Do your New Years resolutions have you thinking about going back to school or making a career change? Are you already in healthcare (or another field) but looking for more of a challenge? I know the feeling!
A few short years ago, I was in the same spot! Wether you want to be an NP, Midwife, CRNA, or something else (maybe not in the healthcare field) that involves going back to school…this is a post for you!
Spoiler alert: I did choose to go back to school but now that I am on the other side and looking back, there are a few things I wish I knew before deciding to pursue a graduate degree. So, grab a coffee and let’s get into it!
Starting out in my Nursing career, I didn’t really give much thought to the whole idea of going back to school. I knew I wanted to be a CRNA and for that, grad school was a necessity. (I fully blame my time spent in the OR, my biochem background, and interest in pharmaceutical physiology for this decision).
If I had a chance to go back in time, I would tell my younger self a few things. I am sharing them today, because perhaps they are things you haven’t thought about. Maybe you found this post because you needed to hear an opinion other than an unwavering “YES, do it!” (Full disclosure: I debated publishing this, but it’s a conservative take and I think it’s an important perspective to share, regardless of how this post is received.)
In no way am I trying to discourage going back to school (and do I love my job as a CRNA), but I am trying to be more candid and include the things I wish I had known before committing to going back. Hopefully you find some insight or helpful tips in the items below.
1. It’s expensive! I know…shocker! Grad school, particularly CRNA school (and I am speaking from personal experience) is expensive. Here’s why:
- I went to a program that was full time. It allowed you to work only during your first semester of classes. The program directors actively discouraged you from working during this time but it was allowed only during the first semester. You weren’t allowed to work during the rest of the program unless it was on a weekend or on a rare holiday break. If you did end up working, but were struggling in any classes or during clinical, the first suggestion provided was to stop working.
- I understand the need to stay focused on your studies, but that also means that there’s NO income coming through the door for 3 years! And, if you are anything like me, the bills still show up every month, and you are the only one that pays them. Rent, car payment, electric bill, etc. even if you are doing the bare minimum, there’s still a cost. No parental bail-outs this time around. There was also no stipend to offset any expenses in my program.
- So, if you are like me: you take out loans, and then more loans. You try to live conservatively. You share a tiny apartment with too many roommates; eating your old college standby of Ramen noodles and hot dogs with macaroni and cheese. Somehow, with all this “lavish” living, you still graduate from grad school in serious debt.
- I’m talking almost 200 K in debt. (This is an actual number. My debt after grad school was 189 thousand dollars, and that was a no-frills, skimping-on-everything budget). With that kind of money, you could go do a lot of things. Like self fund a start up and boot-strap it for almost two years. You could buy a nice house (or at least have a significant down payment for one) depending on where in the US you live. For that kind of money, you could do any number of things.
Another thing to consider, in some states, you cannot write off student loan interest payments if it’s for graduate school loans. That’s a bummer because interest rates are on the high side and a fair amount of your monthly payment goes to interest before principal.
This non-deductible exception was something I didn’t realize during the loan process, not that I could have escaped it. I didn’t have the option to self fund my grad school. So, be prepared for a mountain of debt!
2. Options become more limited. I remember being so excited when I finished grad school and passed my boards. Flash forward, a few years later, after I settled into my job and got comfortable. I started to wonder what else was out there or what else I could do. Well, the realization is that there isn’t much else you can do with a CRNA degree, other than give anesthesia. You are the one that ‘sits the stool’ so to speak.
- Your paycheck and income are tied to physically showing up at the hospital each day. Do you want to travel more than just during scheduled vacations? How about the option to work remotely? Or even to come to work a little late after dropping the kids off at school? Not likely. You have to be at the hospital early and the OR schedule doesn’t just push back if you ‘need to come in a few minutes late’.
- Yes you can take a professional step back and use your RN/BSN/MSN degree. You can absolutely take a position utilizing your nursing background. But you will also be taking a step back with the salary. (Remember those crazy expensive loans from above? The payments are still due, and the loan companies don’t care if you changed jobs unless it fits very narrow criteria).
