Lobbying against CRNAs is not acceptable at UNC

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TimesNewRoman said:
Disclaimer: not an anesthesiologist.

It seems like the motivation behind these issues is never actually patient safety, but all about the almighty dollar.
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I learned this the first week of residency.
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Mman said:
The actual letter was pretty crass. It wasn't well written or professional. While I agree with the topic of the letter it was poorly written and didn't reflect well on physicians.
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Did you see the actual letter?
 
Here's the chairs response:

To Our Physician Anesthesiologists and Certified Registered Nurse Anesthetists,

I am proud to be a member of the anesthesia care team at the University of North Carolina at Chapel Hill. The care our physician anesthesiologists and CRNAs render our patients is exemplary. The collaboration, trust and respect we have fostered at UNC results in extraordinary care for all of our patients. My confidence in our physicians and our CRNAs is unwavering.

Recently, a letter was sent as part of a lobbying effort by one of our physician anesthesiologists expressing a personal opinion regarding a legislative issue involving CRNAs in the VA system. I want to be clear that the opinions expressed regarding our CRNAs are hers alone. I found the characterizations of our CRNA colleagues to be inappropriate, unprofessional, inaccurate and offensive. Our CRNAs are among the most gifted and well trained anywhere in the nation. The trust, respect and working relationships we have between our CRNAs and our physician anesthesiologists exemplify the very best in healthcare. Regardless of ones opinion on the legislative issue, I stand behind each of you and the high quality of care you deliver every day.

In closing, I want to thank each of you for your commitment to the health and wellbeing of our patients. I look forward to each day at UNC as I know that my efforts and those of my physician and CRNA colleagues make a difference in the lives of others.
 
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The Chair, David Zvara also basically forced her to write a letter of apology to the whole department JUST for expressing her views in a CONFIDENTIAL letter to her congressman that was purposefully LEAKED by, most likely, an aide in the Congressman's office. How ANYONE could work in such a department is beyond me.
 
OK, here's the PDF
 

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xfactor99 said:
Also, it looks like the CEO at UNC may have forced the chair to write this letter... http://www.nurse-anesthesia.org/con...empts-to-Obstructs-Veteran%92s-Access-to-Care
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The CRNAs say something very true there: “It is hard to convince someone of something when their salary depends on them NOT being convinced of it.” It applies beautifully to the CEO, the chair, the politicians, and all the bean counters who put CRNAs on (more than) equal footing with anesthesiologists.

I am so tired of this charade, and of having CRNAs practice under our good names. Let them sink or swim on their own, no anesthesia care team, no MDs involved, no firefighters, no preop monkeys, no safety net. It would take just a few months before they would have to rescind the legislation, and they know it; that's why they are afraid to get completely rid of doctors.
 
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FFP said:
The CRNAs say something very true there: “It is hard to convince someone of something when their salary depends on them NOT being convinced of it.” It applies beautifully to the CEO, the chair, the politicians, and all the bean counters who put CRNAs on (more than) equal footing with anesthesiologists.

I am so tired of this charade, and of having CRNAs practice under our good names. Let them sink or swim on their own, no anesthesia care team, no MDs involved, no firefighters, no preop monkeys, no safety net.
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I agree with you - and that statement also applies to the multitude of AANA journal articles they posted without the accompanying analysis that shows how weak those studies are. The ASA website does a beautiful job of looking at the evidence that is out there at this time (both pro and con). And at the end of the day, lets just look around - I don't spend a day a week on average in an operating room rescuing my MD colleagues....I don't need to. They don't get into the same kind of hot water.
 
nurse-anesthesia.org said:
Malpractice insurance for CRNAs working without physician anesthesiologists is 2-3 times less than an anesthesiologist. Apolitical actuaries whose entire job is to determine risk come up with these numbers and the fact is CRNAs are sued for less and less often that anesthesiologist.
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I hope everybody here understands that this is because the anesthesiologist gets to pay the brunt of any malpractice damages, even when the mistake belongs to a CRNA, even if the anesthesiologist was not called promptly.

In the eyes of malpractice law and juries, CRNA = anesthesiology resident. In the eyes of most CRNAs, CRNA = anesthesiologist, hence the attitudes. Good luck finding the fine line to walk in your daily practice.

