How often do you find your expertise as a Certified Registered Nurse Anesthetist (CRNA) overlooked, despite the critical role you play in patient care?
It’s a common complaint of CRNAs that they sometimes don’t get enough respect from their superiors and peers.
So, exactly what barriers stand between CRNAs and the recognition they deserve? But more importantly, how can you overcome them without burning out or losing your passion for the work?
If you're determined to change how you're seen and treated in your career, this guide offers practical steps to finally get the respect you deserve as a CRNA.
The CRNA Experience: Common Complaints
Although CRNA is a rewarding career, it’s not without its challenges. CRNAs often face professional and work environment challenges, which can impact their overall job satisfaction and quality of life.
Here are the common concerns faced by nurse anesthetists:
1. Anesthesiologists vs. CRNAs Politics
In the anesthesia industry, there has always been a comparison between anesthesiologists and CRNAs. While both medical professionals administer anesthesia to patients, their credentials, experience, and scope of practice can vary. That imbalance can sometimes turn into workplace politics, where CRNAs aren’t considered as qualified as an anesthesiologist.
Here’s what a CRNA had to say when asked about the negative aspects on a Reddit thread:
“It’s a daily political battle of MDA vs. CRNA and now CRNA vs AA. Most places you work, unless it’s an all crna model, or completely independent practice, you’ll always be “just a nurse” the MDAs get all the respect, from all the staff and surgeons.”
Healthcare institutions often have varying policies regarding anesthesia care models. In some settings, CRNAs work under the medical direction of anesthesiologists, while in others, they practice on their own.
These differing models can create confusion and tension within the anesthesia team, particularly when roles and responsibilities are not clearly defined. The perception that CRNAs are somewhat less qualified or “just nurses” can impact interprofessional respect and collaboration.
2. Less Autonomy
Despite their extensive clinical training and critical role in delivering anesthesia to patients, CRNAs may encounter limitations in their autonomy. That impacts their professional satisfaction and the efficiency of healthcare delivery.
The scope of practice for CRNAs varies by state. Some states grant full practice authority and allow CRNAs to administer anesthesia without physician supervision. Others impose restrictive regulations.
CRNAs can only practice without supervision in 25 states, which have opted out of the legislation requiring supervision.
Lack of autonomy can be particularly challenging to manage in underserved, rural areas with shortages of anesthesia physicians.
According to the American Association of Nurse Anesthesiology (AANA), CRNAs are crucial for rural hospitals, where they are often the only anesthesia professional for miles.
3. Difficulties with Other Nurses
CRNAs have a unique role in that they combine the technical skills of administering anesthesia with the patient care responsibilities typically associated with a nurse. They often work alongside other registered nurses, who, in most cases, aren’t compensated the same as CRNAs, and that can create friction.
CRNAs are nurses who have attended CRNA school and completed clinical training, which is both demanding and expensive. And once they’re certified, they can demand a higher salary and better benefits because of this step up. That progress may not always be welcomed by fellow nurses.
According to a study on incivility experienced by CRNAs, they get verbal aggression not just from their superiors but also from their coworkers.
4. Tough Schedules and Burnout
CRNAs play a crucial role in various healthcare settings, including surgical hospitals, outpatient care centers, and critical access hospitals. However, the demanding nature of their schedules often leads to significant burnout, impacting both their well-being and the quality of patient care.
In 2024, approximately 56% of CRNAs reported feeling very or somewhat burned out. They blame factors such as long hours, high-stress environments, and inadequate organizational support.
Burnout not just affects the mental health of CRNAs but also has implications for patient safety and care quality.
CRNAs sometimes work extensive hours, with schedules that can include early mornings, nights, weekends, and on-call duties. That’s especially the case in settings with staffing shortages or high patient volumes.
Some facilities may even send their CRNAs elsewhere, which adds another layer of complexity and potential for exhaustion.
5. Problems with Management
A significant factor contributing to CRNA dissatisfaction is the perceived lack of support from hospital administration. Studies have shown that inadequate administrative backing can lead to increased burnout and decreased job satisfaction among CRNAs.
