CRNAS performing TEE

[ProRealDoc]

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the psychological war from the AANA continues, check out the february 2009 issue of the AANA journal. The following picture appears on the cover:
http://www.aana.com/Resources.aspx?...enuTargetType=4&ucNavMenu_TSMenuID=6&id=22730

​

On the cover:
Susan Parry McMullan, CRNA, MSN, chief nurse anesthetist at Hinsdale Anesthesia Associates, Hinsdale, Illinois, uses trans­esophageal echocardiography to evaluate pre­operative heart function in a patient scheduled for coronary artery bypass graft surgery. McMullan is director of region 2 of the Illinois Association of Nurse Anesthetists. She is a doc­toral student at Rutgers, The State University of New Jersey, and a didactic instructor in the Rosalind Franklin University of Medicine and Science, Nurse Anesthesia Program, North Chicago, Illinois. (Photo taken by John Wheeler.)

How can she work in Illinois and at the same time go to school in New Jersey? Must have earned lots of cash and bought her own private jet or maybe she just owns a laptop. 🙄

I HOPE THIS SHOWS YOU STINGY, SELFISH, NON-DONATING RESIDENTS/ATTENDINGS THAT IF YOU DON'T CONTRIBUTE TO THE ASAPAC, YOU WILL BE THE CRNA AND THAT NURSE ON THE PICTURE WILL BE YOUR DNAP BOSS. KEEP BURYING YOUR HEADS IN THE SAND SO THEY CAN KEEP ON KICKING YOUR ASS.

 

[SleepIsGood]

I agree...remember MilitaryMD and those 'old' guys that said this would never happen....

WOW...pathetic...I'm writing an email to the anesthesia group at Hinsdale. Seriously, RIDICULOUS..

LOL...although maybe they'rejust letting her 'hold' the TEE, of course she will report that she's 'using' it to detect myocardial ischemia,etc.

I agree....RESIDENTs and Attendings...OPEN UP YOUR WALLETS!!! worth the $$

the psychological war from the AANA continues, check out the february 2009 issue of the AANA journal. The following picture appears in the cover:
http://www.aana.com/Resources.aspx?...enuTargetType=4&ucNavMenu_TSMenuID=6&id=22730

​

On the cover:
Susan Parry McMullan, CRNA, MSN, chief nurse anesthetist at Hinsdale Anesthesia Associates, Hinsdale, Illinois, uses trans*esophageal echocardiography to evaluate pre*operative heart function in a patient scheduled for coronary artery bypass graft surgery. McMullan is director of region 2 of the Illinois Association of Nurse Anesthetists. She is a doc*toral student at Rutgers, The State University of New Jersey, and a didactic instructor in the Rosalind Franklin University of Medicine and Science, Nurse Anesthesia Program, North Chicago, Illinois. (Photo taken by John Wheeler.)

How can she work in Illinois and at the same time go to school in New Jersey? Must have earned lots of cash and bought her own private jet or maybe she just owns a laptop. 🙄

I HOPE THIS SHOWS THAT YOU STINGY, SELFISH, NON-DONATING RESIDENTS/ATTENDINGS THAT IF YOU DON'T CONTRIBUTE TO THE ASAPAC, YOU WILL BE THE CRNA AND THAT NURSE ON THE PICTURE WILL BE YOUR DNAP BOSS.

 

[militarymd]

Allow me to correct you on quoting what I've said.

I've always said that ANYTHING can happen......

and the other point....Why get so worked up about an advertising photo????

- things will be what they will be.....

It's just competition for turf.......getting all worked up like what you're doing doesn't win you any points with anyone...other physicians....and with the CRNA's.


How to win points?

1) don't be lazy
2) train yourself
3) be prepared for change
4) donate to your pac...

Just because you want something REALLY bad (that you sit on a stool better than a nurse) won't make it true.

I agree...remember MilitaryMD and those 'old' guys that said this would never happen....

WOW...pathetic...I'm writing an email to the anesthesia group at Hinsdale. Seriously, RIDICULOUS..

LOL...although maybe they'rejust letting her 'hold' the TEE, of course she will report that she's 'using' it to detect myocardial ischemia,etc.

I agree....RESIDENTs and Attendings...OPEN UP YOUR WALLETS!!! worth the $$

 

[coprolalia]

Mil,

I want your advice, then.

In my practice, the CRNAs work for the hospital. They have a lot of power. We don't (necessarily) have a lot of say in what they can/cannot do, as they are not "our" employees. In fact, if we don't play "nice-nice" with them, our practice can get into trouble.

