Becoming a Nurse Anesthetist: What is a CRNA
A CRNA is an advanced practiced registered nurse (APRN), who provides the same anesthesia services as an anesthesiologist (MDA). Nurse anesthetists have been providing anesthesia care in the United States for 150 years, and are nationally certified to practice in all 50 states. CRNAs are the only anesthesia providers in more than two-thirds of all rural hospitals in the United States, and they administer approximately 34 million anesthetics to patients nationwide each year.
How to Become a Nurse Anesthetist
Nurse anesthetist have become the major provider of anesthesia in the United States. Nurse Anesthetists practice in a wide variety of settings including academic medical centers, community hospitals, day surgery facilities, pain clinics, or physician’s offices. Nurse Anesthetist can either work side by side with anesthesiologists, or in independent practice. CRNA’s scope of practice includes all accepted anesthetic techniques including general, epidural, spinal, peripheral nerve block, sedation, and local anesthesia.
CRNA School Admissions: The Cold Hard Facts
Get Into CRNA School THIS Year!
Nurse Anesthetists also have the option to specialize in, dental, obstetric, cardiovascular, pediatric, plastic, or neurosurgical anesthesia. Others also hold credentials in fields such as critical care nursing and respiratory care. On the job responsibilities include evaluating patient’s medical history, monitor patient’s pulmonary condition by applying endotracheal intubation, extubation procedures, pharmacological support, mechanical ventilation, as well as respiratory therapy. CRNAs also attend to emergency calls by providing airway management, giving emergency fluids or drugs, or applying basic or advanced cardiac life-support techniques. Nurse anesthesia is one of healthcare’s best kept secrets. Although nurse anesthetist have been administering anesthesia for over 150 years, exactly who they are and what they do is still widely unknown to the general public and even to some healthcare professionals.
Is CRNA School Right For Me?
Being a Certified Registered Nurse Anesthetist is a great feeling, and comes with so many rewards, more autonomy, higher pay, less physically demanding, and much much more. It is important to look over all the facts and information prior to deciding on this career path. This is truly a great profession, however it is not for everyone. There are a lot of factors that need to be considered before applying. Below are a list of factors that will help you decide if CRNA school is right for you.
Cost – Nurse Anesthetists programs are very expensive and require a lot of planning financially. Tuition can range from $20,000 to > $100,000 depending on the anesthesia program you choose. There are government loans available that will pay for 100% of the school’s tuition, and you will be responsible for repaying them after you graduate. It is important to know that other expenses must be planned for in addition to tuition. If you are moving to a new city or state to attend school then relocation cost becomes a factor. On average you can expect to pay $25-50 per school for their application fee. All these fees and expenses can be taken care of with a little planning.
“I had excellent grades in my undergrad, stellar GRE scores, CCRN, however I wasn’t sure I could afford to go to CRNA school. I was surprised how CRNA School Admissions: The cold Hard Facts was able to show me a simple and easy way to start saving for CRNA school. I managed to get accepted into 3 programs and save over half of the tuition cost before I even started. This eBook probably saved me thousands of dollars.” (K. Walker RRNA)
More Autonomy – as an anesthesia provider you will be given a great amount of responsibility. This means you will be making important decisions about patient care including, preoping the patient, type of anesthesia to use, appropriate medications, correct airway management, and postoperative pain management. Being a independent practitioner is a great feeling gives you a high level of satisfaction.
Is School Hard? – This is one of the most important factors to consider when deciding if you want to become a nurse anesthetists. Nurse Anesthetist programs require a large number of hours devoted to studying in order to succeed. In addition to class time you can expect to spend 5-10 hours/day studying. You will be presented with a large amount of information, and it is often compared to “Drinking from a fire hose.” During your time in school your job is to learn. You won’t be able to work while in school, and should not be attempted. School is very manageable if you apply yourself and stay motivated.
