MD CRNA Debacle

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threepeas said:
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.

Why is that? There is a multitude of reasons the bedside nurse does not have a high level of job satisfaction. I get mad a nursing because we don't see we've created the monster! We need to own up and take responsibility to make our profession better, but sadly I'm a solo dreamer in this regard more often than not when talking with my cohorts. I don't proclaim to know all the answers. Both of our professions have a host of ongoing problems that need to be resolved. Thank you for clarifying that you're not being derogatory to nursing. We have enough of that already.

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threepeas said:
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.

Im all for the increased education and this is why. Wouldnt care if it was a doctorate or not but this is why we must advance. Hostillity like this puts us always on the proactive defense. All I hear about here is CRN'sA suck they only have 2.5 yrs of post grad school. CRNA schools cost so much less you guys dont deserve the money you make. we have all the debt, we spend a forutne .YEt when CRNA's address these down falls that you guys point out you guys take out the whips and want us to bend over. Whats it gonna be? What would make the all mightly "CZAR" happy besides a BJ behind the drape. Call us out on education but when we address the issue call us out over it again. Make up your mind. Basically you can pretty much bet that the AANA is going to address 99% of the issues and tactics you use to lobby. They address them to get things done and to prevent or more or less take that lobbying strategy away. You guys lobby for AA's and claim the CRNA education is poor. Then we improve the education. I have met a ton of Pharm D's and not one has intro themselves as Doctor, have met Phd Nursing profs and none introed, in the clinical arena, themselves as doctor. The AANA really isnt even fond about the name but this is not our gig, not our idea, not our concept.

I will not start BS here and ruin threads but this thread was domed from the opening, and is addressed specifically toward my interest so I will put in my 50cents. Go, Go, Go Go Go shorty its ya birthday. Threepeas that last statement pretty much defines what your prof org is out to do and only increases the odds even more.
 
As for you residents I do understand in a little way your feelings. Believe me the paranoid feelings are on both sides of the table. I think this whole DNP issue has been blown out of proportion all togther by all professions.

Quick question. So if the title had no mention of doctorate in it what so ever would it be all gravy and cool. Would MD's encourage the extra education? Do you not think that a clinician administering anesthesia whether MD/CRNA or AA should obtain the highest degree possible within their individual professions.
 
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TheSleepMaster said:
Im all for the increased education and this is why. Wouldnt care if it was a doctorate or not but this is why we must advance. Hostillity like this puts us always on the proactive defense. All I hear about here is CRN'sA suck they only have 2.5 yrs of post grad school. CRNA schools cost so much less you guys dont deserve the money you make. we have all the debt, we spend a forutne .YEt when CRNA's address these down falls that you guys point out you guys take out the whips and want us to bend over. Whats it gonna be? What would make the all mightly "CZAR" happy besides a BJ behind the drape. Call us out on education but when we address the issue call us out over it again. Make up your mind. Basically you can pretty much bet that the AANA is going to address 99% of the issues and tactics you use to lobby. They address them to get things done and to prevent or more or less take that lobbying strategy away. You guys lobby for AA's and claim the CRNA education is poor. Then we improve the education. I have met a ton of Pharm D's and not one has intro themselves as Doctor, have met Phd Nursing profs and none introed, in the clinical arena, themselves as doctor. The AANA really isnt even fond about the name but this is not our gig, not our idea, not our concept.

I will not start BS here and ruin threads but this thread was domed from the opening, and is addressed specifically toward my interest so I will put in my 50cents. Go, Go, Go Go Go shorty its ya birthday. Threepeas that last statement pretty much defines what your prof org is out to do and only increases the odds even more.

no, no, no, no. i am telling you one thing, and you are turning into something else. i am saying a midlevel practioner needs to stay a midlevel practioner or go to medschool. if CRNAs didnt try and expand their scope of practice like they are doing this whole thing wouldnt be an issue. i am saying AA/PAs got it right, and you guys are in the process of getting in wrong. you dont need more education,your group does a great job as it is. and you dont need to become independent practioners either.

if AA/PAs tried to add educational requirements to their training and said "we have a masters now, see we have a degree we'll call a doctorate, let us practice medicine independently" i would be ticked off at them too. but they are not doing that, your group is. your group doesnt have the training to even respect the limitations of your own practice and this is dangerous, and irresponsible. if our country needs more anesthesia providers practicing independently, send your best CRNAs to medschool, dont make up degrees and say you've earned it.

there are no downfalls in your training, only in your hierarchy's political and professional positions regarding autonomy. there cant be two standards for independent practioners who want to practice medicine autonomously. AA/PAs understand that, your group doesn't.

so dont get all emotional about this. you started this thread not me. looking back i dont know what your original point even was. the only two issues on this forum are: 1. MDAs love CRNAs 2. MDAs hate the AANA b/c they are trying to practice medicine without a medical license and think all the nursing courses in the world added to their original training will make a difference.
 
