Buzzfeed CRNA "secrets straight from the source"

[TheLoneWolf]

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Members don't see this ad.

There are so many inaccuracies below it makes your head spin 🤣. The AANA should rubber stamp this and put it in their pamphlets.​

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"If you ever require anesthesia in the US, the service will most likely be performed by an independent, full-service anesthesia provider called a CRNA. These are the providers that actually do anesthesia day in and day out, and who are most experienced and proficient at the enormous responsibility of it all. They have been doing it longer than any other type of anesthesia provider. The issue is this: Before your surgery, you will likely also be seen by an anesthesiologist. This person will tell you he/she will be performing the anesthesia service, when they are, in fact, not. This lie is to protect their $600,000 salary."​

"They do not want you to know that there are CRNAs because it keeps you unwittingly paying for two providers, when you only need one. Their most important task is the BILLING service. Trust me, you don’t want an anesthesiologist actually doing your anesthesia. It sounds counterintuitive, but most have not done anesthesia for many years since training in residency. Then, add rustiness to having become barely proficient in the first place, and you can get a bumbling mess in the operating room. I recently had to get my gall bladder out, and trust me, after years of experience behind the scenes, I knew to confirm I had a CRNA instead of an anesthesiologist to perform my service. I still got stuck with paying for both, though. That was maddening."

People In The Medical Field Are Sharing Things From Their Jobs You'd Only Know If You Read Them

"When you’re rude to them, you will probably wait longer. ... Have some patience, patients!"

www.buzzfeed.com

 

[HemeOncHopeful19]

As a non-Anesthesiologist I have the opposite concern that I or my family will need a procedure and won’t be able to guarantee a physician.

 

[vector2]

Lol I love that their brainwashing is so complete that they actually genuinely believe this horsesht.

 

[chocomorsel]

As a non-Anesthesiologist I have the opposite concern that I or my family will need a procedure and won’t be able to guarantee a physician.

Ask ahead. Plan for it. Most practices I bet can accomodate it unless the run a lean mean, money making machine like some of us here.

 

[IMGASMD]

Ask ahead. Plan for it. Most practices I bet can accomodate it unless the run a lean mean, money making machine like some of us here.

Most recently we had a surgeon who came in for a hernia repair…. Didn’t tell anyone.

On the morning of surgery, one of the partners saw him, was like WTF?! (They actually assigned one of the worst CRNAs in that room.). She ended up taking that room and I got to supervise the CRNA in her original room.

Just ask…. Say something beforehand, most practices will accommodate.

On the OP. Should go read some of the comments. They were pretty good too. One of the “nurse” was trying to tell people, crnas are not regular nurse, with associate or bachelor degree. They’re nurses with at least master degrees, therefore better…. Aana and crnas should be ashamed of themselves.

 

[secretasianman]

I read the comments and was surprised to see less than the usual amount of virtue signaling and circle jerking from the nursing propaganda unit.

 

[TheLoneWolf]

I read the comments and was surprised to see less than the usual amount of virtue signaling and circle jerking from the nursing propaganda unit.

Well at least we have solidarity with the redditors

 

[mmag]

The real secret is that the patient pays the same copay/coinsurance whether they get anesthesia from a solo dedicated anesthesiologist or from an unsupervised nurse anesthetist.

 

[OptionOffense]

This should be our response to the CRNAs.

 

[TheLoneWolf]

This should be our response to the CRNAs.

Or if the ASA grew a spine:

URGENT: Potential CRNAs in Canada – Important Advocacy Update

 

[nimbus]

Part of the problem is that some anesthesiologists think “sitting the stool” is beneath them.

 

[2Fast2Des]

Part of the problem is that some anesthesiologists think “sitting the stool” is beneath them.

Sad... Because sitting the stool is where quality is ensured. What is the point of being an anesthesiologist if you don't want to be in a room?

 

[OptionOffense]

Part of the problem is that some anesthesiologists think “sitting the stool” is beneath them.

There needs to be more of a nuanced answer than this. A lot more to it than this.