Higher Salaries & Job Security – Certified Registered Nurse Anesthetist are the highest paid specialty in the nursing field. A study done by Merritt Hawkins & Associates in 2009 showed that the average CRNA salary was $189,000. This is higher than the average salary in 2006 which was $160,000/year. Increased pay and job security are some of the great benefits this career path offers, and one of the reasons nurses are curious on how to become a nurse anesthetists. The anesthesia community is about to lose a large number of practicing CRNAs due to the recertification regulations that have come with the new healthcare laws. A high percentage of CRNAs today are in the later part of their careers, and are not wanting to re-certify once the new laws are introduced. This means that a lot of hospitals will be in need of nurse anesthetists.
Clinical Hours – Each program contains a clinical component which provides supervised direct patient care experiences for the students. They get to apply a variety of anesthesia techniques and monitoring techniques, improve critical thinking skills, and apply evidence-based knowledge to clinical problems. Every nurse anesthetist student that graduates is required to complete a minimum of 550 cases before becoming a nurse anesthetist. In 2009 the average graduate actually delivered more than 1,700 hours of hands-on clinical anesthesia care, which is over 850 individual cases. You can expect to spend a minimum of 40 hours/week at the hospital. This doesn’t include “call time” which requires the student to be available if they are needed for a case. Some hospitals require students to stay in-house for their call shift, and others let them leave as long as they live close to the hospital. You won’t mind spending time at the hospital, because you will be learning exciting new things like, intubation, inserting arterial lines, and getting to use anesthesia medications to put patients asleep. Overall this is a great experience.
CRNA School Admissions: The Cold Hard Facts
Becoming a Nurse Anesthetist: How Do I Start
Everyone has different work experience, so it is important to figure out what things you specifically will need to focus on first. Some people may still be in nursing school, and they will need to focus on completely different things then someone who is a seasoned ICU nurse. Our eBook CRNA School Admissions: The Cold Hard Facts starts you off with the “Analysis phase”, and this is where we will help you to examine your current starting point in the application process. During the application process it is easy to do things in the wrong order (getting certifications, taking the GRE, studying for the CCRN, etc), and this can waste a lot of your time and money. We will show you the most efficient way to meet all the requirements for applying. Our goal is to help you become a nurse anesthetist. Below is a list of the different starting points.
“I agree that this program not only gives the applicant a stellar resume and application, but the tools to develop a strong knowledge base in the areas of hemodynamics, pharmacology, physiology, and critical thinking. I highly recommend this program” (T. Sharp CRNA)
I haven’t started nursing school.
So the very first thing you need to do is research your local colleges and talk with a counselor in student services to set up a degree plan for you to attain your BSN. They will be able to tell you what classes are required and help you to register. If you already have completed some college courses the counselor will be able to tell if any of them will apply to the BSN degree plan. Make sure that you are well informed on which colleges in your area offer a Bachelors of Science program in Nursing.
I am still in nursing school.
During this time you need to focus on getting good grades. A GPA of 3.5-4.0 is needed in order to have a strong application. In addition to your GPA, you also need to get involved with extracurricular activities. Schools like to see that you are well rounded and work well with others. Look for a list of organizations that are offered through the school and nursing program.
I am a nurse but I don’t have ICU experience.
Your main focus at this point is finding a position in critical care. If you are currently employed at a hospital check with Human Resources and ask what ICU positions are currently available. They will also be able to discuss with you the process of applying and what paperwork will be needed.
I am a nurse with a lot of ICU experience.
People who are currently employed in ICU have a slightly easier road then those people who are not. You won’t have to worry about learning the new skills that are specific to the critical care environment. In our eBook CRNA School Admissions: The Cold Hard Facts you will find Lesson Three “Areas to Work.” This chapter will make sure you are in the highest acuity unit possible. SICU, MICU, CCU, etc are not all equal in the eyes of the admission committee. If you are not currently working day in and day out with ventilators, hemodynamic monitoring, vasoactive drips, and EKG interpretation you will need to find somewhere, either in your current hospital or at a different hospital, that will give you access to these types of skills.
