dealing with CRNAs

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midazme

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so this post is partially to vent, and partially to get (realistic) ideas on dealing with an issue.

i'm at a pretty big academic institution, and we've had our share of CRNA/resident problems. most of it is centered on the fact that we have a large CRNA presence, and not enough residents to provide anesthesia to high-acuity patients.

recently i've had some interactions with a CRNA who is, quite simply, obnoxiusly loud. today, as i was taking over a simple room from her, she saw that i was carrying a textbook and said 'oh, i haven't read that one'.

that led to a discussion about how the books that anesthesiologiy residents read are very different from the ones that SRNAs read. she insisted that she had read the same books, and even said that the CRNA boards were like those for MDs, since she had oral boards. I asked her if she thought she could pass our boards, and she said she was sure she could.

at this point, I have no idea what to say to her. mind you that we're in the OR, and i am floored. Instead, I just looked at her in disbelief and watched her leave.

my jaw is still on the floor.

have any of you had success in dealing with people like this? i know we all have our fantasies about how such a conversation would go, but in reality there's little to no chance of getting such a person to either shut the f*ck up or actually admit their limitations.
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Why'd you feel the need to even go down that road of comparing programs. Should've just discussed the textbook, when she tried to turn it into a comparison of programs a simple "I'm not here to discuss that" is all that's needed.
 
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midazme said:
so this post is partially to vent, and partially to get (realistic) ideas on dealing with an issue.

i'm at a pretty big academic institution, and we've had our share of CRNA/resident problems. most of it is centered on the fact that we have a large CRNA presence, and not enough residents to provide anesthesia to high-acuity patients.

recently i've had some interactions with a CRNA who is, quite simply, obnoxiusly loud. today, as i was taking over a simple room from her, she saw that i was carrying a textbook and said 'oh, i haven't read that one'.

that led to a discussion about how the books that anesthesiologiy residents read are very different from the ones that SRNAs read. she insisted that she had read the same books, and even said that the CRNA boards were like those for MDs, since she had oral boards. I asked her if she thought she could pass our boards, and she said she was sure she could.

at this point, I have no idea what to say to her. mind you that we're in the OR, and i am floored. Instead, I just looked at her in disbelief and watched her leave.

my jaw is still on the floor.

have any of you had success in dealing with people like this? i know we all have our fantasies about how such a conversation would go, but in reality there's little to no chance of getting such a person to either shut the f*ck up or actually admit their limitations.
Click to expand...

everyone knows that you cant reason with a crna and or teach one. You cant teach them anything. WHy? Because they know everything already. How can you teach anything to anyone if they know everything already.... So do yourself a favor NOD with affirmation, yes them to death(great idea, sounds good, oh really?, must have been hard, anyone can pass our orals.. you get the picture and move on about your day. You will get through your day a lot faster and easier. As i said earlier its not your fight, its our leader's fight but they wont do anything because of the whole invertebrate thing. the government hates doctors. They hate anesthesiologists..(even though the sickest humans get through surgery without a hitch).. because they feel that we are the reason why medicine is soooooooooo expensive. We are everything that is wrong with the current medical system.

OUr leaders ASA have done us soooooooooo wrong. They focus more on failing aba candidates and tacking on extra years to out training than on preserving whats left of this specialty...

peace out..
 
Should serve as a lesson to those applying for residency. Avoid all programs with srna's.
 
Don't worry about it. It's not worth it. She sounds like she got what she wanted from that interaction. Next time just look at the preop, ask if the patient was easy to intubate, and then tell her to either leave or if she wants to stay you can go relieve somebody else. You'll be surprised how quickly she scoots out the door. Remember who she is, sooner or later you will get a chance to assign her to a room, make sure it's a good one.
 
midazme said:
so this post is partially to vent, and partially to get (realistic) ideas on dealing with an issue.

i'm at a pretty big academic institution, and we've had our share of CRNA/resident problems. most of it is centered on the fact that we have a large CRNA presence, and not enough residents to provide anesthesia to high-acuity patients.