 

[OptionOffense]

If you advance the C-AA profession in all 50 states and open up schools for every CRNA school out there, I can almost guarantee this fix the problem with the CRNA encroachment issues for the younger folks byt the time they finish residency. The adage, biting the hand that feeds y ou applies here.

So IF the CRNAs want to work in anesthesia, they would have to go "indy". And if you want to know the truth, that is unpalatable to many entities. This will limit their employment options.

 

[secretasianman]

Honestly anyone of them who practice independently should sign a waiver saying they take 100% respobsibility for their anesthesia and their malpractice premiums should be adjusted accordingly. None of this hiding behind the nearest MD/DO and claiming “just a nurse” when it hits the fan.

 

[TheLoneWolf]

Honestly anyone of them who practice independently should sign a waiver saying they take 100% respobsibility for their anesthesia and their malpractice premiums should be adjusted accordingly. None of this hiding behind the nearest MD/DO and claiming “just a nurse” when it hits the fan.

I had interviewed at a hospital employed position where you sit all your own cases, dont sign the CRNA records, and the CRNAs were fully independent and also hospital employees. On the day of interview, it became abundantly clear that you have to be available for immediate backup to the CRNAs. I felt the nurses had a false sense of equivalence. Hospital employed fireman where I can't direct care and must get involved when problems arise is probably worse than the ACT model IMO. I do think this may be a future hospital employed model to complete with the ACT model as each person is in a room outside the board runner.

 

[norski]

Honestly anyone of them who practice independently should sign a waiver saying they take 100% respobsibility for their anesthesia and their malpractice premiums should be adjusted accordingly. None of this hiding behind the nearest MD/DO and claiming “just a nurse” when it hits the fan.

As a foreign nurse anesthetist, I absolutely agree with this statement. In my country, we had five patient cases making national news a few years back about nurse anesthetists in plastic surgery clinics being directed by surgeons, dictating the anesthetics, all of these cases turning to **** with near fatalities due to both the surgeons' and the nurse anesthetists' inability to provide adequate countermeasures to complications arising.

The cases, and consequences of the lacking management of issues were of the same type as the ones shared in these fora. Deep spontaneously ventilated sedations (MACs, in US terms?), infiltrated LA, turning to laryngospasms,LAST, inability to secure airways, etc etc.

There are,of course, rules and guidelines for anesthesia practice here, nationally, but before these instances were made public, nobody in the cosmetic surgery world gave a crap, nurse anesthetists wanting to keep their lucrative side hustles just let surgeons direct them. After all of this, it's become par for the course to have at least one anesthesiologist per four ORs, both private and public.

The day I'm letting a non-anesthesiologist direct my anesthetics is my last day in this profession.

 

[OptionOffense]

Hospital employed fireman where I can't direct care and must get involved when problems arise is probably worse than the ACT model IMO. I do think this may be a future hospital employed model to complete with the ACT model as each person is in a room outside the board runner.

I am not saying you are wrong, but who would sign up for that? What satisfaction is derived from that kind of practice especially if you are young. What will happen after the old folks die ? Medically directed practices are becoming unpalatable so I am told on account of the arrogance and insubordinate nature of the neo modern CRNA.

 

[Zekchar]

I had interviewed at a hospital employed position where you sit all your own cases, dont sign the CRNA records, and the CRNAs were fully independent and also hospital employees. On the day of interview, it became abundantly clear that you have to be available for immediate backup to the CRNAs. I felt the nurses had a false sense of equivalence. Hospital employed fireman where I can't direct care and must get involved when problems arise is probably worse than the ACT model IMO. I do think this may be a future hospital employed model to complete with the ACT model as each person is in a room outside the board runner.

To be clear, there is no "independently practicing" CRNAs. There are only independently practicing (WITHOUT Anesthesiologist surpervision) CRNAs. That happens in opt-out states (all 22 of them). This is an important distinction because unbeknown to surgeons who are then in the rooms with "independently practicing (WITHOUT Anesthesiologist)" CRNAs ... they are legally responsible for supervising the CRNAs.