That whole page proves again, if it was even necessary, that militant CRNAs don't know what they don't know.
 
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I love that they start by quoting copro. That post is an evergreen.
coprolalia said:
Okay, kid. Nice to meet you. I'm sure that others will tell you to "do a search" and that "this has been answered before", but here's cop's response:

You are sixteen. I admire your vision. But, do not - for the sake of your own sanity and happiness of being - go into medicine. Pick business. Get a top notch MBA from a big B-school, and sail into the corporate world working half the time and making ten times the money when you get to the top of your game. Sure, you'll have to start your way at an entry job and work-up, but with a top 25 B-school degree, you'll be pulling $100-$125k in your first corporate job at the age of 24-25. By the time you're 35, you'll be making 5 times that if you play your cards right. You'll be able to travel, have a life, and not spend every day fixing other people's problems under the constant threat of getting sued or being someone else's byQtch.

But, if you are steadfast and earnest in your quest and you remain undeterred, let me lay it out there for you...

1) You've probably already started too late. You need to kill the SAT's and get into a top 25 undergrad program somewhere. So, if you're under 1300 aggregate right now, you gotta tell your friends you can't hang with them next weekend because you're working on getting your score up at Sylvan. Start pimping the teachers in school who'll sponsor you for a spot in NHS, if you aren't already in it... (another leg down, I might add).

2) Next, get into college and go pre-med with a Biochem or P Chem major. Sure, you can do Biology, but you better shine brighter than Jesus on Easter if you want to get into a competitive med school. Now, don't party on the weekends... okay, maybe once a month or so and after exams... and study, study, study. Give up the best four years of your life to ensure that you get an "A" in all of your undergrad pre-reqs. Whatever you do, don't f-up 2nd semester Organic Chemistry. First semester ain't that hard. If you get anything less than a B+ in second semester, you're going to have a hard time getting into the med school of your choice. And, this is just the first two years of college.

3) Keep busting your ass in your junior and senior years of college. Remember, you gotta keep that GPA above 3.5 to have a realistic shot at the better programs. And, you better score at least a 32 (or higher) on the MCAT. Oh, the MCAT! That's right. That thing, if you have a bad day, can screw it all up for you. And, don't forget about your extra-curriculars. You know? Volunteering at the homeless shelter, working extra hours shadowing a doc in the local hospital, etc., etc. And, you can't get jealous because some of your friends from home are reporting they're having the time of their lives. Your friends will be co-pre-meds, and they will be the most vicious, back-stabbing, competitive, two-faced people who exist only to make you miserable you've ever met. But, remember, they're your friends. Which, if you think about it, is actually pretty good training for learning how to deal with the type of people who will be future professional colleauges.

4) Apply for school through AMCAS, and fund this by getting in line with all the crack addicts at the local blood bank and selling your plasma. Don't worry, you can do this twice a month and it pays pretty well. You'll realize that, when they take your plasma, they're also probably taking that last little piece of what's left of your soul. That is, the part that you didn't give away while shoving your noise up some a-hole Ivory Tower professor's arse just so he'd give you a good med school recommendation.

5) Now, you're in med school. Think you were miserable before? Be prepared for the hardest two years of your life. You will feel like jumping off of a bridge at certain points because there is no way that anyone can actually expect you to learn the volume of information coming at you in the time it is coming at you. Somehow, you get through it, though. And, now you are faced with the first of the "Steps". You'll spend 6-12 weeks preparing for this, and the next four waiting for your score afterwards in a complete panic that you failed it. Because, you know, so much rides on what you get on that test. You can pass it, but you better at least get a 220 or better, or your probably not going to get your spot at that top tier anesthesia program you've been eyeing since you were sixteen.

6) Third and fourth year teach you about the abuse you're going to take as an intern. Sure, you'll be fresh off learning all of this medical knowledge in the first two years of school and ready to apply it. Problem is, no one will let you because they know that you have no earthly idea how to apply it and, you will soon learn, they are right. Soon, you'll figure out that the first two years of med school were - for all intents and purposes - one big masturbatory session that has little to do with actually practicing medicine.

