A CRNA Career Path: Meet Bijal Chaturvedi

A CRNA Career Path: Meet Bijal Chaturvedi

Nurses considering a career in nurse anesthesiology know the role is complex and demands a high level of critical thinking and commitment. The career path, in which many certified registered nurse anesthetists (CRNAs) obtain a doctor of nursing practice degree, also offers a high salary and an upward projection of job openings. With a dynamic mix of clinical practice and the capability to work in many settings, nurse anesthetists find a rewarding career.CRNA Bijal Chaturvedi headshot in a black top

Bijal Chaturvedi, DNP, CRNA, GHLC is a member of the American Association of Nurse Anesthesiology (AANA) and gave Minority Nurse some insight into this career path.

How did your career path lead to nursing and becoming a CRNA?
During my final year in college, I battled severe bronchitis and sought help at the health clinic. The provider who attended to me was not a doctor but a nurse practitioner, displaying both kindness and extensive knowledge. This encounter sparked a conversation about her nursing career, introducing me to the world of advanced practice nursing. This pivotal moment inspired me to explore nursing as a career path.

Upon college graduation, despite my Indian parents’ desire for me to pursue medical school, I knew I wanted a profession that combined science, pharmacology, and interpersonal interactions. Armed with a bachelor’s degree in cellular biology, I promptly earned another Bachelor of Nursing within a year. Upon graduation, I entered the field of critical care nursing, working in the most acute critical care unit settings such as burn, cardiac, and transplant ICUs.  It was during my time at Northwestern Memorial Hospital’s Neurospine ICU that I witnessed the role of CRNAs. This experience solidified my decision to pursue a career as a CRNA.

I earned my Master of Science in Anesthesia Nursing from Rush University in Chicago in 2005. In 2021, I received my Doctorate of Nursing from University of North Florida, and in 2022 I received my Global Health Leadership Certification from Northwestern University. I have participated in numerous global mission trips and currently co-chair the AANA’s Diversity Equity and Inclusion (DEI) Committee. I am also the chair of the Illinois Association of Nurse Anesthesiology’s DEI committee. I am passionate about healthcare equity and access and have my own nonprofit called Citizens For Humanity which addresses social determinants of health.

Do you specialize in a certain area or population?
Numerous healthcare environments rely on anesthesia services, encompassing fields such as dentistry, podiatry, surgery, obstetrics, and pain management. In my professional journey as a CRNA, I have experienced diverse settings, including community hospitals, ambulatory surgical centers, and plastic surgery centers, and participation in large teaching hospitals as part of an Anesthesia Care Team. The degree of autonomy varies across these settings, ranging from those with no supervision to those adopting a more interdependent model. I have experience working with diverse patient populations, including pediatric, low-income, and critically ill individuals.

What part of your job is particularly meaningful to you?
The profession of nurse anesthesiology offers a richly diverse and demanding path. In the clinical realm, you have the profound privilege of impacting individuals during their most vulnerable moments. A significant aspect of the gratification derived from administering anesthesia lies in the opportunity to support individuals through what may be the most daunting day of their lives. They grapple with fear of diagnosis, anticipation of pain, and uncertainties ahead. Your presence as a reassuring figure by their side during this critical juncture becomes paramount. While your expertise and competence in ensuring their safety throughout the procedure are undeniably vital, it is the compassion and humanity you extend that hold greater significance than any medication you administer.

Is there something or someone that helped you in your career that others thinking of this career path will find helpful?
My foremost recommendation is to shadow multiple CRNAs across various cases. This immersive experience will provide a comprehensive understanding of what lies ahead. Engage in conversations with current students to gain insights into the rigorous nature of anesthesia school. Recognize that anesthesia training demands significant dedication; therefore, it’s prudent to prepare financially by saving diligently.

Building a robust financial cushion alleviates stress and minimizes post-graduation debt, especially considering the constraints on working while in school. Enhance your academic foundation by enrolling in graduate-level courses in anatomy and physiology, pathophysiology, and pharmacology. This not only demonstrates your commitment but also strengthens your candidacy, particularly if your undergraduate GPA is subpar. While these courses may not be transferrable to most anesthesia programs, they serve to fortify your knowledge base and reacquaint you with the rigors of student life.

What would you like others to know about a being a CRNA?
I believe that aspiring RNs should possess a robust grasp of physiology, pathophysiology, and pharmacology prior to embarking on anesthesia school. Embracing challenging assignments, volunteering for cases involving the most critically ill patients, and delving deeply into the rationale behind every action are crucial steps in nurturing a profound understanding of patient care. This comprehension extends to the selection of medications and interventions, ensuring that aspiring CRNAs are well-prepared for the demanding journey ahead. The ability to think critically is paramount in the delivery of safe anesthesia.