recently i've had some interactions with a CRNA who is, quite simply, obnoxiusly loud. today, as i was taking over a simple room from her, she saw that i was carrying a textbook and said 'oh, i haven't read that one'.

that led to a discussion about how the books that anesthesiologiy residents read are very different from the ones that SRNAs read. she insisted that she had read the same books, and even said that the CRNA boards were like those for MDs, since she had oral boards. I asked her if she thought she could pass our boards, and she said she was sure she could.

at this point, I have no idea what to say to her. mind you that we're in the OR, and i am floored. Instead, I just looked at her in disbelief and watched her leave.

my jaw is still on the floor.

have any of you had success in dealing with people like this? i know we all have our fantasies about how such a conversation would go, but in reality there's little to no chance of getting such a person to either shut the f*ck up or actually admit their limitations.
Click to expand...

Although much of what this CRNA said is BS, why would you have a problem believing they read many of the same textbooks?
 
jwk said:
Although much of what this CRNA said is BS, why would you have a problem believing they read many of the same textbooks?
Click to expand...

because she said she studied for the OB section of her exams using baby miller.
 
midazme said:
so this post is partially to vent, and partially to get (realistic) ideas on dealing with an issue.

i'm at a pretty big academic institution, and we've had our share of CRNA/resident problems. most of it is centered on the fact that we have a large CRNA presence, and not enough residents to provide anesthesia to high-acuity patients.

recently i've had some interactions with a CRNA who is, quite simply, obnoxiusly loud. today, as i was taking over a simple room from her, she saw that i was carrying a textbook and said 'oh, i haven't read that one'.

that led to a discussion about how the books that anesthesiologiy residents read are very different from the ones that SRNAs read. she insisted that she had read the same books, and even said that the CRNA boards were like those for MDs, since she had oral boards. I asked her if she thought she could pass our boards, and she said she was sure she could.

at this point, I have no idea what to say to her. mind you that we're in the OR, and i am floored. Instead, I just looked at her in disbelief and watched her leave.

my jaw is still on the floor.

have any of you had success in dealing with people like this? i know we all have our fantasies about how such a conversation would go, but in reality there's little to no chance of getting such a person to either shut the f*ck up or actually admit their limitations.
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Maybe it's just me, but it sounds like she was commenting on a book and you were trying to pick a fight.

They do mostly read our books. Which isn't to say they have the background to take away the same points as you would take away or that most of them have the memory to retain as much detail.

It's probably better to avoid the pissing match in the first place. If it did come up and a crna says they could pass our boards I'd just ask what that claim is based on? Did they do retired questions and find them easy? Did they sit in on your practice oral boards and know all the answers? Do they know any nurse who took a medical board exam and found it comparable to a nursing exam?

I think that this is a problem at academic institutions. The crnas see that you don't know basic stuff as a ca1, and think that it reflects your education as a whole. How could you know more than them about heart failure or sepsis when dumb ca-1s don't know to put the nibp and pulse-ox on opposite sides? They assume that only your ca1-3 are actually worthwhile since you obviously didn't know 'anything!' starting out.

I think this is not an issue in the real world.
 
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midazme said:
at this point, I have no idea what to say to her. mind you that we're in the OR, and i am floored. Instead, I just looked at her in disbelief and watched her leave.
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Here's how you handle that situation. Rehearse this response, and then feel free to use it (or some variation thereof) ad libitum:

"Okay, nice. It's so great you are well-read. Here's something I hope you can help me clarify. I've read in Stoelting that phenylephrine is primarily a venoconstrictor acting in the vascular beds, and serves mostly to increase pre-load. But, Barash says it has a mixed effect on arterioles and venules, increasing both pre-load AND afterload. Still, Mikhail & Morgan isn't really clear where the primary mechanism of action occurs. Also, none comments about how it's broken down, whether it is through catechol-o-methyltransferase, monoamine oxidase through cellular uptake, some non-specific plasma esterase or some other degradation pathway. Since we use this drug pretty much every day, I'm sure you've thought about this too and have an answer, right?"

