jetproppilot

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I am a team-model advocate, as you all know.

I am also anti-militant-CRNA.

There is no model in anesthesia that can touch the MD-CRNA model in terms of safety and efficiency, in my humble opinion.

I am also ANTI CRNAS/VERY GREEN SRNAS WHO ARE TALKING WAY BEYOND THEIR EXPERIENCE COMING TO A DOCTOR THREAD WITH THEIR PROPEGANDA.

What are you trying to accomplish, GREEN SRNAS?

This is a doctor forum.

You are no different than a KKK dude posting on BET. Or Joe Dirt going to an "uppity" website. Or an "uppity" going to a redneck website.

Your presence here is not welcomed. You are intruders.

F uck you.
 

VolatileAgent

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new jersey is the bomb.

The Board has never contended that there is a higher complication rate with CRNAs; it has determined to require responsible physicians to be knowledgeable and capable of responding to all types of emergencies, not only those limited to anesthesia related problems, but also to those complications relating to physiological systems that may arise as a consequence of anesthesia or other factors. More importantly, the Board understands that outcome evidence may be considered one aspect of the issue, at the same time, the Board is aware there is no provision of law in this State which authorizes independent practice by CRNAs. Administration of anesthesia is the practice of medicine and, as such, physician direction is required and appropriate. Existing Department of Health and Senior Services rules require such oversight in the hospital and in ambulatory care facilities. The rules strike a balance, recognizing the valuable role that CRNAs can and do play.
http://www.state.nj.us/lps/ca/adoption/bmead16.htm
 

VolatileAgent

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new jersey rules!

The Board does expressly note, however, that it does not accept the NJANA's position that there is no difference in the training of physicians and CRNAs. As was stated in comments on behalf of the American Association of Nurse Anesthetists, CRNAs engage in the practice of nursing and are trained in nursing, not medicine.
 
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Where is Ghandi and Martin Luther King Jr. when you need them?
 

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new jersey gets the facts straight and keeps the discussion on topic!

Angela Richman, CRNA, testified as the President of New Jersey Association of Nurse Anesthetists, representing over 350 nurse anesthetists in the State. She stated that any CRNA who is working in a hospital has already been granted hospital privileges to give anesthesia. She further stated that CRNAs, like anesthesiologists, are fully qualified through training and education to give anesthesia and resolve anesthesia-related complications. She noted that, upon graduating from an accredited nurse anesthesia program, CRNAs must pass a national certification exam and must go through a recertification process. Ms. Richman opposes the requirement that a CRNA must be supervised by an anesthesiologist or a physician with special training. She noted that 65 percent of all anesthetics in this country are provided by CRNAs who, she said, are experts in anesthesia care. She stated that the medical literature indicates there is no difference in patient outcomes by anesthesia providers. She maintains that the rule unreasonably limits the ability of CRNAs to be employed in a physician's office. Ms. Richman expressed her dismay with the requirement that a surgeon (with no specific training in anesthesia) providing conscious sedation with a CRNA is required to obtain eight hours of training, while no such training requirement is in place for the surgeon providing conscious sedation alone. An eight-hour course will not enable a surgeon to handle an airway or to intubate a patient as well as a CRNA could. She requests a revision to the June 15, 1998 rules on anesthesia and office practice so a physician may choose equally between a CRNA and an anesthesiologist.
At the outset, it should again be noted that many of the comments of Ms. Richman, like those of Ms. Saravia and the others speaking on behalf of CRNAs, go to issues not germane to the current proposal. The Board incorporates its points above concerning statistical evidence in the literature and training differences and notes that the remedy the speaker seeks cannot be accomplished through this rulemaking proceeding. Many of the comments are directed to provisions of subchapter 4A which are not part of this rulemaking and are unchanged. Any change to sections not proposed for amendment at this time would be a substantive change requiring reproposal. Nonetheless, certain additional recurring points, beyond statistical evidence and training, were made in opposition to physician supervision and warrant clarifying correction or comment, even though beyond the scope of the rulemaking.

The Board first notes that the reference to 65 percent of anesthetics appears to be incomplete and, therefore, misleading because it does not include the equally relevant data concerning the cases in this statistic in which the CRNA are under physician supervision and which also involve anesthesiologists. Although the source of her data was not specifically identified in Ms. Richman's submission, other written submissions from the American Society of Anesthesiologists (ASA) and the New Jersey Society of Anesthesiologists suggest that the statistics are from the Centers for Medicare and Medicaid Services (CMS), formerly the Health Care Financing Administration (HCFA), and that the statistics provided by Ms. Richman are incomplete. For example, additional, contextual, statistical information provided by the ASA asserts that more complete Medicare figures for 1999 show that a total of 9,721,571 Medicare anesthesia claims were paid and 6,098,604 were paid on claims by doctors (not counting medically directed CRNAs). While, nationwide, CRNAs may be involved with much of the anesthesia delivered, ASA offered figures identified as based on 1999 Medicare data, that 72 percent of the Medicare claims made by CRNAs involved CRNAs under medical direction and the number of non-medically directed CRNA claims were equal to 9.7 percent of the total Medicare anesthesia claims paid. In addition, the information provided by the American Association of Nurse Anesthetists includes the fact that approximately "80 percent of Certified Registered Nurse Anesthetists work as partners in care with anesthesiologists" (from "Nurse Anesthetists and Anesthesiologists Practicing Together").
funny how 65% really means 9.7%. maybe it's all that extra schooling we get that helps us better understand reality. i dunno.
 