CRNAs must excel as problem solvers and keen observers, interpreting data independently and making informed decisions that can profoundly impact patient outcomes. The weight of responsibility underscores the imperative of being both accurate and decisive, recognizing that lives hinge on the choices made in the operating room.

What is your advice for RNs considering a career as a CRNA?
Research various CRNA programs to find the one that best suits your needs. Consider factors such as clinical opportunities, cultural diversity, and program structure. Make an informed decision based on your personal preferences and goals.

Once enrolled in a program, maximize every educational opportunity, even if it seems insignificant. Graduate-level education requires proactive engagement, and your dedication will determine the quality of your learning experience. Learn from every case and practitioner, embracing the lessons they offer.

Collaborate with CRNAs who may be perceived as challenging, as they often uphold high standards and offer valuable insights. Maintain a positive attitude and remain open to feedback to maximize your learning potential. Avoid being labeled as unteachable, as it can hinder your educational progress.

Recognizing National CRNA Week

Recognizing National CRNA Week

National CRNA Week kicked off its inaugural celebration when the American Association of Nurse Anesthesiology introduced it in 2000. Since then one week in January (this year it’s January 22-28) is designated as a time to celebrate the nearly 60,000 nurse anesthetists practicing in the United States.

Certified Registered Nurse Anesthetists  (CRNAs) work collaboratively with healthcare teams or independently. They administer or assist with administering anesthesia for patients undergoing procedures in various healthcare settings. CRNAs can be present for planned surgical procedures, in emergency settings, in pain management clinics, in dental offices, and in birth centers to name a few.

Nurse anesthetists are responsible for caring for and monitoring a patient’s anesthesiology needs during a procedure, but their work pre- and post-procedure are critical. They will gather medical history, medication information, and assess the patient’s physical and emotional condition when possible. They are constantly looking for and identifying any potential issues that could interfere with plans for anesthesia.

As with other nursing specialties, CRNAs have taken on more responsibility and needed to master increasingly complex healthcare conditions and tech-based equipment. Because of this, changes to the practice entry requirements now require all nurses entering a CRNA program to exit with a doctor of nursing practice (DNP) or a Doctorate of Nursing Anesthesia Practice (DNAP) . Practicing CRNAs aren’t required to return to school for this additional advanced degree if they already have a master’s degree and have been in practice. Although it’s not required, some nurses may find that employment parameters are changing and that the DNP might be a requirement in a new place of employment.

CRNAs have careers that are dynamic and exciting. They can work directly with patients or they may choose to work in administration where they can have an impact on the conditions for patients and nurses. CRNAs also have options to work in government settings or to become active within committees to help shape the policies that surround CRNA work and career expectations. As CRNAs take on more leadership roles, they can use their direct real-world experience to inform the nuances of proposed changes.

As in all nursing specialties, time spent on the job is an excellent way to build skills and empathy for patients. CRNAs will want to continue learning about the rapid changes in the field with certification through the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA). Certification, which needs to be renewed to stay current, helps you remain informed on the latest developments that impact the duties you perform in your work. By staying up-to-date on the most current techniques and developments, you’ll be able to offer high-quality patient care that will result in better outcomes for your patients and the best performance by your team. Certification is a way to learn about everything from patient care to technological changes in equipment that can change your process.

Celebrate the CRNAs on your team this week and if you’re a CRNA take time this week to reflect on the work you do with your patients and your healthcare team. Be proud of the change you make in each patient’s life as you perform a critical task within the process.

From Minority Nurse to Nurse Anesthetist

From Minority Nurse to Nurse Anesthetist

Like many other nursing specialties, nurse anesthesia education programs face the challenge of recruiting, retaining and graduating a sufficient number of qualified students to meet the demands of the health care workforce. A significant aspect of this challenge is the struggle to achieve a racially and culturally diverse student mix that represents the patient population.

The assertion that racial and ethnic minorities are underrepresented in the field of nurse anesthesia does not require sophisticated statistical analysis. One need only visit the meeting rooms and exhibit halls of a professional nurse anesthesia conference to arrive at this conclusion. A recent survey by Dr. Prudentia Worth, director of the Nurse Anesthesia Program at Wayne State University, reveals that only 16% of students in such programs are non-Caucasian.

The Nurse Anesthesia Program at Georgetown University has begun to address this challenge by developing a project designed to prepare more minority nursing students for nurse anesthetist careers. Funded by a grant from the Health Resources & Services Administration’s Bureau of Health Professions, Division of Nursing, the project’s approach is multifaceted, encompassing student recruitment, admissions and, above all, successful completion of the program.

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The success of this diversity initiative serves to benefit not only students but also communities that are at the greatest risk of suffering from a shortage of nurse anesthetist professionals. In creating and implementing this project, our goal was to produce a diverse group of graduates with the competencies to deliver cost-effective, culturally appropriate, quality care to all patients.

