Hello all,

I am a nurse practitioner that loves being a provider but is somewhat dissatisfied with my current practice. I work in a small regional hospital in a specialty practice that allows me to frequently care for ICU patients. Prior to becoming an NP I was a CICU nurse and love critical care. I debated CRNA vs NP at the time and eventually chose the latter due to ease of access at my local state school. I am an ANP/AGNP and want to focus my career on inpatient and critical medicine and have been thinking about pursuing CRNA vs ACNP certification. I would consider myself a strong academic candidate that has a good GPA (3.91 masters and 4.0 doctorate) and is almost finished with my post-masters DNP. I previously shadowed CRNAs and feel that this would be something I would enjoy.

The source of my current dissatisfaction lies with how NPs are treated in my area. My employer has previously referenced an inability to negotiate raises or other compensation due to not "providing that the regular nurses". I am relatively well compensated for what I do but am frustrated by a lack of respect and such a huge divide in treatment between the MDs and NPs at my facility. I recognize that things may be different if I switched jobs although I have several other colleagues in other practices that are also dissatisfied for similar reasons. There seems to be this strong sentiment of "mid levels" in my area that negatively impacts the perceived value of my practice.

I live in a state that is severely limiting on NP scope and practice ability is tied to close oversight by an MD. However, my state grants CRNAs independent practice. I also understand that this can vary due to hospital policy.

My questions specifically are:
1. what is the job market and future outlook for the CRNA field? I have read various reports of saturation in some markets. I am concerned about the trend of so many new NP programs that this may saturate the nurse practitioner market and wonder if it is the same in the CRNA realm?
2. Can a practicing CRNA speak to their overall satisfaction or dissatisfaction with practice issues (eg. feelings of respect, working relationships with surgeons and MDAs, etc)? Are CRNAs treated like providers, and respected as such, or is there this sense of "mid level practice"?
3. Would I be correct in assuming that I may have to go back to the bedside to obtain recent critical care experience? I have not worked as a staff ICU nurse in 5 years.
4. Will the transition of CRNA programs to DNP have any effect on my applying or being accepted into programs as I will already have this degree? I know there are still post-masters certification programs but have not seen any post-doc programs.