So, what can I do - my practice, that is - to prevent infringement into scope of practice, such as what is advertised on this picture, when we have no real control over these hospital employees?

-copro

 

[militarymd]

Mil,

I want your advice, then.

In my practice, the CRNAs work for the hospital. They have a lot of power. We don't (necessarily) have a lot of say in what they can/cannot do, as they are not "our" employees. In fact, if we don't play "nice-nice" with them, our practice can get into trouble.

So, what can I do - my practice, that is - to prevent infringement into scope of practice, such as what is advertised on this picture, when we have no real control over these hospital employees?

-copro

YOU don't determine the "scope of practice" for them.

That is determined by:
1) board of nursing
2) hospital regulations

As hospital employees, what they do is usually referred to as "job description" as defined by "human resources" with input from the Chief of the department.

There are variations on this theme....depending on how the hospital treats advanced practice nurses.

There is NOTHING you can do...it is what it is.

 

[ProRealDoc]

Allow me to correct you on quoting what I've said.

I've always said that ANYTHING can happen......

and the other point....Why get so worked up about an advertising photo????

- things will be what they will be.....

It's just competition for turf.......getting all worked up like what you're doing doesn't win you any points with anyone...other physicians....and with the CRNA's.


How to win points?

1) don't be lazy
2) train yourself
3) be prepared for change
4) donate to your pac...

Just because you want something REALLY bad (that you sit on a stool better than a nurse) won't make it true.

It's competition for turf alright. My brother-in-law is a 6' tall, blonde, blue eye dude from AK. Has been in pool/construction business for a long time. Few years ago, on a friday afternoon after picking up his paycheck, his boss calls him into the office and tells him not to come in on monday anymore. My brother-in-law asks why and boss tells him "Well, I got another guy named Jose who will be taking over you starting monday".

So yeah, I understand.

 

[coprolalia]

YOU don't determine the "scope of practice" for them.

That is determined by:
1) board of nursing
2) hospital regulations

As hospital employees, what they do is usually referred to as "job description" as defined by "human resources" with input from the Chief of the department.

There are variations on this theme....depending on how the hospital treats advanced practice nurses.

There is NOTHING you can do...it is what it is.

Yeah, obviously I don't go to those meetings (yet), but am involved in the group meetings (although I can't vote yet).

I guess among my concerns is that we split fees when they sign on, and we've been told that we can't really say "no" when some come in at 3:00 PM to get us out for the day, even on a "blue chip" case. This has been an ongoing concern. If they are there (we have a couple that work 3:00 PM to 11:00 PM, and if the ORs are done they cover OB too) they are put to work, as the hospital obviously wants to maximize their usage.

It's not horrible, I suppose, that I get to get out at 3:00 PM on those days, but sometimes I don't want to leave the case. That's fine. If they are told to come to my room, I'm more than welcome to stay until the case is done - but they still sign-in and thus split the fee for the case.

I just see this as "infringement" on my practice rights, and now TEE? Give me a friggin' break.

-copro

 

[militarymd]

Yeah, obviously I don't go to those meetings (yet), but am involved in the group meetings (although I can't vote yet).

I guess among my concerns is that we split fees when they sign on, and we've been told that we can't really say "no" when some come in at 3:00 PM to get us out for the day, even on a "blue chip" case. This has been an ongoing concern. If they are there (we have a couple that work 3:00 PM to 11:00 PM, and if the ORs are done they cover OB too) they are put to work, as the hospital obviously wants to maximize their usage.

It's not horrible, I suppose, that I get to get out at 3:00 PM on those days, but sometimes I don't want to leave the case. That's fine. If they are told to come to my room, I'm more than welcome to stay until the case is done - but they still sign-in and thus split the fee for the case.

I just see this as "infringement" on my practice rights, and now TEE? Give me a friggin' break.

-copro

If you (the group) feels so strongly, then tell the hospital that you don't want any crna's....and that you guys, md's , will cover EVERYTHING.

That's putting your money where your mouth is....and I GUARANTEE you that those crna's will be GONE immediately at the end of their notice.

Your group READY to do that?

If not, then you really have no right to complain about "infringement".

 

[ProRealDoc]

Yeah, obviously I don't go to those meetings (yet), but am involved in the group meetings (although I can't vote yet).

I guess among my concerns is that we split fees when they sign on, and we've been told that we can't really say "no" when some come in at 3:00 PM to get us out for the day, even on a "blue chip" case. This has been an ongoing concern. If they are there (we have a couple that work 3:00 PM to 11:00 PM, and if the ORs are done they cover OB too) they are put to work, as the hospital obviously wants to maximize their usage.

