Anesthesiology/CRNA School

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Question
Hi Mike, thanks for taking the time to answer my questions involving CRNA school. To give you a little background on me, I'm a 22 year old "professional" student. I graduated from high school with highest honors as my class valedictorian with a 4.25 GPA (AP coursework) and had a composite score of 30 on my ACT (I should've taken it more.) I immediately left my small hometown for a 4 year public university that offered me a full ride scholarship, or else I would've been unable to go.

I was unsure of my plans originally and put off taking math and science courses contigent upon my major; I thought I might go pre-pharm or med. I had even considered nursing as an option after high school, but unfortunately got swept up in the romantic notion of being a starving writer after falling in love with classic literature in a gen ed course. I declared a double major in English and creative writing and spent two years honing those skills only to find that the only possible career choice for me was teaching, and I did not want to do that. I also got married at 20 and realized that I did not want to scrape by my entire life the way my parents had done. I decided to change my major and do something in the medical field, even though I was unsure of what path yet.

I declared nursing and moved home because although my 4 year school had a BSN option, I wanted to be closer to my parents, whose health are both declining. I left the university with a 3.89 GPA. I enrolled at my local community college and took all my LPN prereqs in one summer. I am completing the program in 11 months instead of 18 and I will graduate in June. Immediately after, I am finishing my RN prereqs immediately after and beginning RN school in Janaury. It will take 11 months, and I've already researched every school in my state that offers a BSN degree. I plan to finish my BSN at the university I previously attended because all my gen eds I took before count towards this degree. It is online and after RN graduation, I will have 3 courses left before I am able to start my BSN coursework.

I live in a small community with rural hospitals and they do have ICUs. I know several of the RN's on staff and can hopefully land a job there as soon as I graduate RN school. I even had one nurse tell me that I can get on as an LPN as long as I'm already in RN school. I want to get my experience in ICU as soon as possible and apply to CRNA school. Do you suggest that I relocate to a larger place so I can get more experience, perhaps even in a NICU or some specialized intensive care unit? Would it give me an advantage over other applicants? Is it mandatory that I be BLS certified?

I apologize for my lengthy introduction, but I am just so worried about getting in. I have spent hours upon hours researching CRNA schools and admission requirements. It is so competitive! I am 100% sure that this is the right career choice for me, but sometimes I get worried that maybe I can't do it, maybe I'm not smart enough, what if they don't think I'm cut out for it? I have an excellent work ethic when it comes to school. I love to learn and know that I can do something if I set my mind to it, but I still wonder about past SRNAs? What level of intelligence does it take to complete such a strenous courseload? What do I need to make on the GRE? Do I need to take it now, so I can prepare myself better later?

Also, I was wondering if you knew any CRNA's in Arkansas. I would love to shadow one, if at all possible. I want to see what a day is like as a CRNA from beginning to end.

Also, if a CRNA works specifically as a pediatric anesthesist, is there more special training other than a MSN or DNAP required?

My husband and I want to have children at some point, but do I need to do that while I'm working in ICU getting experience or wait? I know CRNA school is supposed to be intense.

Again, sorry for such a lengthy question, and thank you for taking time to answer it for me. Best wishes, Brittnee

Answer
Hi Brittnee and thanks for the question.

Ill do my best to answer some things for you. Some of it will not be what you want to hear but i endeavor to answer questions realistically.

The first thing I want to tell you is that you have to focus on becoming an RN first. Only the top notch and best RNs end up in CRNAs school and graduate. Until you spend a few years (not one) as an ICU RN getting what will be foundation experience with critical patients you simply will not be prepared for CRNA school. The expectation is you come comfortable with sick patients and there is no time to teach you when in anesthesia school. One year of ICU experience is, frankly, barely enough to know the paperwork and protocols but not NEARLY enough to be a critical thinker. A better number is three years and this comes from Benners research on novice to expert.

Now onto your questions!

"Do you suggest that I relocate to a larger place so I can get more experience, perhaps even in a NICU or some specialized intensive care unit? Would it give me an advantage over other applicants? Is it mandatory that I be BLS certified?"

Yes, i do suggest you get as much experience as you can in a high acuity facility. I do not know the acuity of your local facility but if it isnt sufficient it wont be accepted for CRNA school. NICU or PICU would not help get you into anesthesia school as > 98% of anesthesia is done on adults. In fact some schools do not accept NICU and PICU. You are better off in a SICU or CVICU.

