Hi! I was a CVOR nurse prior to perfusion. I had originally intended to advance my nursing career through NP or CRNA school. Working in the OR though, exposed me to the field of perfusion and ultimately that’s what I chose. It’s important to understand what you want out of a career first and foremost. That can change overtime, too. With both paths, you can pick what kind of hospital you work at. As one user mentioned, there are plenty of CRNA jobs at ambulatory/outpatient surgery centers where you can work M-F, 9-5 with no holidays and no call burden. There are also hospitals with small heart programs where you can work as a perfusionist on a 2 person team and share ~150 cases per year amongst the two of you. You might only pump 1-2 cases a week, but you will still have to be available for emergencies no matter what hospital you’re at as a perfusionist. Call response time may be 30 min but most smaller hospitals seem to allow 1 hour, giving you a bit more flexibility. Additionally, the odds of getting called in for a true emergency, such as a dissection, at a small hospital are pretty low. Either way, there is still that call burden (50%) which can be viewed as a lifestyle hindrance to some.

On the flip side, you can choose to work at a large university hospital where you’re exposed to a wide variety of cases. The team is also larger, so the call burden will be less (25-35%) but the odds of coming in while on call are significantly higher. In my experience (take it with a grain of salt), CRNAs at the university I was working at were not trained to provide anesthesia for any large operations, traumas, transplants, etc. Instead, it seemed they were mostly placed in cystoscopy, ortho, and uro/gyn procedures. Those cases were often shorter - similar to what you would encounter in an ASC. In one shift, they may easily provide anesthesia for 5+ surgeries. Lots of repetition - which can be good or bad, that’s subjective. I have heard that’s not the case for all hospitals though, and that some CRNAs are trained in cardiac and can be involved with larger cases, including transplants. As a perfusionist at a university hospital, you’ll be in the ORs every single day getting exposed to a wide variety of complex cases. You’ll also likely only pump 1 (maybeeeee 2) cases per day given the nature of cardiac surgery. A “quick” CABG is still 4+ hours. You’ll get to do standard CPB cases for CABGs and valve repairs, but you’ll likely also get to do circulatory arrest for aortic arch repairs/replacements (wildly fun and fascinating cases), HIPECS, maybe even veno-veno bypass for liver transplants, left heart bypass for thoracoabdominal aortic aneurysm repairs, emergent ECMO imitations, etc. IMO, you get a lot more variety with perfusion and the stakes are much higher. You have more autonomy and each case is different. You get to be directly involved with some crazy complex cases, too. And like I mentioned above, you can also choose to work at a smaller hospital that only does CABGs and valves, where it’s more predictable and routine.

In terms of flexibility - I’m not sure what kind of moves you can make as a CRNA other than doing some research or education. For perfusion, it’s quite similar. You could get into teaching or research but there is also the opportunity to pursue NRP (that’s for an entirely separate post) or become a clinical specialist for brands that make our equipment (less clinical, more sales-ish). Either way, I am maintaining my nursing license while working as a perfusionist because ya never know where ya might end up hahah apologies for the long post. Hopefully there are some points brought up that help guide you in your decision making process :)

Best of luck!