MD CRNA Debacle

[SilverStreak]

I just wanted to give my view point on this touchy topic as a SRNA wanna be this year. I clearly understand both sides, and I know that both of our professions are trying to in essence fight for the rights of both medicine and advanced nursing practice. I have had the opportunity to shadow with several anesthesiologists and they have always been supportive and eager to share their knowledge with me. I, in turn am appreciative, value their wealth of knowledge, and enjoy seeing how despite the differences anesthesiologists and CRNAs come together to work very well in the ACT model at my facility.

It bothers me that the problem has escalated to an extent that the physicians on this form have to resort to a secret club to discuss matters of the field of anesthesia. However, I understand why you feel that this is necessary. I know some of you may feel threatened (some clearly do not by your posts) by what you are hearing that CRNAs want to take over the anesthesia world (we all know that is not going to happen if we're being honest and realistic), but realize there are some nurses out there who just want to advance their education. I'm not trying to step on your toes, take your job, proclaim I'm as smart as you, or know as much as any of you do. I want to do anesthesia for a variety of reasons, none of which includes a secret wish to be a doctor, or because I see anesthesia school as an easy alternate route to medical school.

There are the good and the bad with any type of job, be it medicine, business, or any other field. The letters behind your name don't necessarily make you be the best at what you do. I just want to reiterate to those of you who don't or haven't work with CRNAs yet that if there is a mutual respect between the two professions, the working environment is not full of the attitudes you may hear expressed on these types of public forms.

In closing, with the projected shortage of anesthesia providers, I don't think any of the 3 groups- MD, AA, or CRNAs need to worry about job prospects. The baby boomer generation is on the horizon and they will only increase the demand for anesthesia in years to come. I hope that we can find a happy medium for anesthesia to be a more cohesive field. Sadly, I fear we are a long ways from this because of the "us against you" mentality on both sides. Take this post for what it is, I am not trying to start a war, no disrepect intended to any physicians on here. I love my profession and want to see it continue to grow and get better just as I know all of you want the same for medicine and anesthesiologists.

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[rn29306]

Well said.

 

[supahfresh]

Silverstreak, sometimes I don't speak right, but yet I know what I'm talking about. I know you're workin' for the CIA, they wouldn't have you in the Ma-fi-a. Why can't we be friends Why can't we be friends Why can't we be friends Why can't we be friends...

 

[jetproppilot]

I just wanted to give my view point on this touchy topic as a SRNA wanna be this year. I clearly understand both sides, and I know that both of our professions are trying to in essence fight for the rights of both medicine and advanced nursing practice. I have had the opportunity to shadow with several anesthesiologists and they have always been supportive and eager to share their knowledge with me. I, in turn am appreciative, value their wealth of knowledge, and enjoy seeing how despite the differences anesthesiologists and CRNAs come together to work very well in the ACT model at my facility.

It bothers me that the problem has escalated to an extent that the physicians on this form have to resort to a secret club to discuss matters of the field of anesthesia. However, I understand why you feel that this is necessary. I know some of you may feel threatened (some clearly do not by your posts) by what you are hearing that CRNAs want to take over the anesthesia world (we all know that is not going to happen if we're being honest and realistic), but realize there are some nurses out there who just want to advance their education. I'm not trying to step on your toes, take your job, proclaim I'm as smart as you, or know as much as any of you do. I want to do anesthesia for a variety of reasons, none of which includes a secret wish to be a doctor, or because I see anesthesia school as an easy alternate route to medical school.

There are the good and the bad with any type of job, be it medicine, business, or any other field. The letters behind your name don't necessarily make you be the best at what you do. I just want to reiterate to those of you who don't or haven't work with CRNAs yet that if there is a mutual respect between the two professions, the working environment is not full of the attitudes you may hear expressed on these types of public forms.

In closing, with the projected shortage of anesthesia providers, I don't think any of the 3 groups- MD, AA, or CRNAs need to worry about job prospects. The baby boomer generation is on the horizon and they will only increase the demand for anesthesia in years to come. I hope that we can find a happy medium for anesthesia to be a more cohesive field. Sadly, I fear we are a long ways from this because of the "us against you" mentality on both sides. Take this post for what it is, I am not trying to start a war, no disrepect intended to any physicians on here. I love my profession and want to see it continue to grow and get better just as I know all of you want the same for medicine and anesthesiologists.

Nice post which I respect.

And the "us against you" exists primarily in the academic milleau, the inexperienced, and the insecure.

 

[supahfresh]

Nice post which I respect.

And the "us against you" exists primarily in the academic milleau, the inexperienced, and the insecure.

exactly. and its not just in anesthesia. its in all specialties in academia. i hate academia.

 

[SilverStreak]

Silverstreak, sometimes I don't speak right, but yet I know what I'm talking about. I know you're workin' for the CIA, they wouldn't have you in the Ma-fi-a. Why can't we be friends Why can't we be friends Why can't we be friends Why can't we be friends...

???
Okay, forgive me I worked the last 4 nights on 12 hour shifts and I know I'm sleep deprived, but I don't get it. Or, maybe I'm just not up on your slang?

 

[sdn1977]

I'm not a physician nor am I a nurse - just a lowly pharmacist who over 30 years has had a good relationship with both professions. I, also, am saddened by the result of the deterioration of this forum. I am surprised that the physicians do not have a restricted place online for them to go since many of the rest of us do - just to talk about topics which are clinicially related to our fields - or to just vent about our fields. In that case, this is their opportunity to find that which is good.

However, selfishly, I found this to be a refreshing multidisclipinary place to be exposed to those folks who use the drugs I send them on a daily basis. It has given me a different perspective on how they practice and that has changed what I do (Yes - it really has!) Perhaps, on those few occasions I posted, it gave them my perspective which they might otherwise not have thought about.

No one asks nor cares about my opinion, but since this is a public forum, I'll advance it! The fault lies here as much with the moderators as it does with the posters. For some reason, this professional denigration was allowed to go on far longer than it should have. We, all of us in the health professions who value & appreciate listening to & sharing information outside our specialties, will suffer for the intemperance of those who chose to inflame the personal and professional integrity of physicians and those moderators who chose not to exert their judgment earlier.

I wish you all the very best and hope I've addressed all of you with all the respect due any of my colleagues. I appreciate all who have been respectful & thoughtful in their responses to me and hope to see you in the OR! Stop by the pharmacy anytime!

 

[jetproppilot]

I'm not a physician nor am I a nurse - just a lowly pharmacist who over 30 years has had a good relationship with both professions. I, also, am saddened by the result of the deterioration of this forum. I am surprised that the physicians do not have a restricted place online for them to go since many of the rest of us do - just to talk about topics which are clinicially related to our fields - or to just vent about our fields. In that case, this is their opportunity to find that which is good.

However, selfishly, I found this to be a refreshing multidisclipinary place to be exposed to those folks who use the drugs I send them on a daily basis. It has given me a different perspective on how they practice and that has changed what I do (Yes - it really has!) Perhaps, on those few occasions I posted, it gave them my perspective which they might otherwise not have thought about.

No one asks nor cares about my opinion, but since this is a public forum, I'll advance it! The fault lies here as much with the moderators as it does with the posters. For some reason, this professional denigration was allowed to go on far longer than it should have. We, all of us in the health professions who value & appreciate listening to & sharing information outside our specialties, will suffer for the intemperance of those who chose to inflame the personal and professional integrity of physicians and those moderators who chose not to exert their judgment earlier.

I wish you all the very best and hope I've addressed all of you with all the respect due any of my colleagues. I appreciate all who have been respectful & thoughtful in their responses to me and hope to see you in the OR! Stop by the pharmacy anytime!

Uhhh, Dude, I mean Sir, you are so f ukking wrong.

Your opinion is just as valuable here as any of us.

And I'm repectfully requesting you speak up more on this forum, since you know alotta stuff we do not.

Jet's opinion on the private send-in-your-foreskin-for-admission forum is that its more novelty than anything else.

Yeah, I'll stop in occassionally...

I dont hang out with doctors on my days off.

The last thing I want to do is restrict my internet blogs to doctors.

I enjoy the I enjoy learning/interacting with all professionals here. Wouldnt really be the same without everyone.

But I'll continue to assassinate trolls with a thirty-ought-six.

Maybe to my demise.

But SDN anesthesia is where I'll stay.

