CRNA exam

[sones]

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I think we agree on our fundamental positions, but I am still bothered by the semantics. Let's agree it's not just a willingness to work 80-100 hours per week and have additional legal responsibility that separates mid-levels from physicians. When you stated that here and in prior post(s), it sounded like you meant that was the ONLY difference and if only mid-levels would work longer hours and accept more responsibility, they would be equal to physicians, despite not going to medical school or doing a physician's residency. Please acknowledge that physicians do, in fact, bring more to the table than mid-levels with respect to the diagnosis and treatment of disease. Let's also agree that respect is NOT a two way street. Respect must be earned on both sides. Just because someone respects me for being a professional, and doing a good job does not automatically grant them my respect for their professinalism, or the quality of their work. What if they suck at what they do? That respect has to be earned on both sides. Now, if you're talking about simply respecting them as a fellow human being, and not treating them like dirt, well of course that works both ways.

I disagree that I have ever stated that legal responsibility and longer hours are the only thing that lies between a physician and a midlevel. I do acknowledge that doctors know more in terms of physiology and diagnosis etc. I don't think I have ever denied that. I do not agree that a physician is the only one who can care for a patient with quality care. It may be a team effort in many ways, but I think midlevel providers DO provide quality care for their patients (within their scope of practice, hopefully) and this needs to be respected and acknowledged by physicians. As for respect for being human...THAT in itself should be a reason not to call nurses dumb and stupid. Everyone has a mind and is worth something. As for the quality of work they do...I agree with you on that one. Quality of work does make you respect someone. Definitely why I have respected some of my coworkers more than others and some of my doctors more than others. Ok, I have acknowledged that doctors bring more to the table in terms of diagnosis, physiology, general medical knowledge, etc. Now, I hope you can also state that midlevels bring valuable patient care to the table as well. We know more than you guys (doctors in general) give us credit for. CRNAs, AAs, NPs, PAs, CNMs are not glorified technicians as was suggested by an earlier poster. We go to school and put in our time too. So please, would you acknowledge this.

 

[powermd]

I disagree that I have ever stated that legal responsibility and longer hours are the only thing that lies between a physician and a midlevel. I do acknowledge that doctors know more in terms of physiology and diagnosis etc. I don't think I have ever denied that. I do not agree that a physician is the only one who can care for a patient with quality care. It may be a team effort in many ways, but I think midlevel providers DO provide quality care for their patients (within their scope of practice, hopefully) and this needs to be respected and acknowledged by physicians. As for respect for being human...THAT in itself should be a reason not to call nurses dumb and stupid. Everyone has a mind and is worth something. As for the quality of work they do...I agree with you on that one. Quality of work does make you respect someone. Definitely why I have respected some of my coworkers more than others and some of my doctors more than others. Ok, I have acknowledged that doctors bring more to the table in terms of diagnosis, physiology, general medical knowledge, etc. Now, I hope you can also state that midlevels bring valuable patient care to the table as well. We know more than you guys (doctors in general) give us credit for. CRNAs, AAs, NPs, PAs, CNMs are not glorified technicians as was suggested by an earlier poster. We go to school and put in our time too. So please, would you acknowledge this.

1. I respect mid-levels for the valuable services they provide. I never intended to imply otherwise.

2. I respect nurses who do their jobs well and are pleasant. I believe I even used the word "blessed" previously to describe how it feels to work with a good nurse.

3. Mid-levels are more than glorified technicians, but less than physicians as a group. I'm not sure how to describe what mid-levels are, other than to say they are just that: mid-levels.

4. I acknowledge that mid-levels put in hard work in school and in clinical practice prior to receiving their degrees, and also in practice.

5. I am unwilling to acknowledge that some people are, in fact, of deficient intelligence that is unsuitable for the job they have. The words dumb, or stupid come to mind to describe such a person. It's not nice, but neither is failing to draw a patient's cardiac enzymes or coagulation studies until baggered by the physician hours after they were due. This goes beyond merely being lazy and unprofessional.

 

[sones]

1. I respect mid-levels for the valuable services they provide. I never intended to imply otherwise.

2. I respect nurses who do their jobs well and are pleasant. I believe I even used the word "blessed" previously to describe how it feels to work with a good nurse.

