oldManDO2009

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I have been on the fence (anesthesiology v EM) with career choices and feel ER is a good fit since I have spent the last 5 years there as a nurse while in med school and working on my pre-reqs...but also like anesthesiology.

So I felt it was important to look at both sides of the fence - CRNA and MDA views on anesthesiology. I am a bit shocked at their (CRNA) attitude about the A$A and the practice of pain mgt. It seems that the CRNA view is that it is a procedure and the diagnosis and management of the patient is a minor part of the total picture. Anyway, the procedure is already part of their "scope of practice" seems to be their philosophy (IMO).

I figure this has been beaten to death (as a subject) but I would be concerned about anesthesiology as a career if CRNAs see the whole field within their scope of practice. When will the slippery slope end and is there an end in sight?

Some of the road blocks such as prescriptive authority may be removed and apparently the BON can write what ever they want as a scope of practice and it will not be challenged (sarcasm)

One comment on allnurses.com was very enlightening. The SNA stated this was the most difficult thing (CRNA program) that you would ever do...what about med school - no walk in the park. Maybe they don't see the doctors position as necessary and valuable since they don't requires supervision and they provide the same kind of care...just my speculation.

I like the idea of pain mgt and dealing with chronic pain. It is life altering (pain) and you can wear scrubs in the office :laugh:
 

Taurus

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Louisiana has already set the precedent both legislatively and judicially (up to state supreme court) that pain management is not within the scope of CRNA's. It's medicine.

Physicians now need to spread this to the rest of the nation.
 

oldManDO2009

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absolutely, It is like watching a train wreck - I can't take my eye off it...

I have spent the better part of this evening wading through the tripe posted on allnurses. There is a common thread of hate and a chip so large that a shoulder should not be able to support it yet it does.

A few docs post on the site but mostly the nurses try to equate their experience in nursing school and on floor experience as equal to a doctors and that they provide better care - because it is about the patient - it is always about the patient.

Yet, after a few hours it was clear it was about the money, it is really about the money. The patient care card is pulled out at every opportunity.

This fight extends to NP's that want to extend their scope, CRNA's in pain mgt, what ever the reason (don't forget the patient) we need to respond with greater intensity. Because increased scope of practice and unsupervised care will lead to increased M&M - wait it is about the patient.

I have approached my local medical association to volunteer my time to combat this assault on safe patient care (and my money???). I will offer financial support when I actually have a real job, we need to staff the front-line with docs willing to take on this fight. We need to educate the public that their provider may not be a doctor and that they have a choice and they should exercise that choice.

I worked in the ER (as a nurse ironic isn't it) that had poor patient satisfaction scores. We worked are arse off and pushed that score into the 90's. The comments I received from patients is that they chose this ER because of the excellent care.

CRNA's have an important place in the health care system but their current approach to patient care disregards their difference in training compared to an anesthesiologist and we should educate the public.....

rant finished:thanks
 

beezar

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I really don't like to get into this CRNA vs. MD stuff, but frankly, I am offended when nurses use the reasoning that their care is better because their training is focused on "patient care" and is all about the patient.

WTF? So all of my training had nothing to do with patient care? Every intervention I make has nothing to do with patient care?

Sorry, I forgot, I'm just a cold-heartless bastard who gives a rat's ass about patients. But thanks for reminding me...
 
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