contact with CRNA's

[Mr_Money]

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Oh by the way we can write prescriptions as well..duh enough said !

CRNAs can write prescriptions?!?!? Okay, everybody raise their hand if they think its time we test GASCRNA's urine....


Mr. Money <---------- hand shoots right up

 

[Mr_Money]

... face the fact their are other people out there that can do your job just as well or better than you.

You're right! There absolutely are. Those people are either board certified MD or DO anesthesiologists!

 

[tkim]

Please keep it civil. Thanks!

 

[gasnurse]

CRNAs can write prescriptions?!?!? Okay, everybody raise their hand if they think its time we test GASCRNA's urine....

you can test his urine if you'd like but in the state of WA we have prescriptive authority....call the state board of nursing if you would like to verify this information.

 

[MacGyver]

CRNAs can write prescriptions?!?!?

Uhh newsflash! Every state in the freaking country allows CRNAs to write scripts.

Wake up and start lobbying your state legislature NOW!

 

[MacGyver]

GasCRNA is delusional, but no moreso than most of the MDAs on this forum.

I swear, havent you people learned a damn thing? CRNAs can and do run pain practices, they can and do run procedures that MDAs run, they can and DO write scripts for all the gas drugs in existence.

I know more about the scope of practice of CRNAs than 90% of the MDAs who have posted here! Thats absolutely ridiculous, I'm not even a gas resident yet I know far more than most of you about wht CRNAs are allowed to do. You guys need to get out of the OR and do some research! Your ignorance about how the CRNAs are pushing their scope forward constantly are going to come back and bite you guys in the ass!

Now I'm starting to understand why the CRNAs have been so successful in getting their scope expanded into independent practice. All the MDAs were too busy in the OR to pay attention, and they failed to do ANYTHING ABOUT IT until after the fact! The MDAs out there are a bunch of fatcats who thought the world revolved around them and were too smug and arrogant to think that anybody would ever try to knock them off the pedestal.

 

[Tenesma]

false... CRNAs have prescriptive authority in only 14 states in the US. (http://www1.va.gov/apn/docs/ANA-DEA.doc)... and in those 14 states, 9 states require a physician-set guideline for prescription.

false... CRNAs cannot implant nerve stimulators. Any procedure that requires an incision into the skin needs to be done by either a physician or an advanced practice nurse with privileges to do so... Implanting a nerve stimulator can only be done by Neurosurgeons/Orthopedic Surgeons/Anesthesiologists/Pain docs and some PM&R folk.

false... a CRNA can not manage critically ill patients in an ICU without physician supervision. A CRNA may come to intubate, may come to assist w/ Lines, but that is it...

just clarifying a few fallacies

 

[painmanager]

BOOOOOOOOOOOOYAAAAAAAAAAAAAAAA, in your face GASmurse and Macdouchebag

 

[bestiller]

Its *****s like you that give all MD's a bad name ! I suggest you actually do your home work and look at scope of practice for CRNA's and look at state regulatory guidelines for advanced practice nurses and CRNA's. Oh by the way we can write prescriptions as well..duh enough said !

JWK, isn't an MD he/she is an AA; disregard most of what he/she posts! 🙂

 

[jwk]

JWK, isn't an MD he/she is an AA; disregard most of what he/she posts! 🙂

Ah, I knew you'd pop up sooner or later, confirmed AA-basher that you are. I never claimed to be an MD. My profile clearly states that I'm an AA. Do you think my opinions count less because I'm an AA?

I notice your profile still shows nothing, so just to let the group know where your opinions are coming from, let's make sure everyone knows that you're a CRNA.

 

[jwk]

Its *****s like you that give all MD's a bad name ! I suggest you actually do your home work and look at scope of practice for CRNA's and look at state regulatory guidelines for advanced practice nurses and CRNA's. Oh by the way we can write prescriptions as well..duh enough said !

Quote me the scope of practice from any state that allows CRNA's to do surgery.

 

[georgia_aa]

JWK, isn't an MD he/she is an AA; disregard most of what he/she posts! 🙂

Bestiller, whatever you are (CRNA, SRNA, nursing student) you are about as obnoxious as they come. JWK is an extremely experienced anesthetist whose posts are both thoughtful and insightful. Why are you so opposed to intelligent discourse? If you are a CRNA (which I doubt), then your attitude is precisely why you should not be allowed to practice independantly - you seem quite limited intellectually, and only able to resort to insults and the endless regurgitation of ancient CRNA rhetoric against MDs and AAs.

BTW, I don't believe for one second that ANY CRNA is implanting nerve stimulators. If it is somehow true, all it will take is one lawsuit and a story on 20/20 to tumble the entire CRNA house of cards.

I have known many CRNAs and AAs alike who have gone on to complete med school and subsequent residencies in anesthesia. They have all expressed to me the idea that it is scary how much they didn't know and scarier still, they didn't realize it.

And Bestiller let me trump your next move, I am an AA also with 14 years experience in a major metropolitan academic hospital. I specialize primarily in cardiac and major vascular cases and have a wonderful cooperative relationship with every anesthesiologist in my department. BUT, I do know my limits.

 

[Docgeorge]

You know whats funny? I had the same conversation with a guy in my class who was a PA before he decided to go to med school. He said the same thing about 1/2 way through our first year. Furthre more he went on to say that before he started school he thought that he learned every thing he needed in PA school and the rest from his years of clinial experience. He says it will be really interesting to see what how he feels after he finishes residency.

It funny but it seems like every physician extender thinks they can do the physicans job better then the physican untill they decide to go to med school and see for them selves what they were missing out by not getting that extra year or two of training.