3. Mid-levels are more than glorified technicians, but less than physicians as a group. I'm not sure how to describe what mid-levels are, other than to say they are just that: mid-levels.

4. I acknowledge that mid-levels put in hard work in school and in clinical practice prior to receiving their degrees, and also in practice.

5. I am unwilling to acknowledge that some people are, in fact, of deficient intelligence that is unsuitable for the job they have. The words dumb, or stupid come to mind to describe such a person. It's not nice, but neither is failing to draw a patient's cardiac enzymes or coagulation studies until baggered by the physician hours after they were due. This goes beyond merely being lazy and unprofessional.

I thank you for that acknowledgment. i hope you have better luck with nurses in the future. And I agree...the cardiac enzymes etc should have been done immediately upon discovering the orders unless other pressing issues were occurring (ex. another patient coding).

 

[endodoc]

I was referring to critical care nurses, who often seem to think they are better than doctors (not in my personal experience, but based on the stories I hear, and what I read in these forums).



I'm not sure what you personally are implying here, but some seem to think that ability to do a technical procedure under the supervision of a doctor (or unsupervised, in rural Kansas), means you essentially providing the same level of care as a physician. Or the ability and legal right to diagnose and treat problems within your narrow scope of practice essentially make you equal to an MD within that scope. Most of us find that a tad cavelier because none of you can possibly know what you don't know. Then you (again, perhaps not jwk personally) cite examples of a dopey acting physician or two, and conclude that medical school is unnecessary to proving comprehensive medical care. I have no problem giving mid-levels credit for their ability to do technical procedures, follow protocols, and think reflexively. I begin to have a problem when they become overconfident and begin to second guess physicians. In some cases they may be right, but in most they are probably wrong.




Resident pay has little to do with the value of our work. Hospitals pay PAs, NPs, and CRNAs more than residents because they have to- it's a free market. Resident choices of where to work are much more limited, and involve factors like prestige and quality of training, which wouldn't matter if we were just looking to do a job for a paycheck. One could even argue that top academic medical centers could get away with making us pay them to let us work there in some cases. You're not paid more because you're work is more valuable. I'm not sure if that's what you implied, but you should certainly understand that. If resident pay did not involve these other non-monetary factors, and there were more competition between hospitals for residents, pay would certainly go up.

I would like to add my 2 cents here. Residents are paid for tranning, what other field can you say pays to learn. PA's and the like are paid more because they max out at a lower pay rate. These people who think that as a mid level they get paid more, they should track us down after residency. Oh ya, I forgot you have to be a member of the country club to visit. Point being, our(MD's) salary are by far better. If the mid levels keep having their ways, we will be lower take home salary, since we have to pay for their mal practice mistakes.

 

[nitecap]

All you people just need to take a breather. Believe me their will be enough jobs for all MDA's, CRNA's and AA's in the next 50 plus years. I understand that each profession feels threatened by one another but lets just face the facts. Bottom line is that all you med students or anesthesia residents upon finishing residency and becoming partners in groups and starting your own or what ever, bottom line is that you are going to need CRNA's and AA's to make your practice more profitable. Thats what it comes down to today and you cant deny it. There will never be enough MDA's to handle to US case load so you need us whether you want to accept it or not. And no CRNA's are not MD's and yes you have more schooling and yes you have more science and yes blah blah blah, eveyone has heard this load of BS millions of times and nobody denies it. I have seen great MDA's and CRNA's and poorly practicing MDA's and CRNA's. I see CRNA's that provide safer anesthesia than some MD's do everyday. But I know some MDA's that are better than all other MDA's and CRNA's combined it seems. So why dont all you med students / residents get off your high horse and face reality. You are going to need us in the long run.

In the real world CRNA's , MDA's, AA's, RN's, OR tech's all work together in a collaborative effort to make the perioperative experience a safe and profitable one. Thats one thing that you as med students and residents dont learn despite your 11 plus years of schooling. If you work together as a team and yes you as the MD may be the leader of the team, care is delivered more effectively, efficiently and safe.

