Becoming a Certified Registered Nurse Anesthetist (CRNA) can be a daunting journey, and it’s often difficult to know where to even begin.
the moment you decide that CRNA is the career for you all the way to
the glorious finish line, there are 8 strategic steps you can take to
ensure that you are as highly qualified as possible before you apply
to CRNA school.
1) Graduate from an accredited BSN program
It doesn’t matter how you obtain your BSN, but be wary of pass/fail programs because they will hurt your GPA. If you already have your MSN you can still go back for CRNA. (Hopefully some of your graduate coursework will transfer!)
in mind that your ADN GPA will matter more than your BSN GPA because
your ADN demonstrates your competence in core sciences. For example,
if you get a 3.0 in your ADN but a 4.0 in your BSN and your average
is a 3.5, you might still fail to get an interview. This is because
they look at your science GPA from your ADN which would not meet the
minimum to apply (3.0), or it isn’t competitive enough. I have met
a wide variety of CRNA’s with various educational backgrounds,
dentistry, EMT, business, accounting, NP, military, just to name a
no matter how you obtain your BSN just focus on your GPA as much as
possible, especially your core sciences.
2) Maintain good grades
To be considered competitive for CRNA school you should aim to have a
3.5 or higher. Keep in mind that a lower GPA will still be considered
because they look at the candidate as a whole.
there are necessary steps you need to take to be competitive with a
lower GPA. They will evaluate your core science GPA, like chemistry,
A&P, micro-bio, etc.
GPA is calculated differently in each school. Some only consider your
BSN or the last 60 credits along with core sciences. Others combine
all grades (all degrees) to figure overall GPA. Some even look at
high school GPA and ACT/SAT scores.
Rejection is common regarding lower GPA, so be willing to apply to multiple schools and to go the extra mile to make up for a less competitive GPA by retaking courses and/or graduate-level courses.
aware that science grades have to have been completed within the last
5-10 years, depending on the school.
Another thing to keep in mind is some CRNA schools limit how many times you can interview/apply, (two times seems to be the max at schools that set a limit). This is why it is important to reach out and get guidance prior to applying.
3) Obtain critical care experience as an RN
Before you apply to CRNA school, ideally you should accumulate 3-5 years of experience to be competitive. You should always shoot for a level 1 adult ICU (not ER). However, in areas that this is not possible a level 2 can still be competitive. If you do not want to work in an adult ICU know that you may struggle to find a school that will accept your experience. (Some will accept NICU/PICU/ER.)
note that a lot of schools only require 1-2 years at minimum for ICU
experience, but to be competitive aim for more than the minimum.
often determine that ICU experience greater than 5 years could
potentially hinder your ability to be a “teachable” student
again. Do not let this intimidate you, but go into the application
and interview knowing that you need to make it clear that you are
ready and able to be a novice again.
It also helps to have taken a recent graduate-level course in which you get an A to provide proof that you are ready academically to be a student once again.
you do not have a level I or II hospital near you, consider commuting
to get this experience. Remember where your program of choice is
located, if the school is near a level one hospital you will be
competing with those applicants.
quality over quantity in most cases.
4) Be a leader in your community—get involved
Seek out learning opportunities. It will help give you a competitive
extra certifications, (CCRN at minimum even if it is not required).
involved in a unit leadership committee, precept students, volunteer
or offer to work on a research project with your unit’s CNS.
5) Job Shadow
Do this as much as possible. A highly competitive CRNA candidate on average spends 40 hours or more shadowing. Even if the school only recommends shadowing experience, still DO IT!
programs turn away highly qualified candidates simply because they
did not take the time to shadow a CRNA.
want to see you have put a lot of thought into pursuing anesthesia
and that you have taken the time to make sure this is a career in
which you will thrive.
can be difficult to get this experience. I encourage you to continue
to start with your current hospital of employment.
that does not work, then reach out to local hospitals or surgery
you still can not find experience, call your program and ask for
6) Take the GRE/CCRN
Most schools will require prospective CRNA candidates to take one or the other or even both. If the schools say they require the GRE but do not give you a benchmark score, know that to be competitive you need a score of 300 or greater with a 3.5-4 on writing.
schools will state the minimum GRE to be 290-300. Know that getting a
290 or 300 is equivalent to just having a 3.0 GPA in the realm of
being competitive, so always aim for more than their minimum.
schools do not look at CCRN scores, but some do. It never hurts to
find this information out ahead of time- you can even use it to your
advantage on your resume if you did score high.