 

[Midwest Medic]

As many people have said before, it all depends on the person. I have only done one anesthesia rotation during my last month in my fourth year, and learned the majority of what I know about anesthesia from a CRNA. I was also amazed at one who thought 1 MAC was when the expiratory and inspiratory concentrations matched, and had no clue what a beta blocker was....so both ends of the spectrum, same as with doctors.....

 

[Catfish John]

I think the take home point in the MD/DO vs CRNA is that you DON'T see the same both ends of the spectrum with physicians. Reaching the point of passing through medical school and then a residency program assures at least a certain level of quality control that is absolutely not there when it comes to the midlevel practitioner. There are CRNAs, and for that matter PAs and NPs, who later go to med school to show that they are amongst the best trained and to have the security that goes along with it. Sure you have your outstanding CRNAs and I've met many, hat's off to them, but you have your clueless ones too. That is why if I or anyone of family or friends were to go into a surgery, I would want at the very least physician supervision, or more likely a physician providing the anesthesia, depending on the procedure. That is the heart of the difference: the bar is simply set higher for physicians.

 

[jwk]

I think the take home point in the MD/DO vs CRNA is that you DON'T see the same both ends of the spectrum with physicians. Reaching the point of passing through medical school and then a residency program assures at least a certain level of quality control that is absolutely not there when it comes to the midlevel practitioner. There are CRNAs, and for that matter PAs and NPs, who later go to med school to show that they are amongst the best trained and to have the security that goes along with it. Sure you have your outstanding CRNAs and I've met many, hat's off to them, but you have your clueless ones too. That is why if I or anyone of family or friends were to go into a surgery, I would want at the very least physician supervision, or more likely a physician providing the anesthesia, depending on the procedure. That is the heart of the difference: the bar is simply set higher for physicians.

Oh, I'll have to disagree with that one. You're implying that there are no bad physicians. That simply isn't true. There are most certainly some clueless docs out there as well. There are great docs and lousy docs, just as there are great anesthetists and lousy anesthetists. For you to think otherwise is pretty arrogant. The bar may be set higher, but not every doc clears it!

And depending on where you are in the country, even in a department with lots of physicians, they may rarely (if ever) actually perform an entire anesthetic. More likely than not, there is an anesthetist sitting at the head of the table.

 

[juddson]

It funny but it seems like every physician extender thinks they can do the physicans job better then the physican untill they decide to go to med school and see for them selves what they were missing out by not getting that extra year or two of training.

You see, now - this is funny. I thought that as an attorney I knew everything an MD knew. It will be interesting to see whether med school actually expands on that knowledge base.

Judd

 

[ayndim]

Oh my gosh has this thread gotten uncivil. I cannot figure out why. MDA jobs aren't threatened by CRNA's and CRNA jobs are not threatened by AA's. Last I looked there weren't enough trained professionals to go around. I find anesthesiology interesting (but my primary interest in CNM) and thought out in the real world that all of these professional providers got along. Am I wrong? No a CRNA nor an AA are equivalent to MDAs. They never will be. I don't know alot about anesthesiology (except that it is a pain to spell ) but I would imagine there are many cases that are better off with an MDA. But there are many that can be handled by the midlevels too. And both AAs and CRNAs are perfectly capable of working within their scope.

Looking at the BLS stats I seriously doubt any of the three will be out of a job soon. Even with the argument that CRNA's are cheaper -- there aren't enough to go around and probably will never be! Can't see how they would replace MDA's when there is a shortage of both at the moment. Personally if I were a CRNA, I sure would like an MDA on the staff that I could go to with questions. They have had more training.

I know they can practice unsupervised but how common is it for hospitals (non-rural) to use a CRNA without an MDA? Is it not like midwifery? CNM's can deliver low-risk babies unsupervised but an OB/GYN is always used as backup and comes in and supervises higher risk cases. An CNM can deliver twins but only with an Ob in the room (at least where I am from). Only Ob's do forceps, vaccums and sections. Is that how it works? Are there some cases only MDAs do? I am all for midlevels but even I think there should be limits.

 

[sones]

Oh my gosh has this thread gotten uncivil. I cannot figure out why. MDA jobs aren't threatened by CRNA's and CRNA jobs are not threatened by AA's. Last I looked there weren't enough trained professionals to go around. I find anesthesiology interesting (but my primary interest in CNM) and thought out in the real world that all of these professional providers got along. Am I wrong? No a CRNA nor an AA are equivalent to MDAs. They never will be. I don't know alot about anesthesiology (except that it is a pain to spell ) but I would imagine there are many cases that are better off with an MDA. But there are many that can be handled by the midlevels too. And both AAs and CRNAs are perfectly capable of working within their scope.

Looking at the BLS stats I seriously doubt any of the three will be out of a job soon. Even with the argument that CRNA's are cheaper -- there aren't enough to go around and probably will never be! Can't see how they would replace MDA's when there is a shortage of both at the moment. Personally if I were a CRNA, I sure would like an MDA on the staff that I could go to with questions. They have had more training.

I know they can practice unsupervised but how common is it for hospitals (non-rural) to use a CRNA without an MDA? Is it not like midwifery? CNM's can deliver low-risk babies unsupervised but an OB/GYN is always used as backup and comes in and supervises higher risk cases. An CNM can deliver twins but only with an Ob in the room (at least where I am from). Only Ob's do forceps, vaccums and sections. Is that how it works? Are there some cases only MDAs do? I am all for midlevels but even I think there should be limits.

To answer your question, there are definitely some cases that are only performed by MDs (at least where I work). MDs only do liver transplants, CABG, heart transplants, and many of the very intricate procedures. Now that is where I work. I have heard of CRNAs doing many of these procedures other places, but not where I work. I agree with you, an MDA available for questions, even with bread and butter cases is wonderful. CRNAs are very similar to midwives in that the more mainstream, low risk cases they are wonderful, but with more high risk cases they are better off working with MDAs.