And know as an RN I never called the resident over some BS just to bother them. Believe me I hold out as long as possible on a BS call just not to bother someone. Hey some nurses are not as professional as others I am not going to doubt that. In the ICU that I worked in I frequently taught and or collaborated with med students and residents everyday as an RN. We all learned from each other with the Attending MD overall.

So will you people just quit crying. Besides if you really feel that negatively about CRNAs then why dont you lobby against them. Which will in the long run decrease the profitability of your practice. Im sure once you start practicing you are going to be praying one night that this new grad CRNA passes his boards so you can hire him because your current staff cant handle the case load.

 

[KerriE]

I have to say that I will always be for CRNA's. I of course have respect for MD's but a qualified CRNA can do thier job effectively. Just as you can do your job effectively. Case in point.....

I recently had my very first and only surgery. Who do you think I remember? Who do you think spent more time with me? Who do you think checked on me after the procedure? Who do you think calmed my fears and treated me with true kindness and a soothing manner? Who EXPLAINED every step to me in DETAIL of how she would put me under and bring me out?

Any guesses?

It was the CRNA! I saw the MDA for 5 minutes as he wrote down a few things in my chart. Im sorry, but as far as im concerned my real world experience with crna's is one of high gratitude and respect. You residents and students dont realize how intrical a part a good crna can play in caring for YOUR patients. They are not stealing a piece of your pie and putting themselves on a pedestal to make their line of work equal to yours. It never will be. But dont downplay the role they play as highly educated well versed individuals who paid their dues and took lumps like the rest of them. I feel like a qualified well trained crna has the right to do any non-lengthy procedure that isnt high risk. Lets leave the other stuff to the big boys...the MDA who have every right to feel as though an CRNA is not adequately qualified to do such a surgery. We all have our place and should respect each other for their place. I have equal respect for all in the healthcare field and frown upon those that think they are better than their qualifications imply.

As a patient that CRNA did more for me than any doctor including my OB who did the surgery. Maybe she is not the norm and maybe she is but I aspire to be her when caring for future patient. I am currently on track to become a CRNA in the future and guess what....it took me one marriage(still married), two kids, and 27 years to realize who I wanted to be and why. So at 27 with a young family I find myself going back to college to start from ground zero to become a CRNA because I love people and love medicine and I look forward to that position in a hospital.

Im not being biased just saying what I know to be true and what my experiences are as a patient. After all, arent we a providers supposed to worry about the end result for the patient and their time in our care? Not who is making more than whom and why CRNA should be ousted because they are midlevel? I dont want to be top level....I like being midlevel because I have time to give to patients and that is what they want and need. Someone to care for more than 10 minutes.

 

[nradsoit3]

"So at 27 with a young family I find myself going back to college to start from ground zero to become a CRNA because I love people and love medicine and I look forward to that position in a hospital.

Im not being biased just saying what I know to be true and what my experiences are as a patient. After all, arent we a providers supposed to worry about the end result for the patient and their time in our care? Not who is making more than whom and why CRNA should be ousted because they are midlevel? I dont want to be top level....I like being midlevel because I have time to give to patients and that is what they want and need. Someone to care for more than 10 minutes.

Yet another example of being intoxicated by $$$. Are you sure you really want to be a CRNA all of a sudden now because you "love people and love medicine"??? According to your last post on Sunday (THREE DAYS AGO) you stated you wanted to be a psychologist. 😕

"Hi all I am a 27 yr old married mom of two who just realized I wanted to go back to school.

My final goal would be my own private practice in michigan as a psychologist".

 

[KerriE]

Yet another example of being intoxicated by $$$. Are you sure you really want to be a CRNA all of a sudden now because you "love people and love medicine"??? According to your last post on Sunday (THREE DAYS AGO) you stated you wanted to be a psychologist. 😕

"Hi all I am a 27 yr old married mom of two who just realized I wanted to go back to school.

My final goal would be my own private practice in michigan as a psychologist".

Yes that is true I did state that. I wanted opinions of that field and the course of study. I have changed my mind after more analysis of the field and its work options etc. I have also come to my senses knowing that I am more of a hands on person than a research person sitting at a desk all day. While my initial thoughts of the job were founded for my love of people....after some investigation I have realized what would better suit me and my personality.