It's not horrible, I suppose, that I get to get out at 3:00 PM on those days, but sometimes I don't want to leave the case. That's fine. If they are told to come to my room, I'm more than welcome to stay until the case is done - but they still sign-in and thus split the fee for the case.

I just see this as "infringement" on my practice rights, and now TEE? Give me a friggin' break.

-copro

If those nurses are salaried hospital employees, aren't you actually splitting the fee with the hospital?

 

[ProRealDoc]

If you (the group) feels so strongly, then tell the hospital that you don't want any crna's....and that you guys, md's , will cover EVERYTHING.

That's putting your money where your mouth is....and I GUARANTEE you that those crna's will be GONE immediately at the end of their notice.

Your group READY to do that?

If not, then you really have no right to complain about "infringement".

I'd be all over that.

 

[coprolalia]

If those nurses are salaried hospital employees, aren't you actually splitting the fee with the hospital?

Correct. The point is, we're splitting the fee whether we want to or not.

-copro

 

[coprolalia]

If you (the group) feels so strongly, then tell the hospital that you don't want any crna's....and that you guys, md's , will cover EVERYTHING.

That's putting your money where your mouth is....and I GUARANTEE you that those crna's will be GONE immediately at the end of their notice.

Your group READY to do that?

If not, then you really have no right to complain about "infringement".

Well, to be more precise, I really have no power to do anything about it... yet. At this point in the group, all I can do is complain.

Otherwise, I agree with everything you've said.

-copro

 

[militarymd]

Well, to be more precise, I really have no power to do anything about it... yet. At this point in the group, all I can do is complain.

Otherwise, I agree with everything you've said.

-copro

that's the ONE thing that no one likes..and you probably shouldn't do.

 

[ProRealDoc]

Correct. The point is, we're splitting the fee whether we want to or not.

-copro

We should start a group with a bunch of newly graduated, hungry (actually starving), hardworking attendings and I can guarantee you we'd clean house in no time.

 

[coprolalia]

We should start a group with a bunch of newly graduated, hungry (actually starving), hardworking attendings and I can guarantee you we'd clean house in no time.

👍

We'll see how it goes here. I think I'm probably in the same boat (but not as bad) as MilMD was when he started in his PP gig. There are definitely some awesome, hard-working, killer, smart dudes/dudettes here, but there's also some "top bloat" fat-cats who like their big paychecks and easy lifestyles.

As far as complaining, don't worry. I vent here.

-copro

 

[militarymd]

👍

We'll see how it goes here. I think I'm probably in the same boat (but not as bad) as MilMD was when he started in his PP gig. There are definitely some awesome, hard-working, killer, smart dudes/dudettes here, but there's also some "top bloat" fat-cats who like their big paychecks and easy lifestyles.

As far as complaining, don't worry. I vent here.

-copro

If you're going to the asa, we can compare notes.

 

[coprolalia]

If you're going to the asa, we can compare notes.

Eh... wish I was. Maybe next year.

-copro

 

[jwk]

YOU don't determine the "scope of practice" for them.

That is determined by:
1) board of nursing
2) hospital regulations

As hospital employees, what they do is usually referred to as "job description" as defined by "human resources" with input from the Chief of the department.

There are variations on this theme....depending on how the hospital treats advanced practice nurses.

There is NOTHING you can do...it is what it is.

Doesn't the medical staff have control over mid-level practitioners or other credentialled personnel, whether they are hospital employees or not?

Also, the chairman of the department should still be in charge of those who work within that department. This is generally true even with a bunch of independently practicing MD's, or multiple groups within a single facility.

 

[leaverus]

This is ridiculous. These RNs certainly aren't learning TEE in SRNA school - they don't get nearly enough heart numbers for that and they don't have a CT fellowship. So they must be learning it on the job year after year with MD supervisors who are content to just sign the chart and let the CRNA sit in the heart room. It's just gonna keep getting worse and worse as they encroach further on what should be MD- (or DO-) only procedures. Personally, i dont think RNs should ever have been taught to even intubate patients...

 

[SleepIsGood]

We should start a group with a bunch of newly graduated, hungry (actually starving), hardworking attendings and I can guarantee you we'd clean house in no time.

Hear, hear to this.

The problem isnt us 'younger' guys/gals going into anesthesia. It's the 'older' people that are just too greedy/lazy and want CRNAs to do all their work.

It's those older guys that will easily cave when a slightly pretty, blonde CRNA asks him, "oh doc, how do you do x,y,z?"