It is mandatory to have BLS, PALS and ACLS and preferred often to have instructor certifications in these.

"I am 100% sure that this is the right career choice for me, but sometimes I get worried that maybe I can't do it, maybe I'm not smart enough, what if they don't think I'm cut out for it?"

It is great you are doing research and learning about the profession of Nurse Anesthesia, it shows you are motivated! The question is how do you know this is the right choice? At this point you are not an RN yet, I assume you have not shadowed a CRNA and to date have never been responsible for patients. There is no way you can really know if this is for you until after you become an RN, master than and then shadow a CRNA and see what we do. It is nice to see someone so excited but first channel that excitement into being the best RN you can be in the ICU, the person others come to for advice and a resource. Once you have reached this level the next step is looking into anesthesia. The vast majority of RNs never become CRNAs and many who attempt to get in never do, additionally many in the program fail out. The best thing you can do right now is focus on being the best RN!

"What level of intelligence does it take to complete such a strenous courseload? What do I need to make on the GRE? Do I need to take it now, so I can prepare myself better later?"

Nurse Anesthesia is the height of nursing. There is nothing harder that can be done in the profession or that requires anywhere close to the same commitment or course work, that is a fact. In most programs you need to take the GRE but taking it now would be irrelevant. Wait till you are an RN with a BSN and have 3 years of ICU experience and are ready to apply because the GRE expires.

"Also, I was wondering if you knew any CRNA's in Arkansas. I would love to shadow one, if at all possible. I want to see what a day is like as a CRNA from beginning to end. "

That is a good idea since you cannot possibly know what a CRNA is or does until you see one working. The best bet is to contact the AK association of nurse anesthetists and ask if they have a contact to shadow an INDEPENDENT CRNA.

"Also, if a CRNA works specifically as a pediatric anesthesist, is there more special training other than a MSN or DNAP required?"

No. CRNAs who work specifically with kids, while very rare, are trained the same way. In specialty pediatric hospitals there is often a period of training which most CRNAs do not get. You hit the ground running day one.

"My husband and I want to have children at some point, but do I need to do that while I'm working in ICU getting experience or wait? I know CRNA school is supposed to be intense. "

It would be nearly impossible to work or have children in CRNA school. It is nearly impossible to be involved with your family during CRNA school. That is part of the commitment. I can tell you that during the time you are in CRNA school your life is on hold and so are all your relationships. It is all you do. As for having kids, only you can decide where that takes you. It may be that you do have them as an RN and then never goto CRNA school. No one can know at this point.

Brittnee, the best advice i can give you is focus on what you are doing now. Anything that takes away from that will only hinder your future goals. Become an RN, get in a high acuity ICU, be the best RN you can be, get a BSN and then have 3 years experience and decide if you still want to be an advance practice RN with significantly more responsibility, expectation and work. Look into all the options and shadow providers in each to see what you really want to do. I am not sure how you decided on nurse anesthesia without knowing what either an RN really does or a CRNA but it is far to early to make such a decision. Work hard and make an informed decision later!

Good luck in your future!

Anesthesiology

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Mike MacKinnon MSN FNP-C CRNA

Expertise

I am a former Trauma Flight RN now a Family Nurse Practitioner and a Nurse Anesthetist (CRNAs). I can help answer questions on the CRNA profession and clinical anesthesia. I work full time as an independent practice CRNA and have a special interest in regional anesthesia, particularly peripheral nerve blocks. I also teach ultrasound regional anesthesia and lecture all over the country. If I do not know the answer, I will find it for you.

Experience

I am a Family Nurse Practitioner and a Nurse Anesthetist who works as an independent/autonomous practitioner. There are often questions about my profession and I would like to offer the service of an actual CRNA. If you did not know, there are about 40000 of us which equates to 50% of the anesthesia providers in the USA today. I also lecture and teach ultrasound regional anesthesia all over the country.

Organizations
AANA (American Association of Nurse Anesthetists)
IARS (International Anesthesia Research Society) AANP (American Association of Nurse Practitioners)

Publications
Air Medical Transport Journal
OutPatient Surgery Magazine


Education/Credentials
Bachelors of Science in Nursing
Masters in Nursing
Family Nurse Practitioner
Certified Registered Nurse Anesthetist (CRNA)


Awards and Honors
Excellence in anesthesia education award

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