 

[dogbone65]

I just wanted to give my view point on this touchy topic as a SRNA wanna be this year. I clearly understand both sides, and I know that both of our professions are trying to in essence fight for the rights of both medicine and advanced nursing practice. I have had the opportunity to shadow with several anesthesiologists and they have always been supportive and eager to share their knowledge with me. I, in turn am appreciative, value their wealth of knowledge, and enjoy seeing how despite the differences anesthesiologists and CRNAs come together to work very well in the ACT model at my facility.

It bothers me that the problem has escalated to an extent that the physicians on this form have to resort to a secret club to discuss matters of the field of anesthesia. However, I understand why you feel that this is necessary. I know some of you may feel threatened (some clearly do not by your posts) by what you are hearing that CRNAs want to take over the anesthesia world (we all know that is not going to happen if we're being honest and realistic), but realize there are some nurses out there who just want to advance their education. I'm not trying to step on your toes, take your job, proclaim I'm as smart as you, or know as much as any of you do. I want to do anesthesia for a variety of reasons, none of which includes a secret wish to be a doctor, or because I see anesthesia school as an easy alternate route to medical school.

There are the good and the bad with any type of job, be it medicine, business, or any other field. The letters behind your name don't necessarily make you be the best at what you do. I just want to reiterate to those of you who don't or haven't work with CRNAs yet that if there is a mutual respect between the two professions, the working environment is not full of the attitudes you may hear expressed on these types of public forms.

In closing, with the projected shortage of anesthesia providers, I don't think any of the 3 groups- MD, AA, or CRNAs need to worry about job prospects. The baby boomer generation is on the horizon and they will only increase the demand for anesthesia in years to come. I hope that we can find a happy medium for anesthesia to be a more cohesive field. Sadly, I fear we are a long ways from this because of the "us against you" mentality on both sides. Take this post for what it is, I am not trying to start a war, no disrepect intended to any physicians on here. I love my profession and want to see it continue to grow and get better just as I know all of you want the same for medicine and anesthesiologists.

HERE HERE!! Well said. I tried to say something to that effect as a reply to a certain poster who I won't mention but seems to be the primary source for most of this ,in some thread a while back. Consequently, I received the pm from hell and then realized that perhaps, Houston, we have a problem. I respect the rock stars on this forum: jpp noyac, jwk, mmd, et. al. apologies for not including everyone. My limited experiences have been the same as those expressed by the previous posts on this thread. We all have bad days.
As I begin my educational journey to anesthesia professional I want to thank you all ahead of time for contributing to my development. Hopefully, as I learn more and become more experienced I will be able to contribute more...for now just the occasional smart ass humorous remarks.

 

[jetproppilot]

???
Okay, forgive me I worked the last 4 nights on 12 hour shifts and I know I'm sleep deprived, but I don't get it. Or, maybe I'm just not up on your slang?

Uhhhh..


Its a SONG, dude/dudette.

Just a song.

 

[SilverStreak]

Uhhhh..


Its a SONG, dude/dudette.

Just a song.

Oh, where have I been? I don't know it.

 

[threepeas]

thank you for your original post. good luck in your training. however.....

sometime long, long ago society decided that you needed to go to medical school then residency before being able to practice medicine independently. i have dealt with nursing politics for years as a PA in the state of MD before going to medschool and this is were the issue lies. the everyday MDA doesnt have a problem with the everyday CRNA. the reason MDs are upset during posts when discussing CRNA autonomy is not that CRNAs are threatening to take jobs away from us, it is because the CRNAs hierarchy are attempting to redefine the training that should take to practice medicine independently. they arent attacking anesthesiologists they are attacking the medical field in general. they are lobbying states with the greatest practitioner need and getting governors to allow nurse's to practice medicine independently. regardless of the field of medicine this is a breach of what most citizens consider to be the standard of care that they have come to expect.

the masters degree that is awarded for CRNAs and NPs is a professional masters created by the nursing world. it holds no value in the graduate training world where graduate schools oversee training and award masters of science in such and such field. now there are PhDs in nursing-again a degree totally made up by the nursing world (hello Dr. Nurse how are you today). now nurses want to redefine what practicing medicine means too. dont you see a pattern. Call it something else but dont call it nursing. now all the great bedside nurses have their sites on advanced nursing degrees leaving a huge shortage in quantity and quality which in my mind is a clear sign of irresponsibility and conflict of interest to the patient.
this is not a small issue, this is huge. philosophies are being laid out, defined and challenged. i dont think nurses will stop pushing the envelope until someone stops them. the hierarchy are power hungry and aggressive.
PAs have from the beginning defined their existence humbly as being dependent practitioners, nurses arent respecting their dependent role, they are becoming independent and it is happening in enough states that people are taking notice.

In summary, there are great CRNAs and MDAs alike but ones training program has to be extensive enough not so the best can practice independently, it is so the worst (lowest common denominator) can practice independently. so either nurses should have to go to medschool and residency, or doctors should be able to go to nursing school and advance training programs to practice independently. but there shouldnt be two standards. doctors need to do a better job in educating the public as to what is happening in certain states and that is it coming to a local hospital near you.

Props to all the hardworking healthcare providers in this country. keep up the good work.

 

[jetproppilot]

thank you for your original post. good luck in your training. however.....

sometime long, long ago society decided that you needed to go to medical school then residency before being able to practice medicine independently. i have dealt with nursing politics for years as a PA in the state of MD before going to medschool and this is were the issue lies. the everyday MDA doesnt have a problem with the everyday CRNA. the reason MDs are upset during posts when discussing CRNA autonomy is not that CRNAs are threatening to take jobs away from us, it is because the CRNAs hierarchy are attempting to redefine the training that should take to practice medicine independently. they arent attacking anesthesiologists they are attacking the medical field in general. they are lobbying states with the greatest practitioner need and getting governors to allow nurse's to practice medicine independently. regardless of the field of medicine this is a breach of what most citizens consider to be the standard of care that they have come to expect.

the masters degree that is awarded for CRNAs and NPs is a professional masters created by the nursing world. it holds no value in the graduate training world where graduate schools oversee training and award masters of science in such and such field. now there are PhDs in nursing-again a degree totally made up by the nursing world (hello Dr. Nurse how are you today). now nurses want to redefine what practicing medicine means too. dont you see a pattern. Call it something else but dont call it nursing. now all the great bedside nurses have their sites on advanced nursing degrees leaving a huge shortage in quantity and quality which in my mind is a clear sign of irresponsibility and conflict of interest to the patient.
this is not a small issue, this is huge. philosophies are being laid out, defined and challenged. i dont think nurses will stop pushing the envelope until someone stops them. the hierarchy are power hungry and aggressive.
PAs have from the beginning defined their existence humbly as being dependent practitioners, nurses arent respecting their dependent role, they are becoming independent and it is happening in enough states that people are taking notice.

In summary, there are great CRNAs and MDAs alike but ones training program has to be extensive enough not so the best can practice independently, it is so the worst (lowest common denominator) can practice independently. so either nurses should have to go to medschool and residency, or doctors should be able to go to nursing school and advance training programs to practice independently. but there shouldnt be two standards. doctors need to do a better job in educating the public as to what is happening in certain states and that is it coming to a local hospital near you.

Props to all the hardworking healthcare providers in this country. keep up the good work.

Geez.

Such insight in this post.

Dontcha see why I dont wanna be a member of the foreskin society?

Gotta give ya my two cents on the CRNA PhD (meaning they wanna be called doctor) stuff.

Look, I'm a Florida dude. I drive a truck. I've got a dip of Copenhagen in as we speak.

Kinda a down to earth dude.

And the CRNA DOCTOR s hit is a buncha crap. Smoke and mirrors.

Not indoctrined to advance their education.

Indoctrined for power issues.

And it will clandestinely confuse the unsuspecting surgical patients.

The AANA has gone too far with this.

Wanna be a doctor? Practice medicine?

Go to med school.

There are no short cuts.

 

[cfdavid]

Nice post OP. I will admit that I have limited experience. I'm starting MS1 in August.

I think many of the more abrasive post were a result of inflammatory remarks made by certain individuals. And sometimes the responses to such remarks can be a bit reactionary. So, perhaps none of us are really at odds to the extent that some post might suggest.

As someone that is interested in the field of anesthesiology and that has 10 years in the business world (outside of medicine), I've experience and truly believe in the principles of constantly reevaluating one's position in the "value chain". I submit that this applies to anesthesiology (and any field for that matter). And, although there will be many opportunities for all providers of anesthesia in the coming years, we must ALL be proactive in finding ways in which we may further increase the value that we provide our customers (surgeons, admin, patients etc.). It's just good "business".