For instance, a study published in the AANA Journal highlighted that administrative support is a key predictor of burnout, job satisfaction, and turnover among CRNAs during periods of increased demand, such as the COVID-19 pandemic.
When management fails to prevent overwork or offer scheduling flexibility, CRNAs are left struggling to balance their responsibilities. Over time, this can lead to a profound sense of disconnection between nurse anesthetists and their administration.
That, too, contributes to burnout. And the same study mentioned earlier found that burnout is correlated to CRNA job satisfaction and turnover intention.
The Importance of CRNAs
As advanced-practice nurses, CRNAs play an incredibly important role in the healthcare ecosystem. They manage all aspects of anesthesia care, including preoperative assessments, intraoperative management, and postoperative recovery.
In rural hospitals and critical access hospitals, CRNAs often serve as the sole anesthesia providers. Their presence ensures that patients in these communities have access to essential surgical and pain management services without the need for long-distance travel.
For healthcare employers, CRNAs offer a cost-effective means of delivering anesthesia to their patients. Research indicates that a CRNA-only model can reduce facility costs by as much as 25%.
More importantly, CRNAs are trained as nurses, too. They look after their patients, which may not exactly fall in the domain of anesthesiologists.
In an interview study on CRNA experiences, participants confirmed that they viewed their profession as an integration of technical expertise and patient care, with the patient relationship and advocacy at the center of their role.
If you’re a CRNA and have had to experience the ‘just a nurse’ stereotype, you must remind yourself of the importance of your profession for the effective and quality delivery of anesthesia.
How to Get Respect as a CRNA
Although not all workplaces are toxic for CRNAs, there can be instances where you may feel out of place and not respected.
Your role, which combines both anesthesia administration and compassionate patient care, deserves full recognition and respect. There are steps you can take to strengthen both your standing and job satisfaction.
Some actionable strategies to enhance recognition and respect in your practice are:
1. Understand Your Value
CRNAs are among the highest-paid nursing professionals, with a median annual salary of $223,210 as of May 2024. This compensation shows the extensive clinical training and expertise required in administering anesthesia to patients.
Plus, there’s a shortage of anesthesiologists, which is only going to get worse in the coming years. As a CRNA, you are well-positioned to fill in and help healthcare facilities meet the growing demand for anesthesia.
Without your work and dedication, many patients may not receive the anesthesia that they need for crucial procedures. Hospitals and clinics, on the other hand, may not be able to deliver quality care during such procedures if it weren’t for CRNAs.
Recognizing your worth is the first step in asserting your professional value.
2. Communicate Confidently and Effectively
Effective communication is crucial in establishing authority and trust within interdisciplinary teams, including those comprising physicians, surgeons, CRNAs, and nurses.
When working in a team, articulate your opinions and decisions clearly and confidently to ensure that your input is valued in patient care discussions. Similarly, if you find that someone in your workplace, whether a superior or co-worker, isn’t giving you the respect you deserve, turn to the power of communication.
Select a suitable time to discuss your concerns privately with the individual involved. Clearly and calmly explain how their behavior affects you and the work environment. And if push comes to shove, don’t hesitate to speak to a superior or HR about it.
3. Demonstrate Clinical Excellence
Maintaining high standards in clinical practice is necessary. CRNAs should stay updated with the latest anesthesia techniques and evidence-based practices.
Education can further increase your competency. As you put in the hours and gain more experience, leverage it in your communication to demonstrate that you thoroughly understand the profession.
If you work in a state where you can work independently, you can use your clinical experience to demand more autonomy. If it’s legal, you might as well take advantage of it and build your reputation.
4. Advocate for Your Profession
Active involvement in professional organizations, such as the AANA, allows CRNAs to contribute to policy-making and advocacy efforts. It also provides networking opportunities, allowing you to meet other CRNAs from various regions of the country and gain insights into their work experiences.
Meaningful exchanges in CRNA and nursing communities can drive innovation in the profession.
Find events where CRNAs and other anesthesia professionals may be meeting and participate.
You can even pitch such conferences and seminars to your employer as a training and career advancement exercise, and get compensated for your attendance.