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Ms. Richman applauds the Board's attempts to provide a safe environment for patients in an office setting.
:laugh:
 

jetproppilot

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jetproppilot said:
I am a team-model advocate, as you all know.

I am also anti-militant-CRNA.

There is no model in anesthesia that can touch the MD-CRNA model in terms of safety and efficiency, in my humble opinion.

I am also ANTI CRNAS/VERY GREEN SRNAS WHO ARE TALKING WAY BEYOND THEIR EXPERIENCE COMING TO A DOCTOR THREAD WITH THEIR PROPEGANDA.

What are you trying to accomplish, GREEN SRNAS?

This is a doctor forum.

You are no different than a KKK dude posting on BET. Or Joe Dirt going to an "uppity" website. Or an "uppity" going to a redneck website.

Your presence here is not welcomed. You are intruders.

F uck you.
VERY GREEN SRNA-I'M-TALKING-WAY-ABOVE-MY-KNOWLEDGE-BASE-DUDES/DUDETTES,

WANNA TALK TRASH AND STIR S HIT?? GREAT. I RESPECT THAT.

DO IT ON YOUR MILITANT-RN.COM FORUM.

NOT HERE.

HOW MANY MDs ARE POSTING PRO MD PROPAGANDA ON WWW.CRNA.COM??????
 

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hey Jet et al

Firstly, Jet thanks for coming aboard on this topic as you are one of the big guns on here. Although I may be mroe conservative than you when it comes to the CRNA-MDA model, atleast I think we see eye to eye on the topic of SRNAs and CRNAs growing to big for their britches.

Volatile..that was strong work getting those quotes. See I wouldnt have known where to find it.

all i have to say is this. we must keep this subject alive. I really wish that it would turn into a sticky or something and that all young and old MDAs would partake in it. It would be nice if the CRNAs would be banned from posting on it but I doubt that will be possible.

I dont know what's been said about the subject (if anything) at the last ASA meeting (couldnt go--was scheduled but got sicK). I figure this is a blossoming topic because I have heard many PDs talk about this subject.

Any one know?
 

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Fellow MDAs ---guys check this out..I went out onto pubmed right now because all these CRNAs on my former thread were saying, "there's no difference in MDA vs CRNA administered anesthesia". Guess what? every friggin journal i saw that stated that was from a CRNA journal like the AANA, or some nurse journal!! That's like having a study done by pfizer on the effectiveness of viagra!

but check this one out. One I saw that was actually pro-MDA was in ANESTHESIOLOGY:

Influence of the type of anesthesia provider on costs of labor analgesia to the Texas Medicaid program.

Abouleish AE, Prough DS, Vadhera RB.

Department of Anesthesiology, University of Texas Medical Branch, Galveston, TX 77555-0591, USA. [email protected]

BACKGROUND: The Texas Medicaid Program (Medicaid) defines billable time for labor analgesia as face-to-face time; therefore, anesthesia providers determine billed time. The authors' goal was to determine the influence of anesthesia providers on labor analgesia costs billed to Medicaid. METHODS: Under the Freedom of Information Act, Medicaid provided data on claims paid for 6 months in 2001 for labor analgesia administered during the course of a vaginal delivery. Claims were either time based (codes 00946 or 00955) or a flat fee (codes 26311 or 26319). Using modifiers, the authors grouped time-based claims as either anesthesiologist group or certified registered nurse anesthetist (CRNA) group. The cost to Medicaid was based on the 2001 fee schedule. The conversion factor was 18.21 USD per American Society of Anesthesiologists unit. The flat-fee reimbursement was 152.50 USD. CRNA services were paid at 85% of the fee schedule. Average time per time claim, percent of providers with more than 4 h of billed time, and cost per claim were determined for each group. Providers with more than 120 claims (> 20 claims/month) were considered high-volume. RESULTS: The database included 21,378 claims (anesthesiologist group: 12,698 claims from 219 providers; CRNA group: 8,680 claims from 117 providers). For time-based claims, the average time per case was significantly higher in the CRNA group (146 min) than in the anesthesiologist group (105 min). The CRNA group cost to Medicaid (225.11 USD) was 19% more per claim than the anesthesiologist group (189.26 USD). The difference in cost per claim was greater among high-volume providers--213.10 USD for the CRNA group versus 168.76 USD for the anesthesiologist group. If a flat-fee program were instituted using the average cost per claim for all groups (203.81 USD), the Texas Medicaid program would save more than 500,000 USD annually. CONCLUSIONS: The costs of labor analgesia billed to Texas Medicaid were 19% to 26% less per patient when provided by anesthesiologists than by CRNAs.


but guys this is piss pour...we MDAs as much as some of us hate research need to be conducting this type of outcome research. Of course if we let the CRNAs crank out the research, it's going to be in THEIR favor. By conducting/collecting this type of data I think we would be more likely to influence politicians, the general public, and hosp administration! any thoughts from MDAs ?
 

jetproppilot

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mountaindew2006 said:
hey Jet et al

Firstly, Jet thanks for coming aboard on this topic as you are one of the big guns on here. Although I may be mroe conservative than you when it comes to the CRNA-MDA model, atleast I think we see eye to eye on the topic of SRNAs and CRNAs growing to big for their britches.

Volatile..that was strong work getting those quotes. See I wouldnt have known where to find it.

all i have to say is this. we must keep this subject alive. I really wish that it would turn into a sticky or something and that all young and old MDAs would partake in it. It would be nice if the CRNAs would be banned from posting on it but I doubt that will be possible.

