"Hey, I'm going to be in your field too!"

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Well I hope all of you that get these dumb, ignorant comments and responses by people ... (snip)

Immediately after being accepted to med school, I learned ... (snip)

With all due respect, you both are missing the point slightly.

The bottom line perception out there by people in not only the realm of the hospital but also the real world is that (1) our job is relatively easy and (2) it pays well. Depending on your particular work environment both of those could be either 100% true or 100% false. That's beside the point for now. There is a reason for this general perception though.

It is predicated on the notion that all anesthesia is the same. Yes, that comes from ignorance. Most have no clue the differences in planning of anesthetics for a CABG vs. a cystoscopy vs. a knee replacement. You get the drift. In their minds anesthesia is anethesia. This happens because most actually haven't ever been exposed to what the field of anesthesiology is. So it has nothing to do with smacking them down or building them up.

It has to do with the AANA which has been (with some success) campaigning that the training level of a physician is not necessary. That the field can be brought down, if you will, to the nursing realm where access to the pathway is far more readily available to anyone who can get into some local nursing program. The irony is that at the same time these same nurses will tell you that they are actually special and highly-trained medical professionals with just the right amount of extra training and skill to place them as our equals. That their field is rigorous and scientific and safe... and blah, blah, blah... as much as ours. The truth is that if we were to only let them pick the low hanging fruit of the wideworld of patient morbidities and diseases they might have an argument.

Look, I get that this "kid" (and that's what she was) was excited and interested in what I do. But what truly pissed me off is that she has no f*cking clue what I actually do. None. Zero. And deep in her salad days of youth made an assumption that there was some sort of "pair bond" between us simply because of her desire to be an nurse anesthetist someday. And from what I could tell that desire was nothing more, like a lot of other CRNAs, to simply cash in on my chosen profession at some yet indiscernible point in the future. It was my real sense that she had, although at this point in her education accomplished nothing more than high school diploma and phlebotomy training, somehow already elevated herself in her mind to my level. Or perhaps conversely was trying to bring me down to hers.

I take a lot of pride and have a lot of passion for excellence in what I do. Maybe 10 years ago when I was still a CA1 I might have taken the time to engage this young lady. But honestly I've heard so much of this kind of crap from so many different people in the hospital food chain that all I feel it deserves anymore is yawning indifference. But the biggest disappointment I've also seen in that time is that no longer does a 20-year-old phlebotomist have to strive to be my equal. She can simply dream it and she already is.

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But the biggest disappointment I've also seen in that time is that no longer does a 20-year-old phlebotomist have to strive to be my equal. She can simply dream it and she already is.

That's kind of harsh. I totally understand where you're coming from, but does it *really matter* what someone who isn't your "equal" thinks? Is it THAT important to you to make sure those beneath you understand their place?
 
That's kind of harsh. I totally understand where you're coming from, but does it *really matter* what someone who isn't your "equal" thinks? Is it THAT important to you to make sure those beneath you understand their place?

What did someone else say on this forum in a different thread recently... "Get back to me when you have a little more hair on your nuts, kid."

There's a reason why the military has ranks. And the privates don't call the shots. Someday perhaps you'll understand this better.
 
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That's kind of harsh. I totally understand where you're coming from, but does it *really matter* what someone who isn't your "equal" thinks? Is it THAT important to you to make sure those beneath you understand their place?

Perceptions is everything. If enough people perceive Nurses to be equivalent to Physicians, then they are. Insert Primary Care, here.

Nurses figured this out a long time ago.
 
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Well you must simply forgive the amc ceo's for thier pile if "yourr money" because you have no clue what they really do. As stated earlier no one in any high paying profession feels the work or sacrifices they make are understood. As for "your field" dentists did it first, nurses did it the many years. Anesthesiology is new relatively speaking.
And she is your equel, you are not some god on olympus, just an overgrown rude adolecent with an inferiority complex.
 
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What did someone else say on this forum in a different thread recently... "Get back to me when you have a little more hair on your nuts, kid."

Well that's a strong argument.

I hope I'm never quite so defensive of my ego and status that I couldn't respond to the young woman in the OP with "that's great! Good luck to you."
 
Btw did you ever think this could be another dr Fitch. Probably not.
 
