The Orange Bowl this year is a showdown between the defending National Champion USC Trojans and the Oklahoma Sooners. At half time the Trojans are dominating this game. Amazing isn’t it!

According to the experts, this game is going to be close with most favoring the Sooners. To quote Trev Alberts of ESPN Sports:

It doesn’t get any better. You couldn’t have imagined a better championship game. Both teams are so balanced between the run and pass that it will come down to which defense can make the opposing offense one-dimensional. Since the return of cornerback Antonio Perkins, the Sooners’ defense has been dominant. USC has struggled at times to pressure the passer.

At the half time the score is 45 to 7 Trojans. With four turn overs in the first half and all turned into 7 points each by the Trojans, the second half looks like its going to be a long one for the Sooners. Go Trojans. Who will say that they are not National Champions after this game will have to hang their head in shame. From the sports desk of the Extremist, GO TROJANS!

Becoming a Certified Registered Nurse Anesthetist (CRNA) is a challenging career choice to say the least. For anyone interested in Nurse Anesthesia I highly recommend spending some time at the American Association of Nurse Anesthetists (AANA) web site. There is so much information there that will guide and enlighten any one that is looking to pursue a career in Nurse Anesthesia. USNews.com web site has a list of all 85 Nurse Anesthesia programs listed alphabetically with links. It is another interesting place to start your search for a school.

Choosing a school is not a simple matter. Most of us look to local resources to find academic settings that are accessible without relocation plans. At the AANA’s web site there is a section on Accredited Programs which are listed by state. Here it is possible to start the search for a program of Nurse Anesthesia. For any one that is looking seriously to become an Anesthetist, exploring all of the programs, their requirements for admission, and the academic program details will prove extremely enlightening. For instance, what are the two academic degree options for Nurse Anesthetists programs?

All of the programs in the United States must be accredited and fall into one of two categories. Either the program is in a school of Nursing or it is not. The degree options are determined by this. Those programs within a School of Nursing such as Columbia, Rush, Duke or the University of Pittsburgh offer Masters of Science in Nursing degrees (the MSN) with a specialty in Nurse Anesthesia. For those that already have an MSN these programs may only offer a certificate of completion rather than another degree. This depends on the program. Often in these programs the students will be taking course work in the School of Nursing with other Nursing students in other programs such as the Nurse Practitioner option. I have a friend at the University of Buffalo , another MSN program, who has told me that her first pharmacology class is with all of the Nurse Practitioner students. Another point concerning the programs in a School of Nursing, there are a few requirements for the MSN that require general didactic course work generic to all MSN programs. These classes may be something like “General Health Care across the Life Span”, or some such class. The requirements of the MSN mandate this course work in addition to the anesthesia class and clinical. That is something to think about.

The other programs of Nurse Anesthesia are located in programs in Medical schools, Biology departments and so on. These programs do not offer an MSN degree but as in the case of the University of Southern California offer a Masters in Nurse Anesthesia through the department of Medicine. The University of Michigan-Flint/Hurley is another program offered at a Medical school that is well respected. If you must have an MSN these programs are not for you. A benefit of not being in a school of Nursing and a candidate for the MSN is that all of the course work is science and directly applicable to the practice of anesthesia. Maybe my bias is showing here. As an example, here is the course work at USC program of Nurse Anesthesia:

Human Anatomy (3)
Systems and Integrative Physiology(4)
Pharmacology of Anesthesia Practice (4)
Principles of Anesthesia Practice I (4)
Advanced Pharmacology of Anesthesia Practice (3)
Pathophysiology Related to Anesthesia Practice (4)
Clinical Residency in Nurse Anesthesia I (3)
Advanced Principles of Anesthesia Practice II (4)
Clinical Residency in Nurse Anesthesia II (2)
Research: Investigative Inquiry (2)
Professional Study for Nurse Anesthesia (3)
Advanced Clinical Residency in Nurse Anesthesia I (3)
Advanced Clinical Residency in Nurse Anesthesia II (8)
Research Integration: Capstone Experience (1)
Advanced Clinical Residency in Nurse Anesthesia III (1)
Specialty Fellowship *(optional) (2)

For me, the programs located within a School of Medicine are more attractive. The reason for this is that I already have an MSN degree and do not wish to receive a post graduate certificate from an MSN program. This fits for me. Besides, the science is what I am looking for, not another nursing class, again my bias.