Now, you may get all variety of answers from, "I don't know" to "That's not important in the 'real world' when you get out into private practice" to "Are you mocking me?" or even some attempt at a bona fide answer. No matter what she says, your only response should be...

"Oh... I'm surprised to hear you say that."

And, then say nothing else.

You can't approach her now and do this, though. Be patient. Don't seek her out. Wait for a similar situation and then drop this on her. If that doesn't shut her up, nothing will.

Best of luck!

-copro
 
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Bertelman said:
Yet every time someone starts a thread on board review, several insist that knowing Baby Miller 'cold' is all you need to pass the boards.
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Maybe Baby Miller plus a medical education is all you need for the written?


Still, I've always been a little uncomfortable with the fact that so many anesthesia residents can put up passing scores on the ITE after just the CA1 year. If you look at the norm sheets, they're not outliers, they're a substantial percentage. Curious how many other specialties have a similar early pass rate.

That said, although I "passed" the ITE by an easy margin after my CA1 year, there's no way in hell I'd have passed the oral exam then too.
 
pgg said:
Maybe Baby Miller plus a medical education is all you need for the written?


Still, I've always been a little uncomfortable with the fact that so many anesthesia residents can put up passing scores on the ITE after just the CA1 year. If you look at the norm sheets, they're not outliers, they're a substantial percentage. Curious how many other specialties have a similar early pass rate.

That said, although I "passed" the ITE by an easy margin after my CA1 year, there's no way in hell I'd have passed the oral exam then too.
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It shouldn't be a surprise that ca-1s often do well on the ite since they just studied for their step 3s, most just did a year of medicine, and they just got lectures (and read) about anesthesia equipment and pharmacology.
 
A better response would have been "oh, really". "It's a good one".

That crap is gonna happen. We need to save our engergy and pick our battles. So, far most of my experiences have been pleasant with the CRNA's at my program. I'm sure they talk behind my back or whatever, but face to face it's been actually more positive than negative.

Face it, these are people whom we need to work with. It's better to be civil while training because it just doesn't benefit YOU to be anything but.

****I feel that many CA1's can get a little too sensitive. Frankly, I do believe that female residents have it a bit harder (since a lot of CRNA's are also female), but I also think they get more defensive and sometimes it's not warranted.

I've heard female residents complain about things which could have gone either way, yet consistently CHOOSE to take the defensive approach. I'm sure this happens to dudes as well, but the point is DON'T BE SO DEFENSIVE.

**As a resident, you're not REALLY going to make a big splash in the policy changing department. But, sock it away and then once we're through with training and actually have a bit more power, influence, EXPERIENCE, then we can impact some change. In the meantime, just kick a few bucks over to the ASA-PAC, develop good skills, read, and be a good little resident (bow your head like JPP first said) and you'll be fine even in the worst of all programs.

Again, the take home point is not to let the truly petty stuff bother you.

*******Not long ago I posted about how a female OR nurse got under my skin. I vented on this forum, got some great advice, and I swear to you that over the next two times I've worked with her (I just kept up a positive, friendly but confident attitude and CHILLED versus getting seriously hostile on her) our interactions have been really great.

As a CA1, you may not be new to the hospital, but you're new to the OR. People will feel you out, and you will be tested. But, remember that you need to function and enjoy yourself over the next 3 years (o.k. over the next "just over 2 1/2 years....lol)
 
pgg said:
Maybe Baby Miller plus a medical education is all you need for the written?
Click to expand...

Yeah.. that second part is a weee bit important.


pgg said:
That said, although I "passed" the ITE by an easy margin after my CA1 year, there's no way in hell I'd have passed the oral exam then too.
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That is most certainly a different beast. The smartest cats need to seriously prepare for that one. Check out the mock oral video by the ABA:

http://www.theaba.org/home/VideosP24

If you get the wrong examiner... He can really put you up between a rock and a hard place.

This exam was easy compared to the one I had. Seriously.