I don't think the relationship between CRNA's (or AA's) and MD/DO's need be adversarial at all. There IS an overlap in services that we provide. But, that does not mean that our services are the same, just that they overlap in certain areas. That's fine, and our field is not alone (in medicine or otherwise) in that respect. But, whenever that is the case, both parties must be proactive in emphasizing their unique, individual, strengths. And it's always been bad business to thrash the other party, especially when that other party is an integral member of one's team. However, promoting the value that one brings to the table, and that set's them apart, is in no way trashing anyone else.

The approach for any smart professional (or professional organization) is to be proactive in finding ways in which our customers recognize the unique value that we provide. In times of change (i.e. all the time), any profession should strive to emphasis any unique services provided to their customers. And it's important to educate our customers on what the hell it really is that we do add to the value chain. I've mentioned before that it can be a big mistake to assume that everyone automatically knows. And it's not as simple as "well, duh, they do anesthesia".

Truly, I view any of these challenges as a wonderful and interesting opportunity. And that's exactly what they are. As a budding anesthesiologist to be, I welcome the ability to continue to find those niches in which I as a physician practicing medicine will be able to add more value to the chain, and to find creative ways to be recognized (and rewarded accordingly) for that value. And in no way do I plan on being adversarial with any other member of the healthcare team. This is the future.

 

[TheSleepMaster]

Geez.

Such insight in this post.

Dontcha see why I dont wanna be a member of the foreskin society?

Gotta give ya my two cents on the CRNA PhD (meaning they wanna be called doctor) stuff.

Look, I'm a Florida dude. I drive a truck. I've got a dip of Copenhagen in as we speak.

Kinda a down to earth dude.

And the CRNA DOCTOR s hit is a buncha crap. Smoke and mirrors.

Not indoctrined to advance their education.

Indoctrined for power issues.

And it will clandestinely confuse the unsuspecting surgical patients.

The AANA has gone too far with this.

Wanna be a doctor? Practice medicine?

Go to med school.

There are no short cuts.

While I agree that CRNA's dont need to be called doctor in the clinical arena not sure what we could call the advanced degree awarded. In proposals that I have seen the AANA has specifically addressed this issue with the American Association of Nursing Colleges(AACN). They are requesting that some statement address this issue and understand that to be honest with you the Doctor title may cause CRNA's that really dont give a damn problems at work. I believe they are asking that it only be used in the education arena.

The advanced degree is needed in my opinion no matter what purposes it serves educational or political. With all the BS drama constantly going down you have to ensure that education is the highest it can be. IF anyone is pushing us to do this it is you guys.

 

[jetproppilot]

Nice post OP. I will admit that I have limited experience. I'm starting MS1 in August.

I think many of the more abrasive post were a result of inflammatory remarks made by certain individuals. And sometimes the responses to such remarks can be a bit reactionary. So, perhaps none of us are really at odds to the extent that some post might suggest.

As someone that is interested in the field of anesthesiology and that has 10 years in the business world (outside of medicine), I've experience and truly believe in the principles of constantly reevaluating one's position in the "value chain". I submit that this applies to anesthesiology (and any field for that matter). And, although there will be many opportunities for all providers of anesthesia in the coming years, we must ALL be proactive in finding ways in which we may further increase the value that we provide our customers (surgeons, admin, patients etc.). It's just good "business".

I don't think the relationship between CRNA's (or AA's) and MD/DO's need be adversarial at all. There IS an overlap in services that we provide. But, that does not mean that our services are the same, just that they overlap in certain areas. That's fine, and our field is not alone (in medicine or otherwise) in that respect. But, whenever that is the case, both parties must be proactive in emphasizing their unique, individual, strengths. And it's always been bad business to thrash the other party, especially when that other party is an integral member of one's team. However, promoting the value that one brings to the table, and that set's them apart, is in no way trashing anyone else.

The approach for any smart professional (or professional organization) is to be proactive in finding ways in which our customers recognize the unique value that we provide. In times of change (i.e. all the time), any profession should strive to emphasis any unique services provided to their customers. And it's important to educate our customers on what the hell it really is that we do add to the value chain. I've mentioned before that it can be a big mistake to assume that everyone automatically knows. And it's not as simple as "well, duh, they do anesthesia".

Truly, I view any of these challenges as a wonderful and interesting opportunity. And that's exactly what they are. As a budding anesthesiologist to be, I welcome the ability to continue to find those niches in which I as a physician practicing medicine will be able to add more value to the chain, and to find creative ways to be recognized (and rewarded accordingly) for that value. And in no way do I plan on being adversarial with any other member of the healthcare team. This is the future.

Geez.

Another phenomenal post.

Just another reason to minimize The Foreskin Forum.

 

[cfdavid]

thank you for your original post. good luck in your training. however.....

sometime long, long ago society decided that you needed to go to medical school then residency before being able to practice medicine independently. i have dealt with nursing politics for years as a PA in the state of MD before going to medschool and this is were the issue lies. the everyday MDA doesnt have a problem with the everyday CRNA. the reason MDs are upset during posts when discussing CRNA autonomy is not that CRNAs are threatening to take jobs away from us, it is because the CRNAs hierarchy are attempting to redefine the training that should take to practice medicine independently. they arent attacking anesthesiologists they are attacking the medical field in general. they are lobbying states with the greatest practitioner need and getting governors to allow nurse's to practice medicine independently. regardless of the field of medicine this is a breach of what most citizens consider to be the standard of care that they have come to expect.

the masters degree that is awarded for CRNAs and NPs is a professional masters created by the nursing world. it holds no value in the graduate training world where graduate schools oversee training and award masters of science in such and such field. now there are PhDs in nursing-again a degree totally made up by the nursing world (hello Dr. Nurse how are you today). now nurses want to redefine what practicing medicine means too. dont you see a pattern. Call it something else but dont call it nursing. now all the great bedside nurses have their sites on advanced nursing degrees leaving a huge shortage in quantity and quality which in my mind is a clear sign of irresponsibility and conflict of interest to the patient.
this is not a small issue, this is huge. philosophies are being laid out, defined and challenged. i dont think nurses will stop pushing the envelope until someone stops them. the hierarchy are power hungry and aggressive.
PAs have from the beginning defined their existence humbly as being dependent practitioners, nurses arent respecting their dependent role, they are becoming independent and it is happening in enough states that people are taking notice.

In summary, there are great CRNAs and MDAs alike but ones training program has to be extensive enough not so the best can practice independently, it is so the worst (lowest common denominator) can practice independently. so either nurses should have to go to medschool and residency, or doctors should be able to go to nursing school and advance training programs to practice independently. but there shouldnt be two standards. doctors need to do a better job in educating the public as to what is happening in certain states and that is it coming to a local hospital near you.

Props to all the hardworking healthcare providers in this country. keep up the good work.

Very good post. We can handle these issues if we stay strong as an organization. That way we can address such matters in congress (and have the money to advocate our position, which you elucidated) as a unified, organized, lobby.

Simply educating our customers (in this case congress. lol) of the unique value offered by an MD/DO physician is what we'll do. We must always be proactive at ALL LEVELS in this "value chain". Let's do it.

 

[SilverStreak]

Interesting replies to my original post, and exactly what I had hoped. I think part of the problem with the two professions is fundamentally when you define anesthesia- is it medicine or can it be nursing? I AM NOT looking for an answer to this loaded question here, just pointing out the root of the independence problem.

Historically, the AANA would have me say no, that CRNAs are not trying to practice medicine independently because anesthesia was originally performed by nurses. Before anyone flames me I am well aware of the significant morbidity and mortality rates back then with nurses administering the gas, but it was the ice ages for crying out loud. Let's be fair about that argument and realize we have made leap and bounds with decreases in morbidity and mortality in every aspect of patient care because of safer techniques, technologies, and drugs.

I know the ASA has research about how much safer anesthesia is today because doctors are involved, but anesthesia is safer today for reasons independent of your knowledge and contribution to the field (not that I'm in any minimizing your training and expertise). To be honest, I'm straddling the fence with this argument of should CRNAs be allowed to practice without physcian oversight simply because my god there are some doctors I wouldn't want treating my dead cat they're so scary in practice. I'm leaning towards the fact that we should not practice independently simply because why am I coming here? To learn from all of YOU. Your training is different and you approach problems and treatments differently that CRNAs are trained to do. I think in a perfect world, MDs and CRNAs should complment one another in the OR, not have the constant pissing match on who is better.

