I came here to learn

[SilverStreak]

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Okay everybody,

If you read my first post on here, you obviously know I am a nurse. I work in the ICU setting, and I'm applying to anesthesia school this year to eventually become a CRNA. I have no beef with any of you here and I'm not looking to start the tiresome CRNA vs MDA threads that we all love to participate in so much. Plain and simple, I want to learn, and you have knowledge that I seek. I've learned quite a bit today just from reading the sticky posts.

I see some of what you guys are debating in my practice- colloid vs crystalloid for fluid resuscitation, beta blocker protocols, fluid shifts in a variety of post op patients. ICU nurses have more autonomy than many of you realize, and I want to know when I'm making judgements for treatment to give my patient that I'm making the best choice, and fully understand why and the ramifications for what I'm doing. Granted, I follow protocols set up by the surgeons, but in my unit I am given a lot of lee way with what I can do, and have many options to decide from, especially in the post op hearts. I know the more I can learn, the better nurse I can be, and the better care I will give to my patients.

 

[VolatileAgent]

first off, we are not "MDA"s, a term made up by recruiters and the AANA. we are doctors (including osteopaths) who practice anesthesiology and peri-operative medicine. thank you in advance for avoiding in the future, what is to some of us, potentially derisive terminology when referring to our training.

secondly, good luck as you continue along your educational path. never forget to call us if you are unsure what to do, or sometimes even when you think you are. i've specifically seen firsthand a seasoned icu nurse do what he thought was the "right thing for the patient" under the guise of a protocol and standing order, when it was actually the wrong thing (i.e., giving a beta-blocker for hypertension to a motor vehicle accident patient who was having ischemic changes secondary to acute cocaine intoxication). fortunately, the patient suffered no serious sequelae from that action. just today i (thankfully) had a unit nurse call me because she wanted to push labetalol (under a standing prn order) on a patient whose systolic bp was 194. his heart rate was 51.

just always remember who is ultimately responsible for your patient-care actions, namely the MD or DO who is signing their name on those orders. protocols can only take you so far down the decision tree.

 

[toughlife]

first off, we are not "MDA"s, a term made up by recruiters and the AANA. we are doctors (including osteopaths) who practice anesthesiology and peri-operative medicine. thank you in advance for avoiding in the future, what is to some of us, potentially derisive terminology when referring to our training.

secondly, good luck as you continue along your educational path. never forget to call us if you are unsure what to do, or sometimes even when you think you are. i've specifically seen firsthand a seasoned icu nurse do what he thought was the "right thing for the patient" under the guise of a protocol and standing order, when it was actually the wrong thing (i.e., giving a beta-blocker for hypertension to a motor vehicle accident patient who was having ischemic changes secondary to acute cocaine intoxication). fortunately, the patient suffered no serious sequelae from that action. just today i (thankfully) had a unit nurse call me because she wanted to push labetalol (under a standing prn order) on a patient whose systolic bp was 194. his heart rate was 51.

just always remember who is ultimately responsible for your patient-care actions, namely the MD or DO who is signing their name on those orders. protocols can only take you so far down the decision tree.

Volatile is right on the money.

 

[SilverStreak]

These postings are exactly my point. Just because we have protocols to cover us in certain situations does not always mean it is the best treatment for the patient. I realize this and couldn't agree more with what you both have to say. Unfortunately for us as nurses, sometimes the MDs we work with expect us to have already exhausted our possibilities on troubleshooting before calling them (I work nights, so some of them don't want to be bothered unless its an absolute emergency). I never hesitate to call if I have that feeling there is something I'm missing or something the MD needs to make the ultimate decision on about treating a patient.

My reason for coming to this board to learn is that in the end, when all of the healthcare providers strive to broaden their learning, we are only stronger as a healthcare team. I value the learning you have to offer on this board and have no hidden agendas. I also meant no disrespect by MDAs, it just easier to type than anesthesiologist, as CRNA is easier than anesthetist.

 

[jetproppilot]

These postings are exactly my point. Just because we have protocols to cover us in certain situations does not always mean it is the best treatment for the patient. I realize this and couldn't agree more with what you both have to say. Unfortunately for us as nurses, sometimes the MDs we work with expect us to have already exhausted our possibilities on troubleshooting before calling them (I work nights, so some of them don't want to be bothered unless its an absolute emergency). I never hesitate to call if I have that feeling there is something I'm missing or something the MD needs to make the ultimate decision on about treating a patient.

My reason for coming to this board to learn is that in the end, when all of the healthcare providers strive to broaden their learning, we are only stronger as a healthcare team. I value the learning you have to offer on this board and have no hidden agendas. I also meant no disrespect by MDAs, it just easier to type than anesthesiologist, as CRNA is easier than anesthetist.

So just type MD, saving yourself a stroke.

Good luck with your future aspirations.

 

[militarymd]

I have thick skin...it's pretty hard to insult me....you can call me "MDA" if you want.

 

[OldManDave]

I have thick skin...it's pretty hard to insult me....you can call me "MDA" if you want.

LOL!!!

That makes me a DOA!!!