If you have a 3.4 GPA or less, having a good GRE score can help
admission committees look past this shortcoming. Some schools will
require GRE from students with a lower GPA. Even if they don’t, it
would be in your best interest to take the test as long as you are
prepared to do well on it (and only if you have exhausted other
measures, like graduate level courses).
In my opinion, if they do not require the GRE, you would be better off taking more than one graduate-level course that will transfer to prove your academic abilities.
taking the GRE is one more modality to overcome a less than desirable
7) Take Graduate level courses
If you want to be a competitive candidate for CRNA school this is a must.
Taking a graduate-level stats or chemistry that will transfer into the program will help boost your application and is a MUST for candidates with less than a 3.4 GPA.
in mind that if you have a science grade (undergrad) of a C or less
that you may have to take that class over again.
Start by assessing your core science GPA. If you have less than a 3.4 then consider retaking an undergrad science class (if you got a C or lower) on top of a graduate-level course.
consider where you are applying and what their average student GPA
is. If you do not know, then email the admissions counselor to find
8) The interview is KEY
You can have the most competitive application, but without a good interview you will not be accepted by a CNRA school. So preparation is of vital importance.
should start well before you get an invite to interview. All schools
have a different interview style.
hit mostly personal questions (emotional intelligence style), while
others hit pathophys/Pharm. Some do both along with a written CCRN
style test (math, and on the spot short essays).
is very beneficial to network and attend open houses. Speak with
current students to determine what to expect.
houses are also a great opportunity to talk to the program director
and allow you to get to know them. This helps take the edge off on
interview day when you see a familiar face.
following these 8 steps, you can ensure that you will stand out
amongst a sea of applicants and be well on your way to reaching your
goal of becoming a CRNA!
While you will face a number of challenges along your path, you are not alone in this journey. Check out the CRNA School Prep Academy. Membership provides access to a powerful community, individual instruction, and accredited guidance. Another helpful resource is the 4,500+ member Facebook Group, I.C.U. Dreaming About Anesthesia.
Technology is leading the way as hospitals and clinics around the world fight coronavirus. The latest medical software and health care tech help health care providers give patients the lifesaving care they need as they test and treat COVID-19. From the likes of artificial intelligence to Electronic Health Records, technology is a crucial component in the battle against the virus. Read on to learn five ways technology is helping hospitals combat COVID-19.
1. AI Detects the Spread of COVID-19
In order to fight the coronavirus as effectively as possible, hospitals must rely on testing todetect infected individuals and predict the spread of the virus. Thanks to artificial technology, hospitals and other medical facilities are using AI platforms to provide accurate data and identify trends, helping medical professionals anticipate the spread of COVID-19. To illustrate, systems like Bluedot correctly predicted the path of the virus, alerting epidemiologists to important insights about the movement of the virus.
2. Interactive Maps Monitor Regional Cases
The incredible rate of infection is one of the reasons COVID-19 is especially dangerous. With the rest of the world struggling to keep up with the latest developments regarding the virus, hospitals are relying heavily on interactive maps to monitor regional cases. These interactive maps act as dashboards to track and visualize all reported cases on a daily basis as they display recoveries, confirmed deaths, and new cases of the virus. Sourcing data from the CDC, WHO, and similar organizations from around the world, this technology provides the medical professionals and the general public with real-time data.
3. Innovative Tech Detects the Virus
As the coronavirus spreads at a rapid rate, health care workers struggle to keep up with the rate of infection. The latest technology makes it easier for hospitals and clinics to quickly detect the presence of the virus within hours, making it easier to provide proper medical care to infected individuals. This rapid technology is essential for hospitals that are overcrowded as it will allow health care workers to isolate patients that are infected with the virus from those that are not.
In addition to tech for rapid testing, hospitals and other businesses use thermal imaging technology to determine the status of an individual’s health. These thermal imaging cameras allow businesses and hospitals to scan an individual’s temperature safely to detect if they have a fever. While this technology doesn’t test for coronavirus, it can pinpoint which individuals are at risk with higher than average temperatures.