Obviously, this doesnt apply to EVERYONE. However,unfortunately some older people have loved the 'good ol days' of just supervising.

I agree...if us young ones got together and put together a value packed group with ONLY physicians and marketed ourselves well...ie...do what the ASA is doing right now with the Lifeline Campaign...we could seriously be more attractive to both hospitals, patients, and surgeons. Older guys that just want to 'supervise' can have the option to work or else get the boot.

 

[Noyac]

We should start a group with a bunch of newly graduated, hungry (actually starving), hardworking attendings and I can guarantee you we'd clean house in no time.

That's what we did. I am one of the oldest members and I'm 8 yrs out of residency. There are 2 guys older than me but they work just as hard.

Copro, Mil is right, if you want to change it then you need to approach the hospital and say that you docs will cover it all. Show them how it will work with you guys as the sole providers. I assume the hospital is billing for the nurses and they are reluctant to give up that billing. You will need to do your math b/4 offering this and your offer will be much stronger. Things like how much the crna salaries cost, how much in collections, ancillary staff to manage the nurses, benefits, vacation, the list goes on. You can make it appealing if you do your homework. But your group has to be on-board and the fat cats must go.

 

[dhb]

Wow what a cast of caracters in this post 🙂 just wanted to add myself

I believe TEE is just like any other technical aspect it can be learned but it's the reasoning behind is and how you manage the information that it gives you that's important.

Anybody that drops a probe for 1 year in the heart room will be able to perform a basic exam.

 

[SleepIsGood]

Wow what a cast of caracters in this post 🙂 just wanted to add myself

I believe TEE is just like any other technical aspect it can be learned but it's the reasoning behind is and how you manage the information that it gives you that's important.

Anybody that drops a probe for 1 year in the heart room will be able to perform a basic exam.

I hear you DHB

I think we as a profession need to exert caution when saying certain things are 'monkey skills'. When we make what we do seem superfluous, the nurse like leeches love to eat it up.

Same thing with intubating,etc. We perfect things and then the nurses are taught these skills by us!

In a public forum, I believe we need to exert caution when making statements like this, is all I'm saying.

 

[militarymd]

I hear you DHB

I think we as a profession need to exert caution when saying certain things are 'monkey skills'. When we make what we do seem superfluous, the nurse like leeches love to eat it up.

Same thing with intubating,etc. We perfect things and then the nurses are taught these skills by us!

In a public forum, I believe we need to exert caution when making statements like this, is all I'm saying.

You got to call a spade a spade....Perhaps you are still having trouble learning some of these "monkey skills", and that's why you are threatened by non-MD's who can do it just as well as you....perhaps even better?

It's OK to battle over turf. It's OK to feel threatened by people who COULD perhaps replace you.

It's NOT ok to call nurses, who ALSO take care of patients, LEECHES.

 

[coprolalia]

Copro, Mil is right, if you want to change it then you need to approach the hospital and say that you docs will cover it all. Show them how it will work with you guys as the sole providers. I assume the hospital is billing for the nurses and they are reluctant to give up that billing. You will need to do your math b/4 offering this and your offer will be much stronger. Things like how much the crna salaries cost, how much in collections, ancillary staff to manage the nurses, benefits, vacation, the list goes on. You can make it appealing if you do your homework. But your group has to be on-board and the fat cats must go.

Good points. And you're definitely right.

Unfortunately, I think there are currently too many partners who like the status quo. Some of them are good at pressing the flesh with the right folks, but not so good (frankly) at giving anesthesia. Actually, giving anesthesia seems almost to be kind of the irrelevant part of most of their day.

(Did I just say that out loud?)

Trust me. I'm learning a whole new skill set.

-copro

 

[militarymd]

Good points. And you're definitely right.

Unfortunately, I think there are currently too many partners who like the status quo. Some of them are good at pressing the flesh with the right folks, but not so good (frankly) at giving anesthesia. Actually, giving anesthesia seems almost to be kind of the irrelevant part of most of their day.

(Did I just say that out loud?)

Trust me. I'm learning a whole new skill set.

-copro

You have no IDEA how important that skill set is.

 

[periopdoc]

Some of them are good at pressing the flesh with the right folks,

IMHO this is probably the most important skill set that is not taught in residency, followed closely by billing.

- pod

 

[SleepIsGood]

You got to call a spade a spade....Perhaps you are still having trouble learning some of these "monkey skills", and that's why you are threatened by non-MD's who can do it just as well as you....perhaps even better?