5. Build Strong Interprofessional Relationships
As a CRNA, you collaborate with various healthcare professionals on a daily basis. A good working relationship with your superiors and coworkers can help create a positive and thriving work environment.
Create collaborative relationships with fellow nurses, anesthesiologists, and other healthcare professionals, so you can learn from them and vice versa. Strong interprofessional relationships improve team dynamics and, by extension, patient care.
Also, understanding and respecting each team member's role promotes a cohesive work environment and mutual respect.
6. Set Clear Professional Boundaries
Establishing and maintaining professional boundaries is vital in preventing role ambiguity. This is particularly relevant for CRNAs, as they often play a dual role in most healthcare settings.
However, the very interdisciplinary nature of their role can sometimes lead to responsibilities that are not exactly agreed upon.
To avoid instances where you’re asked to do something you’re not supposed to, you should clearly define your scope of practice and responsibilities as a CRNA. This can be established in your employment contract and also verbally with your supervisor.
Having clear professional boundaries ensures that your role is understood and respected by colleagues and administrators.
7. Create Personal Branding
The age-old saying that ‘respect is earned, not given’ may hold some truth to it. While every individual deserves respect, in some instances, you may need to go the extra mile to prove yourself. That’s especially the case in competitive environments.
As a CRNA, your services and professionalism may be compared with those of your peers and other anesthesia providers. Work on developing a personal brand that helps you stand out from the rest. With the right skills, networking, and professionalism, you can get recognized.
8. Master Negotiation Skills
CRNAs are among the highest-paid nursing professionals. Still, you may need some negotiating power to get the best deal.
According to U.S. Bureau of Labor Statistics data, only the 50th percentile of nurse anesthetists earns over $200,000 per year. With negotiation, you can be in that bracket.
A study published in the Journal of Organizational Behavior examined the salary negotiation behaviors and outcomes of newly hired employees. It found that individuals who chose to negotiate their starting salaries earned an average of $5,000 more than those who did not negotiate.
The study also indicated that using competitive and collaborative negotiation strategies was associated with higher salaries.
Begin by determining which CRNA hiring model (W-2 or 1099) works best for your professional goals and personal needs. Then negotiate the salary, schedule, and benefits that are fair and competitive with your market value.
Ready for a Workplace That Respects Your Expertise? AAG/H Can Help
CRNAs often face a healthcare environment that doesn't always fully recognize their extensive clinical training and critical care expertise.
By understanding your value, building effective communication, setting clear professional boundaries, and actively engaging in healthcare policy discussions, you can solidify your position as an irreplaceable member of the anesthesiology team.
The CRNA job market is strong and is expected to remain so throughout the current decade. You can leverage the demand for your expertise to get the respect of your peers, superiors, and even patients.
If you're ready to take the next step in your career, AAG/H is here to help. As a CRNA-focused recruitment agency, we connect talented professionals like you with employers who truly value your expertise.
Get in touch today and find a workplace where your skills are recognized, and respected.
FAQs
Why is professional respect particularly important for CRNAs?
Professional respect is essential for CRNAs as they play a critical role in patient care. CRNAs often serve as the sole anesthesia providers in various settings, including rural hospitals and outpatient surgical centers. Their advanced practice status and autonomy makes them a key component of healthcare delivery.
How to earn respect at CRNA school?
CRNA students can earn respect through clinical competence, good communication, and professionalism. Actively engage in clinical training, get feedback, and show a commitment to learning. All these things can build trust and respect from preceptors and peers. Additionally, understand the scope of practice and follow the ethical standards during the nurse anesthesia program and beyond.
Are there particular communication techniques CRNAs should master?
Yes, mastering therapeutic communication techniques can be helpful for CRNAs. Techniques such as active listening, providing clear explanations, and showing empathy increases patient trust. Clear and effective communication is also important for interprofessional relationships, like those with other nurses, MDs, and anesthesiologists.
How much should a CRNA get paid?
As of May 2024, the median annual salary for CRNAs in the U.S. is approximately $223,210. Salaries depend on factors such as geographic location, years of experience, and the specific practice setting. For instance, CRNAs working in outpatient care centers tend to earn higher salaries, averaging approximately $263,960 per year