The project was officially launched in July 2001. As the result of our initial efforts, the Nurse Anesthesia Program’s class of 2003 has more minority students enrolled than any previous class.

Beginning the Journey. . .

The academic journey toward a career as a practicing nurse anesthetist is not an easy one. After earning a bachelor’s degree and licensure as an RN, the nurse must acquire experience in an acute care setting. From there, the formal application and enrollment process into a nurse anesthesia program can begin.

The length of these programs ranges from two to three years, with 27-28 months being the average. The student faces a rigorous course of study, including classes in the basic sciences (e.g., anatomy, physiology, pathophysiology, pharmacology), professional aspects of nurse anesthesia and advanced principles of nurse anesthesia practice. Upon completion of the program and conferral of a master’s degree, the graduate may sit for the certification exam. It is only after all of these steps are successfully completed that a nurse becomes a Certified Registered Nurse Anesthetist (CRNA).

The Georgetown project’s first step in bringing a more diverse group of nurses into this journey was to initiate strategies for recruiting qualified minority RNs into the Nurse Anesthesia Program. This ongoing effort currently includes outreach to members of student associations, state and regional nursing associations, nurses practicing in local critical care units, and minority nurses’ professional organizations, such as the National Association of Hispanic Nurses.
Another key focus of this outreach effort is personal visits by faculty, alumni and admissions recruiters to hospitals that have a high percentage of nurses of color. Students in our program spend 15-16 months in clinical rotations in the operating room, providing anesthesia under the supervision of a licensed anesthetist. Because of a growing need for more nurse anesthetists in the D.C. area, enrollment in Georgetown’s program has risen 400% in the past five years.

This has required an increase in the number of hospital sites students can use to obtain their clinical experience. To dovetail this need with the goals of our diversity initiative, we have sought out new clinical sites that not only provide contact with minority nurses who could be potential applicants to the program but also give students exposure to a more diverse patient population.

Applicant selection is important to the success of a nurse anesthetist education program, in order to minimize the student attrition rate without compromising the professional expertise of the graduates. For this project, we developed a selection tool based on such criteria as previous nursing education, GPA (undergraduate and graduate), GRE scores, number of years of nursing and critical care experience, three references and a personal statement. The process also includes a personal interview with faculty.

The admissions committee then ranks candidates based on their overall presentation, including academic, clinical and personal accomplishments. In addition, the faculty identifies candidates who have potential but may not meet all requirements or have deficiencies in certain areas. For these applicants, the faculty recommends specific actions, such as additional course work or clinical experience, to increase the candidate’s chance of being accepted into the program and completing it successfully.

In 2001, Georgetown faculty and students conducted a pilot study that describes the benefits of providing associate degree nursing students with information about nurse anesthesia as a career path. As a result of this study, our diversity project also focuses on establishing partnerships with local associate degree programs. This provides minority graduates of these programs with information about the field of nurse anesthesia and the opportunity to pursue an advanced degree. Georgetown offers a number of bridge programs for associate degree students, including RN-to-MSN and a second-degree program.

. . .and Finishing It

The philosophy of Georgetown’s Nurse Anesthesia Program is that every effort must be made to ensure that the students who receive their degrees on graduation day are the same students who sat in orientation on the first day of the program. This level of commitment to student retention requires a labor-intensive strategy of evaluation and advisement throughout the course of study.

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Program faculty conduct individual evaluations with students at least once each semester. Students who need to improve their performance receive assistance in the form of advising, tutoring and mentoring. In the program’s clinical phase, mentoring is provided by practicing CRNAs. A more formal peer mentoring program for incoming students is also under development. When indicated, faculty provide individualized remediation programs to help students address specific areas of weakness.

A concern of all students is the ability to fund their education, and this is even more critical if the students are economically disadvantaged. The project at Georgetown is addressing this issue by seeking means to increase financial assistance sources for minority students. These sources include future employers who are willing to provide tuition assistance, corporate funding, support within the nursing school and the university, government-sponsored minority scholarships, program traineeships and alumni-sponsored scholarships.

A major initiative to recruit more minority students also requires appropriate resources in terms of faculty and staffing. We have addressed this by increasing the number of full-time faculty, hiring a full-time administrative assistant and using adjunct faculty and teaching assistants to provide supplemental teaching and administrative support.

Another of the project’s goals is to provide role models for the students by increasing the number of minority faculty in the program. Our diversity recruitment efforts at the faculty level include both short- and long-term solutions: recruiting from areas where minority faculty work and encouraging new minority graduates and junior CRNAs to pursue teaching careers.