I dont know what's been said about the subject (if anything) at the last ASA meeting (couldnt go--was scheduled but got sicK). I figure this is a blossoming topic because I have heard many PDs talk about this subject.

Any one know?
Yes, I know.

I'm ten years outta residency (almost) and the same OH MY GOD WE'RE BEING TAKEN OVER bull s hit was alive and well back in 1996.

I've yet to be threatened by a CRNA takeover, and I'm sure MilMD, Noyac, UT, Zippy et al will echo that.

The world will always WANT and NEED anesthesiologists, despite the naive, cocky, arrogant, repulsive, ignorant posts from a (VERY ) small representation of our country's crnas/srnas.

The militant CRNA/SRNAs posting here have some type of inferiority issue....

why else would they infiltrate the STUDENT DOCTOR NETWORK which was created for the interaction between PRE MEDS, MED STUDENTS, RESIDENTS, and PRACTICING MDs with ANTI MD PROPAGANDA????

As you can tell, this really P ISSES ME OFF.

I've yet to check into www.militantI'mtalkingwayabovemyknowledgelevelRN.com.

Still wonder why they are here stirring s hit.
 

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jetproppilot said:
Yes, I know.

I'm ten years outta residency (almost) and the same OH MY GOD WE'RE BEING TAKEN OVER bull s hit was alive and well back in 1996.

I could not agree with you more on all your above posts jet. You are on the money with most things. I like your approach to that 2 yo with downs with the pacemaker on the other post by the way. I would not have let the parents in for the induction for the same reason that another poster said after my post in that thread.

Im sure when you got out in 96 "we were being taken over", but there werent 14 states who opted out of the supervision requirements.. So I think there has been some advancement politically in the crna lobby which are making people (in power) believe " length of training and education doesnt matter" when providing anesthesia, when indeed it does. And being passive about it ( Im not implying that you are, because i dont think you are) is not helping matters.

I do all my own cases for a reason.

Next time you have an a line or a central line or an epidural you have a right to say that Im putting this one in. Thats not restricting crna practice. thats what they call it. what kind of b u l l s h i t is that. If im going under, i would want you to do it. all you have to do to put this to bed is get informed consent. Just ask the patients pre operattively Do you want the nurse to dig around in your neck and back or the PHYSICIAN. ?
 
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mountaindew2006

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jetproppilot said:
Yes, I know.

I'm ten years outta residency (almost) and the same OH MY GOD WE'RE BEING TAKEN OVER bull s hit was alive and well back in 1996.

...

Agreed, ever since the wall street journal anounce the 'takeover' in their column, the MDA world was scared $ hitless about it. Obviously many US grads at the time strayed away from the field upon hearing the news.

But things are different now. I believe (couldnt get any solid #'s) but there are more CRNAs and CRNA schools nowadays. Plus theyre more of a threat nowadays it seems. Plus, docs in general arent as respected nowadays given the expansion of mid-levels. You wont even believe this! I walk into a local drug store chain today. The pharmacy is now offering testing for PSA, TSH, Cholesterol, BP (they always did), DM, and a few more! I was like :eek: I mean come on, this was how primary care docs made their ends meet. Additionally, I really cant imagine how a pharmacist could explain why a PSA test was falsely increased or what in the world it is.

yo, seriously docs in general are just letting go of too much. Just imagine what would happen if docs started selling meds in their offices. what kind of madness would have broken loose in the pharmacy community (lol one of my best friends is a pharmacist...)
 

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davvid2700 said:
Im sure when you got out in 96 "we were being taken over", but there werent 14 states who opted out of the supervision requirements.. So I think there has been some advancement politically in the crna lobby which are making people (in power) believe " length of training and education doesnt matter" when providing anesthesia, .... ?
dude are we reading each others minds or what??

LOL

The AANA has definitely made some large strides in recent past.
 

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Nothing would stop the CRNA political jugernat like 25 AA schools at Medical schools across the country. Just need to stop teaching the CRNAs at our acedemic centers and trade them out for AA schools.

for example your an attending, PD, or Chair at a training center like XYZ that has both a CRNA program and an anesthesia program just start an AA school. The didactics for the first year can be taught at the university and clinicals done at the medical center. Just run the the CRNAS out of town. I know this happens at Henry Ford in Detriot. PD did not like the CRNAs around and gave them and there training program the boot.

We have the power to control the situation. We control the contracts in the private sector and the acedemic hospitals will listen to what we have to say.
 

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apellous said:
Nothing would stop the CRNA political jugernat like 25 AA schools at Medical schools across the country. Just need to stop teaching the CRNAs at our acedemic centers and trade them out for AA schools.

for example your an attending, PD, or Chair at a training center like XYZ that has both a CRNA program and an anesthesia program just start an AA school. The didactics for the first year can be taught at the university and clinicals done at the medical center. Just run the the CRNAS out of town. I know this happens at Henry Ford in Detriot. PD did not like the CRNAs around and gave them and there training program the boot.

We have the power to control the situation. We control the contracts in the private sector and the acedemic hospitals will listen to what we have to say.
nice sounds like a plan...

now to go to the PGA ( next month) and every other meeting i can get my hands on..

anyone going to the post graduate assembly the New York state society of anesthesiologists meeting
 

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Mountaindew & Jet - I apologize for intruding on your thread, but those tests you see offered in drug stores are not viewed as a positive direction for everyone in our profession either (I'm a pharmacist). We see them for what they are - a business venture and way to make money (for the drug company/chain-not the pharmacist) - not as a replacement for seeing an MD. It actually makes out job more difficult because I do not have time in my day to explain all the ways the lab test can be inaccurate - I ALWAYS refer them to their MD (which is where they should have gone if they had a concern enough to purchase the service/product). I appreciate you all allowing my input and must thank each of you since I never would have thought to ask who would be doing my anesthesia for my surgery which is scheduled in Jan....you can be sure I will do so now!! Again - apologies for going off point of the thread! btw - how do you let the public know their anethesia might not be given by an MD? I worked 20 years in a hospital pharmacy and didn't know it was as common as it is.......
 