I will go out on a limb and say that your average general surgeon, urologist, neurosurgeon, ob/gyn, ENT, etc ... do not know jack **** about anesthesia and yet medico-legally they are "supervising" CRNAs. This doesn't compe up when things are peachy. This comes up when there is a bad outcome, followed closely by a lawsuit due to inferior CRNA knowledge and skills compared to anesthesiologists. This is where non-anesthesiologists learn the terms "liability, deposition, breach in the standard of care, negligence, and trial."

 

[deleted1130227]

 

[nimbus]

I had interviewed at a hospital employed position where you sit all your own cases, dont sign the CRNA records, and the CRNAs were fully independent and also hospital employees. On the day of interview, it became abundantly clear that you have to be available for immediate backup to the CRNAs. I felt the nurses had a false sense of equivalence. Hospital employed fireman where I can't direct care and must get involved when problems arise is probably worse than the ACT model IMO. I do think this may be a future hospital employed model to complete with the ACT model as each person is in a room outside the board runner.

We run the board from a room. It’s easy with snapboard.

 

[OptionOffense]

To be clear, there is no "independently practicing" CRNAs. There are only independently practicing (WITHOUT Anesthesiologist surpervision) CRNAs. That happens in opt-out states (all 22 of them). This is an important distinction because unbeknown to surgeons who are then in the rooms with "independently practicing (WITHOUT Anesthesiologist)" CRNAs ... they are legally responsible for supervising the CRNAs.

I will go out on a limb and say that your average general surgeon, urologist, neurosurgeon, ob/gyn, ENT, etc ... do not know jack **** about anesthesia and yet medico-legally they are "supervising" CRNAs. This doesn't compe up when things are peachy. This comes up when there is a bad outcome, followed closely by a lawsuit due to inferior CRNA knowledge and skills compared to anesthesiologists. This is where non-anesthesiologists learn the terms "liability, deposition, breach in the standard of care, negligence, and trial."

I think opt out means they do not need supervision and it exonerates the surgeon from any liability. Although that AZ Meeker case throws my theory out the window since the surgeon is in big trouble for the easy anesthetic that Meeker ****ed up

 

[deleted1130227]

I think opt out means they do not need supervision and it exonerates the surgeon from any liability. Although that AZ Meeker case throws my theory out the window since the surgeon is in big trouble for the easy anesthetic that Meeker ****ed up

"opt out" refers to billing requirements that CRNAs be supervised... Nothing else.

 

[nimbus]

Or if the ASA grew a spine:

URGENT: Potential CRNAs in Canada – Important Advocacy Update

Unlike the CAS, the livelihoods of many ASA officers and members depend on CRNAs. Hard to stuff the genie back in the bottle.

 

[secretasianman]

“Opt out” does not lay out any foundation for how the law operates when things go wrong.

Nurse Anesthetist Liability in California- Clarification and Confusion (Part II)

“ So we now know that nurse anesthetists in California can be held liable for their own negligence. But we also know that the associated anesthesiologist, surgeon, gastroenterologist, or hospital can also be found liable for their actions—even if the nurse anesthetist is found to be the responsible party, and irrespective of whether or not the nurse is even named in the lawsuit. And it bears emphasizing that, despite nurse anesthetists being legally liable for their actions in our state, we find no report of them being held to this account in California (while there are reported cases of the physicians responsible for them being found liable).”

Want to have zero culpability? Come to california!

 

[deleted1130227]

Unlike the CAS, the livelihoods of many ASA officers and members depends on CRNAs. Hard to stuff the genie back in the bottle.

While true, what we want is an ASA leadership who is willing to say in plain, blunt, clear, language that NURSES are not DOCTORS. DOCTORS are not NURSES. The education and training are not the same and the difference matters. Anesthesiologist supervision of CRNAs saves lives.

Fück ASA leadership for their cowardice and self serving actions for failing to do so.

 

[OptionOffense]

"opt out" refers to billing requirements that CRNAs be supervised... Nothing else.

woah, woah, woah!!

Are you saying what I think you're saying? That CRNAS must be supervised by a physician irregardless of what the billing arrangement is? So all the indy' CRNAs are running afoul of practice law?

