesthesiology by Morgan and Mikhail (you MDA buffs should have this one), in which the Dr. talks about CRNAs being in a prime position to be acute care physicians within the current medical arena.

I hope this clears up what Critical Care has to do with being a CRNA. When you have a patient on the OR table who has had their entire Autonomic nervous system wiped out by anesthetics, beta blockers, and various other drugs you better be a bad ass at managing hemodynamics, and there is no better place to learn this than in critical Care.

 

[core0]

I don't know who wrote this question, but it is blatently apparent that you have no comprehension of what a CRNA is/does. As a critical care nurse who is both nationally certified in Critical Care and sub specialized in Cardiovascular Surgical Critical Care, as well as a current CRNA student, I am well aware of the qualifications and rigors that are required of a CRNA.

1.) First and Foremost the CRNA is the Ultimate Airway manager. CRNAs (as well as MDAs) are the experts in Emergency management and ventilation, as well as emergency access to patent airways

2.) The CRNA is essentially a hemodynamic badass, or at least that is the intent. This is why CRNA schools require the CCRN certification for school. In critical care, especially cardiovascular critical care you learn in depth hemodynamic control. As a CVSU nurse I have been left alone on thousands of occasions to manage fresh post op hearts. I manage all aspects of swan gang cath care such as SVR, CVP, PA pressures. I have to know normal pressures, how to manage pressures, and patient trends. I have to not onl know what drips do, but how they work. I have to know that dobutamine is a positive ionotrope and that it acts on beta 1 and 2 as well as alpha 1 and 2 andrenergic receptors. I have to know that because it acts on all of these receptor sites there is a potential for many side effects. Such as, bc it is a beta 1 agonist it will increase ionotropy, lusitropy, chronotropy, and dromotropy. If my patient is dry and their CI is low I have to know that dobutrex's influence on chronotropy will probably throw my patient into Sinus tach, and that I should probably give fluid instead of starting dobutrex. The fluid will increase CVP and preload, which is greatly needed in a post op heart that has severe myocardial stunning from beta blockers and cardiapleagia, not to mention the cool 92 degrees that the heart may be. I have to know that giving fluids and rewarming the patient will allow the patient to loosen their Systemic Vascular Resistance and therefore decrease after load and increase CI/COO. I have to know that the formula for SVR is (MAP-CVP*80)/COCO and that if I have an inadequate CVP waveform I will not have an accurate SVR.

3.) Beyond number two, the CRNA is well versed in all areas of Critical Care IE Central line placement, airway management, epidural/pain control, Arterial line placement/management, hemodynamic stabilization, airway management.

In fact there is a really good article written by an MD in a book called Clinical Anesthesiology by Morgan and Mikhail (you MDA buffs should have this one), in which the Dr. talks about CRNAs being in a prime position to be acute care physicians within the current medical arena.

I hope this clears up what Critical Care has to do with being a CRNA. When you have a patient on the OR table who has had their entire Autonomic nervous system wiped out by anesthetics, beta blockers, and various other drugs you better be a bad ass at managing hemodynamics, and there is no better place to learn this than in critical Care.

What does the Muscular Dystrophy Association have to do with this?

 

[deleted87716]

I don't know who wrote this question

You apparently don't know when they wrote it, either.

 

[deleted432032]

You apparently don't know when they wrote it, either.

Just looked at the when.

From 2007 to 2008 to CRNAs post yesterday, what a resurrection .

 

[jwk]

I don't know who wrote this question, but it is blatently apparent that you have no comprehension of what a CRNA is/does. As a critical care nurse who is both nationally certified in Critical Care and sub specialized in Cardiovascular Surgical Critical Care, as well as a current CRNA student, I am well aware of the qualifications and rigors that are required of a CRNA.