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apellous said:
Nothing would stop the CRNA political jugernat like 25 AA schools at Medical schools across the country. Just need to stop teaching the CRNAs at our acedemic centers and trade them out for AA schools.

for example your an attending, PD, or Chair at a training center like XYZ that has both a CRNA program and an anesthesia program just start an AA school. The didactics for the first year can be taught at the university and clinicals done at the medical center. Just run the the CRNAS out of town. I know this happens at Henry Ford in Detriot. PD did not like the CRNAs around and gave them and there training program the boot.

We have the power to control the situation. We control the contracts in the private sector and the acedemic hospitals will listen to what we have to say.
Well, our 4th AA school is now accepting applications, and more are in the planning stages. :) We would welcome your support wherever new programs are established.

Hadn't heard about Detroit, but I'm very familiar with a residency program in the southeast that also has a CRNA program. The director of the CRNA program was told by the chair of the anesthesiology department that their students would need to get their regional and invasive monitoring training at other clinical sites because they were taking too many procedures away from the residents.
 

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mountaindew2006 said:
I dont know what's been said about the subject (if anything) at the last ASA meeting (couldnt go--was scheduled but got sicK). Any one know?
There's plenty of talk within the ASA, but it's not like there will be an open forum on the problems with CRNA's. The ASA Legislative Conference is an excellent meeting to go to. You wanna get into the politics? Go to this meeting and you'll come away with a whole new level of awareness.

And of course it goes without saying that ya gotta join the ASA if you're not already a member, and right behind that is the ASAPAC.
 

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jetproppilot said:
I am a team-model advocate, as you all know.

I am also anti-militant-CRNA.

There is no model in anesthesia that can touch the MD-CRNA model in terms of safety and efficiency, in my humble opinion.

I am also ANTI CRNAS/VERY GREEN SRNAS WHO ARE TALKING WAY BEYOND THEIR EXPERIENCE COMING TO A DOCTOR THREAD WITH THEIR PROPEGANDA.

What are you trying to accomplish, GREEN SRNAS?

This is a doctor forum.

You are no different than a KKK dude posting on BET. Or Joe Dirt going to an "uppity" website. Or an "uppity" going to a redneck website.

Your presence here is not welcomed. You are intruders.

F uck you.
You may or may not have been referring to me in this post, but I would like to respond to the above post. I came in swinging a little bit when I first started looking at this site, just going on emotion. That I will admit.
Since then, I have come to realize certain things. First off, academic teaching centers must be malignant places to work, both on the CRNA aspect and resident side. Both seem to dislike the other side. Me personally, I would never work where I was looked at as a 3pm relief or do ASA I hangnail cases all day, just so a resident could do a heart. I am based at a Level 1 center with medical affiliation, but no anesthesia program for residents. We have a small, anesthesia 8 week deal with two residents at a time going around and doing tons of intubations. We are a CRNA-MD approach, with CRNAs doing all cases you could imagine a Level 1 doing. So yes, it chaps my ass to see all the negatives about CRNAs that are abound on this board, mostly it seems from people who have never seen how either a CRNA can function or who have never seen private practice run, but I have come to realize that this is your board and people can make opinionated rants the way they want, without my interjection, as long as these rants are based on fact.

You will notice my previous postings on the thread that just closed down only popped up when outright lying was started. I never said which provider was better or the education of CRNAs was equal. I attempted to straighten out some incorrect details on law and hospital policy. If you want to rant, go for it, this is a public forum. Slam CRNAs all you want. You will never hear a peep from me. But make it a TRUTHFUL and INFORMED rant. You owe to to yourself to make an attempt to understand things before stating incorrect facts. (You meaning not JPP personally, but just a general statement for those ranting...) Facts and opinion are totally separate. And if you don't know the difference, someone should appreciate clarifying things so at least an arguement makes factual sense.

That said, I'm awaiting my angel designation. Neva should have paid by check card....Waiting sucks..
 

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I don't think you would hear anything from the nurses on your Doctors only forum if the Doctors would not post your threatening positions toward CRNA's. None of the nursing forums are trying to undermine your existance. Many posters on this forum have made it quite clear they want to eradicate nurses from entering anesthesia.

Jet, you make claims that SRNA's on this forum are no different than the KKK and the only thing they want to do is sabotage the forum. But its OK if the med students,residents and some Anesthesiologists plot agendas for the eradication of nurses in the proffesion of anesthesia. Pardon me if I'm wrong but I beleive Joseph Stalin had similar views. The word fascism comes to mind.

Mountain man and King David are no different from Hitler and the Nazi Germans. They simple want to eradicate nurses from entering anesthesia.

If you want SRNA/CRNA's off of your forum quit posting threatening views
 
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I am amazed how this type of thread does not die out. Has anything productive ever come from arguing about this crap.
 

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bell412 said:
I don't think you would hear anything from the nurses on your Doctors only forum if the Doctors would not post your threatening positions toward CRNA's. None of the nursing forums are trying to undermine your existance. Many posters on this forum have made it quite clear they want to eradicate nurses from entering anesthesia.