4. Genome Sequencing Discovers Potential Vaccines
As COVID-19 continues to wage war against the world, scientists and health care professionals are rushing to create a vaccine. Technology like genome sequencing makes it easier to understand how the virus is transmitted, creating a vaccine, monitor viral evolution, and prepare for the future. When it comes to how the coronavirus is transmitted, genome sequencing focuses on understanding variations in the virus’ genetic sequence as genomes are collected from various patients. This allows researchers to create a “family tree” to monitor the spread of the disease.
In addition to understanding how the virus is transmitted, genome sequencing is helpful in designing vaccines and treatments. Researchers can use the information from the gene sequences to design therapies that target specific aspects of the virus. With the help of completed gene sequences, scientists around the world continue to develop diagnostics and vaccines. Additionally, this information will make it easier to track the virus and monitor its evolution as it spreads and changes.
5. Electronic Health Records Give Easy Access to Patient Information
As hospitals fight against the clock to treat COVID-19 patients, it’s important for them to have access to medical software that lets them instantly access patients’ electronic health records. As many patients with coronavirus may also have chronic diseases, instant access to this patient information makes it easier to provide special treatment when fighting the virus. This type of software centralizes patient information, improving the response of healthcare professionals when treating patients.
Technology affects every aspect of the health care industry. With the right tech and advanced software, health care professionals will be well-equipped to treat their clients and meet the needs of those at the forefront of this coronavirus epidemic.
As staff struggle to cope with the working conditions created by the COVID-19 crisis, nursing leaders may find themselves in new territory as they strive to support them. Eloise Cathcart, MSN, RN, FAAN, director of the nursing administration program at NYU Rory Meyers College of Nursing, has some valuable tips on leadership during the pandemic. She observes that this is a uniquely difficult time: “No nurse manager practicing today has experienced anything like the coronavirus pandemic… None of us has managed this degree of chaos, complexity, and uncertainty before so, in a sense, we’re all new nurse managers trying to find our way.”
1: Embrace your leadership role, even if you’re uncertain about what to do
Worried that you’re not ready to take on the challenges of leading in the middle of a crisis? As we have often been told, the current situation is “unprecedented.” Keep your focus, and remember that you’re not alone. Remarking that “no one has done this before,” Trust your clinical skills and judgment, Cathcart counsels, but “Don’t hesitate to reach out to a more experienced nurse manager colleague or your director for help.” Be sure to establish a supportive presence, she recommends, and “be visible and available to engage in patient care so that you can assess how individual members of your team are coping.” This will also keep you up to speed on the particular needs of COVID-19 patients and help you to uphold the highest standards of care.
2. Now, more than ever, your comportment is your most important management tool
Healthcare workers are especially vulnerable to a virus like COVID-19. While fear is a natural response, though, it has to be managed and overcome. Like an officer on a battleground, the nursing leader’s behavior and demeanor exerts a powerful influence on the esprit de corps. Be present and connected to your staff, Cathcart says, and approach them with empathy and understanding: “As you strive to meet individuals where they are emotionally, it’s okay to relax your boundaries a bit so you can connect with your staff on a very real and human level. This is a time to give people more room to express their feelings.”
3. Express a vision for the day and acknowledge short-term wins
At the start of each shift, show respect for the courage of your team, and remind them of their duty to keep themselves and their patients safe. Cathcart also notes, “Staying focused on the present and acknowledging the small wins that come from a team working together to do their best can help bolster staff morale.” However, she urges leaders to remain grounded and realistic, warning that “there’s lots of difficult news, but denying reality makes people assume you’re out of touch.”
4. Keep the voice of the clinical nurse in the conversation
Finally, Cathcart emphasizes how important it is for nurses to make their voices heard, and to use this experience to reaffirm their passion for nursing. A leader should recognize that the clinician’s voice is vital: “Intentionally creating opportunities for nurses to speak about their experiences will validate the value and worth of the incredible work they’re doing and lessen the tremendous burden they carry.”
Leaders working on the front lines are in an excellent position to hone their abilities and learn to excel. “Ask yourself,” Cathcart suggests, “how you’ve learned to focus your mind, control your stress, excel under pressure, work through fear, build courage, and adapt to adversity. Knowing these things about yourself can help you develop the spiritual and ethical resilience that will form you into a great leader.”