Well you must simply forgive the amc ceo's for thier pile if "yourr money" because you have no clue what they really do. As stated earlier no one in any high paying profession feels the work or sacrifices they make are understood. As for "your field" dentists did it first, nurses did it the many years. Anesthesiology is new relatively speaking.
And she is your equel, you are not some god on olympus, just an overgrown rude adolecent with an inferiority complex.

Your horrible grammar and near inability to form a cogent thought underscores precisely the sentiment I am describing. Welcome to the dumbing down of American medical care.
 
Well that's a strong argument.

I hope I'm never quite so defensive of my ego and status that I couldn't respond to the young woman in the OP with "that's great! Good luck to you."

Gerontology. That's the field for you. Trust me on this one.
 
Btw did you ever think this could be another dr Fitch. Probably not.

Is this honestly your counterargument? That most CRNAs actually desire to go to medical school and complete an anesthesiology residency after becoming a CRNA? That this is the true sentiment and position of the AANA? Do you even know what Jane Fitch's position on this matter is? That she "didn't know what (she) didn't know" before completing her medical training?

Man, you are clueless!
 
What did someone else say on this forum in a different thread recently... "Get back to me when you have a little more hair on your nuts, kid."

There's a reason why the military has ranks. And the privates don't call the shots. Someday perhaps you'll understand this better.

I'm going to have to agree with johnnythan here.

If you say, "that's great, I wish you the best of luck, but I hope you realize there's a lot of time/effort/money between you and your goal," then you've validated that person's feelings, plus at least made an effort to correct any perception they had that anesthesia is easy or a quick way to make a buck.

If you say nothing, you probably aren't making them feel better or worse, but you certainly aren't correcting any misconceptions they have about anesthesia. Plus you just stew on it internally for awhile.

The general populace is never going to have an appreciation for what we do; but we all knew that anesthesia was not the field for glory when we chose it.
 
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BuzzPhreed's tag line is "Anti-AANA and Militant CRNA." Also review his started threads: multiple threads about how awful CRNAs are.

CRNAs may or may not be awful, but there's a rather obvious bias here. I don't really think it's worth engaging this particular poster on the topic any longer.
 
BuzzPhreed's tag line is "Anti-AANA and Militant CRNA." Also review his started threads: multiple threads about how awful CRNAs are.

CRNAs may or may not be awful, but there's a rather obvious bias here. I don't really think it's worth engaging this particular poster on the topic any longer.

Oh... really. So now you're the judge and jury of the anesthesia forum? Remind me again: you're a "medical student"?
 
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Oh... really. So now you're the judge and jury of the anesthesia forum? Remind me again: you're a "medical student"?

I'm the judge and jury for myself, and it's not worth it to engage in this sort of conversation with someone who appears to be an activist. I doubt my opinion has any relevance or importance to anyone else. Just putting the info out there and stating my own opinion about it.
 
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If you say, "that's great, I wish you the best of luck, but I hope you realize there's a lot of time/effort/money between you and your goal," then you've validated that person's feelings, plus at least made an effort to correct any perception they had that anesthesia is easy or a quick way to make a buck.

Did you read the part where I said that I probably would've done this ten years ago? Hair -> nuts.
 
I'm the judge and jury for myself, and it's not worth it to engage in this sort of conversation with someone who appears to be an activist. I doubt my opinion has any relevance or importance to anyone else. Just putting the info out there and stating my own opinion about it.
He states his bias in his title, why are you restating it as if you've stumbled onto some scandalous truth?
 
The general populace is never going to have an appreciation for what we do; but we all knew that anesthesia was not the field for glory when we chose it.

WholeLottaGame7:

I like you. You seem like a nice person. I'm assuming that you are still in residency. Correct?

Do you know my story? I was happy in a job that paid well. After spending a year at my home institution after finishing residency, I took my first real private practice job in a community hospital off the relative beaten path. I did this happily and it was a great job that paid well. I was making good money. I was doing mostly my own cases where there was some CRNA supervision. The few CRNAs that were there were seasoned and respectful. "Old school" if you will. They were helpful.