 

[OptionOffense]

While true, what we want is an ASA leadership who is willing to say in plain, blunt, clear, language that NURSES are not DOCTORS. DOCTORS are not NURSES.

Fück ASA leadership for their cowardice and self serving actions for failing to do so.

Dude, we are beyond that. Lets say the ASA DID say that, you think the AANA will say,
"Oh well why didn't you say so? Youve never said anything before?" Nope. They will continue on their scourge on medicine continue to lie and mislead the public and patients. We are the dumb ones. We are allowing this to happen at the academic medical centers.

The ASA would be better served in supporting C-AAs and introducing them as Just like CRNAs only better.

 

[vector2]

While true, what we want is an ASA leadership who is willing to say in plain, blunt, clear, language that NURSES are not DOCTORS. DOCTORS are not NURSES. The education and training are not the same and the difference matters. Anesthesiologist supervision of CRNAs saves lives.

Fück ASA leadership for their cowardice and self serving actions for failing to do so.

"Nurse anesthetists are valued members of the anesthesia team, but their nurse education and limited clinical training does not equal the medical education and training of a physician. Nurse anesthetists are not trained in medical decision making, differential diagnoses, medical diagnostic interpretations or medical interventions. Removing physician supervision of anesthesia care makes no more sense than removing it from any other critical care location."

Opt-Outs

www.asahq.org

 

[Iso4ane]

I had interviewed at a hospital employed position where you sit all your own cases, dont sign the CRNA records, and the CRNAs were fully independent and also hospital employees. On the day of interview, it became abundantly clear that you have to be available for immediate backup to the CRNAs. I felt the nurses had a false sense of equivalence. Hospital employed fireman where I can't direct care and must get involved when problems arise is probably worse than the ACT model IMO. I do think this may be a future hospital employed model to complete with the ACT model as each person is in a room outside the board runner.

If I'm going to be a **** magnet, it's better due to **** I stirred up.

 

[TheLoneWolf]

To be clear, there is no "independently practicing" CRNAs. There are only independently practicing (WITHOUT Anesthesiologist surpervision) CRNAs. That happens in opt-out states (all 22 of them). This is an important distinction because unbeknown to surgeons who are then in the rooms with "independently practicing (WITHOUT Anesthesiologist)" CRNAs ... they are legally responsible for supervising the CRNAs.

I will go out on a limb and say that your average general surgeon, urologist, neurosurgeon, ob/gyn, ENT, etc ... do not know jack **** about anesthesia and yet medico-legally they are "supervising" CRNAs. This doesn't compe up when things are peachy. This comes up when there is a bad outcome, followed closely by a lawsuit due to inferior CRNA knowledge and skills compared to anesthesiologists. This is where non-anesthesiologists learn the terms "liability, deposition, breach in the standard of care, negligence, and trial."

Even at the risk of being laughed out of this forum, I did not know that until you mentioned it.

 

[TheLoneWolf]

I am not saying you are wrong, but who would sign up for that? What satisfaction is derived from that kind of practice especially if you are young. What will happen after the old folks die ? Medically directed practices are becoming unpalatable so I am told on account of the arrogance and insubordinate nature of the neo modern CRNA.

Good points. It's for the reasons you mentioned that I didn't take the job. Also, can't correct inappropriate behavior if they are hospital employees like myself. Fast way to put a target as a non team player to the admin. No thanks

 

[vector2]

I will go out on a limb and say that your average general surgeon, urologist, neurosurgeon, ob/gyn, ENT, etc ... do not know jack **** about anesthesia and yet medico-legally they are "supervising" CRNAs. This doesn't compe up when things are peachy. This comes up when there is a bad outcome, followed closely by a lawsuit due to inferior CRNA knowledge and skills compared to anesthesiologists. This is where non-anesthesiologists learn the terms "liability, deposition, breach in the standard of care, negligence, and trial."

Unfortunately, I think the practice settings where a surgeon or other practitioner "supervises" the CRNA tend to be the same ones where bad outcomes are just brushed over unless it's a 10/10-makes-the-local-news egregious event involving a young person. We're talking critical access hospitals and surgicenters that don't do QI, RCAs, or M&Ms, etc..