1.) First and Foremost the CRNA is the Ultimate Airway manager. CRNAs (as well as MDAs) are the experts in Emergency management and ventilation, as well as emergency access to patent airways

2.) The CRNA is essentially a hemodynamic badass, or at least that is the intent. This is why CRNA schools require the CCRN certification for school. In critical care, especially cardiovascular critical care you learn in depth hemodynamic control. As a CVSU nurse I have been left alone on thousands of occasions to manage fresh post op hearts. I manage all aspects of swan gang cath care such as SVR, CVP, PA pressures. I have to know normal pressures, how to manage pressures, and patient trends. I have to not onl know what drips do, but how they work. I have to know that dobutamine is a positive ionotrope and that it acts on beta 1 and 2 as well as alpha 1 and 2 andrenergic receptors. I have to know that because it acts on all of these receptor sites there is a potential for many side effects. Such as, bc it is a beta 1 agonist it will increase ionotropy, lusitropy, chronotropy, and dromotropy. If my patient is dry and their CI is low I have to know that dobutrex's influence on chronotropy will probably throw my patient into Sinus tach, and that I should probably give fluid instead of starting dobutrex. The fluid will increase CVP and preload, which is greatly needed in a post op heart that has severe myocardial stunning from beta blockers and cardiapleagia, not to mention the cool 92 degrees that the heart may be. I have to know that giving fluids and rewarming the patient will allow the patient to loosen their Systemic Vascular Resistance and therefore decrease after load and increase CI/COO. I have to know that the formula for SVR is (MAP-CVP*80)/COCO and that if I have an inadequate CVP waveform I will not have an accurate SVR.

3.) Beyond number two, the CRNA is well versed in all areas of Critical Care IE Central line placement, airway management, epidural/pain control, Arterial line placement/management, hemodynamic stabilization, airway management.

In fact there is a really good article written by an MD in a book called Clinical Anesthesiology by Morgan and Mikhail (you MDA buffs should have this one), in which the Dr. talks about CRNAs being in a prime position to be acute care physicians within the current medical arena.

I hope this clears up what Critical Care has to do with being a CRNA. When you have a patient on the OR table who has had their entire Autonomic nervous system wiped out by anesthetics, beta blockers, and various other drugs you better be a bad ass at managing hemodynamics, and there is no better place to learn this than in critical Care.

Well, aren't we just totally impressed with ourselves. All this huffing and puffing about critical care - and almost no mention of anesthesia, which I thought was what CRNA's tend to do on a daily basis.

 

[410322]

I have to know normal pressures, how to manage pressures, and patient trends. I have to not onl know what drips do, but how they work. I have to know that dobutamine is a positive ionotrope and that it acts on beta 1 and 2 as well as alpha 1 and 2 andrenergic receptors. I have to know that because it acts on all of these receptor sites there is a potential for many side effects. Such as, bc it is a beta 1 agonist it will increase ionotropy, lusitropy, chronotropy, and dromotropy. If my patient is dry and their CI is low I have to know that dobutrex's influence on chronotropy will probably throw my patient into Sinus tach, and that I should probably give fluid instead of starting dobutrex. The fluid will increase CVP and preload, which is greatly needed in a post op heart that has severe myocardial stunning from beta blockers and cardiapleagia, not to mention the cool 92 degrees that the heart may be. I have to know that giving fluids and rewarming the patient will allow the patient to loosen their Systemic Vascular Resistance and therefore decrease after load and increase CI/COO. I have to know that the formula for SVR is (MAP-CVP*80)/COCO and that if I have an inadequate CVP waveform I will not have an accurate SVR.

So you know what most MS-2's do, except in a very narrow field? Congratulations?

 

[SilenceDoBad]

CRNA's are incompetent and when they inevitably mess up they will be sued by my Uncle Phil and will lose everything. Then the only job opportunity they will have is to drive a cab with a license plate that says 'FRESH' and dice hanging from the mirror.

 

[deleted432032]

CRNA's are incompetent and when they inevitably mess up they will be sued by my Uncle Phil and will lose everything. Then the only job opportunity they will have is to drive a cab with a license plate that says 'FRESH' and dice hanging from the mirror.

But they won't be moving in with their Auntie and Uncle in Bel-Air.