😀
 
midazme said:
so this post is partially to vent, and partially to get (realistic) ideas on dealing with an issue.

i'm at a pretty big academic institution, and we've had our share of CRNA/resident problems. most of it is centered on the fact that we have a large CRNA presence, and not enough residents to provide anesthesia to high-acuity patients.

recently i've had some interactions with a CRNA who is, quite simply, obnoxiusly loud. today, as i was taking over a simple room from her, she saw that i was carrying a textbook and said 'oh, i haven't read that one'.

that led to a discussion about how the books that anesthesiologiy residents read are very different from the ones that SRNAs read. she insisted that she had read the same books, and even said that the CRNA boards were like those for MDs, since she had oral boards. I asked her if she thought she could pass our boards, and she said she was sure she could.

at this point, I have no idea what to say to her. mind you that we're in the OR, and i am floored. Instead, I just looked at her in disbelief and watched her leave.

my jaw is still on the floor.

have any of you had success in dealing with people like this? i know we all have our fantasies about how such a conversation would go, but in reality there's little to no chance of getting such a person to either shut the f*ck up or actually admit their limitations.
Click to expand...

Keep you head down during residency. Stay under the radar.
Best way to avoid such interactions once you are out:

MD ONLY PRACTICE
 
sevoflurane said:
Yeah.. that second part is a weee bit important.




That is most certainly a different beast. The smartest cats need to seriously prepare for that one. Check out the mock oral video by the ABA:

http://www.theaba.org/home/VideosP24

If you get the wrong examiner... He can really put you up between a rock and a hard place.

This exam was easy compared to the one I had. Seriously.

😀
Click to expand...


LOL @ the Improper Candidate video, but not really, because that guy is out there somewhere. Really good acting, though.
 
pgg said:
Maybe Baby Miller plus a medical education is all you need for the written?


Still, I've always been a little uncomfortable with the fact that so many anesthesia residents can put up passing scores on the ITE after just the CA1 year. If you look at the norm sheets, they're not outliers, they're a substantial percentage. Curious how many other specialties have a similar early pass rate.

That said, although I "passed" the ITE by an easy margin after my CA1 year, there's no way in hell I'd have passed the oral exam then too.
Click to expand...

I'd like to see what the pass/fail is on Part I this year. It's been creeping close to 90%. Wonder if they will "recalibrate" any time soon.
 
Join the ASA and stay active either financially and/or teaching and attending. Entrust those working hard for you. Treat mid levels as mid levels. Keep your boundaries and respect them. If you can't hold your tongue and have to say something, tell them to refer to you as dr so and so or call them nurse so and so. Remember you are a resident. U r replaceable. Channel anger through Asa
 
BLADEMDA said:
Isn't pass something like 12th percentile? Hence, getting 15-20th percentile is quite possible studying just BABY MILLER. But, you have learned more than just that book during your Residency.
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I agree 100%. I just hate to see the newbies sweating the writtens too much. My feeling is if they worked diligently during residency and they read baby Miller three times or know it cold, then they shouldn't sweat the writtens.
 
the one thing that is impossible to control for when you compare crna's to md's is innate intelligence. call it IQ, mental agility, or whatever, IN GENERAL, md's tend to be smarter, have higher IQs (merely using this is as a semi-accepted, semi-objective measure of intelligence), and have greater intellectual dexterity (ability to think along multiple lines of thoughts, ability to transfer knowledge and recognize patterns from familiar situations to unfamiliar ones, ability to creatively solve problems). until you can control for this non-random distribution of intelligence between the two groups, it will continue to be difficult to make valid comparisons. furthermore, due to the inherent safety of our system, the ability of modern anesthetic care to resolve the differences between smarter and more clinically gifted providers from inferior providers (md or crna) is limited. our system is like a test with an average score of 88, as opposed to an average of 48. the latter test, being too easy, will fail to differentiate the absolute smartest from the sort of smart. the former test, being more difficult, will be able to resolve the uber smart, from the absolute smart, from the sort of smart, from the dumb.

all that said, i wouldn't be surprised or offended at all to learn that crna's use the same textbooks we do. it doesn't mean they get the same out of it. it would be like steven hawking being offended that i also read einstein's theory of relativity. if i told steven hawking that i read that book, too, he would probably think to himself, "that's cute."
 