Doctors, nurses, and health care providers are on the front lines of the coronavirus pandemic, providing care and saving lives. Given how little is known about the virus, and how contagious it appears to be, many health care workers are understandably nervous about contracting the disease or bringing it home to their loved ones. Whether you’re a nurse in the ICU or a home health care worker in a senior facility, here are seven precautions you can take to combat COVID-19 and protect yourself, your family, and your friends.
1. Make sure your facility is following CDC guidelines.
At this point in the coronavirus epidemic, your facility should already be following the guidelines from the Centers for Disease Control (CDC). This includes measures such as identifying airborne infection isolation rooms (AIIR) or negative pressure rooms for quarantine and screening. Another important measure is outlining staffing protocols to facilitate the care of patients with COVID-19. Since developments are changing so rapidly and new research is proceeding apace, you should double-check that your facility is staying up to date with the most current findings. You can find more guidance from the CDC’s centralized portal.
2.Observe proper PPE protocols.
Personal protective equipment (PPE) shortages are a sad reality in some areas, even as companies and individuals race to make more masks, face shields, gowns, and gloves. As much as possible, you should wear PPE and follow safety protocols, including proper hand sanitation. Sanitize your hands, step into your isolation gown, put on your N95 respirator, add your goggles or face shield, wash or sanitize your hands again and put on your gloves. Then, you may finally enter the patient room. Before exiting the room, remove the gloves and gown and dispose of them. After exiting the room, perform hand hygiene before and after removing the face shield and mask.
3.Watch yourself for symptoms.
Health care workers are unfortunately at a greater risk of catching coronavirus, especially if they are working directly with patients who are ill with COVID-19. Watch yourself carefully for symptoms such as fever, cough, and shortness of breath within 2-14 days of exposure. Symptoms present very differently from individual to individual, and you can also be asymptomatic while carrying the virus without knowing it. You can measure your temperature to make sure that you’re not sick if you think you might have been exposed. If you start exhibiting symptoms, it’s imperative to get tested immediately. You don’t want to infect otherwise healthy patients, so the safest action you can take is to self-isolate and wait for your test results.
4. Educate your patients.
Yes, health care providers can spread the coronavirus — and so can your patients. In fact, the vast majority of people have picked up the virus from other civilians in perfectly ordinary situations, like going to the grocery store. Talk to patients about the importance of self-isolation and following CDC guidelines, such as not touching their faces, washing their hands properly for at least 20 seconds, and limiting trips outside the house. Make sure that your patients are only coming in for an appointment if absolutely necessary. If there’s any chance they have coronavirus, even if their symptoms are mild, it could be best for them to ride it out at home rather than to come in and potentially infect other people. As always, make sure all patients consult with their health care providers about any such decisions.
5.Leave the germs at work.
Bring a set of clean clothes and shoes with you to work in a sealed plastic bag. At the end of your shift, perform hand hygiene and change into the new clothes and shoes. Place your scrubs in another sealed bag to bring home with you and don’t put the dirty clothes in the same bag as the clean clothes if you plan to reuse them. If you can, leave your slip-resistant shoes in your locker so you don’t have to take them home with you. Once you leave the hospital, wipe down your cell phone, pager, and other personal devices with disinfectant. You might also want to disinfectant the door handles, steering wheel, and other high touch areas in your car.
6.Clean your scrubs and shoes.
At home, leave your shoes outside the door. Take off your clothes and put them in the washer immediately alongside your nursing scrubs. Wash the clothes on the hottest setting possible with plenty of detergent. If you want, you can also add bleach to the wash cycle. Dry the clothes for at least 30 minutes on the hottest setting available. If your shoes are made of a hard material, wipe them down with disinfectant after each shift. If they’re not, wash them periodically in a separate load.
7. Protect your family.
Even if you’re not currently exhibiting symptoms, if you work in a role that exposes you to patients that likely have coronavirus, you might want to self-isolate from your family. You can isolate yourself in your own living space, but you’ll need to sleep in a different bedroom, use a different bathroom, and eat your meals separately from the rest of your family. If your current living arrangement doesn’t allow you to do that, some hotels and short-term rentals are offering accommodations to health care workers for drastically reduced rates so they can keep their families safe.
Following these guidelines and erring on the side of caution will cut down on your odds of spreading COVID-19 or catching it yourself. Stay abreast of the latest guidelines and do everything you can to leave the germs at the hospital.