At the behest of my wife a little over a year ago, I took a job in a better geographic area. Upon my arrival, it was a disaster. It was full of fresh-outta-school CRNAs who basically did whatever they wanted. I took a huge cut in pay with a false promise of partnership in this group somewhere down the road. It didn't take long to realize that this was complete bullsh*t. All the fatcat senior grayhair partners wanted was someone to stack the work on and sign the charts and make everything look pretty for the regulators. CRNAs (some of whom were nice) ignored my plans. Some backtalked. Some openly confronted me in front of surgeons. They would do complex regional blocks without discussing with me. Some told me that they flat out weren't going to do what I said. Sometimes they never called me when they went to the room and went to sleep. Often they never called me when the woke-up. But I was expected to show-up and sign all the paperwork like TEFRA was being followed to the letter of the law. I could not get out of that place fast enough. None of the partners had my back.

No offense, but you sound like the whipped little puppies that I met at that job who were fresh out of residency and, quite frankly, didn't know any better. They thought that this is what practicing anesthesia in the "real world" meant. That covering a ridiculous amount of rooms, filling out pre-ops and consents, and running around trying to make sure everything was signed so the CRNAs could do all the clinical work - that this was safe and the way it goes in the real world. They had nothing else to compare it to unlike myself. It was a 100% piss-away of the training I endured.

I sincerely hope you go find a job where you actually practice anesthesia on your own for a while. That is doing mostly your own cases. Because if you leave training and put yourself into the same position I was, like most of the other anesthesiologists there you are going to become rapidly out of date with your knowledge base and your skills are going to start to suck. And when it becomes the norm for you, you're going to turn into one of them and you're going to start to suck at truly being an anesthesiologist as well.
 
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Did you read the part where I said that I probably would've done this ten years ago? Hair -> nuts.

Experience has nothing to do with it. I know plenty of attendings with more than your 10 years of experience who don't use hairy nuts as an excuse to not care about decency and educating someone less informed than you.

I'm not looking to change your mind or your attitude, the post was just an explanation for younger members than even myself of the pros/cons of different approaches.
 
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Didn't insinuate it was harder than medical school or residency. It being easier than your undergrad degree...Ok?

Not even close. The honors degree I got from a prestigious university probably accepts about 3-5% of HS applicants into the program and the people applying are cream of the crop. I mean my science classes in undergrad were more advanced than what the SRNAs learn. No offense to them as their RN experience gives them a clinical background I didn't have in undergrad, but my undergrad science curriculum was better than what they graduate as a CRNA with. And then I went to medical school and residency which was obviously no cake walk either.
 
WholeLottaGame7:

I like you. You seem like a nice person. I'm assuming that you are still in residency. Correct?

Do you know my story?

Correct, one more month, than a year of fellowship.

I'm truly sorry you had a s**tty experience. While it is of little solace to you, your story (and others like yours on this forum) serve as a valuable learning tool for those of us starting to look for jobs. Being able to identify and avoid a situation like yours is one of the biggest stressors about job hunting that I have. Likewise, the warnings about skills atrophying and the like are similarly high on my list of concerns.

So I'm definitely not trying to discredit what you are saying or where you are coming from.

My point is that we have enough trouble winning propaganda battles without coming across as condescending and disinterested, whether it be to patients, surgeons, future anesthesiologists, etc.
 
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Not even close. The honors degree I got from a prestigious university probably accepts about 3-5% of HS applicants into the program and the people applying are cream of the crop. I mean my science classes in undergrad were more advanced than what the SRNAs learn. No offense to them as their RN experience gives them a clinical background I didn't have in undergrad, but my undergrad science curriculum was better than what they graduate as a CRNA with. And then I went to medical school and residency which was obviously no cake walk either.

I couldn't comment. I haven't gone to CRNA school nor completed your undergrad. Seems irrelevant and incomparable.
 
There is no value like your own personal experience. While wise men learn from the mistakes of others and fools their own, people never learn anything by being told - they have to find out for themselves. That's the value of getting a little balder and grayer... and more hair on your nuts (and your back and your ass... etc.). You'll soon learn that it's not worth wasting your breath with some people. Don't take it personally. You'll see.

Correct, one more month, than a year of fellowship.

After your year of fellowship, what are the plans?

I'm truly sorry you had a s**tty experience. While it is of little solace to you, your story (and others like yours on this forum) serve as a valuable learning tool for those of us starting to look for jobs. Being able to identify and avoid a situation like yours is one of the biggest stressors about job hunting that I have. Likewise, the warnings about skills atrophying and the like are similarly high on my list of concerns.