Although this project is still in its infancy, the initial results are encouraging. At open houses for the Nurse Anesthesia Program this year, 38% of the attendees were nurses of color. And while it is difficult to accurately measure changes in the racial and ethnic makeup of new applicants and enrollees, because 25% of these nurses chose to not specify their race or ethnicity, we have seen increased minority representation in both of these areas between 2001 and 2002.

Other quantitative and qualitative results we will evaluate on an ongoing basis to monitor the project’s success include student feedback, review of the selection tool and of admissions committee comments, enrollment of minority students whose initial nursing degrees were at the associate level and employer participation in tuition assistance programs.

Making an Investment in Nursing

The finance industry and the nursing profession may seem worlds apart. But Juan Pineda, RN, a former investment officer for the Massachusetts State Treasury Department who is now a cardiac surgery ICU nurse at NewYork-Presbyterian Hospital/Columbia in New York City, was able to make a smooth transition from the world of number crunching to the challenging and rewarding field of nursing, thanks to a passion for patient care and a love for helping people.

Making a total career change is often a risky endeavor, but for Pineda the bigger risk was remaining in a field that he was not passionate about. “I was more afraid of staying in my investment job than I was of making such a big change,” he says. “As hard is it might be to [have to start all over] in terms of education, it was harder for me to imagine myself in that same position .” Still, he admits, making such a dramatic career shift “definitely takes guts and determination.”

Pineda is the son of Colombian parents who immigrated to the United States in the early 1970s. They settled in the Boston area, where Pineda, along with his older brother, was born and raised.

Pineda’s interest in the health care field emerged in high school when he had to complete a community service project as a Spanish-language interpreter at Massachusetts General Hospital to earn credits toward graduation.

“It exposed me to the hospital environment and I thought it was great,” he recalls. “I really enjoyed helping people. Whenever I walked in to translate for a patient or a family, their faces would light up. They were probably so afraid about what was happening, and finally [here was someone who spoke their language] and could help them understand what was going on, rather than just having people poking and prodding them.”

After graduating from high school, Pineda thought about going to college as a pre-med major. But at 18 years old, he felt he was not ready for the rigor of pursuing a medical degree. “After I did the interpreting for about two months, I went away to college thinking that I was going to major in pre-med after having that experience in the hospital,” he says. “I was really interested in science and the human body. But I don’t think I was really ready to go to college at 18. I wanted to take some time off and really think about what I wanted to do. However, my parents didn’t think that was a good idea, and they strongly encouraged me to continue [with my education].”

He ultimately decided to remain at the University of Massachusetts Amherst to complete his degree, but not as a pre-med student. “[Back then], I just didn’t have the dedication for it,” he says. The thought of having to take difficult science classes, like organic chemistry, scared him. He decided to switch gears and pursue a degree in political science, one of his other big areas of interest.

As a political science major, Pineda focused his studies on international relations, comparative politics and issues affecting Central and South America. “At that time I thought I would go to work for the UN or something,” he says. “I minored in French and lived in France for a while and thought I would go down the path of working in international relations.”

After graduating with his bachelor’s degree in political science, Pineda took advantage of an opportunity to work at the Massachusetts State Senate. The job, however, focused more on the financial side of state politics than on the policy-making side.

“I worked as a budget analyst for the Ways and Means Committee,” he explains. “Then I moved to the State Treasury and became an investment officer. I did general fund investments in bonds and long-term debt, investing up to $1 billion. This wasn’t really complicated work—I didn’t have a background in investing. But I wanted to learn more [about the field], so I accepted a position at [the financial services firm] Morgan Stanley.”

At the time, the job at Morgan Stanley seemed like an attractive offer that would give him opportunities to use his Spanish-speaking skills and his background in international relations. With the possibility of assignments that would involve traveling to South America to gain clients seeking to invest money in the U.S., Pineda thought he had finally found a way to combine some of his interests.

But by the time he had completed his training and licensing in early 2001, the economy was in a downturn. It was not a good time to be working in the financial sector, and Pineda never got his chance to travel for Morgan Stanley. He was also beginning to feel that his career path was leading him further and further away from his original interest in public service.

“I didn’t feel like I was helping people by working in investing,” he says. “I realized I wouldn’t be successful in that career, because I didn’t have enough passion for what I was doing.”

Ready for Change

After quitting his job at Morgan Stanley and taking some time to think about what he really wanted to do, Pineda finally decided to return to square one and refocus on his first love: health care.

“That’s when I decided to go to nursing school,” he recalls. “I had a friend who was in nursing school and I would flip through his textbooks. He reminded me that it wasn’t too late to change careers. I agreed, and in 2001 I enrolled at Bunker Hill Community College and began taking anatomy and physiology courses.”