7) Now, you'll apply to anesthesia residency. You'll waste another huge chunk of money applying to 30 or 40 programs, get tons of interviews, and drag yourself all over the country trying to impress people you don't know and don't really care about all over again. You'll wonder to yourself, "when does this end?" to which someday you'll sadly realize in a moment of brilliant insight, an epiphany if you will, that it never does. You'll Match into a spot, maybe your top choice, after you ride the angst once again.

8) Suddenly, you find yourself at age 26 - the prime of your life - in residency. You'll be expected to know and do everything, but you'll quickly realize that you don't really have any authority. You'll be working 90-100 hours (but only allowed to report 80 hours... wink, wink) a week making $38,000/year while your buddy who went to B-school just got promoted to Director of Some Department in a Manhattan business and is now pulling $175k. Your Friday night consists of disimpacting a 89-year-old man's rectum of retained stool. His Friday night consists of partying with a bunch of hotties looking to score a B-school grad and wondering where his doctor buddy is... if only he was there. This goes on for the next four years. It doesn't get better as you progress through residency. You just get more responsibility with the same level of authority: none.

9) Towards the end of your residency, you go on more interviews with people you don't really care about and, somehow everywhere you go you are vaguely reminded of those back-stabbing college "friends" that said to your face "congratulations" when you got accepted to Top Choice School of Medicine, but then discussed how much they hated you when you walked away with their next breaths. Guess what? These are your professional "colleagues" now, AND your future "partners".

So, then there's ...

10) CONGRATULATIONS! Now you're finished college, med school, and residency! You're a board-eligible anesthesiologist! And, you're thirty! You've just given the biggest part of your soul and the best years of your life away to be bombarded by people who think you're "not really a doctor" and battles with midlevels who think they can do your job just as well - if not better - than you can.

Welcome to anesthesiology! If you remain undeterred by what I just wrote, you may actually have a chance at being successful. But, I'll tell you at 16 I was in no way prepared for all of this. And, if I had to do it all over again knowing what I know now, I can't say I would. But, can't say I wouldn't either... ;)

-copro
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My favorite thing is that after reading that post a few of the nurses questioned if it was a TACTIC to keep people from entering medicine!! Love it.
 
But I wish copro had added to the laundry list the number of paraprofessiona
FFP said:
I love that they start by quoting copro. That post is an evergreen.
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Heres a post by a CRNA about becoming a CRNA:
This is probably going to be the most negative post I have ever written to potential applicants to CRNA schools. While I will admit that there may be some subliminal, selfish, personal reasons for writing this, that isn’t my real goal. I’m trying to do what I have always done. Be up front and honest about the profession and your chances for becoming not just a CRNA, but a happily employed CRNA. Things have changed in the profession, and you need to be fully aware of what you are pursuing.

Let me start by telling you that I have been a CRNA for 10, almost 11 years, and I love what I do. I love the interaction I have with patients, and to a more limited extent, with their families. I love the daily challenge of anesthesia, and I love learning new techniques, I love the variety in my day to day employment. That said, I’ve seen some troubling developments in the last several years. Let’s start with the realities of schools. I’m not going to talk about any specific schools, and when I talk about things I’ve seen, I won’t reveal what schools I’m talking about, so don’t ask.

There has, in the last few years, been an explosion in the number of schools that offer CRNA programs. There are a couple of reasons for this. When I started school in 1999, there were far fewer schools, and our profession was facing a critical shortage of CRNA’s. Competition for the few school seats was tight, and schools were able to select only the best candidates. That situation has completely reversed. Now, the schools are competing for candidates to fill the seats. As a result, many folks who would not have even made it to the interview stage 12 years ago are being accepted into schools. This isn’t meant to be nearly as elitist as it sounds. The fact is, both the students and the profession are being done a great disservice in the overall process. Let me explain:

First, there are “CRNA mills” that accept as many as 120 students per class. If they could graduate that many (which they can’t), they would long ago have completely killed the job market in a wide radius around their location. So, how do they avoid doing that? Well of course, they accept students from other areas, knowing these students are likely to go “home” after graduation. But there is another built in safeguard. I’ve heard of more than one of these mills that accept more students to start the class than they have clinical sites to support. In other words, while they may initially accept 120, they have only 80-100 available spots with the didactic phase ends and the clinical phase begins. That means in the intervening time between acceptance and clinicals, they must lose (i.e. flunk out) 20-40 students. Think about that for a minute. This means that the school has no incentive to help the struggling student, the student who is just not getting it. In fact, these schools have a strong incentive to not help these students in any meaningful way. Get into one of these programs, and you are competing with 120 other students for a professor’s “office hours.” And the closer a class gets to the clinical phase, the less incentive the school has to help the struggling.