“I believe that this is the single greatest resource out there for helping applicants get into CRNA school. If I hadn’t purchased this book I don’t know if I would have gotten accepted as fast as I did. CRNA school has been a dream of mine, and now it is here.” (C. Thompson. RRNA)
Standards and Scopes of Practice of a Nurse Anesthetist
Perform a thorough and complete pre-anesthesia assessment. Responsibility for the care of patient begins with the pre-anesthetic assessment. Except in emergency situations, the CRNA has an obligation to complete a thorough evaluation and determine that relevant tests have been obtained and reviewed.
Obtain informed consent for the planned anesthetic intervention from the patient or legal guardian. Must have permission to proceed. The patients don’t really have any idea of how risky the anesthesia is. There is no presumed consent. CRNA shall obtain or verify that an informed consent has been obtained by a qualified provider. Discuss anesthetic options and risks with the patient and/or legal guardian in language the patient can understand. Document in the patient’s medical record that informed consent was obtained.
Formulate a patient-specific plan for anesthesia care. Plan of care developed by the CRNA is based upon comprehensive patient assessment, problem analysis, anticipated surgical or therapeutic procedure, patient and surgeon preferences, and current anesthesia principles. A care plan will be made for every patient that receives anesthesia. Most of them will be in the head. Surgeon will have requests also and sometimes we will override those requests. However, the patient needs the surgery is why they are getting the anesthesia.
Implement and adjust the anesthesia care plan based on the patient’s physiological response. Continually monitor the patient’s status to give anesthesia.
Monitor the patient’s physiologic condition as appropriate for the type of anesthesia and specific patient needs. Monitor ventilation continuously Continuously monitor ETCO2 during controlled or assisted ventilation including any anesthesia or sedation technique required artificial airway support. (If they’re breathing by themselves then this isn’t required) Monitor oxygenation continuously by clinical observation, pulse oximetry, and if indicated, arterial blood gas analysis. Monitor CV status continuously with EKG and heart sounds. Record BP and HR at least every 5 minutes. Monitor temp continuously on all pediatric patients receiving gen anesthesia and when indicated on all other patients Monitor neuromuscular function and status when NMB agents are administered Monitor and assess the patient positioning and protective measuring.
There shall be complete, accurate, and timely documentation of pertinent information of the patient medical record.
Transfer the responsibility for care of the patient to other qualified providers in a manner which assures continuity of care and patient safety. Assess patient’s status and determine when it is safe to transfer the responsibility of care to other qualified providers.
Adhere to appropriate safety precautions, as established within the institution, to minimize the risks of fire, explosion, electrical shock and equipment malfunction. Document on the patient’s medical record that the anesthesia machine and equipment were checked. Inspect anesthesia machine and monitors Readiness, availability, cleanliness, and condition of equipment Monitor the integrity of the breathing system.
Precautions shall be taken to minimize the risk of infection to the patient, the CRNA, and other healthcare providers.
Anesthesia care shall be assessed to assure its quality and contribution to positive patient outcomes. Anesthesia medications and machines change during your career. You will continuously improve and learn about things as they come out. Review quality and appropriateness of anesthesia care. Look introspectively on the outcomes and figure out what can be done to improve your practice continuously.
The CRNA shall respect and maintain the basic rights of patients. Patient can’t protect themselves in any way. You have to stand up for the patient.
CRNA School Admissions: The Cold Hard Facts
Get Into CRNA School THIS Year!
This eBook gave me a clear laid out plan that I followed. I passed the CCRN, scored really well on the GRE, and even got accepted to Georgetown Universities CRNA program. If you are serious about CRNA school I recommend this eBook. If I can get into nurse anesthesia school anyone can.” (S. Strickland RRNA)
Information on Standards and Scopes of Practice was gathered from the AANA website.
“Do what you can, with what you have, where you are.”