It's OK to battle over turf. It's OK to feel threatened by people who COULD perhaps replace you.

It's NOT ok to call nurses, who ALSO take care of patients, LEECHES.

Right and nurses are just these unselfish and righteous people that don't care about monetary gain. HELLO? I thought there was a nursing 'shortage'? How many nurses would go into nursing to do regular old bed side nursing? How many would do ICU work if it wasn't for the fact they could potentially be a CRNA in the future?

News for you. The 'nursing' shortage isnt because there arent enough of them around. It's because most of them are trying to play doctor by pursuing DNP or CRNA status. Blurring the line between what a physician does and a nurse does is called taking advantage of the vulnerable PATIENT. That to me is 'leeching'.

Guys like you are ok with that. You just want to get the hell out at 3pm since you've made your loot already. You just want to work the CRNAs and cash out of the profession.

You think your job is secure and you have your niche....Can't wait until you see the light. We'll all be waiting..

 

[militarymd]

Right and nurses are just these unselfish and righteous people that don't care about monetary gain. HELLO? I thought there was a nursing 'shortage'? How many nurses would go into nursing to do regular old bed side nursing? How many would do ICU work if it wasn't for the fact they could potentially be a CRNA in the future?

News for you. The 'nursing' shortage isnt because there arent enough of them around. It's because most of them are trying to play doctor by pursuing DNP or CRNA status. Blurring the line between what a physician does and a nurse does is called taking advantage of the vulnerable PATIENT. That to me is 'leeching'.

Guys like you are ok with that. You just want to get the hell out at 3pm since you've made your loot already. You just want to work the CRNAs and cash out of the profession.

You think your job is secure and you have your niche....Can't wait until you see the light. We'll all be waiting..

I do see the light....here are a few things for you.

- There is nothing wrong with going for more....whether it be nursing or medicine....this is the future...it's a coming......I know you want to sit on a stool, and all, but it's probably not in the future for you.

- There's a "physician" shortage....you know what? ...plenty of MD's ....it's just that no one wants to do primary care like my wife and brother....everyone wants to sit on a stool...like you....wake up...there isn't a physician shortage....perhaps YOU are the one who is LEECHING.

- I haven't made my money...I can't retire...I have a mortgage...I have kids in school.....I just turned 40 something...the only reason I don't have school debt is because I paid in blood/sweat (really just sweat) with service in the Navy.

- You know what happens a 3 pm....we (the MD's) go into rooms to relieve the crna's....the easy part of my day gets to start.

- you want to meet me at the asa, we can discuss this in real life..things in the real world is not the simple black and white you would like it to be while in residency.

 

[flashgordon]

Gotta love the AANA. Such a classy publicity stunt.

Can't wait to see them return to their roots and also take over the ICU. If they're managing sick ASA4 cardiac patients with TEE, then they can easily manage any ICU patient right??

In fact, why don't they expand into surgery. All of it is just technical "monkey skills". Anyone can learn to do a lap appy right? CRNAs aren't regulated by the Board of Surgery, so what's stopping them?

 

[SleepIsGood]

I do see the light....here are a few things for you.

- There is nothing wrong with going for more....whether it be nursing or medicine....this is the future...it's a coming......I know you want to sit on a stool, and all, but it's probably not in the future for you.

- There's a "physician" shortage....you know what? ...plenty of MD's ....it's just that no one wants to do primary care like my wife and brother....everyone wants to sit on a stool...like you....wake up...there isn't a physician shortage....perhaps YOU are the one who is LEECHING.

- I haven't made my money...I can't retire...I have a mortgage...I have kids in school.....I just turned 40 something...the only reason I don't have school debt is because I paid in blood/sweat (really just sweat) with service in the Navy.

- You know what happens a 3 pm....we (the MD's) go into rooms to relieve the crna's....the easy part of my day gets to start.

- you want to meet me at the asa, we can discuss this in real life..things in the real world is not the simple black and white you would like it to be while in residency.

Clearly, you are letting your own agenda get ahead of reason. IF you read what was typed above, you will note that i DO NOT want to stool sit. I prefer to get down and do the 'dirty' work. The fat cats like yourself, like to 'supervise' CRNAs until 3pm or whatever it is you claim.

That is the problem.

YOu want to make a quick buck by pimping the CRNAs out..Yes, you do make some nice dough now. It's helping to send your kids to high school and then to college. Buy those expensive motorcycles (which by the way is all good...heck you should be able to buy whatever you want), have that nice house wherever it is,etc. You are 40 something and things are peachy clean. You dont care that when you are 50 or 60 something and you are making half or X % less. Why, you would have made your $$ already.