As you said, the surgeon doesn't know anything about anesthesia and the CRNA either doesn't have enough knowledge to prevent the bad outcome, or if they do they are loath to share details because that would mean taking responsibility. Instead, whenever there's a preventable bad outcome everyone just throws their hands up and says "it was a sick pt" or "it was a freak occurrence" and they go about their business because the pt's family is none the wiser.

Ultimately, patients have been blessed by physician/scientists' technological advances which have made anesthesia safer, but the flip side is that it's made it almost impossible for even the most dingus CRNAs to make egregious kill errors (despite their best efforts).

 

[IMGASMD]

While there’s a lot being said, I think we should acknowledge now, after all these years…. (1986 according to aana). — To use and now almost dependent on CRNAs is a financial decision, nothing more, nothing less. So I think it will also be solved (fat chance, I know) with a monetary one.

Their pay is catching up, folks. Just a few years ago, they’re getting $200/hr is unheard of. Some of us, a least me, would be ecstatic to have gotten that 200/hr. Nowadays, you’re a fool if you do it less than $250/300, because plenty of crnas are getting 200/hr. With them being paid like a nurse, on an hourly basis with overtime after 40 hours. You all can do the math.

I think the day we all become hospital employees. And we make it known, that we are still the fools that we are.
We require only a salary, and we are dumb enough to cover anything and everything you throw at us. No overtime, no union, no hiding behind hospital when **** hits the fan, no crying to admins, no calling in sick last min.
Right there for the low low price of $500K. If I was in administration…. You got it folks.
$300 * 40 * 52 = 624k
$200 * 40hr/week * 52weeks = 416k

If I am not in PP and not making money off CRNAs, why would I care what they do/want to do?

The hospitals I am at, have 20 open CRNA positions! That’s 5 short per hospital! Everyone is short, the price is only going to go up, not down. We are the ones holding the bags by asking our partners to work post call or give up vacations. The nurses couldn’t give a fuk when they’re short. They do their required 40, get full benefits, then Locum/Per diem somewhere else for a better hourly rate.

Just sayin’.

 

[kidthor]

They do their required 40

The CRNAs at my shop work 36hrs a week, no call, no weekends, no holidays, and they raise holy hell if you don’t get them out at least 30 min before their shift is up. Whereas the docs work a required 50 hrs a week plus call, weekends, nights, no overtime differential, and are regularly held over their shifts. But I really blame the docs for not advocating for themselves at all - we let everyone walk all over us like patsies. Much of this problem is our own doing.

 

[Southpaw]

The CRNAs at my shop work 36hrs a week, no call, no weekends, no holidays, and they raise holy hell if you don’t get them out at least 30 min before their shift is up. Whereas the docs work a required 50 hrs a week plus call, weekends, nights, no overtime differential, and are regularly held over their shifts. But I really blame the docs for not advocating for themselves at all - we let everyone walk all over us like patsies. Much of this problem is our own doing.

There is perhaps no worse of a sad sight, for an anesthesiologist, than to work in a spineless department. And yet it’s rampant.

 

[deleted1130227]

There is perhaps no worse of a sad sight, for an anesthesiologist, than to work in a spineless department. And yet it’s rampant.

There are a lot of them. Gotta pay the mortgage. Unwilling or unable to locate. Path of least resistance. Incentive is to do as little as possible and get the hell out of the hospital. "Locker Slammers". Try to affect change and fail and you will make your life much harder. I worked in a department like that for a few years. It took its toll.

 

[kidthor]

There are a lot of them. Gotta pay the mortgage. Unwilling or unable to locate. Path of least resistance. Incentive is to do as little as possible and get the hell out of the hospital. "Locker Slammers". Try to affect change and fail and you will make your life much harder. I worked in a department like that for a few years. It took its toll.

That describes my department perfectly. It has a high rate of turnover and those who are happy enough long term are complacent and put in just enough effort to get their check while making no noise. Indeed it’s soul sucking. I’m tied to this area due to having elderly parents who need a lot of help, otherwise I’d be jumping ship immediately. I’m still thinking of just quitting to do locums instead. Being with a spineless group sucks.