Pineda’s decision to make a career change into nursing was met with some resistance from his family—and even from other nurses. “When I first decided to go back to study nursing, a [nurse] friend of mine let me tour the ER of the hospital where he worked so that I could see up close what it was like. I wanted to be exposed to the ER to see if I would get nervous about seeing blood and things like that,” he explains. “One of the nurses there told me that I couldn’t go from [a field like finance] to nursing. I ignored the comment, because I knew that I can do anything if I really want to do it.”

He says his parents “rolled their eyes” when he announced that he was returning to college full-time to pursue a nursing degree. “Because I had had so many different jobs and was in my mid-to-late 20s and still struggling to find what I really wanted [to do with my life], they didn’t believe that I would [really] do it.”

But Pineda soon proved to his family—and his peers—that he was very serious about nursing. He attended classes during the day and supported himself by working as a waiter and bartender at night. “I needed something stable that wouldn’t interfere with school,” he says.

In 2004 he completed his associate’s degree in nursing, graduating at the top of his class. Shortly after that, he accepted his current position at NewYork-Presbyterian Hospital/Columbia.

Today, Pineda has no shortage of opportunities to feel passionate about his work. “I love my job. I’m one of the luckiest people in the world,” he says enthusiastically. “I can’t believe that I get paid to do this. This is the most interesting job [I’ve ever had]. It’s always challenging—physically, mentally and emotionally. I’m very proud of what I do. I’m helping people. I get to learn so much about the human body, how to work with families and how to educate patients about their recovery. I’m providing emotional support to patients and families. It’s great.”

Communicating and Connecting

Pineda feels there is a strong need for more bilingual Spanish-speaking nurses all over the United States. The community his hospital serves, for example, has a large population of immigrants from the Dominican Republic. “Every day another nurse asks me to interpret,” he says. “I can’t imagine working [here] and not speaking Spanish.”

Although many of the doctors on his unit do speak Spanish, Pineda’s ability to communicate in Spanish is still in demand. “[Here in the cardiothoracic ICU], patients are coming out of surgery, so it’s very helpful for them to connect [with the nurses] and much more effective for everyone that I speak Spanish. There’s a comfort for the patients [knowing] that I share the same culture, language and interpersonal dynamics with them.”

One of the reasons why Spanish-speaking nurses are so underrepresented in the RN workforce, Pineda believes, is the strong emphasis on family obligations in Hispanic communities. “[We] Hispanics seem to have children earlier in life,” he explains. “But [even if you do have kids] it’s worth it in the long run to continue with your education, because it will open so many doors in the future.”

As for being a man in nursing, Pineda doesn’t feel like he’s a minority in that regard. “I’ve been in units where on some days half of the nursing staff is male,” he says. “A lot of men in nursing are drawn to the ER or the ICU. It’s a very fast-paced environment. I’ve even been told by some families that [they think] male nurses are more compassionate than female nurses. The important thing, no matter what gender or race you are, is that this is a great career with lots of opportunities for growth. You can go as far as you want to go.”
Asked what qualities are necessary for a successful career in nursing, Pineda answers that a good nurse is empathetic, hard-working and determined. “You have to love this profession,” he emphasizes. “It can be difficult if you didn’t love it. The decision to become a nurse is so personal, but if [you] have a desire to learn a lot and really help people at the most critical points in their lives, it’s the best job in the world.

“It’s a competitive field,” Pineda continues. “[When you’re in nursing school], the classes are difficult. The first year is hard and from there it only gets harder. Then you have to take and pass the exams. And then when you start your first job, the work is hard and the hours are long. But it’s the most rewarding work. I advise others [interested in nursing careers] to be dedicated and do your best.”

Continuing the Dream

Now that Juan Pineda has fulfilled his dream of becoming a nurse, he is ready to take on new challenges. This summer he began taking courses in general chemistry, organic chemistry and statistics in order to fulfill requirements needed to apply to a master’s program in nurse anesthesia.

“I already had taken many of the [prerequisite courses] during my undergraduate work as a pre-med major, so I just needed three additional classes,” he says.

Today Pineda feels he is on track to achieve the kind of career he always wanted. “Being a nurse anesthetist is my ultimate goal,” he says. “That was my original plan—to have such a special role in someone’s treatment. I’m going to apply [to CRNA programs] in November. I have been focused on getting the best grades [in my prerequisite classes], because anesthesia school is very competitive.”
And what about his long-term goals? Where does he see himself in, say, 10 or 20 years? While Pineda has given it some thought, he admits that right now he’s focusing all his energies on getting through his CRNA program.

“I’ve planned on this for the past six or seven years and it’s such a big goal,” he says. “I’ve been focused on it for so long that [at this point] I’m not sure what my goals for the future are. I have thought about teaching, though. My ultimate goal for when I retire [from nursing] is to be a teacher of English as a second language.”