As far as the doctorate level for advance practice nurses, funny we were discussing it at work last night. I was very disappointed in several of my co workers for moaning about eventually having to go back and get their phd to continue as a CRNA. My oppinion, I think it is way past time nursing upped the ante and made educating our ranks the highest priority. We will never have the respect in our own eyes or other professions until we step up and pull our weight in the world and offer solid research and meaningfull contributions. Now my reasoning for wanting us to require advanced education is not propoganda for us to side step the training to be a doc and practice medicine through the back door route.

I brought up the very aspect of what will they call us? We can't all be doctors, the poor patients won't know who's who, and it is just asking for misrepresentation of titles by some nurses who have god complexes and even said "I will be called DR when I get my phd" but are too lazy to go through med school- we have a lot of those in my unit.

Bottom line is, at the end of the day I don't what the future of anesthesia holds, nor do any of you. We can speculate, but there are way too many variables involved to know for certain. All I know is I love my job, I love nursing, and I'm happy with where I am and where I'm going. I don't need the gratification of being called DR to be secure with who and what I am, I think if more nurses had that attitude, we'd be a much happier lot all the way around.

Sorry so long, I guess none of you would be surprised to know that I'm a big mouth in person as well.

 

[SilverStreak]

Geez.

Another phenomenal post.

Just another reason to minimize The Foreskin Forum.

Well I ain't got my feelings hurt I'm not in the foreskin forum, I couldn't join anyway, I wasn't born with any.

 

[SilverStreak]

now there are PhDs in nursing-again a degree totally made up by the nursing world (hello Dr. Nurse how are you today). now nurses want to redefine what practicing medicine means too. dont you see a pattern. Call it something else but dont call it nursing. now all the great bedside nurses have their sites on advanced nursing degrees leaving a huge shortage in quantity and quality which in my mind is a clear sign of irresponsibility and conflict of interest to the patient.

Until you're walked in our shoes, you don't know the story. I understand and agree with you on most of your points, however, the push for bedside RNs wanting to be advance practice nurses came about for many reasons. Yes we have shortages in bedside nurses, but me wanting to continue my education does not mean I am irresponsible professionally and conflicting with patient interests. I will still take excellent care of my patients, just in a different setting. Bedside nurses have allowed themselves to be put in a terrible position where they are underpaid, not respected, and have very little rights in their job market. We and we alone as a profession are at fault for this, but getting nurses to form a cohesive group and make solid changes to advance ourselves is a long way off. It's easier just to get your FNP and not have to put up with the bull s hit at the bedside. Do you want to know why I'm doing anesthesia? It intrigues me, I love the intensity, the challenge, the learning that comes with a sick patient with multiple comorbidities and the reward at the end of the day when you see quick results, the patient is doing good, and you know you've done a good job. That's what I can't wait for in anesthesia school to push myself and advance. I could go to med school if I wanted, but I have no desire to practice medicine. An ACT is fine with me, I welcome any and everyone's help as I continue on my journey in my career.

 

[rn29306]

Well I ain't got my feelings hurt I'm not in the foreskin forum, I couldn't join anyway, I wasn't born with any.

You mean there's more than one?

 

[jetproppilot]

Interesting replies to my original post, and exactly what I had hoped. I think part of the problem with the two professions is fundamentally when you define anesthesia- is it medicine or can it be nursing? I AM NOT looking for an answer to this loaded question here, just pointing out the root of the independence problem.

Historically, the AANA would have me say no, that CRNAs are not trying to practice medicine independently because anesthesia was originally performed by nurses. Before anyone flames me I am well aware of the significant morbidity and mortality rates back then with nurses administering the gas, but it was the ice ages for crying out loud. Let's be fair about that argument and realize we have made leap and bounds with decreases in morbidity and mortality in every aspect of patient care because of safer techniques, technologies, and drugs.

I know the ASA has research about how much safer anesthesia is today because doctors are involved, but anesthesia is safer today for reasons independent of your knowledge and contribution to the field (not that I'm in any minimizing your training and expertise). To be honest, I'm straddling the fence with this argument of should CRNAs be allowed to practice without physcian oversight simply because my god there are some doctors I wouldn't want treating my dead cat they're so scary in practice. I'm leaning towards the fact that we should not practice independently simply because why am I coming here? To learn from all of YOU. Your training is different and you approach problems and treatments differently that CRNAs are trained to do. I think in a perfect world, MDs and CRNAs should complment one another in the OR, not have the constant pissing match on who is better.

As far as the doctorate level for advance practice nurses, funny we were discussing it at work last night. I was very disappointed in several of my co workers for moaning about eventually having to go back and get their phd to continue as a CRNA. My oppinion, I think it is way past time nursing upped the ante and made educating our ranks the highest priority. We will never have the respect in our own eyes or other professions until we step up and pull our weight in the world and offer solid research and meaningfull contributions. Now my reasoning for wanting us to require advanced education is not propoganda for us to side step the training to be a doc and practice medicine through the back door route.

I brought up the very aspect of what will they call us? We can't all be doctors, the poor patients won't know who's who, and it is just asking for misrepresentation of titles by some nurses who have god complexes and even said "I will be called DR when I get my phd" but are too lazy to go through med school- we have a lot of those in my unit.

Bottom line is, at the end of the day I don't what the future of anesthesia holds, nor do any of you. We can speculate, but there are way too many variables involved to know for certain. All I know is I love my job, I love nursing, and I'm happy with where I am and where I'm going. I don't need the gratification of being called DR to be secure with who and what I am, I think if more nurses had that attitude, we'd be a much happier lot all the way around.

Sorry so long, I guess none of you would be surprised to know that I'm a big mouth in person as well.

Too lazy to go through med school?

No, sorry, dude. Never mentioned laziness. As a matter of fact, all the CRNAs I've hired humble me with their work ethic.

Lemme mention a few.

Becky I. CRNA. Geez. Awesome practioner. Last nite week of mine Becky and I were up ALL night. Becky and I did a ruptured AAA....THIRTY TWO units prbcs, among other blood products....

she'll be there if I ever have to have a GA....

David K., CRNA.....

uhhhh..... my boss and I brought into this world another prodigy last month....

David is skilled in regional.

And he put the spinal in my wife for the C-section.

Flame all you want.

He does a better epidural/spinal than you.

Denise K., CRNA.

Again, awesome practioner.

She can put me to sleep any day of the week.

Same story with Debby S. CRNA.

Denise G, CRNA.

Brian M. CRNA.

Cindy P. CRNA.

John A. CRNA.

Georgia K. CRNA


Are you getting it?

The above practioners are skilled at their job. We're a team practice. We all work to get the job done.

Threatened?

No need.

 

[SilverStreak]

Too lazy to go through med school?

No, sorry, dude. Never mentioned laziness. As a matter of fact, all the CRNAs I've hired humble me with their work ethic.

Lemme mention a few.

Becky I. CRNA. Geez. Awesome practioner. Last nite week of mine Becky and I were up ALL night. Becky and I did a ruptured AAA....THIRTY TWO units prbcs, among other blood products....

she'll be there if I ever have to have a GA....

David K., CRNA.....

uhhhh..... my boss and I brought into this world another prodigy last month....

David is skilled in regional.

And he put the spinal in my wife for the C-section.

Flame all you want.

He does a better epidural/spinal than you.

Denise K., CRNA.

Again, awesome practioner.

She can put me to sleep any day of the week.

Same story with Debby S. CRNA.

Denise G, CRNA.

Brian M. CRNA.

Cindy P. CRNA.

John A. CRNA.

Georgia K. CRNA


Are you getting it?

The above practioners are skilled at their job. We're a team practice. We all work to get the job done.

Threatened?

No need.

Jet, Jet, Jet

I'm speaking to the doctorate degrees for CRNAs and people who want to get into anesthesia school. The only benefit they see to nursing requiring a phd for CRNAs is that they would get to be called "DR". Those types of people are in my oppinion lazy and see nursing anesthesia school as an easier way to make good money, have the prestiege, without having to go to med school. The people I am talking about are not even in anesthesia school yet.

