Get a Load of This AS# Clown

[Consigliere]

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Check it out gang.....this is how we treat our veterans:

http://www.nphealthcarefoundation.org/programs/past_scholarships/2011/proctergamble.html

Colonoscopist. What a fu_cking joke!

 

[cchoukal]

UCSF hired an NP to do colonoscopies at SF General Hospital a couple years ago.

 

[EtherBunny]

Check it out gang.....this is how we treat our veterans:

http://www.nphealthcarefoundation.org/programs/past_scholarships/2011/proctergamble.html

Colonoscopist. What a fu_cking joke!

Welcome to the future of medicine in the United States. I'm convinced that this midlevel nonsense will impact ALL fields of medicine (including surgery at some point). Anesthesiology is just the canary in the coal mine.

 

[Noegrus]

Any procedure that is repetitive, can be done with a high degree of confidence that it would turn out well for the patient, and has a very stable record of safety, will be deputed to NPs/other midlevels. These people are operators and these procedures are repetitive and safe. We snicker because they take away our cash cows. Unfortunately, it is what it is and it also happens with MDs. IR invented cardiac cath procedures, now show me an IR who ever does cardiac cath. Instead, cardiologists make a killing out of doing PCIs by the dozen. I am not surprised. GI was making a lot of money by screening colonscopies and it was really a matter of time before someone decided to let a nurse scope a patient. I don't think that the sky is going to fall if a nurse scopes a patient. With enough practice they will recognize lesions and as usual if they perforate it is going to surgery. The future of gastroenterology may also be in putting out fires uncovered by a midlevel, I guess. We gas folks are not the only damned souls in the playground.

 

[urge]

is nationally certified by the of Gastroenterology Nurses and Associates.

Interesting.

Anyone want to get certified in the Urge Society for Pen Sux Tube Anesthesia?

1 buck. Life time certification.

 

[RT2MD]

Interesting.

Anyone want to get certified in the Urge Society for Pen Sux Tube Anesthesia?

1 buck. Life time certification.

Hells yeah! Man... imagine what I could do with my time without having to do this annoying school thing! Not to mention that obnoxious residency training... Sign me up!

 

[imfrankie]

UCSF hired an NP to do colonoscopies at SF General Hospital a couple years ago.

you're killin me

 

[sevoflurane]

Interesting.

Anyone want to get certified in the Urge Society for Pen Sux Tube Anesthesia?

1 buck. Life time certification.

Naaaaice urge.

 

[cchoukal]

http://www.startribune.com/lifestyle/health/183433371.html

 

[imfrankie]

Imagine an anesthesiologist who is echo credentialed and sets up a business in which (s)he will provide a fee-based TEE exam for patients while they are under general anesthesia (perhaps even while they are undergoing another procedure). If I tried to do that, I'd be pilloried!!! But it's okay for the hospital (or insert another financially-interested entity, payor) to allow an APN to provide and be reimbursed for professional medical services with a little wink-wink and frothy cream left over for the payor.

 

[leaverus]

Any procedure that is repetitive, can be done with a high degree of confidence that it would turn out well for the patient, and has a very stable record of safety, will be deputed to NPs/other midlevels. These people are operators and these procedures are repetitive and safe. We snicker because they take away our cash cows. Unfortunately, it is what it is and it also happens with MDs.

i'm not quite sure i understand your meaning here. ALL procedures require repetition in order to be performed with high degree of confidence and establish a very stable record of safety. no procedure is inherently "repetitive and safe." you think olympians get to be good by sheer talent or the best pilots are the ones who simply have an instinct for it? it doesn't take anyone with special skills or talent or brains to be good at (insert any medical/surgical procedure here). for the most part, all it takes is countless hours of repetition. i'm a firm believer in the "10000-hr rule." the point is, the hours should be logged by medical, not nursing, personnel because quite simply that's we study and train for; and if a complication did occur, for example, we are better prepared to manage it.

 

[cincincyreds]

The New York Mets also use a lot of midlevels for their baseball team.

 

[AngryBird69]

So where the HELL is our study showing that CRNAs increase mortalities in higher risk procedures? What are we waiting for?

 

[IlDestriero]

So where the HELL is our study showing that CRNAs increase mortalities in higher risk procedures? What are we waiting for?

The ethics of randomization for that kind of study are questionable. Joe the independent CRNA isn't going to sign up to participate in any data collection either.

 

[leaverus]

So where the HELL is our study showing that CRNAs increase mortalities in higher risk procedures? What are we waiting for?

Even if you had such data, what exactly would you do with it? If the projected physician shortages are accurate we won't have enough anesthesiologists for the increasing volume of surgical procedures.

 

[Perrotfish]

i'm not quite sure i understand your meaning here. ALL procedures require repetition in order to be performed with high degree of confidence and establish a very stable record of safety. no procedure is inherently "repetitive and safe." you think olympians get to be good by sheer talent or the best pilots are the ones who simply have an instinct for it? it doesn't take anyone with special skills or talent or brains to be good at (insert any medical/surgical procedure here). for the most part, all it takes is countless hours of repetition. i'm a firm believer in the "10000-hr rule." .

I think his point is that many procedures done by physicians don't have the option of 10,000 hour or repition. No genearl surgeon has logged 10,000 hours of whipples, and no anesthesiologist has logged 10,000 hours of craniosynastosis pediatric airways (or whatever you people think is complicated, I don't know). If there is a justification for the obscene length of our training its in the procedures that are either rare enough (whipple) or variable enough (trauma abdomen) that you can't reliably say 'I know how to do this because I've done it before', and it is possible to string enough of those procedures together to make a career. However theres no doubt that any kind of skill where you can log 10,000 hours is going over to midlevels and techs who can focus on just that procedure to the exclusion of all else. Honestly it might be a better training model, anyway.

 

[Ipassgas]

But he's getting his DNP! He's almost DOCTOR "AS# clown". Then the veterans will have a doctor taking care of them! And if he goes to Vandy, he can be a fellowship trained doctor, board certified by the American Board of Nurse Critical Care Specialists (or whatever they're calling it). We should probably (all specialties) look at our hospital bylaws and try to get in front of these things locally. This sort of thing may get our colleagues attention.