Dont judge me for the money... I dont need the money...I am married to someone who makes well above the six figure range now and want for nothing. I am not some young high school kid who sees $$$ as the reason for my choice. Because I dont need the money. I like the field. I like the opportunity that field will bring me. I will enjoy it and try my darndest to be the best CRNA I can regardless of pay.

Dont assume anything about me or my intentions. Never assume anything it will get you nowhere...assume starts with ass for a reason remember that.

 

[Arch Guillotti]

Yet another example of being intoxicated by $$$. Are you sure you really want to be a CRNA all of a sudden now because you "love people and love medicine"??? According to your last post on Sunday (THREE DAYS AGO) you stated you wanted to be a psychologist. 😕

"Hi all I am a 27 yr old married mom of two who just realized I wanted to go back to school.

My final goal would be my own private practice in michigan as a psychologist".

The search function never lies, good sleuthing.

 

[amnesic]

Yes that is true I did state that. I wanted opinions of that field and the course of study. I have changed my mind after more analysis of the field and its work options etc. I have also come to my senses knowing that I am more of a hands on person than a research person sitting at a desk all day. While my initial thoughts of the job were founded for my love of people....after some investigation I have realized what would better suit me and my personality.

Dont judge me for the money... I dont need the money...I am married to someone who makes well above the six figure range now and want for nothing. I am not some young high school kid who sees $$$ as the reason for my choice. Because I dont need the money. I like the field. I like the opportunity that field will bring me. I will enjoy it and try my darndest to be the best CRNA I can regardless of pay.

Dont assume anything about me or my intentions. Never assume anything it will get you nowhere...assume starts with ass for a reason remember that.

Aren't you the same person who was just posting about the "benz land rover" you were going to buy yourself when you became a CRNA? That is moving pretty fast for a decision you made sometime in the last 3 days....you are right though, why should we assume money has anything to do with you coming to your senses...

 

[nradsoit3]

Dont judge me for the money... I dont need the money...I am married to someone who makes well above the six figure range now and want for nothing. I am not some young high school kid who sees $$$ as the reason for my choice. Because I dont need the money. I like the field. I like the opportunity that field will bring me. I will enjoy it and try my darndest to be the best CRNA I can regardless of pay.

Dont assume anything about me or my intentions. Never assume anything it will get you nowhere...assume starts with ass for a reason remember that.

Are you sure you don't see "$$$ as the reason for my choice"? As per your other post today you said:

"You hit the nail on the head. I too would be at sea world and driving a cavalier not a CRNA driving a benz land rover

Ps...im not a CRNA "yet" and a "benz land rover" is my choice of vehicle as a gift to myself after I finish school and can afford one!"

Your written word speaks for itself so I will refrain from commenting. 👎

 

[nradsoit3]

Aren't you the same person who was just posting about the "benz land rover" you were going to buy yourself when you became a CRNA? That is moving pretty fast for a decision you made sometime in the last 3 days....you are right though, why should we assume money has anything to do with you coming to your senses...

you beat me to it amnesic!

 

[KerriE]

Go ahead gang up on me if you want. I am not a money hungry person. Yes I made that comment as a joke....thats my sense of humor and if you knew me you would understand that. I figure after all the years of school and clinical time I am going to put in I will well deserve the one thing I havent gotten yet. Its not like my current vehicle isnt good enough....45k with a dvd player for the kids. I am a lucky 27 year old who married a guy with a future. My kids and I are now living a comfortable life and I dont have too or need to add to our funds. I like using my brains and I feel like this position will be challenging and rewarding regardless of the payscale. In the long run my good nature with people is what I pride myself in and know that I will never get the better than you tude. I just want to be an exceptional nurse who provides outstanding care and makes people satisfied with thier experience.


This is not some fly by night thought as it will take me years to finish my degrees. I thought it was my right to change my mind. I want to make the right choice for me not the money. I can only hope some of you doctors and students made the choice because you genuinely care for people and medicine not to get a cush residency to make 250k starting salary.

Now I am done explaining myself. I am a grown adult looking for other grown adults views and sharing mine. I hope you have better things to do than "sleuthing".