This leaves a number of RN’s, forced to return to jobs paying RN salaries, with anywhere from one to three semesters of CRNA school debt. So, why would they accept more students than they can train? Well, no one has ever come out and said it to me, but I have my own opinion. CRNA education is expensive. Very expensive. The more students the school takes in, the more money they can make, which is the school’s ultimate aim. So, if they can get 120 students, knowing they will have to drop 20-40 students, that’s OK. They will at least get up to half the program’s tuition out of those students they are “forced” to flunk out.

But the smaller schools have their problems, too. The explosion of schools has greatly increased the COA, the body that certifies CRNA graduate programs. While members of that board my say differently, I contend that the increased workload has created a situation whereby weak schools are able to get by with little or no notice. Right off the top of my head, I can think of two programs that have opened since I started practicing whose students I have trained have just been weak across the board. Every student, in every situation. I know of more than one case where these students have graduated, passed boards, then had difficulty keeping a job because they simply could not keep up, could not practice independently enough, even in an ACT environment. And while I have no evidence, I think there is a great potential for these folks to get sued.

The job situation isn’t great, either. A changing economic climate, coupled with the increased number of seats available has vastly changed the employment landscape. When I started, it was projected that as many as 50% of active CRNA’s were going to retire in the next 10 – 15 years. That, coupled with the low number of graduates that were coming out yearly, meant a CRNA could “write their own ticket.” Jobs were plentiful, anywhere one wanted to work. Salaries were climbing fast, and sign on bonuses of $20,000 or more were common.

But, owing to huge losses of retirement savings in the economic crash, most who were projected to retire have stayed in the work force. Couple that the increasing number of people coming out of school, and the employment picture has turned 180 degrees around. Salaries have stagnated, and are falling in some places. Look around this board. There are very few to no jobs to be had in California, Colorado, and other states. Look at just one example (you might not expect).

In Tennessee and Arkansas, when I first moved to the area in 2004, jobs were literally everywhere. Now, there are no fewer than 8 schools in the area producing CRNA’s. Jobs in both states have almost completely dried up. I’ve even heard a rumor that CRNA’s have been laid off in Chattanooga. I just now checked Gaswork, and there are three jobs available in Tennessee, one for a Chief CRNA. There was only 1 in Arkansas, at an endoscopy center in Little Rock. I work with a CRNA in Texas now who is a new graduate from Little Rock. She did not want to leave the area, but there just weren’t any jobs available.

Salaries, as I’ve said, have stagnated. In many urban areas, salaries have even gone down, particularly for new graduates. Raises are non-existent. I make exactly the same base pay now as I made in 2004, but other forms of compensation (i.e. overtime, call pay, etc) have decreased pretty dramatically. If you want to be a CRNA, don’t plan too much on finding a job where you go to school or do your clinicals.

The upshot is this: if you want to be a CRNA for the challenge, for the increased knowledge, then I encourage you to go for it. But if, upon graduation, you will be tied to a particular spot, especially if that spot is where you are going to school, or where you are going to do your clinical rotations, do your due diligence. Make sure there will be a job for you. Get a commitment, if you can (unlikely). Think long and hard. I know more than one CRNA who feels stuck in a suck job because they can’t (or won’t) move. I know others (some on this board) who simply cannot find a job in a place they want to live.
Last edited by kmchugh; 03-17-2012 at 10:07 AM.
 
nurse-anesthesia.org said:
Lastly Dr Ross relays a critical event which happened in the OR resulting in “coding” a child. These events are rare, unfortunate and terrifying often occurring rapidly and without warning particularly in small children. My heart goes out to the child, parents and the CRNA who was in the room during the event. What is despicable and shameful is that Dr Ross has decided to use this tragedy to push her and her association’s political agenda. She makes the suggestion that the CRNA in the room was “too proud” to call for help and further extrapolates that this would happen to YOUR child and our Veterans if an anesthesiologist is not there.