 

[Hoya11]

That describes my department perfectly. It has a high rate of turnover and those who are happy enough long term are complacent and put in just enough effort to get their check while making no noise. Indeed it’s soul sucking. I’m tied to this area due to having elderly parents who need a lot of help, otherwise I’d be jumping ship immediately. I’m still thinking of just quitting to do locums instead. Being with a spineless group sucks.

While there’s a lot being said, I think we should acknowledge now, after all these years…. (1986 according to aana). — To use and now almost dependent on CRNAs is a financial decision, nothing more, nothing less. So I think it will also be solved (fat chance, I know) with a monetary one.

Their pay is catching up, folks. Just a few years ago, they’re getting $200/hr is unheard of. Some of us, a least me, would be ecstatic to have gotten that 200/hr. Nowadays, you’re a fool if you do it less than $250/300, because plenty of crnas are getting 200/hr. With them being paid like a nurse, on an hourly basis with overtime after 40 hours. You all can do the math.

I think the day we all become hospital employees. And we make it known, that we are still the fools that we are.
We require only a salary, and we are dumb enough to cover anything and everything you throw at us. No overtime, no union, no hiding behind hospital when **** hits the fan, no crying to admins, no calling in sick last min.
Right there for the low low price of $500K. If I was in administration…. You got it folks.
$300 * 40 * 52 = 624k
$200 * 40hr/week * 52weeks = 416k

If I am not in PP and not making money off CRNAs, why would I care what they do/want to do?

The hospitals I am at, have 20 open CRNA positions! That’s 5 short per hospital! Everyone is short, the price is only going to go up, not down. We are the ones holding the bags by asking our partners to work post call or give up vacations. The nurses couldn’t give a fuk when they’re short. They do their required 40, get full benefits, then Locum/Per diem somewhere else for a better hourly rate.

Just sayin’.

There is no reason we cant go per diem with defined hours and be just like them.

I would do 1099 work at multiple hospitals making my own schedule and hours. Pay my own benefits. And yeah maybe call out sick if im not feeling it, what are you going to do to me?

 

[deleted1130227]

There is no reason we cant go per diem with defined hours and be just like them.

I would do 1099 work at multiple hospitals making my own schedule and hours. Pay my own benefits. And yeah maybe call out sick if im not feeling it, what are you going to do to me?

-Non compete might be enforceable. (for those who are geographically limited)
-Worry about not having a chair when the music stops. It will at some point.
-Better the devil you know.

 

[Guillemot]

Whereas the bar is low for anesthesiologists, the bar is even lower for CRNA: While there is likely significant overlap in the intelligence of CRNA at the higher end of the CRNA spectrum and the lower end of the physician spectrum, the lower end CRNA are going to be significantly dumber than the lower end anesthesiologists.

Its not really something that is studied AFAIK. Also relies on the premises that there is a relation between intelligence of healthcare provider and patient outcomes - reasonable assumption, but probably difficult to measure.

 

[IMGASMD]

-Non compete might be enforceable. (for those who are geographically limited)
-Worry about not having a chair when the music stops. It will at some point.
-Better the devil you know.

That’s why it’s a young man’s game.
I am not welling roam around for a few months/years then come back to no chairs.

I can however, give up some weekends and/or vacations for a worth while days.

To your third point, that’s another thing. Every new hospital I go to, need to learn the culture, the players. All sort of mental anguish for me…. Also a sign that I am getting old, I suspect. Becoming creatures of habit.

 

[OptionOffense]

The hospitals I am at, have 20 open CRNA positions! That’s 5 short per hospital! Everyone is short, the price is only going to go up, not down.

This

 

[IMGASMD]

This

They may be part of the solution, but it’s just kicking can down the road. One day they’ll be fighting for something. Like “anesthesiologists associate.”

I think crnas when they first came out, probably were respectful and know what their job entail. No longer. We are only handful of the country with nurse anesthetist. Maybe the only one let mid level (mid level of what?) work independently, regardless of if it’s only regulation for billing or worse on paper. When they can spiel **** like that and no one is able to stop it, it’s a problem.