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Robert Loblaw said:
the one thing that is impossible to control for when you compare crna's to md's is innate intelligence. call it IQ, mental agility, or whatever, IN GENERAL, md's tend to be smarter, have higher IQs (merely using this is as a semi-accepted, semi-objective measure of intelligence), and have greater intellectual dexterity (ability to think along multiple lines of thoughts, ability to transfer knowledge and recognize patterns from familiar situations to unfamiliar ones, ability to creatively solve problems). until you can control for this non-random distribution of intelligence between the two groups, it will continue to be difficult to make valid comparisons. furthermore, due to the inherent safety of our system, the ability of modern anesthetic care to resolve the differences between smarter and more clinically gifted providers from inferior providers (md or crna) is limited. our system is like a test with an average score of 88, as opposed to an average of 48. the former test, being too easy, will fail to differentiate the absolute smartest from the sort of smart. the latter test, being more difficult, will be able to resolve the uber smart, from the absolute smart, from the sort of smart, from the dumb.

all that said, i wouldn't be surprised or offended at all to learn that crna's use the same textbooks we do. it doesn't mean they get the same out of it. it would be like steven hawking being offended that i also read einstein's theory of relativity. if i told steven hawking that i read that book, too, he would probably think to himself, "that's cute."
Click to expand...

Does Steven Hawking's internal monologue sound like a computer? I consider it a valid question to ponder... 😀

all_your_base.jpg
 
GypsySongman said:
Maybe it's just me, but it sounds like she was commenting on a book and you were trying to pick a fight.

Couldn't agree more. As many have said, pick your battles. Take the high road and just nod and move on. Sure, she can say she hasn't "read that one"- what's wrong with that? You just say, "I like it" and move on, take over the room. Done. Don't let ego take over so early on in residency. There will be people worth arguing with to save your energy for when it really matters (i.e. when your attending wants to use panc for induction of a horrible looking airway).

The more silly discussions we have with CRNAs resembling this, the more insecure WE come off.
Click to expand...
 
midazme said:
so this post is partially to vent, and partially to get (realistic) ideas on dealing with an issue.

i'm at a pretty big academic institution, and we've had our share of CRNA/resident problems. most of it is centered on the fact that we have a large CRNA presence, and not enough residents to provide anesthesia to high-acuity patients.

recently i've had some interactions with a CRNA who is, quite simply, obnoxiusly loud. today, as i was taking over a simple room from her, she saw that i was carrying a textbook and said 'oh, i haven't read that one'.

that led to a discussion about how the books that anesthesiologiy residents read are very different from the ones that SRNAs read. she insisted that she had read the same books, and even said that the CRNA boards were like those for MDs, since she had oral boards. I asked her if she thought she could pass our boards, and she said she was sure she could.

at this point, I have no idea what to say to her. mind you that we're in the OR, and i am floored. Instead, I just looked at her in disbelief and watched her leave.

my jaw is still on the floor.

have any of you had success in dealing with people like this? i know we all have our fantasies about how such a conversation would go, but in reality there's little to no chance of getting such a person to either shut the f*ck up or actually admit their limitations.
Click to expand...


Do you know the biggest lesson I learned as I made the transition from medical school to residency?

That textbooks didactic training account for half the picture.

Formal in-practice training, as in having someone stand over you and watch you, teach you, and guide your decision-making and application of your didactic training, i.e. in the form of a residency is the other half of the picture.

CRNAs don't have half of your didactic training, nor do they have half of your in-practice training.

This CRNA you were speaking with is a f-ing idiot with an agenda. What else do you expect?

Let me ask you....do you get upset when your dog occasionally sh|ts on your carpet? What else can you expect from a dog? What else can you expect from a CRNA?

(And by the way, I'm beginning to see some of that attitude from the NPs in my department. I look at them like a bunch of ******s who don't realize how dumb they are).
 
FutrrENT said:
Let me ask you....do you get upset when your dog occasionally sh|ts on your carpet? What else can you expect from a dog? What else can you expect from a CRNA?