 

[nradsoit3]

Go ahead gang up on me if you want. I am not a money hungry person. Yes I made that comment as a joke....thats my sense of humor and if you knew me you would understand that. I figure after all the years of school and clinical time I am going to put in I will well deserve the one thing I havent gotten yet. Its not like my current vehicle isnt good enough....45k with a dvd player for the kids. I am a lucky 27 year old who married a guy with a future. My kids and I are now living a comfortable life and I dont have too or need to add to our funds. I like using my brains and I feel like this position will be challenging and rewarding regardless of the payscale. In the long run my good nature with people is what I pride myself in and know that I will never get the better than you tude. I just want to be an exceptional nurse who provides outstanding care and makes people satisfied with thier experience.


This is not some fly by night thought as it will take me years to finish my degrees. I thought it was my right to change my mind. I want to make the right choice for me not the money. I can only hope some of you doctors and students made the choice because you genuinely care for people and medicine not to get a cush residency to make 250k starting salary.

Now I am done explaining myself. I am a grown adult looking for other grown adults views and sharing mine. I hope you have better things to do than "sleuthing".

Wow, your kids get to ride in a vehicle with just 45k miles AND with on board DVD entertainment! Man, I didn't even have cable in my house till I was like 16. Thanks for sharing. Anyway, good luck with your newly found CRNA career.

 

[VentdependenT]

This thread officially blows.

 

[Arch Guillotti]

Yup. I quit reading any thread with ANY mention of CRNA.

 

[siguanabo]

[/QUOTE]CRNAs, AAs, NPs, PAs, CNMs are not glorified technicians as was suggested by an earlier poster. We go to school and put in our time too. So please, would you acknowledge this.[/QUOTE]

During the first week of my Ob/Gyn rotation, I was unfortunate enough to be pimped by the clerkship director (I go to a top ten allo school) on ovarian cancer and a DDx for acute, RLQ pain on a early 20's female patient. He expected me to recite everything I knew and more about both topics and got pissed at me when I forgot some details about the different subtypes of epithelial ovarian cancer (i.e., papillary, mucinous, serous, etc). He even yelled at me for not knowing that some germ cell tumors can actually metastasize to the brain. He then told me I was supposed to know that because that is what makes a physician different from a technician. I wonder if mid-level providers need to worry about knowing the intricacies of diseases as we, as med students are supposed to know them. If not then, at least in my book, they are technicians.

 

[jwk]

Yup. I quit reading any thread with ANY mention of CRNA.

Ah, you don't read, just post.

 

[DivaRN]

Every medical student knows this before we even come near a hospital. I just started floating this week. None of the nurses who page me incessantly knew me before this week, so their behavior has nothing to do with my attitude toward them. I know the risks of giving attitude to nurses so I am always friendly and courteous. I have heard from residents that nurses try to get away with a lot of crap early on in the year because they know interns are ignorant of what nurses can and can't do. Who is it that has the attitude problem? I work hard and do my job well. It pains me to watch nurses huff and puff over having to lift a finger to help a sick patient. Last night a nurse paged me to evaluate a man with chest pain- "you really need to come see him." When I did, and asked if she could check the vitals before I decide what to do, she rolled her eyes and huffed. How professional is that, smartypants? What attitude should I have toward people whose job it is to help the sick but obviously don't care enough to follow up important patient care orders?

Hey, I'm a fair guy- I don't intend to paint all RNs with the same broad brush I think applies to the folks I work with now. I just haven't yet worked at a hospital where most of the RNs are effective care providers. We can't even begin to talk about the ways physicians and RNs may be alike if RNs won't do their own jobs well.