The Minority Student’s Guide to CRNA Programs

It’s often called the best-kept secret in nursing: Certified Registered Nurse Anesthetist (CRNA). These master’s-level advanced practice nurses prepare, administer and monitor the use of anesthetic medicine in patients. According to the American Association of Nurse Anesthetists (AANA), CRNAs practice in every setting in which anesthesia is delivered: traditional hospital surgical suites, obstetrical delivery rooms, critical access hospitals, ambulatory surgery centers and the offices of dentists, podiatrists, ophthalmologists, plastic surgeons and pain management specialists.

Like many other specialty areas of nursing, CRNAs are in short supply and therefore in high demand. They also typically earn six-figure salaries. As the AANA puts it: “CRNAs practice with a high degree of autonomy and professional respect. They carry a heavy load of responsibility and are compensated accordingly.”

Currently, nurses of color are significantly underrepresented in the field of nurse anesthesia. According to some estimates, African Americans and Hispanics each make up less than 2% of all CRNAs. As a result, nursing schools and the AANA are working to increase diversity in the specialty. And that means there’s never been a better time for minority nurses to take advantage of this career’s outstanding professional and financial rewards.

Completing the CRNA educational requirements, though, will require two or three of the toughest years of your life. CRNA programs are rigorous, intense and time-consuming. They are also very competitive to get into. Admissions committees will expect applicants to have high GPAs and high GRE (Graduate Record Examination) scores. Students are also expected to have a couple of years experience in critical-care or intensive-care nursing and outstanding references.

“This is probably one of the most rewarding fields in nursing, and almost [every CRNA] has a high level of job satisfaction. But that also makes it the most competitive,” says Henry Talley V, PhD, CRNA, MSN, MS, BA, director of the newly accredited CRNA program at Michigan State University College of Nursing. He is also the founder of Minority Anesthetists Gathered to Network, Educate and Train (M.A.G.N.E.T.).

How to Choose a Program

The journey toward becoming a nurse anesthetist begins with choosing the CRNA education program that best meets your needs. This means you’ll need to research potential programs thoroughly.

One of the most important things to look at is accreditation. There are currently more than 100 CRNA programs nationwide that are accredited by the AANA’s Council on Accreditation of Nurse Anesthesia Educational Programs. A complete list is available at the association’s Web site, www.aana.com.

In some states, students who earn degrees from unaccredited nursing schools can still take their NCLEX® exams and become RNs. But this is not the case with nurse anesthesia programs. “The program has to be accredited for students to sit for the national [certification] exam,” Talley explains. “Unfortunately, a few students have learned the hard way how important accreditation is.”

Talley also cautions prospective CRNA students to do more than just look for the standard accreditation statement. “Find out from the Council on Accreditation if the programs you’re considering are in good standing or are on probation,” he says. A program on probation may be in danger of losing its accreditation, which could make students ineligible for the exam and certification.

While this type of information is easy to obtain, it’s not always so easy to research whether a CRNA program embraces diversity and will provide an environment where minority students will feel welcome rather than isolated. One approach is to visit the Web sites of programs you’re interested in and look for clues, such as the number of minority nurses on the faculty, the presence of a diversity director and whether the curriculum has a cultural competency component.

However, Talley cautions against placing too much emphasis on these factors.

“If you can find minority faculty in a program, that’s helpful. Sometimes, there are special problems that still occur in society where a minority student needs the input of another minority or a mentor. However, [the reality is that there are very few minority faculty in the nurse anesthesia field], so you can’t make that the top criteria of your program decision.”

Instead, he advises, look at passing and placement rates. Visiting the campus and talking to students and faculty members–preferably meeting them face-to-face–before submitting your application will give you an indication of whether you will fit in at that program.

While the number of racial and ethnic minority CRNAs is still small, the number of men in the specialty is unusually high. According to the AANA, nearly half–approximately 46%–of the nation’s nurse anesthetists are men, compared with only about 8% in the nursing profession as a whole. As a result, male CRNA students are likely to find that their program offers a male-friendly learning environment. They are also more likely to find male faculty members.

It’s also important to compare your learning style to the program’s teaching style.
“Some curricula spend the first three months in the classroom and then begin clinicals with students doing minor work in the operating room,” Talley says. “Other programs cover all of the academic coursework before beginning clinicals. Students work on [patient] simulators. If you’re someone who learns by doing, the first type of program might be best for you.”

You may also want to consider any special circumstances, such as accessibility or degree status. For Wallena M. Gould, CRNA, MSN, who graduated from La Salle University’s Nurse Anesthesia Program four years ago, finding a CRNA school that would accept her even though she did not have a BSN degree was what made the difference.

“My bachelor’s degree is in accounting,” she explains. “I went back to school and earned an associate’s degree in nursing. La Salle’s program did not require a BSN. I was accepted, but I was required to take two years of prerequisites before formally becoming part of the CRNA program.” Gould is now chief nurse anesthetist at South Jersey Regional Medical Center in Vineland, New Jersey.