(And by the way, I’m beginning to see some of that attitude from the NPs in my department. I look at them like a bunch of ******s who don’t realize how dumb they are).
Click to expand...

Seriously? You expect people to respect you with this kind of trash talk?
 
anynoise said:
he is on the money..
Click to expand...

Maybe the two of you will grow up someday. There are of course legitimate differences of opinion about CRNA (and NP) scope of practice and the political debates are endless, and of course physicians have more education than they do. Making comparisons to dogs sh*tting on the carpet and "******s" ? Yeah, that's very mature.
 
I think it all comes down to the fact that nurses see themselves as independent from doctors from the very start of their training. My wifes a nurse so I know this is how they are taught. Even though we write the orders, nurses, especially the bad ones, try to totally manage patients on their own. This is a a good and bad thing. Good because we cant be by every patients bedside 24 hours per day. Bad because many nurses are not equipped to be independently making major decisions in a patients care. I just started my internship but Ive seen what goes on when bad nurses start making bad decisions without the doctors permission. I can already tell its the ones who think they know everything who start attempting to manage things (putting a morbidly obese patient that was hypotensive but with crystal clear mental function in trendelenburg and then walking away while the patient cant breathe comes to mind) on their own that may cause problems. I imagine these are the nurses that go on to get another two year degree, immediately think theyre the cock of the walk and should practice independently the day they finish their new schooling.
 
Maybe its different because I work only in the pediatric world now-- but I have great respect for most of my nurse colleagues-- particularly those CRNAs that do mostly/only peds, my PICU nurse practitioner colleagues, and PICU nurses. They bring a lot to the table, and know their limitations. They defer to their physician colleagues/supervisors when it's appropriate and ask questions when it's appropriate. There is no ego, "I'm just as well-trained as you" stuff.

I have major issues with stereotyping an entire nursing profession- granted I am well aware that not everyone agrees with the likes of FuturrENT-- but there is a role for nurses out there when they practice within the realm that they were intended to. For you med students and early stage residents-- please don't make assumptions about the CRNA's, NPs and nurses that you come across in your day to day interactions. There are some excellent ones and (gasp!) some you can learn from. I know it's cool on this board to hate on CRNAs, but assess each one individually and don't become one of "those" folks who just hates on a group of people who you think are inferior just because they didn't go to school as long as you.
 
I agree with you. There are some excellent CRNA's/AA's.

I'm no hatter, and I appreciate those who are true team players in the ACT model.

On the other hand, I will not stand and watch while hidden (and sometimes not so hidden) agendas are being carried out by militant CRNA's who are overconfident in their ability to run an anesthesia service solo.

I'm glad to hear that legislators in certain states are putting up "brick walls" to the possibility of unsupervised practice.
 
Oh.. and PICU/NICU NP's can be very good as well. Some of them are well versed with neonatal AW's.
 
michigangirl said:
Maybe its different because I work only in the pediatric world now-- but I have great respect for most of my nurse colleagues-- particularly those CRNAs that do mostly/only peds, my PICU nurse practitioner colleagues, and PICU nurses. They bring a lot to the table, and know their limitations. They defer to their physician colleagues/supervisors when it's appropriate and ask questions when it's appropriate. There is no ego, "I'm just as well-trained as you" stuff.

I have major issues with stereotyping an entire nursing profession- granted I am well aware that not everyone agrees with the likes of FuturrENT-- but there is a role for nurses out there when they practice within the realm that they were intended to. For you med students and early stage residents-- please don't make assumptions about the CRNA's, NPs and nurses that you come across in your day to day interactions. There are some excellent ones and (gasp!) some you can learn from. I know it's cool on this board to hate on CRNAs, but assess each one individually and don't become one of "those" folks who just hates on a group of people who you think are inferior just because they didn't go to school as long as you.
Click to expand...

With due respect, any "anti" CRNA stuff that comes out (I should say most, that is) of these threads are often reactionary. Members of our profession REACTING to AANA legislation and even statements coming from perhaps a vocal minority (who knows) of CRNA's whom are truly militant. Or, one only needs to peruse the AANA website. Sometimes it's what's not said which underlies the problem......