- It was a huge surprise to realize that becoming a CRNA was the one professional step I took which actually limited my future possibilities. I think of it using a tree analogy:
- Usually in healthcare (and especially in nursing), each step you take in your career leads you higher up the tree, toward more branches. Branches of leadership, autonomy, management roles, etc. Possibilities open up as you progress and you often find more choice, not less. Becoming a CRNA has been wonderful, but it has led me up the tree, to a very specific branch, with limited off-shoots from that path. There really aren’t many choices once you are on that limb of the tree.
- No matter how many years of experience you have or what you do each day, it’s ‘generally’ similar. Yes, you can go back and get your Doctoral degree (DNP) or additional certifications. Unless your plans include teaching or becoming an associate professor though, there isn’t much that will change your actual job description or salary.
- Plus, the cost of getting your doctoral degree (when you consider both the time and money investment) may be more than the rewards that come with receiving it. Currently, when considering Medicare and Medicaid payments, there is no increased reimbursement for a DNAP degrees versus a Master’s CRNA degree. This means no increase in your salary either.
3. This career path isn’t a ‘work from home’ position. Tele-anesthesia isn’t coming to the US anytime soon, so that’s out for now too!
- Perhaps these things don’t matter much to you in this moment, but think ahead five years. If you want or already have children, do you want to stay at home with them? Would you love to have a more flexible schedule but still sustain your income? How could you do that without showing up at the hospital every day? What if one of your parents got sick and needed full-time care? If your significant other can work remotely, sooner or later, you will start to wish for that as well. There are no ‘right’ answers. Just things to consider.
- What you think is right for you today, may look different in a few years too! Make sure you are able to be flexible.
4. It’s Political. Something I really wish I knew more about was the political side of being an Advanced Practitioner (and speaking from my perspective, specifically the politics of Anesthesia). I won’t delve into the political specifics of being a CRNA, but just know that there IS a political side of things, and I don’t believe it is going away anytime soon. This is something that is generally tied to the part of the country you are practicing in, but in the northeast, it absolutely exists and impacts your practice.
- I bring this up because it was not discussed (or even hinted at) during the time I was training and in clinical. It was actually rather shocking to me upon graduation. I know I am not alone in this, as former classmates and I discussed this issue the first time we met up, several months post-graduation. We were all stunned by how pervasive it is. Having been sheltered from these issues during our training, but now dealing with them almost daily in our jobs was a surprise (and not a pleasant one).
- If you are interested in the political aspects of being an Advanced Practitioner or Nurse Anesthetist, I’ll let you research that on your own. I am happy to have a conversation about my experience with this, at a later time, if you want to know more. If you research this topic, be forewarned, there are a lot of opinions, few actual facts, and not everyone is clear about their agenda. Regardless of politics, I do truly believe that all practitioners, of any background, really are trying to do their best for the patients.
One final thought as I wrap up. I believe the days of retiring from a job you worked at for 30+ years are behind us. As more people (in healthcare and beyond) transition to a job that is more lifestyle friendly and that allows them the freedom to work any hours, from anywhere in the world, some jobs may not have the flexibility that we desire.
It’s worth taking a little time, and asking ourselves the right questions, to imagine where you want to be in five or ten years before committing to a specific path.
I hope this post was helpful. At the very least, I hope it gives you a perspective you may not have considered or made you think in way you hadn’t previously. (I purposely didn’t include the obvious grad school related things like the massive time commitment, the social isolation, the stress and pressure etc. because I am sure you already considered those things!)
Whatever choice you make about graduate school, I hope you feel empowered and excited!
Did you travel down a career path to later discover it wasn’t quite what you thought it had been? Are you working in a field that is a complete departure from what you went to school for? I’d love to hear your thoughts and experience!
I'd love to hear your thoughts!