You should be very ashamed of yourself- There is something very wrong with you if you actually believe that nurses are stupid people- I have been working in the intensive care unit for over 10 years. During this time, I cannot BEGIN to count the number of times I have bailed residents out of potentially FATAL situations. I am not sure where you work, but where I worked, we did everything we could to care for patients and avoid calling for the GREEN CLUELESS IDIOTS who did not know the difference between Norepinephine and Ephedrine- on another note, when is the last time you wiped a patient's bottom after prescribing the INCORRECT tube feeding and inducing a MASSIVE diarrhea? When was the last time you stuck a suction catheter into a patient's mouth to suction out mucous? Have you ever even changed a colostomy bag? Have you provided trach care? The list goes on and on.... My point is, we have very different ROLES but a COMMON goal- SAFE EFFICIENT HEALTH CARE TO THOSE IN NEED. Seems to me that maybe you should be involved in establishing a POSITIVE teaching relationship with these nurses in question rather than berrating them. Something tells me that you must be giving off the "I'm a God" vibe or you would not be treated so badly. Granted, there are some poorly educated nurses AND MDs as well. I have found that 50% of the GREEN MDS I work with treat me with total respect and the other 50% are clueless for about 5 minutes before they are "chilled out." The opposite is true of a REALLY EXCELLENT PHYSICIAN- These individuals treat the TEAM- aka NURSES- with RESPECT and teach them how they want things done for their patients- That seems to work very well. I am currently in CRNA school and I find some of the posts on here appauling. Think about the NURSES who are overseas FIGHTING for your FREEDOM so that you are allowing to POST these comments- I pray that you too will grow up to be a FINE RESPECTABLE MD. Thank you.

 

[powermd]

You should be very ashamed of yourself- There is something very wrong with you if you actually believe that nurses are stupid people- I have been working in the intensive care unit for over 10 years. During this time, I cannot BEGIN to count the number of times I have bailed residents out of potentially FATAL situations. I am not sure where you work, but where I worked, we did everything we could to care for patients and avoid calling for the GREEN CLUELESS IDIOTS who did not know the difference between Norepinephine and Ephedrine- on another note, when is the last time you wiped a patient's bottom after prescribing the INCORRECT tube feeding and inducing a MASSIVE diarrhea? When was the last time you stuck a suction catheter into a patient's mouth to suction out mucous? Have you ever even changed a colostomy bag? Have you provided trach care? The list goes on and on.... My point is, we have very different ROLES but a COMMON goal- SAFE EFFICIENT HEALTH CARE TO THOSE IN NEED. Seems to me that maybe you should be involved in establishing a POSITIVE teaching relationship with these nurses in question rather than berrating them. Something tells me that you must be giving off the "I'm a God" vibe or you would not be treated so badly. Granted, there are some poorly educated nurses AND MDs as well. I have found that 50% of the GREEN MDS I work with treat me with total respect and the other 50% are clueless for about 5 minutes before they are "chilled out." The opposite is true of a REALLY EXCELLENT PHYSICIAN- These individuals treat the TEAM- aka NURSES- with RESPECT and teach them how they want things done for their patients- That seems to work very well. I am currently in CRNA school and I find some of the posts on here appauling. Think about the NURSES who are overseas FIGHTING for your FREEDOM so that you are allowing to POST these comments- I pray that you too will grow up to be a FINE RESPECTABLE MD. Thank you.

Yawn. Your post is a fine example of "the pot calling the kettle black." You won't get far in an MD discussion forum by making fun of doctors-in-training by calling us "GREEN MDS". Don't be so quick to flout your cred being a BIG TOUGH ICU NURSE. If you think us WEAK LITTLE GREEN MDS have nothing to teach you, YOU HAVE AN ATTITUDE PROBLEM. Being a nurse for 100 years still won't replace medical school, and the continuing education we get every day in residency. Also, standards for brainpower in your profession are much lower than in mine. The dumbest MD still got into and conqured med school, and passed the medical boards. Not easy, to say the least. Conversely, it seems like anyone can sign up to be an RN. I suppose you would have me believe that ICU NURSE = MD. If you're that delusional, there's not much more we can rationally discuss. My point is that you really have no buisness talking trash about "clueless idiot doctors." Even if they don't yet know all the protocols of the ICU doesn't mean they don't deserve respect for being intelligent, accomplished professionals. Show some respect for medical residents, and I guarantee you most will reciprocate.

Now, back to reality. My post crticized some RNs who don't do their jobs well, if at all. There's really no debating what role anyone's attitude played in the examples I gave- unprofessional behavior is still unprofessional behavior. Stupid is simply stupid. Last night I got a page at 3am from a nurse who wanted me to know a particular patient who was completely stable "just had a loose bowel movement." Gee, thanks. Either she paged me for this because she wasn't sure of it's medical significance, in which case I feel sorry for her. Or she did it just to mess with me, in which case she was behaving unprofessionally.

