Posters, step back for a moment and read this thread from the big picture.
Most of the posters here, CRNA's, med students, residents and nurses, seem to be fundamentally good people, professionals or student professionals.
And everyone keeps preaching these "common sense" themes, such as letting the CTICU nurse override the med student in a code, MDA's handling the big cases, CRNA's competent for many of the things seen especially in a community OR, etc etc.
Concerned about jobs? Go to neonatology.org, and look at the number of job openings for NNP's versus MD's. There's no whining in peds about job opportunities; they work more for less, especially the subspecialties, and almost all (I for one can't think of any exceptions) of what a neonatologist does can be done by a NNP. Yet there IS NO FRICTION. Why? Is there mutual respect between the approaches? Less ego? It's certainly not due to a lower-stress environment.
To those CRNA's who are unhappy being supervised: I understand your frustration, especially if you're good, but this is the approach medicine in general is taking. It's basically the academic medicine model of attending supervising residents, but taken to the private realm of attending supervising mid-levels. This happens whether in surgery, medicine, neonatology, critical care, or anesthesiology, inpatient or outpatient.
When evaluating fresh graduates, the MD's are the only ones who can guarantee a full-spectrum or care within their specialty. In comparison, there is no guarantee that a mid-level is of equal competence to an MD. I gladly accept that after several years/decades the mid-level's care may be superior to that of your average MD, but there is no way for the public to distinguish between a MLP with 10 years of 10 months of experience. This is why medicine has boarded subspecialties; sure you may have lots of experience in cardiology or endocrinology, pain mangement, hand surgery or critical care, but there isn't away for the public to reliably distinguish this!
What do CRNA's hope to obtain with complete independence? They're able to practice their art (with minimal supervision once they've proven themselves), they set their own hours, they're not beholden to the system (ie, they work 40 hours a week, then go home, whereas someone has to stay until it's ALL done), they make more after just 7-8 years post high-school than most docs who are 12-14 years post-HS, their malpractice is covered by way of supervision...
As always, I'm open to rational, fair counter-arguments, and would be interested in reading them.