The final issue that I want to discuss today concerns the Graduate Record Exam (GRE). There are programs that require the GRE and there are others that do not. Two wonderful Programs of Nurse Anesthesia, The University of Kansas, and the University of Buffalo in New York are both MSN programs but do not require the GRE to be considered for admission. There are those students that struggle with this exam and there are programs where they can be competitive and do well on entrance. Many programs require the GRE and use it as a marker for success. Samuel Merritt College in San Francisco uses the GRE to weed out their applicant pool only considering well GRE endowed applicants.

So, good luck in your pursuit of your dreams. Here is a student, J.C. Thomas, from The University of Pennsylvania reflecting prior to fiber optic brochoscopic confirmation of double lumen tube placement. See what you have to look forward to. Good luck.

Today I received a very nice letter by way of a comment to one of my blog postings from James a nursing student in Australia. He, like many of us, has questions about the profession of Nurse Anesthesia here in the United States. Most people, not to mention those inside of medicine and its related specialties, have never heard of Nurse Anesthesia let alone could describe what it is that they do. The idea that over 50% of all of the general anesthetics in this country are administered by a Certified Registered Nurse Anesthetist (CRNA), some report up to 65%, is a thought that has never touched the consciousness of the average man. So who are these CRNA’s, where do they come from and what is the preparation that goes into becoming a Nurse Anesthetist? Big questions and far too few answers. Below is James original comment/post and a beginning of a response from me.

Hi David…
I have just finished skimming through your Blog. I am an undergrad nursing student who found your site while researching Nurse Anesthetists for a future career. I have some questions and I am not sure where I should post them. Anyway, it’s about the admission criteria for the MSN program. My undergrad marks should be very strong by full graduation time, but I would like to know what is the average amount of years of experience you and your peers have had in ICU-related nursing? Is anyone in that program with only the bare minimum of one year experience? If this is not the appropriate place to ask questions then is there an email address I could have for further discussion. Thank you for your assistance in these matters, it is quite difficult for me to find information from the other side of the world, Australia.
Your reply would be much appreciated.
Thanks
James

Hello
Thank you James for your thoughtful inquiry and questions concerning Nurse Anesthesia. I got your message and wanted to reply to you directly but you did not leave an Email address so the only way to give you an acknowledgment and answer to your questions is here in the blog directly. You may email me anytime at davidgodden(at)hotmail.com for a more personal response.

I too did a lot of research into which were the best schools for Nurse Anesthesia. Beginning with the American Association of Nurse Anesthetists (AANA), I explored many of the web sites of the schools here in the United States that are listed under Certified Programs. In the web pages of the AANA is a document describing what Nurse Anesthetists are at a glance. I guess that is the best place to start.

James, you asked about clinical preparation before being eligible to enter a program of Nurse Anesthesia. The requirement for admission to any school in the US is at least one year of critical care nursing. Different schools interpret what “critical care” is differently. All of them accept intensive care units (ICU) as critical care and exclude all else including Emergency Room experience or Post Anesthesia Care Units (PACU) while other programs are more liberal and examine each person’s application for experience in critical care individually. My advise is to explore the AANA’s web site and the schools that you like to find what a prospective school requires.

The answer to your question about only one year of experience is yes. There are some students that are accepted into Nurse Anesthesia programs with just one year or a year and a half of clinical experience. This may be because the rest of their application is exceptional while for others like myself it takes many years of ICU experience to get ready to apply. Do not be intimidated is the main thing. Get the experience that you need and go for your goal, period.

Academic requirements for most schools include an upper division course in statistics, physics and a year of chemistry including organic and biochemistry as part of your undergraduate nursing program. Many undergraduate programs do not include these as part of their curriculum so adding them now is very important if your goal is to go into Nurse Anesthesia here in the United States. Again, research the individual programs in the AANA web site directory for their requirements.

Finally, it becomes a little bit of a problem for foreign students coming to the US. I advise calling any prospective school now and to talk to the director of the program to see what you can do to make your transcripts attractive and acceptable to their respective programs. I have a friend here in the States who has a Nursing degree from Australia. She has to take classes here to establish a grade point average and to make up some deficiencies including the statistics, physics and chemistry before her application is accepted by a Nurse Anesthesia program here.

One last point about the application process here in the US. Most school require a minimum score on the Graduate Record Exam (GRE). This can stumbling block unless you prepare for it wisely. There are review courses here including Kaplan and the Princeton Review for the GRE. They all are worth while if you are serious about doing well on the GRE.

I hope that some of this helps. There is so much more to talk about but space and time do not permit now. The books that I have found to be essential for anesthesia practice are listed to the right under Books I am Reading Now. Good luck James and follow your dream. I have been struggling with climbing this mountain for a while now and appreciate anyone who wants to do more and make an impact on the world. The bottom line is that as a Nurse Anesthetist your input into patient care becomes very important and valued highly.