};-)

 

[nitecap]

first off, we are not "MDA"s, a term made up by recruiters and the AANA. we are doctors (including osteopaths) who practice anesthesiology and peri-operative medicine. thank you in advance for avoiding in the future, what is to some of us, potentially derisive terminology when referring to our training.

secondly, good luck as you continue along your educational path. never forget to call us if you are unsure what to do, or sometimes even when you think you are. i've specifically seen firsthand a seasoned icu nurse do what he thought was the "right thing for the patient" under the guise of a protocol and standing order, when it was actually the wrong thing (i.e., giving a beta-blocker for hypertension to a motor vehicle accident patient who was having ischemic changes secondary to acute cocaine intoxication). fortunately, the patient suffered no serious sequelae from that action. just today i (thankfully) had a unit nurse call me because she wanted to push labetalol (under a standing prn order) on a patient whose systolic bp was 194. his heart rate was 51.

just always remember who is ultimately responsible for your patient-care actions, namely the MD or DO who is signing their name on those orders. protocols can only take you so far down the decision tree.

Silverstreak my friend please dont throw gas into the fire man. And Volatile I have seen many residents and MD's alike make the wrong call sometimes.

 

[TheSandMan]

LOL!!!

That makes me a DOA!!!

};-)

Now thats funny Never really put much thought into it, but when you think about it MDA is a pretty stupid term. I fall into the MilMD catagory though, takes alot to offend me

 

[KluverBucy]

Silverstreak my friend please dont throw gas into the fire man. And Volatile I have seen many residents and MD's alike make the wrong call sometimes.

hold on. let me get this straight...you've seen MD/DO's and residents(who must not be MD/DO's) make the wrong call sometimes? you're kidding? i always thought that doctors could NEVER make a mistake. Thanks, now i can sleep tonight knowing they're human too!

 

[Noyac]

Silver, I appreciate your desire to learn and the tact that you display here on the forum (not always the case on this forum Md's and Crna's alike). You are, in my mind, welcome to participate at will. I would like to mention something that I notice when good nurses enter anesthesia training. Somewhere in the course of their training they become very anti-MD (I call it militant sometimes). this makes for a very unpleasant environment for all those involved even non-anesthesia personel. I would ask that you keep an open mind and examine everything fed to you. You are starting off on the right foot in my opinion, by frequenting this site and wanting information. Good Luck. You will be an asset to the field. 🙂

 

[OldManDave]

Silver, I appreciate your desire to learn and the tact that you display here on the forum (not always the case on this forum Md's and Crna's alike). You are, in my mind, welcome to participate at will. I would like to mention something that I notice when good nurses enter anesthesia training. Somewhere in the course of their training they become very anti-MD (I call it militant sometimes). this makes for a very unpleasant environment for all those involved even non-anesthesia personel. I would ask that you keep an open mind and examine everything fed to you. You are starting off on the right foot in my opinion, by frequenting this site and wanting information. Good Luck. You will be an asset to the field. 🙂

I echo Noyac's sentiment!

 

[bestiller]

first off, we are not "MDA"s, a term made up by recruiters and the AANA. we are doctors (including osteopaths) who practice anesthesiology and peri-operative medicine. thank you in advance for avoiding in the future, what is to some of us, potentially derisive terminology when referring to our training.

secondly, good luck as you continue along your educational path. never forget to call us if you are unsure what to do, or sometimes even when you think you are. i've specifically seen firsthand a seasoned icu nurse do what he thought was the "right thing for the patient" under the guise of a protocol and standing order, when it was actually the wrong thing (i.e., giving a beta-blocker for hypertension to a motor vehicle accident patient who was having ischemic changes secondary to acute cocaine intoxication). fortunately, the patient suffered no serious sequelae from that action. just today i (thankfully) had a unit nurse call me because she wanted to push labetalol (under a standing prn order) on a patient whose systolic bp was 194. his heart rate was 51.

just always remember who is ultimately responsible for your patient-care actions, namely the MD or DO who is signing their name on those orders. protocols can only take you so far down the decision tree.

That's funny. You had me going there for a minute. Great satire!

 

[SilverStreak]

Silver, I appreciate your desire to learn and the tact that you display here on the forum (not always the case on this forum Md's and Crna's alike). You are, in my mind, welcome to participate at will. I would like to mention something that I notice when good nurses enter anesthesia training. Somewhere in the course of their training they become very anti-MD (I call it militant sometimes). this makes for a very unpleasant environment for all those involved even non-anesthesia personel. I would ask that you keep an open mind and examine everything fed to you. You are starting off on the right foot in my opinion, by frequenting this site and wanting information. Good Luck. You will be an asset to the field. 🙂

Thanks Noyac. I have seen glimpses of the anti-MD attitude you're talking about, and I hope someday our many issues will be resolved amicably. But, when shadowing in the OR, what stands out in my mind the most is the great working relationship anesthesia providers have, regardless of education. I have shadowed several anesthesiologists and loved it. They have all been patient, kind, and willing to teach me anything I want to know. They never act like they are on a pedestal above me. I think this problem between the groups is compounded by the disgruntlement or whatever you want to call it between our two professional organizations. The fight in my limited experience seems to exist more in the political arena than it does in the OR.

 

[jetproppilot]

The fight in my limited experience seems to exist more in the political arena than it does in the OR.

I've said this several times before.

 

[Noyac]

The fight in my limited experience seems to exist more in the political arena than it does in the OR.

You got it. In private practice it is much more amicable. But as you have seen here on SDN, the srna's have some animosity towards the other side. I can only attribute that to the crap they are fed in training because it is definitely different in the trenches. However, I must commend those who "were" that way. The hostility seems to have toned down some.