How'd you like to work with this CRNA?

[BuzzPhreed]

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http://vtdigger.org/2013/08/26/nurs...tal-for-alleged-whistleblower-law-violations/

I guess none of the CRNAs there did/do the same thing he was accusing the anesthesiologists of doing? Really?

Wow, I guess I should invite him to go to the practice I left in January to witness some of the things I saw... NOT! Despite that it wasn't a good fit for me personally or professionally, I still like a lot of the people there, many of whom are just simply stuck in a bad situation that they can't immediately get out of.

What an ***hole.

 

[deleted171991]

Interesting that this piece of media crap does not show up on any other site.

 

[BuzzPhreed]

http://www.rightinginjustice.com/ne...ing-retaliation-for-whistleblower-complaints/

http://www.documentcloud.org/documents/778620-green-v-springfield-medical-systems.html

Probably settled out of court by now. Anyone have access to LexisNexis?

 

[BuzzPhreed]

Actually, the court document is a good read. Start on page 7. If what he says is true, these might just be the fatcat grayhair types I can't stand either.

But whistleblower protection? Come on.

Hell hath no fury like a motivated and pissed-off nurse.

 

[deleted171991]

If he was so concerned , why didn't he report any of the anesthesiologists to the state board? Were those hospital administrators really so stupid, and those anesthesiologists so incompetent? I somehow doubt it.

My feeling is that this CRNA made sure that, in case he's fired, he'll get a payday, in an otherwise at-will employment state. The solution should have been to fire him the first time he showed attitude, without any specific reason (it's an at-will employment state, after all), before he built up a file against the hospital. And that should be the lesson for everybody here. Get rid of disloyal people before they can blackmail you. Of course, a big corporation such as a hospital cannot fire *****s at will, if they blow (in general, not the whistle); but an independent anesthesia group could have.

I have been wronged a number of times in my life, and yet I doubt I have so many details about those incidents. Which makes me think this guy was taking notes, preparing for a payday, especially after he found out he was the worst paid in the group. (Why was that, I wonder, if not because he was so competent in the first place?) Also, how come everybody else in the group was incompetent?

 

[BuzzPhreed]

Maybe he did report them. Would be interested to see what the actual outcome was, if it's not still ongoing (still pretty fresh with regards to how slow the courts move on some of this stuff).

I can just tell you that, if this is the bar, then probably none of us should be in the OR giving care. What matters is outcome. We can't quantify "near misses" very well. If we did, there'd be plenty of CRNAs and Anesthesiologists in deep ca-ca.

 

[deleted171991]

Hell hath no fury like a motivated and pissed-off nurse.

And you know why? Because bearing false witness does not mean being fired automatically, even losing one's license (lack of good moral character). So nurses keep lying, and it's all a contest of he said vs she and her friends said. Happened to me and other people during residency; we were accused of stuff we have never even come close to doing, and they got away with it.

This is why I tend to be unimpressed by most things a generic nurse (whose character I don't know personally) reports. We just have different standards about the concept of truth.

I've seen enough CRNAs who refused taking even the most minimal risks, even when discussed with the patient, if they could get the case cancelled and spend one hour chatting in the lounge instead. That's the translation of "the doctor approved GA on a non-NPO pediatric patient for elective surgery". By the way, a pediatric patient is the kind of patient I would be least concerned about NPO in, but explain that to a non-scientifically educated American lay jury if you can.

Even after many years, I still find aberrant that, in the US, a less-educated person is allowed to pass judgment over the work of her (practically) supervisors. This comes from a misunderstanding of the "team" concept, which makes some people incorrectly assume that all its members are equal. There is no such thing as knowing one's place anymore.

 

[BuzzPhreed]

From what I read, I personally didn't see anything too egregious being done (based on what was reported in the legal complaint). There was some unfortunate airing of some multiply-witnessed dirty laundry but this happens when people are under stress. Again, the outcome is paramount.

I tend to agree with the fact that a nurse is in no position to render a medical opinion. This also goes to some of the other recent discussion here about how the "protocol" mentality has delineated, in some people's minds, a clear right and wrong way to do things. I'm sure I speak for everyone when I say that I run into this on a daily basis. It takes more and more time away from focusing on what's really important and what's really the problem. And you want to see someone baffled? Present them a problem that they don't have a preordained plan for.

 

[Planktonmd]

Ah... unfortunately this is an example of how a nurse would interpret what he sees in the OR from a nurse (lay person) point of view and come up with such outrageous accusations that can not be disputed because for the nurse or lay person it appears legitimate.
We should always remember that nurses are unable to distinguish between what's really essential and what's not, they see any deviation from the protocol, or in this case, the ASA stupid guideline, as a major offense because that's how they were trained ... to follow protocols.
unfortunately... hospital administrators, legislators and juries are not much smarter than these nurses, and they will come up with conclusions similar to their's if asked.

 

[deleted171991]

Ah... unfortunately this is an example of how a nurse would interpret what he sees in the OR from a nurse (lay person) point of view and come up with such outrageous accusations that can not be disputed because for the nurse or lay person it appears legitimate.
We should always remember that nurses are unable to distinguish between what's really essential and what's not, they see any deviation from the protocol, or in this case, the ASA stupid guideline, as a major offense because that's how they were trained ... to follow protocols.
unfortunately... hospital administrators, legislators and juries are not much smarter than these nurses, and they will come up with conclusions similar to their's if asked.