Like I said before, if we actually admit CRNA “problem” is created by financial bottom line, maybe we can get farther. Sometimes when we try to have this conversation even with our medical colleagues, everyone is fast to point out, rampant mid level expansion was started by anesthesia. No other “surgical” speciality is allowed to do what we do. “Supervising” 12 rooms?! That’s just crazy talk.

/end rant.

 

[OptionOffense]

They may be part of the solution, but it’s just kicking can down the road. One day they’ll be fighting for something. Like “anesthesiologists associate.”

What is the answer then? Keep fighting with RNs saying you are better. Their retort will be, "we're cheaper." Then what are you gonna say? They are cheaper. Organizations will always look for the cheaper alternative even if it is inferior. Think about how you shop? Do you shop on quality? or price? That is the only thing people understand. They changed their ****ing name to nurse anesthesiologist. Do you need more evidence of their intent? They do not want to be anesthetists anymore. SO we need replacements if we are to ensure medical anesthesia care to every patient, even poor ones. Replacement for RNs

 

[Zekchar]

What is the answer then? Keep fighting with RNs saying you are better. Their retort will be, "we're cheaper." Then what are you gonna say? They are cheaper. Organizations will always look for the cheaper alternative even if it is inferior. Think about how you shop? Do you shop on quality? or price? That is the only thing people understand. They changed their ****ing name to nurse anesthesiologist. Do you need more evidence of their intent? They do not want to be anesthetists anymore. SO we need replacements if we are to ensure medical anesthesia care to every patient, even poor ones. Replacement for RNs

You are correct that the answer lies in finances. You're wrong in which financial angle it will come from. My personal thought is that our friendly medical malpractice lawyers are the ones who will tilt this battle. Right now, the CRNAs make slightly less than anesthesiologists, but bear (what they percieve) to be little liability. Hospitals view anesthesia services as an expense and dont care if its CRNAs or anesthesiologists, long as the services are provided without interruption. Lawsuits from poor nursing care changes that calculus.

Here's the math:
Medical Direction:
Anesthesiologist: $450,000/yr - W2 - 55hrs/week
CRNA: $300,000/yr - 1099 - 45 hrs/week
4 Sites to staff and 1 person free for codes, OB, etc = 1 Anesthesiologist + 4 CRNAs = 1,650,000 annually

Physician Only:
Anesthesiologist: $450,000 x 5 = $2,250,000 annually (will sit on committees, work on protocols, collaborate with surgeons, and other tangible physician benefits as compared to punch the clock and better give me my breaks CRNA care)

Difference: 2,250,000 - 1,650,000 = $600,000 x 8 years = $4,800,000

1 Lawsuit due to ****ty CRNA care = $5,000,000 judgement, bad publicity, local outrage, state involvement, calls for change

The care provided by CRNAs is inferior. Nobody wants to admit this out loud in public, but for those of us who work with them, we know this to be true. What the math shows is that 1 lawsuit across 8 years undoes 8 years! of "cost savings" by using inferior anesthsia providers. This math is unnavoidable. More and more lawsuits are naming CRNAs since people are wisening up to their inferior care and shadowy "top of the license" until something bad happens then I become "just following physician orders" care.

Happy to hear counter arguments.

 

[OptionOffense]

You are correct that the answer lies in finances. You're wrong in which financial angle it will come from. My personal thought is that our friendly medical malpractice lawyers are the ones who will tilt this battle. Right now, the CRNAs make slightly less than anesthesiologists, but bear (what they percieve) to be little liability. Hospitals view anesthesia services as an expense and dont care if its CRNAs or anesthesiologists, long as the services are provided without interruption. Lawsuits from poor nursing care changes that calculus.