It is truly monstrous to take this unfortunate critical incident without any information on what actually happened and suggest it was entirely the fault of the CRNA and politicize and publicize it in this way. This CRNA provider was ACTUALLY IN THE ROOM and is no doubt already beating themselves up for the incident even if it was unavoidable. Additionally it is disgraceful that Dr Ross would then suggest that one incident is somehow reflective of an entire profession. It only takes a cursory review of the anesthesiology closed claims malpractice files to finds thousands of physician anesthesiologist errors resulting in bad outcomes for their patients and yet Dr Ross has not condemned all of physician anesthesiology. More importantly the American Association of Nurse Anesthetists does not stoop to this unethical level either.
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Seriously??? Do we really need to ask every anesthesiologist whether they have ever had to rescue a patient from imminent death or brain damage because the CRNA decided that there was no need to call the physician? Haven't we all seen this before?

And the nerve to make this out into the big bad anesthesiologist versus the poor CRNA who only cares about the patient.
 
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here it is: As you know, I recently submitted comments regarding the necessity of physician led anesthetic care to
my United States Senator. I submitted these comments with the naïve understanding that they were private comments between myself and someone who represents me in the United States Senate. Given the nature of current political discourse, I felt compelled to use strong language to get my position across. Unfortunately, my comments were fed into the public domain. I am truly sorry that the words I chose hurt the feelings of many of you.

I want to state, without reservation, that I value all the members of our care team and that I have tremendous respect for nurse anesthetists and the important contributions they make to the anesthesia care team. However, I feel very strongly that the level of safety and quality that the team based model of care affords is superior to that proposed by current legislation and that the best level of care should be provided to every patient, particularly our nation's Veterans. My conviction is based in large part on experiences with my two grandfathers, both of whom served in the military and receive medical
care in the VA system. I want my grandfathers to have the best care possible and I believe an anesthesia team benefiting from the unmatched training and education of a physician anesthesiologist is
the best way to deliver that care.

I am proud to stand with my nursing colleagues at UNC in delivering exceptional anesthetic care to our patients. Unfortunately, my passion for this issue and the resultant messaging used a few words which I wish I could take back. I understand how these words could have been interpreted as calling into question the important work that you do each and every day in the care of our patients. I am sorry if you felt devalued. This was not my intent. I think we share the goal of working in an anesthesia team that provides patients the synergistic benefits of the different education and skills
delivered when nurse anesthetists and physician anesthesiologists work together cooperatively.
 
I can't believe that they have to apologize for what should have been a private message to someone that represents them. The leadership needs to grow a goddamn backbone, nothing she says is untrue.
 
Psai said:
I can't believe that they have to apologize for what should have been a private message to someone that represents them. The leadership needs to grow a goddamn backbone, nothing she says is untrue.
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She is junior faculty. She finished her residency in 2012, and her fellowship one year later. She is a small fish, and the big sharks don't give a crap about her.

Watch and learn, because this is exactly what happens if you piss against the wind in any anesthesia group, not just an academic one. Free speech is for rich people who don't need a job.
 
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FFP said:
I hope everybody here understands that this is because the anesthesiologist gets to pay the brunt of any malpractice damages, even when the mistake belongs to a CRNA, even if the anesthesiologist was not called promptly.

In the eyes of malpractice law and juries, CRNA = anesthesiology resident. In the eyes of most CRNAs, CRNA = anesthesiologist, hence the attitudes. Good luck finding the fine line to walk in your daily practice.....
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FFP,
I agree with you re: brunt of malpractice damages, and would like to better educate myself (and others) in this regard. Are there rulings, case law examples, etc that you can direct me towards?
 
ph8 said:
FFP,
I agree with you re: brunt of malpractice damages, and would like to better educate myself (and others) in this regard. Are there rulings, case law examples, etc that you can direct me towards?
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Very good. I'll try to find you a case where the anesthesiologist was liable, despite not being at fault (in the room), and you'll try to find me even one where s/he was not, only the CRNA in the room. ;)
 
