midlevels have a higher rate of complications...we all see it. It may not translate into the current studies or is presented, but ignored, at the suit meetings but we all know it. The studies are not powered or oriented to detect the differences. The blown art line attempt, the attempt at an art line in a pt who didn't need one, the excessive transfusions of fluid, the 9 pm "failed extubation" sent to the ICU for recovery, the OR MI that wasn't detected , the excess narcotics, the missed block attempt since the RNs thinks it's a go after a weekend course...
That's why we are becoming firefighters. The problem is these near-events dont translate into a mortality difference, or a cost difference that is perceptible yet...
I always advocate the higher road. Why roll around in the mud with the RNs as an MDs and have licenses to practice freely. At some point anesthesiologist figured let's do TEE, why not the same for intraoperative monitoring, vascular access ports, ECMO, ICU, TEE, interventional pain, Blocks and straight general Anesthesia. The problem is we sit there and teach our replacements. How many of us let the CRNAs intubate, place lines, run the anesthesia...
There are RNs out there literally picking up TEE probes and making rough roads o. The images.
Why is it frowned upon when I just want to do all the procedures myself.
We should cut the cord. Let the better service win out. But that doesn't mean- you crna intubate while I push meds and take the blame. Sure it might take a year or two in the optho room or GI suite to see that Brady arrest, or failed MAC arrest. And in the main OR just a few months but it will shake out. Im pretty sure if the anesthesiologists in this country just left the ACT and went rogue by actually practicing medicine instead of being a glorified nursing supervisor all the screw ups we patch every single day will come to the light pretty quickly.