 

[TheEarDoc]

The CRNA paycheck is amazing, but the road there is long. I never understood why people have such an issue with nurses making high dollar salaries? A CRNA who is practicing would have several years of critical care experience and years of extra focused education. No one has any issue with a physician say a dermatologist going to medical school for 4 years and 6 years residency making 500k per year, but if a nurse makes over 100k per year we best call the medical board.

As for the students who brag about the money, apparently you all have never worked in our around medical schools. Med students brag about how much cash they can earn in each speciality and have the patient and the service they provide as the last desire for going into that specialty.

 

[jwk]

The CRNA paycheck is amazing, but the road there is long. I never understood why people have such an issue with nurses making high dollar salaries? A CRNA who is practicing would have several years of critical care experience and years of extra focused education. No one has any issue with a physician say a dermatologist going to medical school for 4 years and 6 years residency making 500k per year, but if a nurse makes over 100k per year we best call the medical board.

I have no issues with the money side, but lets get our educational time-frame facts right.

CRNA's need a BSN as a pre-requisite. Start there at zero years, just like a newly graduated pre-med student about to go to year 1 of medical school.

For the CRNA - add 1yr of critical care (which is the requirement) and 2-3 years of anesthesia school leading to a master's degree in nurse anesthesia. That's 3-4 years total, not "years of critical care experience and years of extra focused education". Sure, some will have more critical care experience (many have the minimum), but that's called being employed, not education. The move to the DNP will add little to the time of those programs already at the 3yr mark, and zero in additional clinical capabilities or expertise.

For the MD - 4 yrs of medical school, 1 yr of rotating internship, and from 3-6 years of residency, not counting fellowships. That's 8 years minimum post-college. That's double or more than most CRNA's.

 

[TheEarDoc]

I have no issues with the money side, but lets get our educational time-frame facts right.

CRNA's need a BSN as a pre-requisite. Start there at zero years, just like a newly graduated pre-med student about to go to year 1 of medical school.

For the CRNA - add 1yr of critical care (which is the requirement) and 2-3 years of anesthesia school leading to a master's degree in nurse anesthesia. That's 3-4 years total, not "years of critical care experience and years of extra focused education". Sure, some will have more critical care experience (many have the minimum), but that's called being employed, not education. The move to the DNP will add little to the time of those programs already at the 3yr mark, and zero in additional clinical capabilities or expertise.

For the MD - 4 yrs of medical school, 1 yr of rotating internship, and from 3-6 years of residency, not counting fellowships. That's 8 years minimum post-college. That's double or more than most CRNA's.

Yes CRNA's need a BSN. Some will have this with just four years of college and no experience, but most have this because they have been ADRN's for years then worked to get their BSN while working full-time or part-time. So not everyone is a newb who has a BSN. Now yes the minimum for critical care to get into CRNA school is 1 year, but I bet less than 1% of those admitted have less than 2 years experience. CRNA programs are highly selective and highly competitive. They want the rockstar out of a group of professionals. Being employed to me is worth more than education. Most nurses aren't held by the hand throughout their day. They have to learn to be autonomous and responsible for the decisions they make. There isn't a real safety net for new nurses out there. Team nursing doesn't usually happen like it's supposed to. I've experienced that first hand. Try juggling 6-7 patients while a couple are circling the drain. It's tough and will challenge even the most seasoned of nurses or providers. Education is great, and it has it's place, but to say experience is not education is completely a falsehood. Yes I will agree med school is challenging and it's 4 years and then residencies, but many residencies don't turn you loose on day one (at least not at the hospitals I've been employed by), rather they ease you in while giving you a safety net.

Nursing school is not medical school. I never said it was and it never will be. It's two completely different paths and philosophies on patient care. Completely different education styles too. I was pre-med and could have done the osteopathic school route when I finished my pre-med degrees, I also had the chance when I finished my Au.D.., and right before I chose to pursue my MSN, I again had the chance to go Osteopathic, and I chose not to. I know the differences. I have enough colleagues and friends who are MD's, DO's, FNP's, PA's, etc. to know the differences. It just rubs me the wrong way to see people totally discredit an entire profession because of a few bad apples. I know plenty of people who are physicians who I am amazed could make it through medical school. I know several nurses who are that way too. I know several Audiologists who are that way as well. You want to pull the 1% and say it's representative of the other 99%. We could do the same for physicians, but I could care less. I respect the education and the experience, and at the end of the day we are all working together or it doesn't work.