More recently, there's becoming a "reactionary" feeling that we can no longer react but rather become proactive if we are to win important battles (and they can only be described accurately as just that). So, certain posters have, perhaps more than others, begun sounding the alarm that we just can not do "business as usual".

I agree with you that there are many fantastic CRNA's. I tend to get along with, frankly, every one which I've personally interacted at work. But, it's incumbent on THOSE same CRNA's to become the voice of reason. Because, otherwise this battle will continue and it will get nastier. Then, those very folks with which you mention will become the collateral damage that every war, unfortunately, produces.

Surely, there will be those on these forums that take a more underhanded approach to things. Again, I'd dismiss that stuff as reacting/venting on an internet forum....
 
michigangirl said:
Maybe its different because I work only in the pediatric world now-- but I have great respect for most of my nurse colleagues-- particularly those CRNAs that do mostly/only peds, my PICU nurse practitioner colleagues, and PICU nurses. They bring a lot to the table, and know their limitations. They defer to their physician colleagues/supervisors when it's appropriate and ask questions when it's appropriate. There is no ego, "I'm just as well-trained as you" stuff.

I have major issues with stereotyping an entire nursing profession- granted I am well aware that not everyone agrees with the likes of FuturrENT-- but there is a role for nurses out there when they practice within the realm that they were intended to. For you med students and early stage residents-- please don't make assumptions about the CRNA's, NPs and nurses that you come across in your day to day interactions. There are some excellent ones and (gasp!) some you can learn from. I know it's cool on this board to hate on CRNAs, but assess each one individually and don't become one of "those" folks who just hates on a group of people who you think are inferior just because they didn't go to school as long as you.
Click to expand...

Language has importance in politics. Calling something a "Ponzi" scheme while factually correct can get you in trouble.

The same holds true in our profession. Is an Advanced Practice Nurse your Colleague? Are they your Equal? Should the patient hear that term they would think that individual can do your job. This is exactly the blurry lines the AANA and the Nursing profession desire in the USA.

Do Attorneys refer to their Paralegals as "colleagues"? Don't lawyers insist you PASS the BAR exam before being called a lawyer's Colleague?

Language has importance in all areas of our lives. I am glad you get along well with your fellow Colleagues in Nursing.

Blade



.colleague - a person who is member of one's class or profession; "the surgeon consulted his colleagues";


http://lawmedconsultant.com/1025/ny...ule-when-crnas-give-anesthesia-cost-effective
 
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anynoise said:
OUr leaders ASA have done us soooooooooo wrong. They focus more on failing aba candidates and tacking on extra years to out training than on preserving whats left of this specialty...
.
Click to expand...

Not passing the boards is a big problem. It's your "seal of approval". Focus on that before taking on CRNAs with an inferiority complex.
 
Interesting point blade-- in the true definition it seems colleague is not the appropriate term-- my fellow "team members?"

And I completely agree to all the other responders to my comments-- I for one am totally on board with the agenda that we as anesthesiologists need to uphold and defend in order to maintain and advance our profession as it deserves. You can imagine, as a peds anesthesiologist, how I shudder at the thought of CRNAS practicing independently and being given the power to induce anesthesia without a physician's supervision. That is ridiculous. It is true that it is the militant, overpowering CRNAs that push these agendas that concern all of us.

My reply was intended for all the young grasshoppers out there who are jumping on a bandwagon they don't know enough about. Making uneducated judgments without perspective. Treating an entire group of people early in your career like they are just not worth being respected. Those of us who have been around a while know what battles to pick, and how to play the game of being nice as needed to get through the day-- and when you shouldn't be nice. . I've seen how some surgeon types come into my PICU and talk to my nurse practitioners-- as though they are a bug that needs to be squashed. But that same nurse practitioner caught some ridiculous dosing error that they made in a chronic kids meds, and on and on and on. Same goes for how some surgeons treat some of our CRNAs-- even if they've proven themselves over a long time to be excellent anesthesia providers under the supervision of a physician. Be humble at the beginning and be respectful until you figure out they don't deserve it. Don't burn bridges so quickly in your career-- it's not in your best interest.