And, I have heard the argument over and over if you want to be a doctor, go to medical school. Some have commented that CRNAs don't go to medical school because CRNA route is easier. I'm just saying I'm happy being a nurse, don't have any interest in being a doctor, my choice to be a nurse instead of a doctor doesn't have anything to do with me being lazy or easy as I have heard some argue of the CRNA path.

I know CRNAs have great work ethics and are hard workers, and thank you for giving them props. I never meant to imply you thought CRNAs were lazy.

 

[jetproppilot]

I'm speaking to the doctorate degrees for CRNAs and people who want to get into anesthesia school. The only benefit they see to nursing requiring a phd for CRNAs is that they would get to be called "DR".

I'm speaking from the MD that I am. My profession. Not my identity.

And the above is a f ****** joke that makes me wanna hurl.

 

[TheSleepMaster]

Jet, Jet, Jet

I'm speaking to the doctorate degrees for CRNAs and people who want to get into anesthesia school. The only benefit they see to nursing requiring a phd for CRNAs is that they would get to be called "DR". Those types of people are in my oppinion lazy and see nursing anesthesia school as an easier way to make good money, have the prestiege, without having to go to med school. The people I am talking about are not even in anesthesia school yet.

And, I have heard the argument over and over if you want to be a doctor, go to medical school. Some have commented that CRNAs don't go to medical school because CRNA route is easier. I'm just saying I'm happy being a nurse, don't have any interest in being a doctor, my choice to be a nurse instead of a doctor doesn't have anything to do with me being lazy or easy as I have heard some argue of the CRNA path.

I know CRNAs have great work ethics and are hard workers, and thank you for giving them props. I never meant to imply you thought CRNAs were lazy.

The awarded degree is not a phd(playa hatin degree). I could really give a rats arse about a title but if having clincal doctorate on my resume helps me save my job or profession from a less educated, less documented provider in 30 years then it will be worth it. Many many many professions award doctorate degrees many which also work in healthcare. Pt's misconceive just about everything and if you are not a MD/DO then it is your ethical and professional duty to make that crystal clear.

 

[jetproppilot]

The awarded degree is not a phd(playa hatin degree). I could really give a rats arse about a title but if having clincal doctorate on my resume helps me save my job or profession from a less educated, less documented provider in 30 years then it will be worth it. Many many many professions award doctorate degrees many which also work in healthcare. Pt's misconceive just about everything and if you are not a MD/DO then it is your ethical and professional duty to make that crystal clear.

Play the semantics all you want.

Lets get real.

Its all smoke and mirrors on the AANA political front.

And if you don't admit that, you're not being honest with yourself.

I mean, how much higher can an RN go than on the anesthesia realm?

How many other RNs are making 150-200K a year?

Don't bulls hit a bulls hitter, dude.

Power move only.

Having a PhD in nurse anesthesia will not increase your bottom line.

Take your rhetoric to a more gullable website, or a website that'll feed into your propeganda.

 

[TheSleepMaster]

Play the semantics all you want.

Lets get real.

Its all smoke and mirrors on the AANA political front.

And if you don't admit that, you're not being honest with yourself.

I mean, how much higher can an RN go than on the anesthesia realm?

How many other RNs are making 150-200K a year?

Don't bulls hit a bulls hitter, dude.

Power move only.

Having a PhD in nurse anesthesia will not increase your bottom line.

Take your rhetoric to a more gullable website, or a website that'll feed into your propeganda.

No you are right its not about increasing the bottom line its about maintaining the bottom line. Total power move but needed maybe, not at present but for future generations as this saga continues b/t ASA and AANA. We didnt come up with the idea but are just gonna ride the wave where it takes us. the AANA is requesting tons of modifications mainly to prevent ambiguous language and to define sound scopes. If you could only see the AANA's recommendations to the draft you would realize that we are not so millitant when it comes to the DNP issue.

With the AMA and ASA currently researching midlevel education, most likely for future legislative purposes, we pretty much have no other choice but to set things up for the future now. You may be cordial to CRNA's and like the ACT model but there are millitant Anesthesiologists just as there are millitant CRNA's.

 

[jetproppilot]

No you are right its not about increasing the bottom line its about maintaining the bottom line. Total power move but needed maybe, not at present but for future generations as this saga continues b/t ASA and AANA. We didnt come up with the idea but are just gonna ride the wave where it takes us. the AANA is requesting tons of modifications mainly to prevent ambiguous language and to define sound scopes. If you could only see the AANA's recommendations to the draft you would realize that we are not so millitant when it comes to the DNP issue.

With the AMA and ASA currently researching midlevel education, most likely for future legislative purposes, we pretty much have no other choice but to set things up for the future now. You may be cordial to CRNA's and like the ACT model but there are millitant Anesthesiologists just as there are millitant CRNA's.

Militant anesthesiologists???

Sorry, I dont understand that....

doctors that are defending their rite to practice medicine against a nursing organization????

DNP.....

what the f uc k is that.....

seems like a dichotomy to me.....

a DOCTOR of NURSING?????

I'm a redneck, dude.

Explain Doctor of Nursing to me in Larry The Cable Guy words.

And please interject necessary propeganda to justify why a nurse making 150K a year would wanna challenge the "doctor" concept on grounds other than political/power.

 

[SleepIsGood]

Geez.

Another phenomenal post.

Just another reason to minimize The Foreskin Forum.

The reason for the private forum is so that we dont have to constantly be interrupted every 3 posts by CRNAs who want to advance there agenda. Also, as you can see there are plenty of CRNA lurkers who just want to 'gather' more info to again---advance their own agenda.

I dont know Jet, but personally if I can avoid conflict with these guys, I would rather do that--ie reason for private forum. I dont enjoy 'swatting or having to feel that we need to FBI profile q 3 posts". However, if I have to defend our (anesthesiologists') turf I will.

 

[TheSleepMaster]

Militant anesthesiologists???

Sorry, I dont understand that....

doctors that are defending their rite to practice medicine against a nursing organization????

DNP.....

what the f uc k is that.....

seems like a dichotomy to me.....

a DOCTOR of NURSING?????

I'm a redneck, dude.

Explain Doctor of Nursing to me in Larry The Cable Guy words.

And please interject necessary propeganda to justify why a nurse making 150K a year would wanna challenge the "doctor" concept on grounds other than political/power.

Did you read my post? I didnt question it as a political move. yes you are defending your right to practice medicine as we defend our right to practice nurse anesthesia. We are to different professions. Actually now d/t these few millitant MD's we must defend on 2 fronts.

Jet what is it you are defending? Is there a nurse threatening your employment? Please enlighten me. This is all blown over I think. Like other CRNA's have posted CRNA's are not taking jobs from MD's any where in this country. Now what are you defending. Like I said the AMA ASA are doing research to im sure present to congessional leaders that we are not educated well enough blah blah blah and they should only practice under an anesthesiologist. This is a proactive move. With this threat why should we not award the highest degree possible just like pharmacists, PT's, Clinical Psyc ect. IT really only makes sense from my perspective, though I am sure not yours. Its not a move to say Im a doctor at all.

 

[TheSleepMaster]

The reason for the private forum is so that we dont have to constantly be interrupted every 3 posts by CRNAs who want to advance there agenda. Also, as you can see there are plenty of CRNA lurkers who just want to 'gather' more info to again---advance their own agenda.

I dont know Jet, but personally if I can avoid conflict with these guys, I would rather do that--ie reason for private forum. I dont enjoy 'swatting or having to feel that we need to FBI profile q 3 posts". However, if I have to defend our (anesthesiologists') turf I will.

When the posts are geared toward what I do why shouldnt I comment. My comments are not "millitant" are trash talking just stating my opinion as is everyone else is.

 

[jetproppilot]

Did you read my post? I didnt question it as a political move. yes you are defending your right to practice medicine as we defend our right to practice nurse anesthesia. We are to different professions. Actually now d/t these few millitant MD's we must defend on 2 fronts.

Jet what is it you are defending? Is there a nurse threatening your employment? Please enlighten me. This is all blown over I think. Like other CRNA's have posted CRNA's are not taking jobs from MD's any where in this country. Now what are you defending. Like I said the AMA ASA are doing research to im sure present to congessional leaders that we are not educated well enough blah blah blah and they should only practice under an anesthesiologist. This is a proactive move. With this threat why should we not award the highest degree possible just like pharmacists, PT's, Clinical Psyc ect. IT really only makes sense from my perspective, though I am sure not yours. Its not a move to say Im a doctor at all.