As for the DNP route, we are in total agreement there! DNP is a waste of time and money for nursing. It adds nothing to your clinical experience except the term Dr. and more debt. The schools love the programs though because they like the extra cash. I've seen first hand the lack of change in experience, salary, or skill that moving a master's level degree to a doctorate degree does. I've seen it in physical therapy, audiology, and I see it now in nursing. Unfortunately, in most fields the academic ivory towers have the ears of the boards and grease their palms rather nicely so that's how we get such degree inflation. It all comes down to extra money for academic programs. I have no desire to get another bloated doctoral degree that does nothing for me clinically or financially.

 

[jwk]

Yes CRNA's need a BSN. Some will have this with just four years of college and no experience, but most have this because they have been ADRN's for years then worked to get their BSN while working full-time or part-time. So not everyone is a newb who has a BSN. Now yes the minimum for critical care to get into CRNA school is 1 year, but I bet less than 1% of those admitted have less than 2 years experience. CRNA programs are highly selective and highly competitive. They want the rockstar out of a group of professionals. Being employed to me is worth more than education. Most nurses aren't held by the hand throughout their day. They have to learn to be autonomous and responsible for the decisions they make. There isn't a real safety net for new nurses out there. Team nursing doesn't usually happen like it's supposed to. I've experienced that first hand. Try juggling 6-7 patients while a couple are circling the drain. It's tough and will challenge even the most seasoned of nurses or providers. Education is great, and it has it's place, but to say experience is not education is completely a falsehood. Yes I will agree med school is challenging and it's 4 years and then residencies, but many residencies don't turn you loose on day one (at least not at the hospitals I've been employed by), rather they ease you in while giving you a safety net.

I think you're trying to give credit where credit isn't due, and this is actually a typical APRN claim (I realize you're not an APRN). They want to count ALL of their nursing education starting with their freshman year of college, but they totally discount the four years of college that physicians had as if it didn't exist and/or didn't really relate to anything. Of course you learn things while working - but at what point does it cease to make a difference? I've been in anesthesia more than 30 years - using your logic I clearly must be better than the person who has only been in 29 years, right? You have to start out at a common reference point for a timeline, either start of college or end of college. Anything else is an apples to oranges comparison and is meaningless.

I'm not sure where you get this idea that only 1% of new CRNA students only have one year of critical care experience. That's simply incorrect. One of the biggest debates now with the CRNA crowd is that many think the experience requirement should be raised because there are too many students coming in with that single year of critical care. I know a lot of CRNA's that went to a four year BSN program, did one year of critical care, and then went to CRNA school. They were even accepted before they finished their year of critical care with the proviso that they complete that one year prior to entering the anesthesia program.

You would also be surprised how much residents do on day one, but of course they don't do everything. But please don't tell me that RN's do it all on day one - they simply don't. They have an orientation period just like anyone else in a new environment, and in specialized areas like ICU, ER, OB, and surgery, those orientation periods can easily be 3-6 months or more

 

[mssylmarie]

Count me in as someone who is sick and tired of hearing from fellow nursing students about becoming a CRNA (I am a second degree BSN student). We are merely in our med/surg clinicals and everyone is SO SET on this, even though they don't have much a clue as to what a CRNA does! I personally think it sounds like a lot of liability..

edit: As to RNs being "set loose" on day one, my impression thus far is that this is not exactly the case, especially with some hospitals requiring "residency" programs for new nurses.

 

[acesup123]

.

 

[SouthSideSteve]

CRNA's are incompetent and when they inevitably mess up they will be sued by my Uncle Phil and will lose everything. Then the only job opportunity they will have is to drive a cab with a license plate that says 'FRESH' and dice hanging from the mirror.

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