Yes, but as long as outcomes are not impacted, it should not matter. That's exactly the difference between a physician and a nurse: the former should be able to say "sic volo" and violate "protocol", based on his/her medical education and the fact that the buck stops with him/her.

And that's exactly what I (will continue to) do, when needed, based on what's best for my patients. A guideline or a protocol is not a natural law that cannot be overruled.

 

[HollywdAnesth]

I'm not one to advocate dangerous patient care, but the CRNA has NO skin in the game when it comes to liability. We physicians take all of the responsibility for our screw ups in addition to theirs.
If nobody was harmed and patient care wasn't affected, who cares if the anesthesiologist was on the phone with his/her accountant. If we were forced to take care of personal business when we weren't at work, we'd be screwed.

 

[BuzzPhreed]

Ah... unfortunately this is an example of how a nurse would interpret what he sees in the OR from a nurse (lay person) point of view and come up with such outrageous accusations that can not be disputed because for the nurse or lay person it appears legitimate.
We should always remember that nurses are unable to distinguish between what's really essential and what's not, they see any deviation from the protocol, or in this case, the ASA stupid guideline, as a major offense because that's how they were trained ... to follow protocols.
unfortunately... hospital administrators, legislators and juries are not much smarter than these nurses, and they will come up with conclusions similar to their's if asked.

I wouldn't go so far as to call a nurse a "lay person". But many nurses I have worked with (and continue to work with), especially the greener ones, tend to see the world as very binary. Black and white. There is a clear right and wrong way to do something. And nothing could be further from the truth.

The older more seasoned ones... well... their bad habits and groundless opinions are often VERY hard to change. (Although same can be said for some of my physician colleagues, to be sure.)

 

[BuzzPhreed]

If nobody was harmed and patient care wasn't affected, who cares if the anesthesiologist was on the phone with his/her accountant.

You're exactly right. But this dickhead raised this issue. Now they have to deal with it. And I'm willing to bet pounds to pesos that now the administrators at this hospital are sighing while burying their faces in their hands just wishing this idiot had kept it to himself.

My other bet? More "protocols" and "rules" to come at that hospital.

 

[deleted171991]

My other bet? More "protocols" and "rules" to come at that hospital.

Needing more unneeded bean counters to make sure the needless rules are needlessly enforced.

 

[pgg]

Just to be devil's advocate here, one of the CRNA's accusations was that the anesthesiologist falsified a record. If true (and proven) that's a problem. Just because he's a nurse doesn't mean he wasn't working in a toxic place with a dangerous anesthesiologist. I wish I could say I've never gone into a room to give an anesthesiologist a break or take over a case only to find a paper record precharted all the way through PACU transfer, or the monitors set to CPB mode to disable all alarms.


The rest of it sounds like nonsense though:

In one instance, anesthesiologist “Dr. G.W.” allowed a child operation without following the American Society of Anesthesiologists’ standard of requiring a patient to fast before anesthesiology. This practice, according to the standards, improves the effectiveness of anesthesia and reduces complications.

I'm unaware of such a standard. I thought the ASA published NPO guidelines not intended as standards or absolute requirements.

Green says many of G.W.’s patients were “barely breathing” when they arrived in the post-anesthesia care unit after surgery and often needed “airway interventions.”

Huh. I thought that's why we had a PACU and such a thing as "phase 1 recovery" ... to handle such things until a patient was ready for transfer to a lower level of care or discharge home.

 

[BuzzPhreed]

Just because he's a nurse doesn't mean he wasn't working in a toxic place with a dangerous anesthesiologist.

To be certain.

But if you read further on in the pleading, you'll see that there is a lengthy explanatory section about how CRNAs are equal to physicians and how they can practice independently and that 1/3rd of the states have "opted out" endorsing this... yadda, yadda, yadda. The guy was also a past-president of the Vermont Association of Nurse Anesthetists.

There is clearly a dual-agenda at work here. This guy gets a "5" for a "Buzz coefficient" in my book.

 

[jwk]

Shocking that he worked for 6 years under such substandard condtions. LOL!

Fear not - AA's work in Vermont and have for a number of years. Perhaps more Vermont anesthesiologists would like to work with a profession that wants to work with them rather than against them.

 

[Spinach Dip]

Let me get this straight....

If I report my employer, and/or anyone who works for them, that makes me a whistle-blower and immune to being fired? And if I am, I can sue for discrimination?

I think I found the secret to job security....

 

[deleted126335]

Let me get this straight....

If I report my employer, and/or anyone who works for them, that makes me a whistle-blower and immune to being fired? And if I am, I can sue for discrimination?

I think I found the secret to job security....

uhm, no. It is common that employment agreements state hat one must formally, in writing bring any whistleblower/compliance concerns to the attention of their employer/compliance officer BEFORE filing such a suit/complaint. Failure to follow this procedure subjects one to termination and other potential consequences.