Take a stand. That's all I'm saying. Ask the right questions. Don't sign a sh*tty contract. Make sure you understand exactly what job you're going to be doing before you take it. And, most importantly, the CRNAs are not your equals in training or professional responsibility to the patient no matter what they try to tell you. If you get the sense that this might be the particular zeitgeist of a practice you're considering joining, run for the hills.
 
I couldn't comment. I haven't gone to CRNA school nor completed your undergrad. Seems irrelevant and incomparable.

I can comment. My wife is a CRNA. I have many other CRNA relatives. I've read my wife's textbooks and helped quiz her through school. I am competent to compare both.
 
There is no value like your own personal experience. While wise men learn from the mistakes of others and fools their own, people never learn anything by being told - they have to find out for themselves. That's the value of getting a little balder and grayer... and more hair on your nuts (and your back and your ass... etc.). You'll soon learn that it's not worth wasting your breath with some people. Don't take it personally. You'll see.



After your year of fellowship, what are the plans?



Take a stand. That's all I'm saying. Ask the right questions. Don't sign a sh*tty contract. Make sure you understand exactly what job you're going to be doing before you take it. And, most importantly, the CRNAs are not your equals in training or professional responsibility to the patient no matter what they try to tell you. If you get the sense that this might be the particular zeitgeist of a practice you're considering joining, run for the hills.

Oh for sure there are some people that are convinced that I'm already making half a mil for working 30 hours a week straight out of college. Can't do much about that. But more often than not, people have no reason to know something and I'm happy to enlighten them. I'm not going to waste my time on someone who thinks they know it all already; it's the impressionable, willing to learn people that I'm trying to reach, whether they are patients, RNs, CRNAs, etc.

I am tied geographically to the area for at least another year due to wife's training. I will have first-hand knowledge of both training programs in the area by that point, and for that and other reasons (enjoy teaching medical students, interns, etc) I will probably end up at one of those places. There is also a big "private" group in the area, AMC-run, which seems to get average-ish reviews. The training programs are by no means perfect, but they are also leaps and bounds above what it sounds like you have experienced, and better the enemy you know than the one you don't. I will also likely have more short-term flexibility at those places if we need to relocate after my wife is finished, though she would like to stay in the area as well.

I sympathize with people who are forced into sub-standard groups due to geography, family, availability, other concerns. It seems like joining one of those groups would be a very easy trap to fall into if it's your only option. We're all animals; we adapt to survive, and we all need a paycheck. It's easy to sit back and say "Oh I would never compromise like that," when in reality the vast majority of us would if that was our only option.
 
It's easy to sit back and say "Oh I would never compromise like that," when in reality the vast majority of us would if that was our only option.

You see, I think it's easier to compromise. That's the difference. And eventually you turn into one of "them". That's what I witnessed firsthand. If you find yourself in that situation, be brave. Vote with your feet. Trust me, walking out of that place wasn't easy. I made a lot of investments in time, effort, and monetary loss to take that job. It would've been much easier to suck it up and stay there. But I take the long view. That's what I hope to impart on the n00bs coming out. You - and you alone - are responsible for the compromises you make.

If everyone stood up for what was right, we wouldn't be in this mess right now. I guess I'll have the last laugh ten years from now when the fatcats cash-out and retire, suffer their first major medical illness, and then be the patients in a system that they left for the rest of us. Then we'll see how much they pride their investment in our future.
 
BuzzPhreed's tag line is "Anti-AANA and Militant CRNA." Also review his started threads: multiple threads about how awful CRNAs are.

CRNAs may or may not be awful, but there's a rather obvious bias here. I don't really think it's worth engaging this particular poster on the topic any longer.

Then get out of the thread, bro. Some people want to hear him speak.
 
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You see, I think it's easier to compromise. That's the difference. And eventually you turn into one of "them".

That's what I was trying to say. It's easy to say we wouldn't compromise when in reality most of us would.
 
So i gotta chime in here on this whole CRNA education thing...