How to Get In

Is it really that hard to get accepted into a CRNA program? Just how competitive is the field? The answer, unfortunately, is “very.” CRNA class sizes are small, only a limited number of slots are available and admission standards are very high.

“While our program’s GPA requirement is 3.0, my incoming class average is 3.73,” Talley says. “Meeting the minimum standards does not give you a good chance of getting into a program [that can only accept] 10 or 15 students. You really want to have at least a 3.5 GPA, with excellent grades in your science courses and in your last two years. If your GPA is lower, you need to do very well on your GRE. Get a study book with practice tests and practice, practice, practice.”

CRNA programs also require applicants to submit a 500-word essay. Consider this your opportunity to sell yourself. If your essay is not well written, chances are you won’t be invited in for an admissions interview.

With odds like these, it’s best to not get your heart set on one particular school. To increase your chances of getting into a CRNA program, plan on applying to at least three schools.

While getting in may be tough, take comfort in knowing that once you’re accepted, you’re very likely to succeed. In other words, if you’re good enough to get in, you probably have what it takes to complete the program.

“We’re very selective, but we lose very few students–usually only one or two each year,” says Sass Elisha, CRNA, EdD, academic and clinical educator at Kaiser Permanente School of Anesthesia in Pasadena, California. “At this school, we screen students carefully and accept them expecting success. We do what we can to help them realize that potential, but it is dependent on them. We’ll help them, but the heavy lifting is their responsibility.
“The people that apply are unbelievably high-quality students. Their knowledge base and scholarship are impressive and that makes it very difficult to analyze applicants.” He adds that applicants must show that they have a clear understanding of the program and the specialty.

Gould agrees. “The first question you’re going to be asked in your interview is ‘why do you want to become a CRNA?’” she says. “Applicants should be able to answer that question in a way that shows familiarity with the field and the responsibilities. It’s also very important that you read the requirements for completing the program instead of just getting into the program.” She also advises applicants to use their interview time to talk about how they will manage their family obligations and finances while in the program.

To seal the deal, do your homework. Know the traditions, history or alumni that make a particular program unique or special.

How to Survive

Getting accepted into a CRNA program is just the beginning. Perhaps more than any other nursing education program, earning a master’s degree in nurse anesthesia requires almost complete devotion to your studies. The pace is fast, the classes are rigorous and the clinical portion is so time-intensive that it feels like a full-time job. You pretty much have to live, eat and breathe CRNA for 24 to 36 months, depending on the length of your program.

With few exceptions, all accredited CRNA programs are full time. Students are usually prohibited, or at least discouraged, from working–even part time. If you are a parent, you will be expected to have fail-safe childcare arrangements.

“Many nurses don’t recognize the true rigors of the program and are unprepared when clinicals start,” says Gould. “You need to realize that you’ll be taking at least two exams a week. You’ll be challenged verbally all day during clinicals. Instructors will be asking you, ‘what are you going to do? Why are you doing it? How would you do it differently if the patient had asthma?’”

After seeing a fellow minority student in the La Salle University program struggle and eventually fail, Gould has made it her mission to prepare nurses of color to complete their programs and graduate as CRNAs. She is the founder and coordinator of a diversity mentoring program that currently provides assistance to students from 18 nurse anesthesia programs in eight states and Puerto Rico. (See page TK.)

One of the biggest obstacles minority CRNA students face is financing their education, Gould emphasizes. Very little financial aid or stipends are available from federal sources, and two or three years of graduate school are expensive. And even though there are a number of CRNA scholarships available (see “How to Pay for It” sidebar), there’s still the problem of being unable to work while you’re in the program.
All of the sources interviewed for this article agree that financing a return to school does put pressure on virtually every nurse anesthesia student. “It’s difficult for someone who has been working as a BSN to quit work and begin paying for tuition and books. The students are still paying living expenses with no money coming in,” says Elisha.

For students who are married, it means going from two salaries to one. For single parents, it’s difficult but it can be done, Elisha stresses. He also points out that some CRNA programs do have arrangements with hospitals in which students receive a stipend or scholarship in return for agreeing to work for the hospital for a certain amount of years after they graduate. Working RNs may also want to check with their current employers to see what benefits might be available.

Gould has seen adult students move back in with their parents to manage the financial crunch. “Almost everyone takes out some kind of loan, and some students pay for those three years entirely with loans,” she says. “I encourage nurses I talk to that are interested in the field to think about their finances now, even before they begin applying. Pay off your credit cards and pay down as much debt as you can. Try to save as much money as possible while you’re working.”