Since this is bound to be an issue with you, I'd like to make it clear that my rapport with the nurses on that floor is very good. Don't mistake my curt tone in this forum for my attitude at work. I have no "I am God" attitude. I'm just there to help, and I do the best I can. All I ask is that nurses do their job and think a little before paging the MD on call. We have major problems with this at my hospital- it's a system wide issue that ALL the residents complain about. Not once have I ever seen or heard of a resident MD disrespecting a nurse in any way. I HAVE seen one ICU nurse disrespect a resident colleague of mine behind her back to me (she thought I was her senior!). Having said that, the ICU nurses at our hospital are supposedly very good. It's the floor nurses who need improvement. As a seemingly concerned RN, you should be embarrassed by, not defensive of the stupid or unprofessional behavior of some of your colleagues.

 

[melonque]

sones, I am not going into Anes, but your post are pretty amazing. No matter how you deny it, it seems like you have a such strong ego about being a crna, and such a subjective feeling that crna is very smart, so smart that sometimes you don't want some md to do your works because you "have seen how they work"

Every health profession is regulated by the government which set certain rules and guideline. Everyone of us, the MD, have gone thru the hardest of all regulations/tests/competition to get to where we are right now.

I don't care how competitive CRNA school is right now. Sones, get out of your little box. Casio is not Rolex. period. can't compare both..sure both can tell times... even if you are a movado, so? still not rolex.

 

[jjjez]

bet your patients couldnt give a rat's ass who was giving anaesthetic. and if they didnt know that provider may not be a MD then they must be pretty darn thick/ ill informed.

 

[melonque]

but didn't you give a rat's ass? hhahaha. anything else?

 

[jjjez]

no coz are all doctors in UK.
but actually meant doubt patient gives a rats ass......... because they're probably just worried they might kick the bucket.
and all the blah blah blah 'i'm a doctor, don't worry you're in safe hands' stuff may actually mean d**k minutes before you're able to gas/ IV them and stick a tube down their throat.
get the fussy ones though.
i once had patient who wanted doctor to take blood not the phle

 

[gaspasser2004]

I have read literally hundreds of posts here on CRNA vs MDA anesthesia. I have seen well thought out arguments from both sides and I have seen a lot of childish responses from both sides. Allow me to briefly offer my views.


1. CRNA does not equal MDA and the vast majority of healthcare providers believe this to be true.

From my limited experience, it really is the rare CRNA who thinks he/she has the knowledge/experience/authority to equate themselves as a MDA. There is, however, a vocal minority out there who think of themselves as the equivalent of physicians and expect to be treated/compensated/allowed to practice the same as a MDA.

Furthermore, for the anesthesia team approach to operate effectively, each team member needs to know their role and stick to it. The MDA happens to be the "quarterback" of the anesthesia team and calls the plays - the CRNA's play a vital role as "receiver" and "running back" and take part in executing the plays. All "positions" on the team are important. Any football team would fall apart if all the team members thought they were quarterbacks.


2. Fear motivates anger towards CRNA's.

I don't know about you, but as a recent med school grad with 250K in debt, I am scared to death of the doomsday scenarios of the "CRNA's taking over". I want to be relevant in providing anesthesia and I also want to be compensated fairly commensurate with my knowledge and the sacrifices I have made and will continue to make to obtain and sustain that knowledge. My understanding of the current forecast for anesthesia is that their will be a shortage of both MDA's and CRNA's with the aging baby boomer population which means plenty of work (probably too much work) for all of us.


3. MDA's should fight for every dollar they are entitled, and, at the same time, also embrace change when it comes.

We have spent years acquiring the knowledge and skills to take care of patients. As a group, we should band together to get the lowest malpractice rates, highest reimbursement rates, etc. However, there are some changes that are inevitable and must be embraced. For instance, I don't think that a CRNA practicing unsupervised is an ideal situation, but what about rural areas where MDA's can't be recruited to practice? Surely, we must be willing to give a little on this end. Conversely, CRNA's practicing in saturated suburban/urban areas with many qualified MDA's should not be allowed to practice independently. However, if future studies conclusively show no difference in mortality/morbidity for "simpler" cases when MDA's are compared to CRNA's (hasn't been proven yet), we should accept it and redefine the role of the MDA as a consultant/supervisor of CRNA's much like other fields have dealt with PA's and NP's.