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BLADEMDA said:
$6,500,000 SETTLEMENT IN ANESTHESIA CASE RESULTING IN BRAIN DAMAGE* (Structured Settlement payout of $45,000,000) Medical Malpractice Trial Report ANESTHESIA Medical Malpractice Lawsuit: 
 Failure to Monitor Anesthesia Results in Brain Damage. The Plaintiff, age 7, was admitted to the Hospital for the performance of a tonsillectomy and adenoidectomy. The morning of the surgery the Plaintiff’s father met with the Anesthesiologist briefly. The Anesthesiologist never told the family that the Nurse Anesthetist would actually be inducing anesthesia and monitoring the Plaintiff during the surgery, and that he, the Anesthesiologist would not be physically in the operating room for the majority of the time. After intubation and induction, the Anesthesiologist left the operating room leaving the Plaintiff to be monitored by Nurse Anesthetist. The Hospital had five working operating rooms. On the date in question four operating rooms were in use. Nurse-anesthetists manned three of the operating rooms with the fourth room manned by an anesthesiologist other than the Defendant Anesthesiologist. The Defendant Anesthesiologist's sole responsibility that day, pursuant to the guidelines of the Hospital, was to be the director and supervisor of the Nurse-Anesthetists in the three operating rooms. Following intubation the Plaintiff underwent anesthesia induction with the drug Halothane through the endotracheal tube. Anesthesia is the practice of rendering someone unconscious so that they will not feel pain. Halothane does this by affecting the central nervous system. When given in too high of a dose, the central nervous system will shut down to too large of a degree affecting the transfer of oxygen in the body. This failure of the body to transfer oxygen and oxygenate the blood leads to a condition as know hypoxia. Hypoxia is defined as a decrease below normal levels of oxygen in arterial blood or tissue. When the body is faced with hypoxia it attempts to protect itself from damage. This is done by autoregulation of the blood flow. The brain shunts blood away from the periphery and increases flow to the brain and heart to insure that they are not damaged. Unfortunately, the body can only autoregulate itself for a period of time. Eventually, if the hypoxia continues, there is cardiovascular- collapse and brain damage. One sign of hypoxia is a lowering of the blood pressure and an increase in the pulse rate. The low blood pressure is due to the shunting of the blood; the high pulse rate is the bodies attempt to counteract the decreased oxygen content by increasing the amount of heartbeats. In effect, by having additional beats of low oxygenated blood the body hopes to maintain the same tissue oxygenation that was being supplied by fewer beats of properly oxygenated blood. The Plaintiff was started with an induction dose of O-3.O percent. The standard of care then calls for a tapering of the induction dose to a smaller maintenance dose during surgery. During surgery the Plaintiff was monitored at a dose of 2.5 percent. It was the opinion of the Plaintiff’s various medical experts that Defendants Anesthesiologist and Nurse Anesthetist fell below the standard in the administration and maintenance of the Halothane in that the Plaintiff was overdosed on Halothane. The Plaintiffs expert testified in deposition that the loading dose of 3.O percent and the maintenance dose of 2.5 percent were too high. Also, the anesthesia record for the Plaintiff indicates that during surgery the Plaintiff's pulse became tachycardic (very fast) and his blood pressure was dropping. These symptoms were apparently ignored by the Nurse Anesthetist. Another manner of confirming the patients well being during surgery is through the use of a pulse oximiter. This is a process by which a machine determines the oxygen saturation of blood. This is done through a clip or wrap piece that is placed on a patients finger. Pulse Oximitry was used on the Plaintiff. The pulse oximitry will provide a reading of the percentage of oxygen content. Clearly the percentage should be high in a normal person, 98-100 percent. The Plaintiff was receiving oxygenate during surgery through the intubation tube and therefore his oximitry reading should have been 100%. During surgery the oximitry reading was only 97%. Further, during surgery the pulse oximitry actually dropped on two occasions from 97 to 0. This was a sign of lack of oxygenation that was also ignored by the Nurse Anesthetist. Nurse Anesthetist who simply asked that the clip for the oximitry be replaced did not aggressively investigate this situation. The clip was replaced and again showed readings that went from 97 to 0. Again the Nurse Anesthetist asked for the clip to be replaced. The Nurse Anesthetist did not consider that the oximitry reading might actually be evidence of the Plaintiff becoming hypoxic, which was the case. The Nurse Anesthetists simply assumed that the machinery was not working, and did not confirm the Plaintiffs well being. had the Nurse Anesthetist done so it would have been evident that the Plaintiff was hypoxic, and would have taken action to reverse the hypoxia, well before cardiovascular collapse and brain damage. The pulse oximetry equipment was later checked and found to be properly working without any difficulty. Therefore, the drop in the pulse oximetry from 97 to 0 was not caused by a machine malfunction, as was at one point suggested by the Defendants, but was an indication of hypoxia. Either because of concern due to the abnormal oximetry readings or because it was the conclusion of the surgery, depending upon which deponent was to be believed, the surgical table was turned so that the Plaintiff’s head was away from the surgeon and in front of the Nurse Anesthetists. At that time the Plaintiff was found to be severely cyanotic. Cyanosis is a bluish coloration of the skin due to deficient oxygenation content of the blood. Cyanosis is one of the indications of hypoxia. The bluish color of the child’s sin was not noticed earlier by the surgeon or the Nurse Anesthetist because the child was draped for surgery. Faced with what was now a medical emergency, the Nurse Anesthetist called for a code blue. The supervising Anesthesiologist responded with another Anesthesiologist and CPR was begun. At that time the Plaintiff had no pulse. The second anesthesiologist managed the care of the Plaintiff during the code. This second anesthesiologist stated that he saw a wide QRS rhythm on the EKG. This wide complex rhythm is evidence of a long standing duration of hypoxia rather than an acute event. Due to the long-standing delay in recognizing the Plaintiff’s hypoxia, his condition had deteriorated so badly that it was extremely difficult to regain a pulse. By this time, extensive brain damage had already occurred. Eventually the Plaintiff did regain a pulse and was transferred to another facility. Following the events in question the Plaintiff was diagnosed as being significantly and profoundly brain damaged. The actual diagnosis is anoxic encephalopathy. Apart form the brain damage, he is otherwise physically healthy. The Plaintiff has little cognitive function but does smile appropriately, laughs when tickled and responds to his mother’s voice. The Plaintiff will now be cared for at home with his family. Following the close of discovery, the case was settled at mediation for the amount of Six Million Five Hundred Thousand ($6,500,000.00) Dollars. A portion of the settlement amount was structured. Should the child live for a normal life expectancy, which it is expected he will, the payout for the structure will be in the amount of Forty Five Million ($45,000,000.00) Dollar
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From http://www.klevinelaw.com/wp-content/uploads/2015/04/6-500-000-SETTLEMENT-IN-ANESTHESIA.pdf