Your selfishness now will not allow people that will be 40 something in the near future to make what you are making. You want to milk the system. That's the problem.

Talk to anesthesiologists in their 30s. They loathe you guys that milked the system and pimped the CRNAs who are now too big for thei britches.

As ProReal indicated. Us younger guys have a thirst and desire to WORK and here's the kicker.....PRESERVE OUR PROFESSION for future MDs.

We WANT to do that. We do not want to end up like you looking at the here and the now, and not caring about what happens 10 yrs from now.

The guys at the ASA finally caught on. I supect you secretly are understanding the danger, especially since you were once against the ASA and now are electing to attend the meeting.

OR...are you going inorder to learn and then dispense that knowledge to your CRNA buddies?

Dude..there's no shame in admitting you were wrong. To stand the course and get that rug pulled out from underneath you from a CRNA is the travesty.

 

[maceo]

I agree...if us young ones got together and put together a value packed group with ONLY physicians and marketed ourselves well...ie...do what the ASA is doing right now with the Lifeline Campaign...we could seriously be more attractive to both hospitals, patients, and surgeons. Older guys that just want to 'supervise' can have the option to work or else get the boot.

there are plenty of all physician groups out there.. mine included.. we are well trained we dont cancel cases because we understand whats going on. people who cancel many cases dont have a true grasp of the situation. not to digress. all physician groups are a dieing breed. why? because someone else can sit in the room for 1/3 of my salary..

 

[Noyac]

I do see the light....here are a few things for you.

- There is nothing wrong with going for more....whether it be nursing or medicine....this is the future...it's a coming......I know you want to sit on a stool, and all, but it's probably not in the future for you.

- There's a "physician" shortage....you know what? ...plenty of MD's ....it's just that no one wants to do primary care like my wife and brother....everyone wants to sit on a stool...like you....wake up...there isn't a physician shortage....perhaps YOU are the one who is LEECHING.

- I haven't made my money...I can't retire...I have a mortgage...I have kids in school.....I just turned 40 something...the only reason I don't have school debt is because I paid in blood/sweat (really just sweat) with service in the Navy.

- You know what happens a 3 pm....we (the MD's) go into rooms to relieve the crna's....the easy part of my day gets to start.

- you want to meet me at the asa, we can discuss this in real life..things in the real world is not the simple black and white you would like it to be while in residency.

I hear your point Mil but at the same time I hear the AANA. And I don't like what I am hearing from those F*CKCHOPS. I understand that we need them but they also need us or at least the pts need us. I have a real problem with people saying that they are more qualified than than they really are or with someone claiming to be as qualified as the next guy but with much less training, knowledge and experience. I understand that there are places that cannot recruit physicians and nurse are a good alternative but for them to claim equivalence based on this is just wrong.

I'll meet you in N.O. I'll meet you with Jet. And I don't want to talk about this ****. I want to get drunk or at least buzzed.

 

[Noyac]

there are plenty of all physician groups out there.. mine included.. we are well trained we dont cancel cases because we understand whats going on. people who cancel many cases dont have a true grasp of the situation. not to digress. all physician groups are a dieing breed. why? because someone else can sit in the room for 1/3 of my salary..

Not necessarily. If you play your cards right and you are willing to do the work required then you as a physician are a better option than some nurse.

 

[maceo]

Clearly, you are letting your own agenda get ahead of reason. IF you read what was typed above, you will note that i DO NOT want to stool sit. I prefer to get down and do the 'dirty' work. The fat cats like yourself, like to 'supervise' CRNAs until 3pm or whatever it is you claim.

That is the problem.

YOu want to make a quick buck by pimping the CRNAs out..Yes, you do make some nice dough now. It's helping to send your kids to high school and then to college. Buy those expensive motorcycles (which by the way is all good...heck you should be able to buy whatever you want), have that nice house wherever it is,etc. You are 40 something and things are peachy clean. You dont care that when you are 50 or 60 something and you are making half or X % less. Why, you would have made your $$ already.

Your selfishness now will not allow people that will be 40 something in the near future to make what you are making. You want to milk the system. That's the problem.

Talk to anesthesiologists in their 30s. They loathe you guys that milked the system and pimped the CRNAs who are now too big for thei britches.

As ProReal indicated. Us younger guys have a thirst and desire to WORK and here's the kicker.....PRESERVE OUR PROFESSION for future MDs.

We WANT to do that. We do not want to end up like you looking at the here and the now, and not caring about what happens 10 yrs from now.

