The Anesthesia Record

This months article was written using notes from an interview with Mark Odden, a CRNA.  Please don't let the fact that the author (i.e. me) hasn't been able to secure a job keep you from heeding Mr. Odden's advice!

Contract Considerations: Finding the Right Job Following Graduation

In 2003 I left my undergraduate university with a business degree in hand, eager to put my years of hard-earned knowledge to use.  I had secured a well-paying position in an exciting career field – I was on my way!  It wasn’t until a few months later that I began to notice the cracks in my chosen profession’s perfect façade.  Only 4 promotions stood between my entry level position and the President of the company, leaving little room for upward mobility.  My salary was comparable to that of my peers, but the accompanying benefits package left much to be desired.  The one up-side was that I was able to save most of my earned income, though this was not a difficult task considering that I worked late into the evening and thus had no opportunity to spend money.  I was unhappy and worst of all, by failing to identify my career needs and ensuring that those needs were met by my company and my employment contract, I had no one but myself to blame for my employment situation.

I learned my lesson and, after returning to the classroom to pursue my nursing degree, I scoured my hospital employment contract for any undesirable clauses.  This wasn’t an easy task given that the nursing profession is so vastly different from a career in business.  Likewise, the professional considerations of nurse anesthetists vary greatly from those of our nursing colleagues.  What should our CRNA career priorities be?  Should we focus on reducing our educational debt by accepting a well-paying position following graduation or should clinical learning opportunities be the most important factor in choosing a job?  How can we best ensure that our actual career experience will meet our expectations?

Since I’m not yet a CRNA (insert frowny face here) and can’t personally speak to nurse anesthesia employment considerations, I’ve consulted an expert.  Mark Odden is the Chairman of the AANA State Organizational Development Committee.  He also serves as a clinical instructor for SRNAs attending the University of Iowa and utilizes his anesthesia training and MBA degree as the founder and President of Odden Anesthesia Services, an all CRNA group based in northern Iowa.  Mr. Odden is therefore uniquely qualified to dispense career advice to student nurse anesthetists and was kind enough to offer some insight to SRNAs as we prepare to reenter the workforce.  With his approval, I’ve shared his career advice for new graduates below.

Personal Considerations

We have made countless sacrifices – as have our loved ones – on the road to becoming nurse anesthetists.  Once we attain our objective, we must refocus our attention on pursuing a career path that meets our needs and the needs of those we care about.  Mr. Odden suggests that each SRNA consider what is best for his or her family and use that information to drive their job search.  Your status as single or married should also be taken into consideration before committing to work and live in a rural area versus a younger and more single-friendly urban setting.  Finally, examine the proposed work schedules of the jobs you are interested in.  What is the length of a typical work day?  Will you be expected to work call shifts or weekends and, if so, how often?  This information is invaluable for those interested in maintaining a work-life balance following CRNA school.

Career Considerations

You’ll quickly begin to realize that your personal preferences – such as your desired location and schedule – affect your income.  It’s important to keep in mind, however, that your initial salary isn’t nearly as important as your income growth potential.  Ask your potential employers to detail the current salary range for CRNAs at their institution and find out what factors are taken into account when determining salary raises and bonuses.  It is also critical that new graduates seek out opportunities for professional growth in order to solidify the knowledge they amassed as students, so don’t be afraid to continually challenge yourself.  It’s like the saying goes, “if you don’t use it, you lose it!”  This is easy if you practice in a setting that enlivens you.  Whether you’re passionate about regional anesthesia or the pediatric population, determine what excites you as an anesthesia provider and search out practices that allow you to pursue those interests. 

One common question that many students want to know is whether they should seek to gain employment through a hospital or an anesthesiologist-owned practice.  The answer is the always frustrating “it depends.”  Hospital employees are forced to deal with the politics and bureaucracy inherent in most hospitals, but because large organizations are often slow to change, there comes with it a sense of stability and dependability.  Conversely, anesthesiologist-owned groups tend to be smaller organizations and may therefore offer a greater sense of camaraderie between their anesthesia practitioner employees.  Keep in mind that, when faced with budget cuts, either type of employer may choose to alter or do away with certain benefits that originally attracted you as an employee.  The likelihood of this occurring depends on the leadership of the organization so it’s imperative that students assess the culture and feeling of each group as they proceed through the interview process. 

Professional Considerations

In order for CRNAs to enjoy a life-long career in anesthesia, the profession itself must remain relevant and vital to the health care community.  Doing so requires the financial support and involvement of individual CRNAs, including new graduates.  It is important, then, to ascertain the level of support offered by potential employers.  Will your professional dues be paid by the organization and, if so, is this benefit guaranteed to continue in the future?  Will your work community support you in your efforts to become involved at the local, state, or national level?  Attempt to garner additional vacation time for professional training workshops and meetings.  After all, staying abreast of new advancements in anesthesia will benefit your employer immediately and your career for years to come.   

Ensuring the right “Fit”

Once you’ve decided what you want in a job, you should ensure that the organizations you’re considering will meet your needs.  The best way to do this is to interview in person and make an effort to seek out and talk to the nurse anesthetists on staff – not just the one or two CRNAs who were chosen to speak with interested candidates.  Locate the grumpy CRNAs for an honest dialogue.  Discover what the employed CRNAs like most – and least – about their work setting.  Inquire about the culture of the organization and the relationship between the medical and nursing staff.  If possible, shadow a few CRNAs for a day.  Note whether they are encouraged to administer induction drugs, perform nerve blocks, and take on challenging cases, as these signs indicate that the nurse anesthetists are valued members of the anesthesia team.  Get a good feel for the personalities of the CRNAs that you’d be working with.  Most importantly, remember that you are interviewing the organization in addition to being interviewed yourself, so don’t be afraid to ask a lot of questions.

Other Advice

Once you’ve signed on the dotted line, you should consider hiring a financial planner.  You will likely earn more as a CRNA than you have in the past and, with the uncertain future of the health care system, it’s more important than ever that new graduates learn how to properly manage their income.  A financial planner who is familiar with the opportunities available to nurse anesthetists can also educate their CRNA clients  about many lesser-known financial opportunities available to those in the profession.  Practicing nurse anesthetists should also consider investing in malpractice insurance.  Organizations may differ on the types and coverage of malpractice insurance they offer, and purchasing malpractice insurance may be the only option for CRNAs who provide independent anesthesia services.  Finally, never talk business in front of our nurse or physician colleagues.  Doing so will only introduce jealously and resentment into an otherwise favorable working environment.  If you must discuss business-related topics, do so with your CRNA co-workers in private.

Conclusion

In tough economic times such as these, it’s tempting to accept a job – any job – without first considering your goals.   Doing so may lead to personal, professional, or financial discontent, outcomes which could easily have been avoided.  So as we begin to distribute our resumes and embark on the interview process, it’s important that we are as prepared to ask questions as we are to answer them.  

I would like to once again thank Mark Odden for his contributions to this month’s Student News Column and his continual support of and enthusiasm for student registered nurse anesthetists across the country.