Jet, you make claims that SRNA's on this forum are no different than the KKK and the only thing they want to do is sabotage the forum. But its OK if the med students,residents and some Anesthesiologists plot agendas for the eradication of nurses in the proffesion of anesthesia. Pardon me if I'm wrong but I beleive Joseph Stalin had similar views. The word fascism comes to mind.

Mountain man and King David are no different from Hitler and the Nazi Germans. They simple want to eradicate nurses from entering anesthesia.

If you want SRNA/CRNA's off of your forum quit posting threatening views
Obviously you don't read some of the drivel in the CRNA section at allnurses.com.
 

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bell412 said:
.

Mountain man and King David are no different from Hitler and the Nazi Germans. They simple want to eradicate nurses from entering anesthesia.

Yeah ok! WHatever. Comparing me to HItler. Yeah that' really the case. And people are supposed to take you seriously now...

I dont want to eradicate nurses.. I want to make it clear to the public, to the anesthesia residents coming up that physicians have superior training and education and that the cheaper less trained alternative should not be allowed to practice independently and undermine the long and arduous training that physicians endure.. I mean crna independednt practice undermines medical education everywhere. I mean if i was having a colonoscopy in an office I would not want a crna with out a physician giving me anesthesia. Neither should the public
 

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bell412 said:
If you want SRNA/CRNA's off of your forum quit posting threatening views
Uh. I really doubt that. There appears an intense desire to lurk around here (probably because there are often excellent clinical scenarios and techniques discussed which, apparently, there aren't on the nurse forums. I dont know for sure though because I don't go to nursing forums--if I did I still wouldn't be posting because I'm a physician and thats a nurses forum).

rn29306 said:
Since then, I have come to realize certain things. First off, academic teaching centers must be malignant places to work, both on the CRNA aspect and resident side. Both seem to dislike the other side.
Actually, we have CRNA's at our institution. We have a pretty good working relationship and, until I started reading the militant SRNA/CRNA BullS**T some have been spouting here. I would have, once, considered a practice with them.

However, it is very obvious that there are many with much less education purporting to know everything that those with much more education know.
Similarly, they seem to think that nursing education is the same as medical education which they are not (otherwise they would both be called either nursing or medical but not one of each :rolleyes: ).

Congrats you militant trolls. You have now alienated another anesthesiologist :)

Oh. Here's another suggestion. For all you SRNA's out there "learning just like the residents" why don't you really sit down with your "buddy residents" and simply tell them straight out how your training is equal to theirs. I'm sure they'd believe it and, if they don't, I'm sure your ability to communicate your vast amounts of "physician equivalent experiences" will convince them otherwise :rolleyes:
 

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bell412 said:
we really gotta change the name of this site. The student Woctor network. its gotta nice little ring to it. hows that sound doctor woctor?

doctor woctor? DOCTOR WOCTOR??!!! I thought that was you. good times, good times :sleep:

Yes, this is called student doctor network. The students and doctors can express their opinions here without any regard to what nurses feel about them <shock>.

please direct your further opinions to allnurses.com
 

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bell412 said:
I don't think you would hear anything from the nurses on your Doctors only forum if the Doctors would not post your threatening positions toward CRNA's. None of the nursing forums are trying to undermine your existance. Many posters on this forum have made it quite clear they want to eradicate nurses from entering anesthesia.

Jet, you make claims that SRNA's on this forum are no different than the KKK and the only thing they want to do is sabotage the forum. But its OK if the med students,residents and some Anesthesiologists plot agendas for the eradication of nurses in the proffesion of anesthesia. Pardon me if I'm wrong but I beleive Joseph Stalin had similar views. The word fascism comes to mind.

Mountain man and King David are no different from Hitler and the Nazi Germans. They simple want to eradicate nurses from entering anesthesia.

If you want SRNA/CRNA's off of your forum quit posting threatening views
Go back to your nurse forum or I will be forced to eradicate you.
 

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Why are doctors so insecure about their specialty that you feel you have to "fight" for it.

1) There will ALWAYS be a need for physicians who specialize in the care of the anesthetized patient, No matter what "militant" physicians extenders say or do.

2) There will ALWAYS be a need for physician extenders who anesthetize patients, either independently or under the direction of a physician.

The above statements represent the reality of perioperative care in the 21st century and beyond in the United States.

Young, inexperienced anesthesiologists (d2700, et al.) and militant CRNAs who fight each other in the OR, over a practice, and on anonymous forums only serve to make us ALL look like fools to our surgical colleagues and patients.
 

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jetproppilot said:
They're over on the CRNA forum.

This is a doctor forum.
Right.
Just trying to break the tension in here alittle bit. Not all SRNAs/CRNAs are "Militant" that post on here.
 

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militarymd said:
Why are doctors so insecure about their specialty that you feel you have to "fight" for it.

1) There will ALWAYS be a need for physicians who specialize in the care of the anesthetized patient, No matter what "militant" physicians extenders say or do.

2) There will ALWAYS be a need for physician extenders who anesthetize patients, either independently or under the direction of a physician.

The above statements represent the reality of perioperative care in the 21st century and beyond in the United States.

Young, inexperienced anesthesiologists (d2700, et al.) and militant CRNAs who fight each other in the OR, over a practice, and on anonymous forums only serve to make us ALL look like fools to our surgical colleagues and patients.
Spoken like a true professional.
Excellent care, work hard. That's it.
 

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All you CRNAs please go mind your own business as this is a discussion I would like to have w/ my MDA/future MDA colleagues.

