Life as a CRNA

If you plan to practice in the city where your program is located and it’s at a site that you’ve had clinicals at, I hope you spent the last two years networking with individuals because it’ll have made your job search a lot easier. By networking, I mean, making friends or at least leaving a positive vibe with staff during your rotation as a nurse anesthesia student.

I approached my clinical experience as an opportunity for me to get to know people (from the nurses to the surgeons and ultimately, the anesthesia personnel) and for them to get to know me. I didn’t go into these clinicals masterminding how I could “play the game” and curry favors from individuals. I don’t know. That process seems disingenuous, but that’s just my opinion.

I think when you go into a clinical experience with a relaxed, open, and receptive mind, you’ll be surprised at what kind of doors can open. For me, I felt loose and was naturally friendly to everyone. I was lucky enough that when I graduated from the program, I had two job offers on the table. There were only two places I wanted to work at and I was fortunate that those were the two places that offered.

Of course, having a good attitude and being well-liked helps, but obviously, it’s all about timing too. I just happened to be in the right place at the right time. I don’t want to make it sound as though my magnanimous personality got me these jobs.

Regardless of whether you apply to a hospital that you’ve rotated to or decide to work elsewhere, here are a few things to think about when searching for a job.

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1. It never hurts to cold call.

Just reach out to hospitals and/or groups and inquire about job openings. If you can, schedule a shadow experience. Get a feel for where you potentially might want to work. I never really learned the value of just cold calling people until I started doing private practice. Once I got used to it, I learned it’s a very useful tool to network. Yes, I know I sound ridiculous as the advice I just shared seems trite, but hey, it’s what worked for me and I’m just sharing my experience. 😉

2. Think about what kind of environment you want to start your career in!

An academic environment that employs a medical direction model is very different from a rural setting where you have to be an independent provider. So, think through what it is you’re looking for as a new grad. One big piece advice is you will never find the perfect job as a CRNA. You need to figure out what your priorities are in your career and whatever you’ve decided is your top priority, you find a job that meets that priority. I can tell you that you won’t find a job that meets your top 3 priorities, so the sooner you can accept this reality, the easier it’ll be for you to figure out which job to take.

For example, when I graduated, I had a job offer from an academic medical center and another offer from a large healthcare system. With the academic medical center, I knew that I would be working across several different clinical sites and be exposed to a wide variety of cases. There were multiple opportunities for professional development (e.g., teaching, research, clinical preceptorship, etc.) and lastly, I knew i would never be bored with anesthesia. There’s something to be said about being in an environment where intellectual stimulation is viewed as a premium. To me, I think that’s a huge positive. The downside to working in an academic medical environment, however, is the somewhat limited scope of practice you come across as a CRNA. The residents end up getting to do a lot of the technical skills (e.g., central line placements, regional blocks, etc.) you learn to be proficient in during school. So it kind of sucks that some of your skills atrophy when working in this environment.

The other hospital I was offered a job at allowed CRNAs to be more independent. The cases are bread and butter, but they’re churned out at a fast rate, so you have to learn how be efficient with your anesthesia. Additionally, they had a bustling L&D suite, so being able to maintain your OB skills was a huge plus. Basically, this job allowed me to develop my skills as a new CRNA. The downside to this environment was that it didn’t have the same opportunities for professional development that the academic medical center did.

So, for me, the decision was between working at a place where my skills would diminish a little bit, but I had access to other forms of professional development or work at a place where my skills would be maintained, but those opportunities for professional development would be fairly limited.

Back to my original point, figure out what your priorities are and find a job that fits that first priority. If you can find a job that meets your top 3 priorities, then hold onto to that job for dear life because you just found a unicorn…which leads me to…

3. After 18 months of being in this field and talking incessantly with CRNA friends who live around the country, I’ve come to realize:

• If you want to make a lot of money, want a great scope of practice, but have no other professional development opportunities, go rural.
• If you want to make a decent amount of money, have access to professional development opportunities, minimize your call shifts and you want to live in a city, expect your scope of practice to be somewhat or very limited.
• If you want to have an expanded scope of practice and want to live in a city, expect your pay to be lower than the counterparts who have a restricted scope of practice and expect to work an ungodly number of hours.

4. Remember that your first job won’t be your last.

It’s okay if you end up thinking that your first job isn’t a good fit for you. This whole process is all about finding the right work environment for you to flourish in and if you find that you’re not, leave! Don’t feel bad about it! You’re doing yourself a favor as well as your employer. No one wants an employee who feels unhappy about going into work and furthermore, you shouldn’t be wasting your time if you find yourself miserable at this first job.

5. After all that cold calling or after harnessing your contacts, you’ve got a job interview. Some things to think about when you go in for that interview and what I imagine many department chairs are looking for in a CRNA.

• Flexibility – You want to be able to demonstrate that you can adapt to any situation. Think about some clinical situations where you’ve had to act quickly and develop an anesthesia care plan on the spot. You want to demonstrate that you’re able to think on your feet. However, think beyond your clinical experience. You want to be able to show that you’re also adaptable to the needs of the department and if you can persuade the interviewer that you welcome change in every capacity, you’ll make yourself very marketable.
• Independence – Along the same lines with the previous point. Obviously, in order to be able to think on your feet and come up with an anesthetic plan means you have to have some level of confidence in your ability to manage a variety of different clinical situations.
• Team player – It’s imperative you know how to work well with others. I was told this piece of advice when I first graduated and started working as a CRNA and it’s something I tell every student who rotates through the hospital I work at and it’s very true in private practice…”Anesthesia is easy to learn, but it’s the cultivation of your relationships that will take you far in your career.” Be a team player. Help out when you can. Be affable. Be friendly. Talk to people. The more you interact with the other members of the surgical team, your life will be much easier. Trust me on this.
• Intellectual stimulation/Professional development – I think this is self-evident, but it’s one of those things that you want to emphasize to prospective employers because it gives them the impression that you’re not the type of person who will clock in and out of your job. Think about certain projects and/or committees you were involved in at school or even in your previous career as an RN. Show them that you’re more than a worker bee and how you will add value to the department because of your thirst for knowledge. Think about how you want to grow professionally beyond just practicing anesthesia and be able to articulate those thoughts during your interview.

Hopefully, some of the tips I’ve provided will prove useful. They helped me secure two job offers when I first graduated and they definitely opened up multiple doors for me when I got into private practice. Shoot me an email if you have any additional questions about finding a job. I could go on and on with this topic, but tried to truncate my advice into a handful of tips to think about when going on that search.