BLADEMDA said:
Language has importance in politics. Calling something a "Ponzi" scheme while factually correct can get you in trouble.

The same holds true in our profession. Is an Advanced Practice Nurse your Colleague? Are they your Equal? Should the patient hear that term they would think that individual can do your job. This is exactly the blurry lines the AANA and the Nursing profession desire in the USA.

Do Attorneys refer to their Paralegals as "colleagues"? Don't lawyers insist you PASS the BAR exam before being called a lawyer's Colleague?

Language has importance in all areas of our lives. I am glad you get along well with your fellow Colleagues in Nursing.

Blade




.colleague - a person who is member of one's class or profession; "the surgeon consulted his colleagues";


http://lawmedconsultant.com/1025/ny...ule-when-crnas-give-anesthesia-cost-effective
Click to expand...
 
Last edited:
michigangirl said:
Interesting point blade-- in the true definition it seems colleague is not the appropriate term-- my fellow "team members?"

And I completely agree to all the other responders to my comments-- I for one am totally on board with the agenda that we as anesthesiologists need to uphold and defend in order to maintain and advance our profession as it deserves. You can imagine, as a peds anesthesiologist, how I shudder at the thought of CRNAS practicing independently and being given the power to induce anesthesia without a physician's supervision. That is ridiculous. It is true that it is the militant, overpowering CRNAs that push these agendas that concern all of us.

My reply was intended for all the young grasshoppers out there who are jumping on a bandwagon they don't know enough about. Making uneducated judgments without perspective. Treating an entire group of people early in your career like they are just not worth being respected. Those of us who have been around a while know what battles to pick, and how to play the game of being nice as needed to get through the day-- and when you shouldn't be nice. . I've seen how some surgeon types come into my PICU and talk to my nurse practitioners-- as though they are a bug that needs to be squashed. But that same nurse practitioner caught some ridiculous dosing error that they made in a chronic kids meds, and on and on and on. Same goes for how some surgeons treat some of our CRNAs-- even if they've proven themselves over a long time to be excellent anesthesia providers under the supervision of a physician. Be humble at the beginning and be respectful until you figure out they don't deserve it.
Click to expand...

Excellent Post.👍👍
 
midazme said:
so this post is partially to vent, and partially to get (realistic) ideas on dealing with an issue.

i'm at a pretty big academic institution, and we've had our share of CRNA/resident problems. most of it is centered on the fact that we have a large CRNA presence, and not enough residents to provide anesthesia to high-acuity patients.

recently i've had some interactions with a CRNA who is, quite simply, obnoxiusly loud. today, as i was taking over a simple room from her, she saw that i was carrying a textbook and said 'oh, i haven't read that one'.

that led to a discussion about how the books that anesthesiologiy residents read are very different from the ones that SRNAs read. she insisted that she had read the same books, and even said that the CRNA boards were like those for MDs, since she had oral boards. I asked her if she thought she could pass our boards, and she said she was sure she could.

at this point, I have no idea what to say to her. mind you that we're in the OR, and i am floored. Instead, I just looked at her in disbelief and watched her leave.

my jaw is still on the floor.

have any of you had success in dealing with people like this? i know we all have our fantasies about how such a conversation would go, but in reality there's little to no chance of getting such a person to either shut the f*ck up or actually admit their limitations.
Click to expand...

Yes - happened to me too.
The only way to deal with an issue like this is to avoid this type of conversations.
You are at another level. I understand the CRNA's too - they aren't bad people overall. They try to make some money and they fell that the political and economical atmosphere it is in their favor.
I said a while ago that the AANA it is a terrorist organization and I maintain this view.
The only way to demonstrate that we are way better is to REALLY BE better.
Be the bet one in regional, peds, heart, ccm.
The value is recognized and it will be seen in your paycheck.
Forget the CRNA and focus,,,,,
2win
 
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