Here's the math:
Medical Direction:
Anesthesiologist: $450,000/yr - W2 - 55hrs/week
CRNA: $300,000/yr - 1099 - 45 hrs/week
4 Sites to staff and 1 person free for codes, OB, etc = 1 Anesthesiologist + 4 CRNAs = 1,650,000 annually

Physician Only:
Anesthesiologist: $450,000 x 5 = $2,250,000 annually (will sit on committees, work on protocols, collaborate with surgeons, and other tangible physician benefits as compared to punch the clock and better give me my breaks CRNA care)

Difference: 2,250,000 - 1,650,000 = $600,000 x 8 years = $4,800,000

1 Lawsuit due to ****ty CRNA care = $5,000,000 judgement, bad publicity, local outrage, state involvement, calls for change

The care provided by CRNAs is inferior. Nobody wants to admit this out loud in public, but for those of us who work with them, we know this to be true. What the math shows is that 1 lawsuit across 8 years undoes 8 years! of "cost savings" by using inferior anesthsia providers. This math is unnavoidable. More and more lawsuits are naming CRNAs since people are wisening up to their inferior care and shadowy "top of the license" until something bad happens then I become "just following physician orders" care.

Happy to hear counter arguments.

You are confusing me so you are def confusing people who have no clue about this stuff. Nobody cares about lawsuits except us. You think the hospital cares about lawsuits. No one hospital executive is named in a lawsuit when they force us to supervise ROgue, cowboy Registered Nurses . They are self insured. Lawsuits are sufficiently rare that it doesnt matter. What they care MORE about than lawsuits is public relations and press coverage.

 

[Zekchar]

You are confusing me so you are def confusing people who have no clue about this stuff. Nobody cares about lawsuits except us. You think the hospital cares about lawsuits. No one hospital executive is named in a lawsuit when they force us to supervise ROgue, cowboy Registered Nurses . They are self insured. Lawsuits are sufficiently rare that it doesnt matter. What they care MORE about than lawsuits is public relations and press coverage.

Sir. Don't be so obtuse. This is not tic tok nor is this facebook. No point in coming on here to upvote or hit the "like" button. This is a higher level discussion with 5th grade algebra surrounding our careers and the care patients are provided. There's not a single administrator that cannot understand what was typed above. If it is over your head then you've already admitted defeat and will take what is given to you since you cannot express yourself beyond emotions and anecdotes, which nobody besides your spouse cares about. The logic is sound. The math is simple.

Lawsuits are not as rare as you claim they are. Many simply get settled and thats why you never hear of them, beyond your premiums rising. Their ramifications are actually profound. A sentinel event can ground the only profit center of a hospital (the ORs) to a halt. I agree that nobody sues the hospital execes. But lawsuits targeting staff inhibits hospital operations and that is something every hospital exec cares about deeply.

 

[OptionOffense]

Sir. Don't be so obtuse. This is not tic tok nor is this facebook. No point in coming on here to upvote or hit the "like" button. This is a higher level discussion with 5th grade algebra surrounding our careers and the care patients are provided. There's not a single administrator that cannot understand what was typed above. If it is over your head then you've already admitted defeat and will take what is given to you since you cannot express yourself beyond emotions and anecdotes, which nobody besides your spouse cares about. The logic is sound. The math is simple.

Lawsuits are not as rare as you claim they are. Many simply get settled and thats why you never hear of them, beyond your premiums rising. Their ramifications are actually profound. A sentinel event can ground the only profit center of a hospital (the ORs) to a halt. I agree that nobody sues the hospital execes. But lawsuits targeting staff inhibits hospital operations and that is something every hospital exec cares about deeply.

Sir, you are the one being obtuse. Your math still makes my point. They are cheaper. You can qualify it as much as you want but they are still cheaper and for hospitals that are teetering on going bankrupt it sounds very appealing. That is my point. I am offering an alternative that is still cheaper and more palatable to us and still achieves their objective.

 

[IMGASMD]

Sir, you are the one being obtuse. Your math still makes my point. They are cheaper. You can qualify it as much as you want but they are still cheaper and for hospitals that are teetering on going bankrupt it sounds very appealing. That is my point. I am offering an alternative that is still cheaper and more palatable to us and still achieves their objective.

I think the calculus will be different after the NC suit. If I remember correctly, now the “nurses” who are employed by the hospital can be sued just like doctors. The plaintiff is using the employed nurse to get to the hospital. They may just become more of a liability than you’d think they are worth.