I'm not defending at all their position as "equals," or whatever they wanna say, but to say their education is easier than your undergrad seems like a stretch. I went to a good college and took all the pre-med courses (as there was a time when I wanted to pursue medical school), but undergrad was NOTHING compared to AA school. I studied round the clock in AA school, 10x as much as I did in undergrad at least, and its not like I'm a slow learner or anything. I made close friends with Miller, Barash, and Longnecker...despite the fact that we've drifted apart in recent years. So either CRNA education is nothing like AA education (and maybe its the whole medical model vs nursing model???), but I doubt they can be THAT different.

Perhaps there is just a big discrepancy amongst the different CRNA schools?

I dunno. I can only comment on AA education, but I think all the AA schools are fairly similar in difficulty. Perhaps not so for CRNA...
 
So i gotta chime in here on this whole CRNA education thing...

I'm not defending at all their position as "equals," or whatever they wanna say, but to say their education is easier than your undergrad seems like a stretch. I went to a good college and took all the pre-med courses (as there was a time when I wanted to pursue medical school), but undergrad was NOTHING compared to AA school. I studied round the clock in AA school, 10x as much as I did in undergrad at least, and its not like I'm a slow learner or anything. I made close friends with Miller, Barash, and Longnecker...despite the fact that we've drifted apart in recent years. So either CRNA education is nothing like AA education (and maybe its the whole medical model vs nursing model???), but I doubt they can be THAT different.

Perhaps there is just a big discrepancy amongst the different CRNA schools?

I dunno. I can only comment on AA education, but I think all the AA schools are fairly similar in difficulty. Perhaps not so for CRNA...

AAs > CRNAs.
 
So i gotta chime in here on this whole CRNA education thing...

I'm not defending at all their position as "equals," or whatever they wanna say, but to say their education is easier than your undergrad seems like a stretch. I went to a good college and took all the pre-med courses (as there was a time when I wanted to pursue medical school), but undergrad was NOTHING compared to AA school. I studied round the clock in AA school, 10x as much as I did in undergrad at least, and its not like I'm a slow learner or anything. I made close friends with Miller, Barash, and Longnecker...despite the fact that we've drifted apart in recent years. So either CRNA education is nothing like AA education (and maybe its the whole medical model vs nursing model???), but I doubt they can be THAT different.

Perhaps there is just a big discrepancy amongst the different CRNA schools?

I dunno. I can only comment on AA education, but I think all the AA schools are fairly similar in difficulty. Perhaps not so for CRNA...
This looks like it's turning into an academic d*** measuring contest. But for what it's worth, I agree with Mman. In fact, I would go a step further and say that I think my undergrad degree was as difficult if not moreso than my medical degree. I was chem and biochem at a top 20 university, and while I didn't study as much as I did in med school, the difficulty of the actual content was infinitely higher. There is no concept in medicine that a reasonably intelligent person would not understand if explained to him/her, but in any of the hard sciences (sorry but bio doesn't count), there's a very clear cut level of difficulty, beyond which any amount of studying won't get you further. And it was so obvious what that cut off was for everyone when one kid would not study and fly through questions, while another kid would spend hours over one question and not be able to wrap his head around it.
 
This looks like it's turning into an academic d*** measuring contest. But for what it's worth, I agree with Mman. In fact, I would go a step further and say that I think my undergrad degree was as difficult if not moreso than my medical degree. I was chem and biochem at a top 20 university, and while I didn't study as much as I did in med school, the difficulty of the actual content was infinitely higher. There is no concept in medicine that a reasonably intelligent person would not understand if explained to him/her, but in any of the hard sciences (sorry but bio doesn't count), there's a very clear cut level of difficulty, beyond which any amount of studying won't get you further. And it was so obvious what that cut off was for everyone when one kid would not study and fly through questions, while another kid would spend hours over one question and not be able to wrap his head around it.

Yeah, I suppose some concepts in undergrad were more complicated than those in AA school. Guess it comes down to your definition of 'hard.'
 
So either CRNA education is nothing like AA education (and maybe its the whole medical model vs nursing model???), but I doubt they can be THAT different.

It's just a different pathway. No BSN nurse worth her salt would dare go to AA school. Although they could. Maybe some do.

It still pails in comparison to the hidden curriculum of medical school, namely learning how to make difficult decisions and take full responsibility for them. Nurses think they do this. But they always - always and no matter where they are - have someone higher up the food chain who's there to catch them if they fall. Not true with doctors.
 