4. Every minute spent judging others means it will take one more minute to be an awesome anesthesiologist

It is SO tempting to get caught up in this debate and vent, but in the end it is wasted energy. I'm not perfect, but I strive to be the best anesthesiologist I can be, whether it is taking care of patients this year as an intern, reading outside the hospital, or getting ready for my CA-1 year next July. I don't worry about other peoples' competencies, I worry about my own and what I have to do to be the best. I concede that I may be idealistic and naive, but I hope that if I follow this, everything else will take care of itself.


Just my two cents.

The Gas Passer

__________________________________________________________

Johns Hopkins Hospital Anesthesiology Class of 2008

 

[Justin4563]

sinnmann, paramedics doing a rsi in the field is hardly anesthesia. Not to put him down but you can talk about rsi for hours and hours. I had a paramedic tell me if they fail to intubate after rsi with sux they have orders to give vecuronium. WHile this at certain times may be an appropriate thing to do( while trying to secure the airway asleep with a fiberoptic scope or intubating lma) making sure of course more sedatives are given and ventilation is adequate. this is way way beyond the scope of a paramedic and borderline malpractice if you cant explain it in the proper circumstance. . Just responding to your rsi comment.

generally nurses are NOT on your side and physicians should realize that.

I realize that and I move on. I am friendly but thats it. This includes crnas.

I am an attending anesthesiologist and I work alone. If i need help i call one of my partners. It works out fine. No problems. If I need to use the mens room my partner comes in and I go and come back. i dont have aproblem doing the mundane things in anesthesia. Its fun.

 

[Lonestar]

Life is like a box of chocolates. You never know what you'll get. 😉

 

[Cardiovert]

The moderators really should close and/or prevent this type of thread from appearing. There's no point in repeating the same tired arguments regarding CRNAs vs MDAs etc...

 

[bcs72399]

You're all the same and not worth getting into an argument with. Here is the Bottom Line "Justin" and all other MDAs who presume to think like this. CRNAs do 65% of ALL Anesthesia in the U.S. And there is not a damn thing you can do about it so try not to waste your breath next time. Thanks.

 

[jwk]

You're all the same and not worth getting into an argument with. Here is the Bottom Line "Justin" and all other MDAs who presume to think like this. CRNAs do 65% of ALL Anesthesia in the U.S. And there is not a damn thing you can do about it so try not to waste your breath next time. Thanks.

Do a search and see all the CRNA/MD threads - you'll find you have nothing new to contribute to the discussion.

In particular, it has been pointed out numerous times that your 65% figure is misleading. CRNA's may participate in 65% of the anesthetics in this country, but many of those are with medical direction or supervision.

 

[hoyden]

I have been hearing about CRNA "problem" almost from the moment I came to this country. The funniest thing is i have heard it all before... Back home.
I have been an anesthesiologist for 17 years and anesthesiologists provide CC in my home country. Well, of course nuses in ICU there are much better than those on the floors. We do have an anesthesiology nurse in OR to work together with anesthesiologist and their work couldn't be underestimated. Sometimes in critical situations you depend solely on them. And you better have good relations with people you work with 🙂 To add only a little more - almost any experienced anesthesiology nurse could play some "jokes" with fresh residents and even fresh MDs. And they do 🙂 But all of them did acknowledge good work and respectful attitude.
One reason why I love anesthesiology and am trying to become one also here( against all obstacles) is: it is great experience of team work, of people related to each other in the most human way possible.

 

[Sensei_Sevo]

You're all the same and not worth getting into an argument with. Here is the Bottom Line "Justin" and all other MDAs who presume to think like this. CRNAs do 65% of ALL Anesthesia in the U.S. And there is not a damn thing you can do about it so try not to waste your breath next time. Thanks.

Whatever, douche. Are you upset that you do all the "work" while I chill out and read the newspaper and enjoy coffee and conversation? Oh well, there is not a damn thing you can do about it so try not to waste YOUR breath next time.

Peace