The guys at the ASA finally caught on. I supect you secretly are understanding the danger, especially since you were once against the ASA and now are electing to attend the meeting.

OR...are you going inorder to learn and then dispense that knowledge to your CRNA buddies?

Dude..there's no shame in admitting you were wrong. To stand the course and get that rug pulled out from underneath you from a CRNA is the travesty.

the battle that you are fighting should have been fought 30 years ago.. not now.. the cats out of the bag. our profession has changed. the anesthesia care team i believe will prevail. i guess to save money. For whatever reason its here to stay. expand the role of PA ANESTHESIA

 

[maceo]

Not necessarily. If you play your cards right and you are willing to do the work required then you as a physician are a better option than some nurse.

they can provide anesthesia for 1/3 your salary, how are you a better option.. You are available for Back up because of your judgement. im just playing devils advocate. seriously. we are fighting a economic battle we cant win

 

[Sdp]

Clearly, you are letting your own agenda get ahead of reason. IF you read what was typed above, you will note that i DO NOT want to stool sit. I prefer to get down and do the 'dirty' work. The fat cats like yourself, like to 'supervise' CRNAs until 3pm or whatever it is you claim.

That is the problem.

YOu want to make a quick buck by pimping the CRNAs out..Yes, you do make some nice dough now. It's helping to send your kids to high school and then to college. Buy those expensive motorcycles (which by the way is all good...heck you should be able to buy whatever you want), have that nice house wherever it is,etc. You are 40 something and things are peachy clean. You dont care that when you are 50 or 60 something and you are making half or X % less. Why, you would have made your $$ already.

Your selfishness now will not allow people that will be 40 something in the near future to make what you are making. You want to milk the system. That's the problem.

Talk to anesthesiologists in their 30s. They loathe you guys that milked the system and pimped the CRNAs who are now too big for thei britches.

As ProReal indicated. Us younger guys have a thirst and desire to WORK and here's the kicker.....PRESERVE OUR PROFESSION for future MDs.

We WANT to do that. We do not want to end up like you looking at the here and the now, and not caring about what happens 10 yrs from now.

The guys at the ASA finally caught on. I supect you secretly are understanding the danger, especially since you were once against the ASA and now are electing to attend the meeting.

OR...are you going inorder to learn and then dispense that knowledge to your CRNA buddies?

Dude..there's no shame in admitting you were wrong. To stand the course and get that rug pulled out from underneath you from a CRNA is the travesty.

👍 Lots of hate, but strong post.

 

[SleepIsGood]

the battle that you are fighting should have been fought 30 years ago.. not now.. the cats out of the bag. our profession has changed. the anesthesia care team i believe will prevail. i guess to save money. For whatever reason its here to stay. expand the role of PA ANESTHESIA

I wasnt alive 30 yrs ago. Almost though.

 

[SleepIsGood]

I hear your point Mil but at the same time I hear the AANA. And I don't like what I am hearing from those F*CKCHOPS. I understand that we need them but they also need us or at least the pts need us. I have a real problem with people saying that they are more qualified than than they really are or with someone claiming to be as qualified as the next guy but with much less training, knowledge and experience. I understand that there are places that cannot recruit physicians and nurse are a good alternative but for them to claim equivalence based on this is just wrong.

I'll meet you in N.O. I'll meet you with Jet. And I don't want to talk about this ****. I want to get drunk or at least buzzed.

Noyac

I hear what you are saying. Perhaps you can share a 'life altering' or 'dramatic' experience when you realized that these CRNAs were up to what they are falsely propagating.

I think the fundamental issue here is that nurses are claiming equivalency. Which is again, blurring the line.

Also...and perhaps this is better for the private forum, not here....How did you persuade your hospital that you were more valuable than a CRNA? What milmd is saying doesnt cut it. I feel like hospital admin is concerned about two things....patient safety and cost effectiveness.

 

[militarymd]

Noyac

I hear what you are saying. Perhaps you can share a 'life altering' or 'dramatic' experience when you realized that these CRNAs were up to what they are falsely propagating.

I think the fundamental issue here is that nurses are claiming equivalency. Which is again, blurring the line.

Also...and perhaps this is better for the private forum, not here....How did you persuade your hospital that you were more valuable than a CRNA? What milmd is saying doesnt cut it. I feel like hospital admin is concerned about two things....patient safety and cost effectiveness.

dude,

you are so blinded by your own hatred and propaganda (sort of like your nemesis the AANA) that you can't see the reality of the lanscape of anesthesia in the U.S.

your view is sheltered by being a resident...you need to look around...see how things work in the real world before you can make statements like you're making.