I think @WholeLottaGame7 is on the right track. At a time when the general public is convinced that docs are just fat cats, working 30 hours a week, making $500k+ for solving crosswords, no favors are done by blowing people off. Or worse, "putting them in their place." Whatever crap that may be. You have an option to intervene and say something like, "Oh, I think you are referring to CRNAs. I am an anesthesiologist, which is a specialized type of physician. Here are the difference. This is how many hours, years, dollars, etc it takes to become an anesthesiologist. It isn't for everybody, but I wish you well." If you are feeling really feisty, you could even give them an email address and offer to answer basic questions. Who knows? You might just be helping the next Macintosh get into the game.
 
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I think @WholeLottaGame7 is on the right track. At a time when the general public is convinced that docs are just fat cats, working 30 hours a week, making $500k+ for solving crosswords, no favors are done by blowing people off. Or worse, "putting them in their place." Whatever crap that may be. You have an option to intervene and say something like, "Oh, I think you are referring to CRNAs. I am an anesthesiologist, which is a specialized type of physician. Here are the difference. This is how many hours, years, dollars, etc it takes to become an anesthesiologist. It isn't for everybody, but I wish you well." If you are feeling really feisty, you could even give them an email address and offer to answer basic questions. Who knows? You might just be helping the next Macintosh get into the game.

Who did I blow off? I talked to her. I didn't entertain her. But I talked to her.

And WADR I think you are living in a fantasy world. Do you think this makes a difference? People will persist in their beliefs no matter what I say. And if I were to try to explain that to her like you suggest then she probably would've just thought I was even more of a dick (maybe still does but I don't really care).

And this speaks nothing about the propaganda machine that is the current curriculum in nurse anesthesia school if/when she ever gets there. From when I was a resident and the CRNAs who'd relieve me for lecture would say "I'm here to get you out for anesthesia school" (um, no I'm going to a medical lecture, you *****) to calling us 'MDAs' to demanding - demanding - to do regional anesthesia in some practices to all other manner of bull**** they're bathed in once they start class.

Man, some of you guys really don't realize that we're at war for our profession. Your heads are stuck in the sand. Minnesota just exploded. Who's next?
 
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So i gotta chime in here on this whole CRNA education thing...

I'm not defending at all their position as "equals," or whatever they wanna say, but to say their education is easier than your undergrad seems like a stretch. I went to a good college and took all the pre-med courses (as there was a time when I wanted to pursue medical school), but undergrad was NOTHING compared to AA school. I studied round the clock in AA school, 10x as much as I did in undergrad at least, and its not like I'm a slow learner or anything. I made close friends with Miller, Barash, and Longnecker...despite the fact that we've drifted apart in recent years. So either CRNA education is nothing like AA education (and maybe its the whole medical model vs nursing model???), but I doubt they can be THAT different.

Perhaps there is just a big discrepancy amongst the different CRNA schools?

I dunno. I can only comment on AA education, but I think all the AA schools are fairly similar in difficulty. Perhaps not so for CRNA...

I have no first hand knowledge of AA education. I just know that my science classes in undergrad were more rigorous than those a CRNA takes in their school. The content was more complicated, the tests harder, and it required more studying. I mean keep in mind that in your average CRNA school they have only about 6-12 months of class work and then the rest is clinical (though they may have 2 or 4 hours of classwork during their clinical rotations as well since clinical rotations tend to be 4 days a week or less).
 
That's kind of harsh. I totally understand where you're coming from, but does it *really matter* what someone who isn't your "equal" thinks? Is it THAT important to you to make sure those beneath you understand their place?

It does matter. She is a shining example of what's wrong with public perception of anesthesiology and successful propaganda by aana. I think this was pretty much iterated before I posted this though...
 
Happened to me again recently. This time it was an 18-year-old high school student interested in purportedly nursing who was shadowing one of our CRNAs. Told us that she was going to be an nurse anesthetist. I said, "Great!. Let's have you follow us today."

I took the time, explained what I was doing, showed her all my ortho tricks, let her watch us take care of our patients, showed her how I do blocks. After about 15 minutes of seemingly feigned interest, she started to get that "far away" look in her eyes. By 9:30 AM, she was staring around distractedly, looking at the ceiling, texting, etc.

:rolleyes:

At least she didn't faint (like a lot of them do). What is it with kids these days?
 
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