Read a comment on Reddit that was particularly good.
CRNAs are technicians. Plain and simple. They are not a “profession,” and they are not “professionals.” They are not doctors, regardless what nonsense their “anesthesia school” certificate of completion says on it. They come in, punch the clock, do the tasks assigned to them, and they go home when the shift is done, whether the patient still needs them or not. Don’t worry, the physician will take over and finish the work if you’re tired or your shift is over. They are the real professionals.
CRNAs are, fundamentally, a nurse. c-RN-a.
Nurses do not complete medical school. They are not educated, trained, or qualified to independently diagnose, treat, or formulate a safe plan of care without the supervision of a properly trained physician. They follow orders. They provide important services and care to patients. But they implement the plans and orders of other, more trained medical professionals, regardless the letters at the end of their name near the “RN.”
“Scope creep” has led to an expansion of allowed duties for the CRNA glorified technicians, but the education, training, experience, and fundamental critical thinking skill development has not kept pace.
As a CRNA you will be an important cog in the machine of providing perioperative care, but you will never be a doctor, never be safe to practice independently, and will never understand that the volume of information and expertise that you do not possess is exactly why your care is unsafe without supervision by a physician. To paraphrase Donald Rumsfeld: “the most dangerous information is that which we do not know that we do not know.”
It takes so much longer to become a real physician, an anesthesiologist, for a reason. There are no shortcuts. If you take shortcuts, your patients may pay with their lives and wellbeing, regardless what the CRNA propaganda-mills say. You may “get away with” scamming and providing lousy care for so long that you believe any poor outcomes your patients experience could not be due to your own negligence and poor abilities. In truth, though, you’re relying on the patient’s resilience and healthy physiology to make up for the errors and harm you inevitably cause. Eventually your luck will run out, and you will not have the expertise to either understand what happened or to fix it in real-time and prevent harm. You won’t know what you missed, what you did wrong, or what treatment you didn’t implement because you were unaware of the massive gaps in your own knowledge and training. You may feel “capable” and well-prepared because of the lip service you’re paid by your teachers and fellow students, but in fact, you have the equivalent of the first three pages of the table of contents of the medical knowledge “book” to deliver safe care. CRNAs think knowing the condensed & summarized “Reader’s Digest” version of anesthesia training is adequate. Physicians literally wrote the book, all 3,000+ pages of it, and know that even with all that training, they must have the humility to understand and establish their own limits to prevent causing harm.
Becoming an expert in a profession takes an immense amount of time, study, and training. Athletes in the Olympics don’t practice their sport for 3 months and then attempt to compete on the world stage. They dedicate a lifetime to it. If you are comfortable having the capabilities of someone who says they can “swim” because they can doggy paddle across a hotel swimming pool, become a CRNA. You’ll be able to “doggy paddle” anesthesia care on all your unsuspecting patients. If you expect to become the equivalent of a Coast Guard rescue diver or gold medal Olympic swimmer, commit yourself. Put in the work, time, and effort. Become an anesthesiologist. Your patients deserve the best. Otherwise, if you become a CRNA, expect to practice under the supervision and direction of physicians for your career.
Just because lobbyists and the AANA say a CRNA can practice independently does not mean it is safe to do so, or that any of them should.
And if you choose to become a CRNA, don’t ever call yourself a “doctor.” It is a title only physicians in a hospital have earned. Not wannabe corner-cutting nurses who want to confuse unsuspecting patients. Those “doctorates” are a joke: a political stunt pushed by the AANA to make their constituents feel better about their paltry education and training. Ask any honest recent CRNA grad what they did to earn the doctorate versus a CRNA educated 10 years ago in a master’s degree CRNA program. The answer? They did a BS “research” project that takes them 3-4 weeks to complete and their school calls it “doctoral level work.” Projects like dipping objects in water to see if it makes things wet, or asking CRNAs what their favorite color scrubs are. The only way a CRNA will earn the privilege of being called “doctor” in my presence is if they quit the job, return to medical school, and earn a true MD, DO, or MBBS degree (or equivalent).