Through these threads here's what I think we should propose to the ASA

1) Advocate for the creation of more AA schools. I would much rather work w/ AAs who can do enough of the charting, bread and butter cases, care about the patient (as opposed to taking MDA jobs),etc . Hey MIL MED here you get ur way since these AAs will be doing teh charting etc (the nurse stuff you refer to), but we get our way by having no militant CRNAs.

2) I think the ASA should advocate for TV campaigns or poster campaigns or even magazine campaigns where the question is phrased something like this on the magazines,etc "When you are asleep and unconscious is there a doctor watching over you ???" or "ask your anesthesia provider if he/she is a doctor or a nurse...request a doctor". Why do this? Well i forget the gentleman's name on this thread who was a pharmacist who even stated himself...he's going to get surgery done this year and after reading this thread realizes that he wants a DOCTOR administering anesthesia. I think the general public is just naive when it comes to anesthesia (i mean heck pre op interaction w/ the anesthesia provdier is only like 15 min) and they do need to know who is giving them anesthesia. this way CRNAs can't just get away by saying "hi mr. smith I'm your anesthesist bob,etc". I feel the word anesthesist is soooo misleading, the lay person needs to knwo if it's a doctor or a nurse he/she is dealing with. I suspect patients will almost always request a doctor for their anesthesia.

But guys like Jet, who still want CRNAs can benefit from this. why? well the patient will request a dcotor for anesthesia. at this time Jet can be like "hi i'm Dr. Jet who will be overseeing your anesthesia adminstration today. along w/ me will be nurse 'hot babe' who will be assisting". If you havent figured it out yet, this will
A)allow doctors to be sought out more often by patients
B) Almost always require CRNAs to have a MD over them (that way they can never practice on their own)...why? which pt is going to just settle for a non-physician provider if they know upfront it's not a physician that's administering the Gas?....very minimal

I think the poster/TV campagin is a great idea...orthopedists etc do it all the time. I recall seeing atleast two Am Acad of Ortho posters at two diff airports recently. I think it's time for US to step up and have the ASA step up!

wht do you DOCTORS think?
 
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mountaindew2006

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SigmaSRNA said:
Spoken like a true professional.
Excellent care, work hard. That's it.
dude SRNA cant you read the post by Jet and all the other docs on here.... get the h eck out of this forum..... it's called www.allnurses.com

tht's where you belong bud. dont try to piggy back on militaryMD. I suspect militaryMD will not fall for your brown nosing.
 

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militarymd said:
Young, inexperienced anesthesiologists (d2700, et al.) .

dont call me inexperienced. Im a physician, (board certified in my specialty), who still reads avidly. i completed 4 years of medical school, surgical internship 3 years of residency and 6 months of post graduate cardiac training. I am studying for the TEE exam and perform these when needed. I attend meetings all the time including the asa annual meeting. I have had 3 letters to the editor published and 2 scientific papers published one in ANESTHESIOLOGY and one in A and A. SO get out of my face G. I may be young but inexperienced Im not..
 

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davvid2700 said:
dont call me inexperienced. Im a physician, (board certified in my specialty), who still reads avidly. i completed 4 years of medical school, surgical internship 3 years of residency and 6 months of post graduate cardiac training. I am studying for the TEE exam and perform these when needed. I attend meetings all the time including the asa annual meeting. I have had 3 letters to the editor published and 2 scientific papers published one in ANESTHESIOLOGY and one in A and A. SO get out of my face G. I may be young but inexperienced Im not..
Anyone who confuses "monkey skills" with medical decision making is inexperienced.
 

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jwk said:
Obviously you don't read some of the drivel in the CRNA section at allnurses.com.
Hey Jet,

I was a little surprised, but d2700 posts at the allnurses.com forum.....I guess that's why the nurses come over here to stir the pot.
 

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mountaindew2006 said:
All you CRNAs please go mind your own business as this is a discussion I would like to have w/ my MDA/future MDA colleagues.
why don't you start your "discussion" by ceasing to refer to us as "MDAs".
 

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militarymd said:
Hey Jet,

I was a little surprised, but d2700 posts at the allnurses.com forum.....I guess that's why the nurses come over here to stir the pot.

nurses have a right to come here and post.. last i checked this is america. At least thats where I am. you are allowed the freedom of speech and thought dude.. You can disagree or you can agree.. I tend to disagree with most of what you say.. How can you say what takes 3 years to learn is a "monkey skill". So what is NOT a monkey skill? and what is the definition of a monkey skill
 

militarymd

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davvid2700 said:
what takes 3 years to learn is a "monkey skill". So what is NOT a monkey skill? and what is the definition of a monkey skill

What may have taken you 3 years to learn, is learned by many nurses in 1.

Definition of "monkey skill" = any procedure performed during the course of anesthetizing a patient.

1) intubation
2) Peripheral IV
3) central line
4) epidural
5) a-line
6) lumbar puncture
7) peripheral nerve block

Like I said, it may have taken you 3 years to learn how to do these procedures, but the vast majority of the residents that I trained have mastered these skills by the end of their CA-1 year.

I work with many CRNA/AA who perform these skills at a level where I don't bother putting on my gloves.

Maybe, I have worked with talented folks, or perhaps you are just slow.....either ways....monkey skills.
 

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militarymd said:
Hey Jet,

I was a little surprised, but d2700 posts at the allnurses.com forum.....I guess that's why the nurses come over here to stir the pot.
I think thats a big mistake.

I think we should stay out of their forum and just deal with the terrorists here.

And you can say facism all you want...but I, personally do not bring MD propaganda to MilitantInexperiencedSRNA.com .