Look, Nitecap,

you are incessantly hiding behind the AANA militant front.

You are an SRNA, about to be matriculated into the anesthesia milleau.

Anesthesiologists are the czars of anesthesia.

You can reply on this internet website whatever you wish, but I speak the truth.

And there is no impending threat of CRNAs threatening our jobs or med school applicants/med students/residents future jobs.

A nurse anesthetist who is hell-bent on the idea of having "doctor" in front of their name is totally contributed to the "perceived" battle between MDs and CRNAs, which I'll interject for the twenty-thousandth time is an academic phenomenon.

Total political move. The AANA wanting to blur the clinical realm even more.

Read the sentence above. Then read it again. You cant blur the truth.

Why the banter?

You are not a doctor, dude. Even if you get your "DNP" youre still not a doctor, from a patient's standpoint.

Its not too late to take the Sept MCAT.

 

[cfdavid]

Look, Nitecap,

Jet, would you PLEASE start addressing him by his earned title!? It's NURSE Nitecap, thank you very much.

 

[TheSleepMaster]

Look, Nitecap,

you are incessantly hiding behind the AANA militant front.

You are an SRNA, about to be matriculated into the anesthesia milleau.

Anesthesiologists are the czars of anesthesia.

You can reply on this internet website whatever you wish, but I speak the truth.

And there is no impending threat of CRNAs threatening our jobs or med school applicants/med students/residents future jobs.

A nurse anesthetist who is hell-bent on the idea of having "doctor" in front of their name is totally contributed to the "perceived" battle between MDs and CRNAs, which I'll interject for the twenty-thousandth time is an academic phenomenon.

Total political move. The AANA wanting to blur the clinical realm even more.

Read the sentence above. Then read it again. You cant blur the truth.

Why the banter?

You are not a doctor, dude. Even if you get your "DNP" youre still not a doctor, from a patient's stan

Retracted, im not a hater i just crush alot. Bottom line is we are not here to steal anything from you, or be what you are. We are straight with our salaries and lifestyles as they are. The DNP however you wanna clown it will help to protect us in the future from you prof org.

Lets just say its a aggressive response to the aggressive and ever so out to screw us ASA. What can we expect this has been going on for over 50yrs Jet. If a post here is relevant about my career than I have the right to respond. Sorry Jet you are the top dog here but if you cant take someone else throwing in a comment then maybe the "foreskin" club is right for ya. Heard they like to put foreskin in the Gumbo over in New Orleans. No offense.

 

[dogbone65]

My understanding is that "they" are considering a DNP because by the time it is all said and done the time and effort spent is comparable to earning a doctorate in basketweaving or whatever. Fukkit.........I've had enough..........I donated my foreskin 41 years ago and want to keep what little I have. I too am leaving now....gonna get a dip of cope and do my fukkin job. out

 

[SilverStreak]

Let's please not let this thread disintegrate into another fight about CRNAs. That was not my original intention with my first post. Suffice it to say that although I hope continued cooperation and peace between the two professions will get better, there are some things we will never get along about or agree on. We're dogs and cats for comparison, we walk and talk differently, and we'll see healthcare as a whole differently simply because of our training.

I want some of you to realize though, that while I support my profession 100%, my personal feelings on important political issues relevant to nursing may not always coincide with what our professional organizations like the AANA support. It's the same with me being an American. I love my country, but sometimes I think George W. does the most idiotic things imaginable.

For those CRNAs/SRNAs who post and play devil's advocate, don't think you're going to be well recepted on a physicians site by antagonizing them. You wouldn't react any differently than they do if they posted on a nursing website the same types of things some of you post on here.

 

[stephend7799]

Ban nitecap already..


The "doctor in nursing" Means nothing if you didnt go to medical school.. Medicine is medicine and nursing is nursing... Do you see any doctors who wanna interfere with nursing duties.. Thats like a police man wanting to do what firefighters do.. GO TO FIREFIGHTER SCHOOL.


GO TO MEDICAL SCHOOL IF YOU WANNA BE A DOCTOR.. YOU WONT GET AN ARGUMENT FROM ME.. and plenty of nurses have done that.. They have realized that they wanna be doctors.. So they went to medical school..

 

[TheSleepMaster]

Let's please not let this thread disintegrate into another fight about CRNAs. That was not my original intention with my first post. Suffice it to say that although I hope continued cooperation and peace between the two professions will get better, there are some things we will never get along about or agree on. We're dogs and cats for comparison, we walk and talk differently, and we'll see healthcare as a whole differently simply because of our training.

I want some of you to realize though, that while I support my profession 100%, my personal feelings on important political issues relevant to nursing may not always coincide with what our professional organizations like the AANA support. It's the same with me being an American. I love my country, but sometimes I think George W. does the most idiotic things imaginable.

For those CRNAs/SRNAs who post and play devil's advocate, don't think you're going to be well recepted on a physicians site by antagonizing them. You wouldn't react any differently than they do if they posted on a nursing website the same types of things some of you post on here.

Silver this thread is titled MD/CRNA debacle so I believe posts here relating to the issue are relavant. maybe that is what we should do to ensure eveyone is happy. Have a thread like this and let those who want to speak their mind do so. Others that want no part of it dont even have to open the thread. If anyone brings CRNA issues into other threads then the MODS should intervene. Sounds rational to me.

 

[SilverStreak]

Silver this thread is titled MD/CRNA debacle so I believe posts here relating to the issue are relavant. maybe that is what we should do to ensure eveyone is happy. Have a thread like this and let those who want to speak their mind do so. Others that want no part of it dont even have to open the thread. If anyone brings CRNA issues into other threads then the MODS should intervene. Sounds rational to me.

I agree we should be able to speak freely and professionally on this issue. But you know there is a fine line between what starts out as a healthy friendly debate and what ends up in an all out war. When it comes right down to it, they are doctors, we are nurses, if there has to be a division line, they're gonna take their stance on their side. You can't expect any differently. I'm not saying your oppinions aren't welcome, just bring respect to the table and don't post just to get a rise out of them.

I'm just trying to offer a rational view on the topic and hopefully help some of them see we're not the evil CRNAs out to take their jobs. The experienced MDs know this, but remember some of those not in anesthesia yet form oppinions about us based on things they see here, and things they hear from other physicians. I want those physicians to see what I post and gain insight into a nurse's thoughts. I'm not gonna enter the anesthesia field for at least another 3 or 4 years, but when I do, I don't want the future anesthesiologists to have their guard up against me because I'm a CRNA.

 

[threepeas]

The awarded degree is not a phd(playa hatin degree). I could really give a rats arse about a title but if having clincal doctorate on my resume helps me save my job or profession from a less educated, less documented provider in 30 years then it will be worth it. Many many many professions award doctorate degrees many which also work in healthcare. Pt's misconceive just about everything and if you are not a MD/DO then it is your ethical and professional duty to make that crystal clear.

Dont call it a doctorate. Call it something else. If the nursing field wants to add educational requirements that's great, but dont insult people who do real PhD work, or who slaved in medschool and residency for 8+ years to become a MD. you may not care about a title, but we do because that title represents something special....independence. it is a crazy mixed up world we live in when a bedside nurse can become a doctor and practice medicine independently without going to medschool while getting all their training through nursing channels.

who designs your requirements, who designs the training, who designs the exams. nurses do. this was all fine when CRNAs had to work with a physician, but now nurses are re-writing the rules and standards, and the general public is truly not aware. hopefully they will be soon.

although many other professions may have professional doctorates there is a huge difference in what the nursing community is doing. psychologists have always been able to practice as psychologist independently, now some want prescription rights, and to get that they up their education, maybe add a professional doctorate to their accolades. In addition, a profession needs doctorates when novel research needs to be done. what kind of novel research needs to be done in bedside nursing? come on, man. there is no huge research void in nursing that suddenly exists now to justify nursing PhDs.

nurses are using their masters/doctorate to redefine what they do, and it resembles exactly what another field is doing (ie MDs). Advanced nurses are trying to gain the same amount of independence without going to medschool. i have no problem with a nurse wanting to better themselves, but if an MD has to go to medschool and residency so should that nurse who wants to practice independently. no need to make up a totally new degree and field; we have one already that is tried and true and well excepted by the public. physicians set the standard of training and care through out the world.

that is why PAs and AAs is such a good idea. they are founded on dependence. they know their role and limitations. if a PA/AA wants to practice independently they go to medschool like i did. if i had something to do with it i would of never allowed CRNAs and NPs to exist. they are bastardizing what it means to be a nurse, which is a crime because bedside nurses are great and sorely needed. i would of said if you dont want to do nursing anymore fine...go practice medicine as a PA/AA. if you want to practice independently go to medschool. simple. And look at the clever titling of the names. physician "assistant", anesthesiology "assistant". eventhough CRNAs/NPs were originally to be solely dependent midlevel practioners they never put the word "assistant" in their name and this has publicly made it easier to advance their cause. i say this not because i truly have a problem with the CRNA role, its because in retrospect the public and medical community should of never let this snake out of the bag.

in summary...titles do matter. they should.