1. Do not self-determine that you are ineligible for any kind of federal, state, or institutional financial aid. Submit all financial aid applications. Check with your college financial aid office for specific application forms and required steps.
2. The FAFSA application can be completed at FAFSA.gov, and it is a free application.
3. The FAFSA will ask for tax information from two years ago, even though you are no longer employed. Go ahead and list your income from the two prior tax years, as required, but later you will file an appeal letter documenting your current financial reality. There is no place to write an appeal on the FAFSA form so you will have to write a separate letter, with documentation to the college financial aid office.
4. If your student was offered a merit scholarship by the school, ask for additional merit scholarship funds due to the loss of income, especially if the student will be attending a public out-of-state institution.
5. Are you separated from your spouse? If so, for FAFSA filing, only include the income of the parent that the dependent child lives with more than half time. You do not have to be legally separated or divorced.
6. You should always shop and compare all federal, state, college, and private loan opportunities. For federal and state loan programs, you will still need to complete a FAFSA.
7. If there are other relatives in the household besides a spouse and children that are dependent on the family and reside in the household such as grandparents, make sure to include them in the total number of dependents in living in the household.
8. If there any health costs not covered by insurance, make sure to list them when you submit your letter of appeal, with documentation.
9. If a parent decides to go back to college, at least half-time, tell the financial aid office. They might consider counting the parent as an additional family member in college possibly resulting in additional financial aid.
10. Run, don’t walk, virtually to the college financial aid office for immediate guidance. Follow-up and follow-through.
While coronavirus has turned the health care field upside down, with general practitioners, specialists, and even urgent care facilities turning to telehealth as much as possible or limiting hours, we wanted to know what it’s like in one of the more difficult places to work in a hospital: the ICU.
Rachel Norton, RN, an ICU travel nurse with NurseFly, is currently based in Denver, Colorado. She’s been a nurse for 13 years, working her entire career in critical care.
Norton answered our questions to provide a glimpse into an ICU during COVID-19.
What’s it like to be working as an ICU nurse now? How does this differ from how it was to work as an ICU nurse before COVID-19?
This pandemic is by far the worst experience that has happened during my career. I’ve never seen nurses as anxious and fearful as they are right now. Working in an ICU has been tough, especially when the number of admissions to the ICU is still well above what we would see on a normal daily basis.
As ICU nurses, we worry a lot about lack of personal protection equipment (PPE), supplies, and the survival of our patients. A recent NurseFly survey found that 70% of nurses are concerned about personal safety with their assigned hospitals. I’ve spoken with nurses from all over the country and the general sentiment is: “I am terrified. I am scared for my patient’s livelihood. I am scared for my life.”
In the ICU, I have also seen a lot of change with our doctors. Our doctors are running nonstop as they are trying to care for the rapidly declining COVID-19 patients and also trying to care for the other patients in our unit. This means that we are still taking care of patients with heart attacks, strokes, and all of the other patients that we would see on a normal daily basis.
The patients that are being admitted are requiring an excess of resources—staff/equipment/medication—to care for them. With hospitals running lean for years with staff and equipment, this has only caused additional strain on ICU nurses.
One of the major differences between now and before COVID-19 is the lack of family members at the bedside. Families have instilled their trust in us to care for their loved ones and that is such an act of bravery, and it is an honor to be a part of. Nurses have been voted the most trusted profession for 18 years straight, and this only shows why we remain at the top. We are taking care of humans. We are serving the country like never before.
What are the working conditions like now with COVID-19? How is this different than they were before?
Day in and day out, our ICU is consistently full. Almost 75% of our patients are still confirmed positive for coronavirus. While the media paints one picture of the type of individual most vulnerable to COVID-19, my patients fall within all age ranges and not all have comorbidities or other medical problems. This virus does not discriminate.
Given the volume of patients that come in the door, it is impossible to keep everyone in negative airflow rooms. We are keeping one negative airflow room vacant to use for emergent “aerosol generating procedures.” We are about to open off-site units to accommodate the influx of patients. Nurses are asking: Do we have enough ventilators? Enough IV pumps? Enough medication to keep these patients comfortable and alive throughout their illness?There are no good answers. As health care professionals, we have to adapt our practices to give care with limited resources and supplies.