And this forum is alot more enjoyable when we arent wasting time capping terrorists.

I'd much rather be talking about MilMDs improving wheelie skills, or Noyac's new snowboard move, or what platelet count bothers everyone for neuraxial techniques.

But hey, thats life.

I sat back for a long time, avoiding this stupida ss, periodically-incessant subject that raises its head every cuppla months.

And thats what I'll continue to do...I'll sit back until the terrorists get out of hand, then I'll come in full force like Lawrence Taylor.

Not that all this really means anything, cuz it doesnt.

The SRNAs can tweetie-chirp their propaganda all they want.

The world will always need anesthesiologists, and you are not equal to us. No matter what studies you quote.

We are doctors, and you are nurses.

We practice medicine, you practice nurse-anesthesia.

I hate to stoop to the obvious, but sometimes when you have people that JUST DONT F UKKING GET IT,

you have to lay it out very simply.

No matter how many posts you post, young-terrorist SRNAs,

there is only one truth.

Either accept it, or step up to the Mike With Micatin, kiss your twenties goodbye, and go to med school.

Oh, you've gotta get accepted first.

Good luck.
 

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VolatileAgent said:
why don't you start your "discussion" by ceasing to refer to us as "MDAs".
I too never liked the word MDA...but it seemed like everyone used that abbrev. My bad.

I'm sure thats something 'they' made to describe us.
 

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jetproppilot said:
I think thats a big mistake.

I think we should stay out of their forum and just deal with the terrorists here.

And you can say facism all you want...but I, personally do not bring MD propaganda to MilitantInexperiencedSRNA.com .

And this forum is alot more enjoyable when we arent wasting time capping terrorists.

I'd much rather be talking about MilMDs improving wheelie skills, or Noyac's new snowboard move, or what platelet count bothers everyone for neuraxial techniques.

But hey, thats life.

I sat back for a long time, avoiding this stupida ss, periodically-incessant subject that raises its head every cuppla months.

And thats what I'll continue to do...I'll sit back until the terrorists get out of hand, then I'll come in full force like Lawrence Taylor.

Not that all this really means anything, cuz it doesnt.

The SRNAs can tweetie-chirp their propaganda all they want.

The world will always need anesthesiologists, and you are not equal to us. No matter what studies you quote.

We are doctors, and you are nurses.

We practice medicine, you practice nurse-anesthesia.

I hate to stoop to the obvious, but sometimes when you have people that JUST DONT F UKKING GET IT,

you have to lay it out very simply.

No matter how many posts you post, young-terrorist SRNAs,

there is only one truth.

Either accept it, or step up to the Mike With Micatin, kiss your twenties goodbye, and go to med school.

Oh, you've gotta get accepted first.

Good luck.
well said jet.. i think im gonna toss some money to the asa pac..
 

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militarymd said:
What may have taken you 3 years to learn, is learned by many nurses in 1.

Definition of "monkey skill" = any procedure performed during the course of anesthetizing a patient.

1) intubation
2) Peripheral IV
3) central line
4) epidural
5) a-line
6) lumbar puncture
7) peripheral nerve block

Like I said, it may have taken you 3 years to learn how to do these procedures, but the vast majority of the residents that I trained have mastered these skills by the end of their CA-1 year.

I work with many CRNA/AA who perform these skills at a level where I don't bother putting on my gloves.

Maybe, I have worked with talented folks, or perhaps you are just slow.....either ways....monkey skills.
Dude MilMD I think you are getting way out of line here. I dont think these are 'monkey skills'. Maybe routine skills performed by anesthesiologists that have perfected them soooo well that they can do them w/ their eyes closed etc.

Plus, it's not just about the insertion of a A-line or an epidural. It's also about what are the indications, contraindications. should it really be done? what should I do next if somethign goes wrong. And dude, I really dont think we should degrade each other here on this forum. The SRNAs etc feed of of that!

it's true that both you and d200 have different point of views, but yo let's not start name calling etc against each other (meaning b/w Anesthesiologists). I would really like to see this thread survive.
 

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mountaindew2006 said:
All you CRNAs please go mind your own business as this is a discussion I would like to have w/ my MDA/future MDA colleagues.

Through these threads here's what I think we should propose to the ASA

1) Advocate for the creation of more AA schools. I would much rather work w/ AAs who can do enough of the charting, bread and butter cases, care about the patient (as opposed to taking MDA jobs),etc . Hey MIL MED here you get ur way since these AAs will be doing teh charting etc (the nurse stuff you refer to), but we get our way by having no militant CRNAs.

2) I think the ASA should advocate for TV campaigns or poster campaigns or even magazine campaigns where the question is phrased something like this on the magazines,etc "When you are asleep and unconscious is there a doctor watching over you ???" or "ask your anesthesia provider if he/she is a doctor or a nurse...request a doctor". Why do this? Well i forget the gentleman's name on this thread who was a pharmacist who even stated himself...he's going to get surgery done this year and after reading this thread realizes that he wants a DOCTOR administering anesthesia. I think the general public is just naive when it comes to anesthesia (i mean heck pre op interaction w/ the anesthesia provdier is only like 15 min) and they do need to know who is giving them anesthesia. this way CRNAs can't just get away by saying "hi mr. smith I'm your anesthesist bob,etc". I feel the word anesthesist is soooo misleading, the lay person needs to knwo if it's a doctor or a nurse he/she is dealing with. I suspect patients will almost always request a doctor for their anesthesia.