 

[threepeas]

While I agree that CRNA's dont need to be called doctor in the clinical arena not sure what we could call the advanced degree awarded. In proposals that I have seen the AANA has specifically addressed this issue with the American Association of Nursing Colleges(AACN). They are requesting that some statement address this issue and understand that to be honest with you the Doctor title may cause CRNA's that really dont give a damn problems at work. I believe they are asking that it only be used in the education arena.

The advanced degree is needed in my opinion no matter what purposes it serves educational or political. With all the BS drama constantly going down you have to ensure that education is the highest it can be. IF anyone is pushing us to do this it is you guys.

we arent pushing this at all. we want you to stay just the way you are. if CRNAs are so great at what they do why do you need more education and new titles. the reason is your hierarchy see the golden carrot for your profession eventhough it is not based on anything nursing was founded on. that is power and autonomy.

 

[threepeas]

No you are right its not about increasing the bottom line its about maintaining the bottom line. Total power move but needed maybe, not at present but for future generations as this saga continues b/t ASA and AANA. We didnt come up with the idea but are just gonna ride the wave where it takes us. the AANA is requesting tons of modifications mainly to prevent ambiguous language and to define sound scopes. If you could only see the AANA's recommendations to the draft you would realize that we are not so millitant when it comes to the DNP issue.

With the AMA and ASA currently researching midlevel education, most likely for future legislative purposes, we pretty much have no other choice but to set things up for the future now. You may be cordial to CRNA's and like the ACT model but there are millitant Anesthesiologists just as there are millitant CRNA's.

you are missing a huge, huge, huge point here. the ASA doesnt care about CRNAs when they are dependent practioners. CRNAs get to practice medicine in a dependent fashion, make some serious coin. Docs get much needed help and they make some more coin. everybody wins. the ASA is pissed because you are crossing the line into "independence land" without a medical license which is supposed to be against the law and dangerous.

 

[SilverStreak]

Dont call it a doctorate. Call it something else. If the nursing field wants to add educational requirements that's great, but dont insult people who do real PhD work, or who slaved in medschool and residency for 8+ years to become a MD. you may not care about a title, but we do because that title represents something special....independence. it is a crazy mixed up world we live in when a bedside nurse can become a doctor and practice medicine independently without going to medschool while getting all their training through nursing channels.

who designs your requirements, who designs the training, who designs the exams. nurses do. this was all fine when CRNAs had to work with a physician, but now nurses are re-writing the rules and standards, and the general public is truly not aware. hopefully they will be soon.

although many other professions may have professional doctorates there is a huge difference in what the nursing community is doing. psychologists have always been able to practice as psychologist independently, now some want prescription rights, and to get that they up their education, maybe add a professional doctorate to their accolades. In addition, a profession needs doctorates when novel research needs to be done. what kind of novel research needs to be done in bedside nursing? come on, man. there is no huge research void in nursing that suddenly exists now to justify nursing PhDs.

nurses are using their masters/doctorate to redefine what they do, and it resembles exactly what another field is doing (ie MDs). Advanced nurses are trying to gain the same amount of independence without going to medschool. i have no problem with a nurse wanting to better themselves, but if an MD has to go to medschool and residency so should that nurse who wants to practice independently. no need to make up a totally new degree and field; we have one already that is tried and true and well excepted by the public. physicians set the standard of training and care through out the world.

that is why PAs and AAs is such a good idea. they are founded on dependence. they know their role and limitations. if a PA/AA wants to practice independently they go to medschool like i did. if i had something to do with it i would of never allowed CRNAs and NPs to exist. they are bastardizing what it means to be a nurse, which is a crime because bedside nurses are great and sorely needed. i would of said if you dont want to do nursing anymore fine...go practice medicine as a PA/AA. if you want to practice independently go to medschool. simple. And look at the clever titling of the names. physician "assistant", anesthesiology "assistant". eventhough CRNAs/NPs were originally to be solely dependent midlevel practioners they never put the word "assistant" in their name and this has publicly made it easier to advance their cause.

in summary...titles do matter. they should.

I agree with all you said except the bold part. Nurses have not been as involved in research as we should be. A lot of our practice historically has been we do things because we've always done them this way, it makes sense, and it probably does what we think it does. Some of what we do needs to be researched because other professions don't dictate our bedside activities through documented research. We need to step up and have evidence based practice for why we do what we do. You have research for what drugs to treat what conditions with right, so why shouldn't we have research for our nursing interventions? Believe it or not, what we do at the bedside matters in a huge way.

Also, there has been some discussion about changing the titles in the field of nursing. You may not be aware, but there are also those who want a bachelor's level to be the minimum entry degree, and there has been talk about changing our titles to something other than RN to designate our difference in education (I have my BSN). Long story short, our profession is nostalgic for lack of a better word and doesn't want to let "nurse" go, CRNAs are certified registered NURSE anethetists, FNPs are family NURSE practioners, you get the idea.

As far as not having FNPs and CRNAs, all I can say is that cat is already out of the bag. It's too late now to wish we weren't here.

 

[threepeas]

Did you read my post? I didnt question it as a political move. yes you are defending your right to practice medicine as we defend our right to practice nurse anesthesia. We are to different professions. Actually now d/t these few millitant MD's we must defend on 2 fronts.

Jet what is it you are defending? Is there a nurse threatening your employment? Please enlighten me. This is all blown over I think. Like other CRNA's have posted CRNA's are not taking jobs from MD's any where in this country. Now what are you defending. Like I said the AMA ASA are doing research to im sure present to congessional leaders that we are not educated well enough blah blah blah and they should only practice under an anesthesiologist. This is a proactive move. With this threat why should we not award the highest degree possible just like pharmacists, PT's, Clinical Psyc ect. IT really only makes sense from my perspective, though I am sure not yours. Its not a move to say Im a doctor at all.

the problem is nurse anesthesia is becoming just like practicing medicine by an MD. dont you see this? it isnt nurse anesthesia anymore. it has been redefined. get it. that's the problem. in some states nurses can "hang a shingle" and run their own practice. in louisiana they are trying to perform surgery via invasive procedures for pain management independently. dont you see the trend. dont you see it? dont you see it? dont you see it? look it's right there in front of you. if you cant see it, i can see how governors and the general public are not seeing it. that is our own fault i guess.

 

[cfdavid]

Hell, my cousin, whom already has his MS/MA (not sure which one) just got into a PhD program at U-Mich. He says it'll take him about 4-6 years to complete, and it's in Anthropology. Imagine Biochemistry.

How long will these CRNA's be in school (and is it even full-time, with study, teaching, and research responsibilities full time???) to obtain this PhD in nursing?? It seems like many want their cake and eat it too. I can imagine some 2 year program, with night classes. Come on...

 

[threepeas]

I agree with all you said except the bold part. Nurses have not been as involved in research as we should be. A lot of our practice historically has been we do things because we've always done them this way, it makes sense, and it probably does what we think it does. Some of what we do needs to be researched because other professions don't dictate our bedside activities through documented research. We need to step up and have evidence based practice for why we do what we do. You have research for what drugs to treat what conditions with right, so why shouldn't we have research for our nursing interventions? Believe it or not, what we do at the bedside matters in a huge way.

Also, there has been some discussion about changing the titles in the field of nursing. You may not be aware, but there are also those who want a bachelor's level to be the minimum entry degree, and there has been talk about changing our titles to something other than RN to designate our difference in education (I have my BSN). Long story short, our profession is nostalgic for lack of a better word and doesn't want to let "nurse" go, CRNAs are certified registered NURSE anethetists, FNPs are family NURSE practioners, you get the idea.