A few CRNA programs–including those at University of Detroit Mercy, Rush University College of Nursing and Rosalind Franklin University of Medicine and Science–do offer a part-time track, which allows students to continue working while enrolled. Keep in mind, though, that this option usually applies only to the classroom portion of the curriculum; the clinicals are invariably full time.

While no one ever said that completing a CRNA program is easy, minority nurses who have done it agree that the rewards of this career make it all worthwhile.
Gould says students of color often ask her about the low number of minorities in nurse anesthesia and how that environment will affect them when they start their program. This is a particularly strong concern for nurses who have already struggled with the experience of being the only minority in their undergraduate classrooms or their workplaces. She encourages them to view it as an opportunity to reach out instead of withdraw.

“[In a CRNA program,] your classes are going to be small and you’re going to grow close,” she explains. “I tell students to rely on other classmates. Find a study buddy who is as strong as you and will put in the hours needed, regardless of that person’s color. That’s what counts.”

Putting Minority Students on the Path to Success

When Wallena Gould was studying to become a CRNA at La Salle University in Norristown, Pa., several years ago, she was one of only two students of color in the program. Gould successfully completed her studies and now works as chief nurse anesthetist at South Jersey Regional Medical Center in Vineland, N.J. The other minority student wasn’t so lucky.

“The program at La Salle discouraged students from working, but a few worked a shift or two every month,” Gould recalls. “The other minority nurse in the program tried to work 12-hour shifts on the weekend and it was just too hard. She didn’t make it through the program. I didn’t want to see that happen again. I want minority nurses to enter CRNA programs ready to succeed.”

That’s what led Gould to create the Diversity in Nurse Anesthesia Mentorship Program. Originally designed for students at La Salle, the program has expanded and currently includes students of color from 18 CRNA programs in eight states and Puerto Rico. Gould and other minority CRNAs mentor the students throughout the entire one-year program. “It is a year filled with activities relevant to their education and overall improved graduation rate,” she says.

Each spring, the program begins with a luncheon for new and prospective CRNA students. The event includes presentations on topics like the requirements for entry into nurse anesthesia programs, preparing for the rigors of the program, balancing family obligations during the clinicals stage, financial planning, studying for the board exams and the certification process. There are also opportunities for attendees to dialogue with practicing minority CRNAs and ask them questions about how they survived their SRNA (Student Registered Nurse Anesthetist) experience.

This year’s luncheon will be held in March in Philadelphia and will feature special speaker Goldie D. Brangman, CRNA, MEd, the first African American president of the American Association of Nurse Anesthetists (AANA).

A month after the luncheon, the mentorship program brings new minority CRNA students into the OR for a hands-on introduction to the anesthesia machine and airway equipment. “This helps allay their fears of [not knowing what will be expected of them] in the OR environment,” Gould says.

“In the summer,” she continues, “I match minority nurse anesthesia students with CRNAs for sponsorship to the AANA’s Annual Meeting.” This past October, Gould held a graduation dinner at her home for a group of students from various programs. And this spring, she plans to visit nursing schools at historically black colleges and universities (HBCUs) to speak to students about nurse anesthesia programs.

For more information about the Diversity in Nurse Anesthesia Mentorship Program, contact Wallena Gould, CRNA, MSN, at [email protected].

How to Pay for It

Looking for ways to finance your CRNA education? One possible option is to sign up with Uncle Sam. By far, the largest health care employer that provides financial assistance to pay for CRNA training is the U.S. military.
“We do allow representatives from the military to come and speak to our students,” says Sass Elisha, CRNA, EdD, academic and clinical educator at Kaiser Permanente School of Anesthesia. “The military will pay for your education and offers a lot of money just to sign up. Some students do take advantage of it, in both active duty and reserve status.”

The U.S. Army, for instance, offers a Graduate Program in Anesthesia Nursing for nurses serving in the Army Nurse Corps. The Army pays tuition and educational expenses, and students also receive full Army pay. The catch, of course, is that the program requires an active duty service obligation.

Military CRNA programs do offer a great deal of racial and ethnic diversity, both in the training stage and, when you graduate, in the workplace. However, as the recruiting slogans advertise, the military is not just a job–it’s a way of life. Unlike civilian CRNAs, those in the military could find themselves in combat zones and must meet military standards in areas unrelated to nursing, such as physical conditioning, marksmanship and soldier skills.

If the military option doesn’t appeal to you, there are also a number of funding resources available in the private sector. For example, the American Association of Nurse Anesthetists, through its AANA Foundation, offers scholarships for student members of AANA who are enrolled in an accredited CRNA program. Some local AANA chapters also offer scholarships. For more information, visit www.aana.com.

In addition, some universities and medical centers offer scholarships for CRNA students. Doing a computer search on phrases like “CRNA scholarships” and “nurse anesthesia scholarships” is a good way to get an idea of what options are out there.

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