But guys like Jet, who still want CRNAs can benefit from this. why? well the patient will request a dcotor for anesthesia. at this time Jet can be like "hi i'm Dr. Jet who will be overseeing your anesthesia adminstration today. along w/ me will be nurse 'hot babe' who will be assisting". If you havent figured it out yet, this will
A)allow doctors to be sought out more often by patients
B) Almost always require CRNAs to have a MD over them (that way they can never practice on their own)...why? which pt is going to just settle for a non-physician provider if they know upfront it's not a physician that's administering the Gas?....very minimal

I think the poster/TV campagin is a great idea...orthopedists etc do it all the time. I recall seeing atleast two Am Acad of Ortho posters at two diff airports recently. I think it's time for US to step up and have the ASA step up!

wht do you DOCTORS think?
bump :thumbup:

Guys these are just my ideas, I think we need to come up w/ ideas to pass over to the guys at ASA. We cant just sit around this forum and mentally masturabate. These words needs to come into action. we need to improve our lobbying .
 

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militarymd said:
What may have taken you 3 years to learn, is learned by many nurses in 1.

Definition of "monkey skill" = any procedure performed during the course of anesthetizing a patient.

1) intubation
2) Peripheral IV
3) central line
4) epidural
5) a-line
6) lumbar puncture
7) peripheral nerve block

Like I said, it may have taken you 3 years to learn how to do these procedures, but the vast majority of the residents that I trained have mastered these skills by the end of their CA-1 year.

I work with many CRNA/AA who perform these skills at a level where I don't bother putting on my gloves.

Maybe, I have worked with talented folks, or perhaps you are just slow.....either ways....monkey skills.
DUDE,

who the f are you? what are you a nurse anesthetist in disguise. You think you can confidently learn all the above in one year including peripheral nerve blocks. thoracic epidurals and do it well. youve been sniffing too many exhaust fumes or something if you think that. YOu better re think what you just said and get back to me? If you really really believe that an epidural is a monkey skill and that you only need one year of training to learn all the skills in anesthesia maybe you should go to the nursing forum.. Join the aana and become their spokes person.
 

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davvid2700 said:
DUDE,

who the f are you? what are you a nurse anesthetist in disguise. You think you can confidently learn all the above in one year including peripheral nerve blocks. thoracic epidurals and do it well. youve been sniffing too many exhaust fumes or something if you think that. YOu better re think what you just said and get back to me? If you really really believe that an epidural is a monkey skill and that you only need one year of training to learn all the skills in anesthesia maybe you should go to the nursing forum.. Join the aana and become their spokes person.
CALM DOWN, MIL, CALM DOWN. PUT DOWN THE AK-47. I'VE GOT YOUR BACK.

(yeah right, like milmd needs me to have his six)

Mil has a point.

I've got a CRNA in my group, D270000, that I guarantee drives a Tuohy better than you.

And putting my money where my mouth is, David Kalil CRNA and I will do my wife's C section in March...and he will be driving the needle.

He drives a Tuohy better than most MDs I've worked with.

Ever seen a PA crack the chest for a CABG, and cannulate?

I have.

Ever seen a scrub tech harvest vein endoscopically better than anyone in the US? I have. The CST I'm referring to (first name Johnny) can harvest a saphenous in 15-20 minutes. He is in the training video for the proprietary equipment.

How many general/cardiothoracic surgeons do you know can endoscopically harvest a saphenous vein in 15 minutes??????

Point being,

it takes more than hand-eye coordination to take care of patients.

And if you are banking your future on your ability to perform skills,

there is a list of paraprofessionals a mile long making seventy bucks an hour or less that can replace you tomorrow.

It takes more than hand skills to make an impact on patient care.
 

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davvid2700 said:
DUDE,

who the f are you? what are you a nurse anesthetist in disguise. .
STEP DOWN, YOUNG, NAIVE GRASSHOPPA.

I've got an assignment for you.

Go to MilMD's post history.

And read on.

There is not a CRNA on earth, mars, or saturn that knows .00003% of what the dude knows, anesthesia/critical care knowledge wise.

And keep up your reading.

In ten years you will approach 40% of Mil's anesthesia/critical care knowledge.
 

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mountaindew2006 said:
Agreed, ever since the wall street journal anounce the 'takeover' in their column, the MDA world was scared $ hitless about it. Obviously many US grads at the time strayed away from the field upon hearing the news.

But things are different now. I believe (couldnt get any solid #'s) but there are more CRNAs and CRNA schools nowadays. Plus theyre more of a threat nowadays it seems. Plus, docs in general arent as respected nowadays given the expansion of mid-levels. You wont even believe this! I walk into a local drug store chain today. The pharmacy is now offering testing for PSA, TSH, Cholesterol, BP (they always did), DM, and a few more! I was like :eek: I mean come on, this was how primary care docs made their ends meet. Additionally, I really cant imagine how a pharmacist could explain why a PSA test was falsely increased or what in the world it is.

yo, seriously docs in general are just letting go of too much. Just imagine what would happen if docs started selling meds in their offices. what kind of madness would have broken loose in the pharmacy community (lol one of my best friends is a pharmacist...)
Anyone here know of a hospital in a major metropolitan area forking over their anesthesia contracts to CRNA groups?

ANYONE???

Will never happen.
 

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MAC10 said:
doctor woctor? DOCTOR WOCTOR??!!! I thought that was you. good times, good times :sleep:

Yes, this is called student doctor network. The students and doctors can express their opinions here without any regard to what nurses feel about them <shock>.

please direct your further opinions to allnurses.com
I second that.

F uck you.
 
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