As far as not having FNPs and CRNAs, all I can say is that cat is already out of the bag. It's too late now to wish we weren't here.

not necessarily. i predict as you guys will push the envelope further and the truth will come out and you will be shut down. i saw this happen in my state legislature in MD when nurses were advancing there cause beyond what was originally attend for their role and at the same time trying to restrict the PA cause. they needed and used underhanded tactics and they were banded from the assembly floor. it was great. i mention this because i truly believe advanced nursing is based on a faulty premise. that premise is that a BSN is good enough that when you add two more years of focused training then you can practice medicine independently without a medical license. all the while sucking the life out of the bedside nursing ranks. PAs wont take you into school if they think you are using it as a stepping stone into medschool. they are protecting the integrity and uniqueness of their field. now people are getting their BSN just so they can get their CRNA, etc. you are abandoning your roots which are historically extremely important and special. medicine would not be what it is today without nurses and the best nurses are leaving bedside nursing and just pissing on it. now as a PA and future MD i have to deal with nurses who can barely speak english, are agency and dont care, and are inexperienced and sometimes ignornant. this is a huge disservice to the american patient and the medical community.

why does there need to be reasearch in how to change a bedpan, or inject a medicine into an IV, or write a vital sign down. these are nursing specific issues. how to perform procedures (surgery), the mechanism of a drug or how to treat disease (medicine) are physician issues. your community does not have the basic science training that PhDs and MDs have to be taken seriously. and that's no insult, that is just a fact. if you want to deal with CRNA research issues get into academia as a CRNA or get your non-professional master's of science and assist in a lab or non-professional doctorate of philosophy and run the lab and then go answer your questions. once again you will see that your basic science training is not broad or deep enough to justify basic science nursing research. if you are not answering basic science questions, and you are answering bedside nursing issues you dont need a PhD for that-give me a break.

i would hate to see nurses build a house. first you add a "masters" degree onto your base degree that has nothing to do with your base degree. then you are going to add a "doctorate" degree onto your onto your questionable "masters" degree, that again will have nothing to do with the "mission" of your base degree. this house is going to crumble. in the medical field you get a PhD to answer basic science questions. your BSN and masters degree are clinical degrees. so my point is...if you want to do research get your PhD from a graduate school. doesn't seem so appealing does it when you will have to come out from the safety of your "nursing umbrella" and play in the rain like the rest of us!!!

 

[SilverStreak]

the problem is nurse anesthesia is becoming just like practicing medicine by an MD. dont you see this? it isnt nurse anesthesia anymore. it has been redefined. get it. that's the problem. in some states nurses can "hang a shingle" and run their own practice. in louisiana they are trying to perform surgery via invasive procedures for pain management independently. dont you see the trend. dont you see it? dont you see it? dont you see it? look it's right there in front of you. if you cant see it, i can see how governors and the general public are not seeing it. that is our own fault i guess.

Hey man chill out. Read my above post. I SEE IT. I said myself I'm on the fence with issue, but I'm leaning towards CRNAs DO NOT need to practice independently. Realize I'm a young nurse, just forming oppinions on these topics that have been ongoing for years. I have an open mind, and I'm trying to see the big picture. Don't jump my a ss for AGREEING with almost 95% of what you say. I understand why you're pissed that we want to be independent. You slaved and worked your butt off to get through med school to practice medicine. You think our agenda is to do the same thing you without the legitimacy to be safe and legal doing. I get it. Realize I do not condone everything the AANA does (CRNAs/SRNAs please shoot me if you wish but it's how I feel). I AM NOT THE AANA. I do not set their policies. I am just a peon telling you what I think.

 

[SilverStreak]

why does there need to be reasearch in how to change a bedpan, or inject a medicine into an IV, or write a vital sign down. these are nursing specific issues. how to perform procedures (surgery), the mechanism of a drug or how to treat disease (medicine) are physician issues. your community does not have the basic science training that PhDs and MDs have to be taken seriously. and that's no insult, that is just a fact. if you want to deal with CRNA research issues get into academia as a CRNA or get your non-professional master's of science or non-professional doctorate of philosophy and then go answer your questions. once again you will see that you basic science training is not broad or deep enough to justify basic science nursing research. if you are not answering basic questions, and you are answering bedside nursing issues you dont need a PhD for that-give me a break.

I'm not going to take the bait and get defensive with you when your post is insulting to nursing. My job is more than changing a bedpan, giving an IV med, and writing down a vital sign, and you know it. I do have some science in my background, but I don't need organic chem and advanced pharm because you're right, in my current setting I don't order the medicine to treat- you do, but as you can see from other threads even some of you may not always treat appropriately, so your education does not necessarily equate to you having all the answers in spite of your education being more in depth than mine in certain aspects.

Some of the things nursing should research off the top of my head include: skin prevention/breakdown, best ways to treat, sleep cycles-how to promote to prevent ICU delerium, developing studies on fostering nursing collaboration with physcians and other members of the healthcare team to catch potential problems EARLY so that I don't sit on my butt all night and notice something going on, but I don't call because I know you'll chew me out-in mind here I have the eICU approach we should research it to see if nurses could have better outcomes for their patients with access to this type of technology.

Don't minimize what I do. You couldn't exist as a profession without me. How many times in your career have you been helped by a lowly nurse, or are you too egotistical to admit nurses do more than wipe butts? Sorry I'm getting ugly now but give me a break, I'm not an idiot who just writes down numbers and blindly follows whatever you tell me to do because you're the doctor, I'm the nurse. I make suggestions daily in the care of my patients, that many times our physicians haven't thought of because they are overworked and don't see the details I do, and they are appreciative and very receptive to the nursing staff. Again, I did not come here to this forum to rant with people like you. Please don't turn this discussion into a war. I don't want to fight with you, but if provoked I can give as good as I get.

 

[threepeas]

Hey man chill out. Read my above post. I SEE IT. I said myself I'm on the fence with issue, but I'm leaning towards CRNAs DO NOT need to practice independently. Realize I'm a young nurse, just forming oppinions on these topics that have been ongoing for years. I have an open mind, and I'm trying to see the big picture. Don't jump my a ss for AGREEING with almost 95% of what you say. I understand why you're pissed that we want to be independent. You slaved and worked your butt off to get through med school to practice medicine. You think our agenda is to do the same thing you without the legitimacy to be safe and legal doing. I get it. Realize I do not condone everything the AANA does (CRNAs/SRNAs please shoot me if you wish but it's how I feel). I AM NOT THE AANA. I do not set their policies. I am just a peon telling you what I think.

sorry i must of missed that point you were making. strong work. excellent job. carry on. air assault !!!

 

[threepeas]

I'm not going to take the bait and get defensive with you when your post is insulting to nursing. My job is more than changing a bedpan, giving an IV med, and writing down a vital sign, and you know it. I do have some science in my background, but I don't need organic chem and advanced pharm because you're right, in my current setting I don't order the medicine to treat- you do, but as you can see from other threads even some of you may not always treat appropriately, so your education does not necessarily equate to you having all the answers in spite of your education being more in depth than mine in certain aspects.

Some of the things nursing should research off the top of my head include: skin prevention/breakdown, best ways to treat, sleep cycles-how to promote to prevent ICU delerium, developing studies on fostering nursing collaboration with physcians and other members of the healthcare team to catch potential problems EARLY so that I don't sit on my butt all night and notice something going on, but I don't call because I know you'll chew me out-in mind here I have the eICU approach we should research it to see if nurses could have better outcomes for their patients with access to this type of technology.

Don't minimize what I do. You couldn't exist as a profession without me. How many times in your career have you been helped by a lowly nurse, or are you too egotistical to admit nurses do more than wipe butts? Sorry I'm getting ugly now but give me a break, I'm not an idiot who just writes down numbers and blindly follows whatever you tell me to do because you're the doctor, I'm the nurse. I make suggestions daily in the care of my patients, that many times our physicians haven't thought of because they are overworked and don't see the details I do, and they are appreciative and very receptive to the nursing staff. Again, I did not come here to this forum to rant with people like you. Please don't turn this discussion into a war. I don't want to fight with you, but if provoked I can give as good as I get.

my point is diffenently not to insult you. my point is that if there is going to be a PhD in "Nursing" is should deal with "bedside" nursing issues which i dont feel are complex enough to justify creating a doctorate degree to study and analyze. that's all.

trust me i have seen good nurses on many occaisions save lives either because of their astuteness and observational skills or because they had more experience than a young doc and kept that doc from doing something stupid. it is sad that all those nurses have gone on to get their advanced degrees.