Whenever a CRNA screws up, they can come for the anesthesiologist at least for "failure to supervise".
 
Visited recently.
SUPER friendly atmosphere. Turns out, a few of the CRNAs are very active politically and advocate for independent practice regularly.

I asked about it but didn't get great answers..
"Wouldn't you do the same if you were in their position?" ..

..I'm curious how these CRNAs haven't been eliminated.
 
I hope Dr Ross realizes her career there is over and she will never make professor. She should print out the letter she wrote along with the back story and use that as a CV for PP groups. Assuming she's competent, I'd vote to hire her just based on that. Even in her "apology letter" she stuck to her guns, I like it.
 
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I have her email address and photo.. Not sure if I should post it here. Pm me for email address so you can write her and tell her how awesome she is. She is cute too.
 
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I don't care if I was junior faculty. There are other jobs and I am sure she would be hired because of, and not in spite of, her opinion. If the chair asked me to write the letter I would have simply walked out and the only letter they would get was my resignation.
 
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@criticalelement yes please PM it to me. Thanks. She needs to know she did the right thing and I'm sure she isn't getting that at UNC.
 
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1) The letter could maybe have been worded better.
2) I'd like to know the circumstances of it being made public, and if she has any possibility of legal action. Her current and future career without question will be effected, and she obviously had no desire to make it available to her department head, much less everyone else.
 
This apology and the crushing of this junior attending is a huge victory to the CRNA's propaganda machine.
The worst part is that the ASA president actually sent a letter to all members indirectly referencing this situation, and asking for civility when Lobbying!
He has the audacity to mention civility while the AANA banners are everywhere, calling themselves the future of anesthesia, and openly claiming that physicians are not needed and not necessary!
This is why the ASA is so useless!
 
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