While we have found ways to adapt, we need a solution that will fix these questions and issues in the long term—we cannot wait until we have another pandemic or public health crisis to acknowledge and fix this.
Currently, hospitals are still cutting nurses. Travel nurses are scrambling for contracts and rates are becoming less competitive as the desperation rises. Yet, hospitals are still short staffed. In fact, NurseFly’s recent survey found that 30% of nurses do not believe their current placement or full-time position is secure for the next 2 months. Patients still need care. We cannot treat health care as a business and decrease the number of workers as the needs are still present.
Before the COVID-19 crisis elevated, our working conditions were already less than ideal. Many facilities often ran short staffed or made last-minute changes to the staffing to accommodate needs. This is stressful for nurses. Now, just as we are beginning to see an improvement, staffing is being cut again. Companies like NurseFly have been working to fill needs that are being posted. Yet, hospitals and health care systems continue to cut staff at alarming rates.
Describe your typical work day. How does this differ from the ICU before COVID-19?
My typical workday is a 12-hour shift and I work 7:00 a.m. – 7:30 p.m. I arrive at work at 6:45 a.m. and count the positive patients listed on our staffing board.
Staffing at our hospital has survived so far, but as we prepare to open additional ICU beds in off-site areas, many questions are being asked about who is going to take care of those patients.
On an everyday basis, our jobs are inherently fast-paced and demand a lot of physical and emotional resources. I am feeling the most anxious I have felt in a long time, maybe ever. ICU nurses are generally high-energy people with an ability to handle enormous stress levels, but this is different from what we’ve seen before.
How are you managing your own stress during this time?
My day-to-day job involves stressful and emergency situations. This level of stress has been heightened during the pandemic, where it is my responsibility to control, contain, and treat coronavirus patients, and where I am at risk of being exposed. Many nurses are feeling the same way—NurseFly’s recent survey found that nearly 80% of health care professionals feel more stressed in their day-to-day job since the COVID-19 crisis elevated.
However, as ICU nurses, it is our duty to stay healthy, mentally prepared, and protect ourselves and keep our patients safe—it’s crucial for health care workers to take 5-10 minute mental health breaks to refocus and re-center our thoughts. This is one of the ways that I manage my own stress.
In terms of managing stress from my day-to-day role, I stay focused on routine nursing care and continue to provide safe and adequate care. This can be especially challenging in this crisis, as there is extra work in donning and doffing personal protection equipment (PPE) constantly, which is particularly exhausting, but so important.
Another way I maintain calm and manage my own stress is by staying organized and advocating for myself and my coworkers—this is more important now more than ever. We always need to make sure we have adequate PPE supplies, that we cluster nursing care to avoid multiple re-entries into patient rooms, and decrease the amount of people necessary to enter each room.
With patients’ families and friends not allowed to visit, how has that changed the care that you provide? Are you having to help keep them calm/relaxed?
One of the hardest things to experience is not allowing patients to have visitors, but this is absolutely critical to stopping the spread. Being a support system for the confirmed and ruled out patients is just as important as basic care but can be even more emotionally taxing. It breaks all nurses’ hearts to watch people suffer and have no one to help them cope with this illness.
As nurses we treat the patient as a whole person and try our best to help patients keep calm and relaxed. We know how important human interaction is, and we are trying our best to connect patients and family members. We are doing what is necessary to protect ourselves and the immunocompromised patients we are caring for. Of course, exceptions can be made in life-or-death situations, but we are dealing with something like we have never dealt with before.
Is there anything else that is important for our readers to know?
There are no solid predictions on the course of this pandemic. Nurses need to stay vigilant and continue to treat every patient as a possible positive. The public needs to stay aware and stay protected. Masks reduce the risk of one person passing it to another and are a great way to prevent the spread.
As places start to reopen, stay smart. We cannot return to “normal.” I know this is frustrating, boring, and economically depleting. But is it worth the cost of human life? Is it worth burning out our health care system? We are not prepared to accommodate another massive wave of cases.
If you are asking yourself, “Should I cancel?” the answer is yes. Cancel and reschedule routine appointments and stop the spread. The most likely way to stop this virus is containment.
And most importantly, advocate for what is right for our health care teams. We actively and knowingly are putting ourselves at risk to help those that can’t help themselves. What we are doing is unprecedented. Consider our perspective and do what is right. And thank you for trusting us serve you.