I believe the cop has learned a few things since his graduation....I know that volatileagent has.


Noyac...I plan on getting sh it faced...not just buzzed.

 

[militarymd]

Clearly, you are letting your own agenda get ahead of reason. IF you read what was typed above, you will note that i DO NOT want to stool sit. I prefer to get down and do the 'dirty' work. The fat cats like yourself, like to 'supervise' CRNAs until 3pm or whatever it is you claim.

That is the problem.

YOu want to make a quick buck by pimping the CRNAs out..Yes, you do make some nice dough now. It's helping to send your kids to high school and then to college. Buy those expensive motorcycles (which by the way .......Dude..there's no shame in admitting you were wrong. To stand the course and get that rug pulled out from underneath you from a CRNA is the travesty.

so you don't want to sit on a stool....AND you don't want to supervise.....so what are you going to do?

I am NOT worried that a crna will pull the rug from underneath me....why are you?

What are you soooo threatened by a crna? I'm not.

 

[Gern Blansten]

I believe the cop has learned a few things since his graduation....I know that volatileagent has.

Whatever happened to that guy? You and him used to go round and round.

 

[Surfer]

so you don't want to sit on a stool....AND you don't want to supervise.....so what are you going to do?

Mil, you disparage our profession by constantly referring to it as "sitting on a stool." Is that what you think anesthesiologists do who don't supervise CRNA's? We're just stool sitters?

you are a sellout. make yourself feel better any way you want. but you are a sellout.

 

[militarymd]

so you don't want to sit on a stool....AND you don't want to supervise.....so what are you going to do?

I am NOT worried that a crna will pull the rug from underneath me....why are you?

What are you soooo threatened by a crna? I'm not.

Sleep...

actually if you listen to yourself....it is VERY amusing.

1) you claim SUPERIORITY in training..skills...etc...
2) then in the same breath you get all threatened by your competition.

If 1) were so true (and i'm not arguing that), then you shouldn't feel 2)

Number 1 and 2 together in the same individual suggests.....perhaps an........insecurity/inferiority complex....look it up in dsmIV...or is it V or VI now.

 

[militarymd]

Mil, you disparage our profession by constantly referring to it as "sitting on a stool." Is that what you think anesthesiologists do who don't supervise CRNA's? We're just stool sitters?

you are a sellout. make yourself feel better any way you want. but you are a sellout.

if you're not "sitting on a stool", then what are you doing?

sure ...there's a little of this or that....but the majority of the time....you're warming that stool.

call a spade a spade...

And finally....unless you have contributed as much as me to the ASAPAC...you have not bought the right to call me a SELLOUT.

 

[dhb]

Mil, you disparage our profession by constantly referring to it as "sitting on a stool." Is that what you think anesthesiologists do who don't supervise CRNA's? We're just stool sitters?

you are a sellout. make yourself feel better any way you want. but you are a sellout.

Oh please now every physician supervising CRNA's is a sellout? so i guess every ICU doc is a sellout supervising several patient while the nurses do most of the job?

Mil is speaking the truth from the real world, he's not obscured by some nurse that stole the good case from you or because the nurse punches the clock everyday at 3pm and you don't make any more money for it...

The system has worked for a very long time the way it's working now so get over it.
This doesn't mean we shouldn't fight AANA propaganda as Mil is obviously doing and more so than some of the big mouths around here.

 

[badasshairday]

Maybe this thread should be moved to the private forum.

 

[militarymd]

Maybe this thread should be moved to the private forum.

why?

I'm NOT embarrassed by any of the things that I say......perhaps I'm a little harsh and non-PC, but the sentiments don't change.

There's nothing that I would say/type about a crna or physician that I wouldn't say to their face in person.

But feel free to move, if there are things that others may want to say about non-ASA members that they wouldn't say to their face or repeat to others.

 

[Arch Guillotti]

I'll move the thread only if the OP desires

 

[mille125]

why?

I'm NOT embarrassed by any of the things that I say......perhaps I'm a little harsh and non-PC, but the sentiments don't change.

There's nothing that I would say/type about a crna or physician that I wouldn't say to their face in person.

But feel free to move, if there are things that others may want to say about non-ASA members that they wouldn't say to their face or repeat to others.

My old friend, military md. ....... I am still not sure what side you are on but I do enjoy the banter. I would like to know if your group would hire/allow a CRNA to do TEE for your cases (unsupervised of course)? Would you allow a non fellowship trained anesthesiologist to do it?