TheSleepMaster said:
Im all for the increased education and this is why. Wouldnt care if it was a doctorate or not but this is why we must advance. Hostillity like this puts us always on the proactive defense. All I hear about here is CRN'sA suck they only have 2.5 yrs of post grad school. CRNA schools cost so much less you guys dont deserve the money you make. we have all the debt, we spend a forutne .YEt when CRNA's address these down falls that you guys point out you guys take out the whips and want us to bend over. Whats it gonna be? What would make the all mightly "CZAR" happy besides a BJ behind the drape. Call us out on education but when we address the issue call us out over it again. Make up your mind. Basically you can pretty much bet that the AANA is going to address 99% of the issues and tactics you use to lobby. They address them to get things done and to prevent or more or less take that lobbying strategy away. You guys lobby for AA's and claim the CRNA education is poor. Then we improve the education. I have met a ton of Pharm D's and not one has intro themselves as Doctor, have met Phd Nursing profs and none introed, in the clinical arena, themselves as doctor. The AANA really isnt even fond about the name but this is not our gig, not our idea, not our concept.

I will not start BS here and ruin threads but this thread was domed from the opening, and is addressed specifically toward my interest so I will put in my 50cents. Go, Go, Go Go Go shorty its ya birthday. Threepeas that last statement pretty much defines what your prof org is out to do and only increases the odds even more.

I think the point is that few of us are convinced that a doctorate in nursing is not as much focused on improving ones skills, but rather a shortcut around medical school. I don't think most of us believe that a master's level practitioner is lacking in education. Rather, we are skeptical of the actual value that a 2 year nursing PhD program would actually provide, other than a title of doctor and lots of patient confusion.

For example, PhDs, in the traditional sense, must do extensive research and publish an origional finding, as well as put in years (4-7) of studying, working on research projects, and teaching. But, what is it that this PhD in nursing entails exactly??

Also, I don't think most of us have a problem calling a PhD "doctor". We've been doing it since undergrad science class. But, to have a bunch of "doctor" nurses strolling around the wards seems a bit ridiculous and a lot confusing.

Again, if you want to be a doctor in the medical sense, then go to medical school. If not, just be happy with the highly skilled, well trained, intelligent, well paid, mid-level that you are.
 
TheSleepMaster said:
As for you residents I do understand in a little way your feelings. Believe me the paranoid feelings are on both sides of the table. I think this whole DNP issue has been blown out of proportion all togther by all professions.

Quick question. So if the title had no mention of doctorate in it what so ever would it be all gravy and cool. Would MD's encourage the extra education? Do you not think that a clinician administering anesthesia whether MD/CRNA or AA should obtain the highest degree possible within their individual professions.

i could care less what degree you have, what education you have. have fun, get all the extra education you want. why stop at a doctorate-get a super dooper nursing doctorate and maybe you could run the AMA. the issue is the standard of care. when a patient goes to a hospital they expect doctors to be in the loop of how their care is provided whether this is directly or indirectly. the AANA is trying to take the MD out of the loop. people get arrested for practicing medicine with out an MD license. CRNAs and PAs can do their thing because they are "supposed" to be practicing under some form of supervison, atleast that what the general public believes exist.

as an MD i cant be hired as a nurse, how can a nurse be hired as a doctor (independent practioner)?
 
threepeas said:
so dont get all emotional about this. you started this thread not me. looking back i dont know what your original point even was. the only two issues on this forum are: 1. MDAs love CRNAs 2. MDAs hate the AANA b/c they are trying to practice medicine without a medical license and think all the nursing courses in the world added to their original training will make a difference.

Actually I started the thread threepeas to offer hopefully a rational voice into this topic. We've digressed from that intent as usual with a thread about CRNAs, but I think this thread has been much nicer than others. At least we are all for the most part nicely stating what we have to say.
 
SilverStreak said:
Actually I started the thread threepeas to offer hopefully a rational voice into this topic. We've digressed from that intent as usual with a thread about CRNAs, but I think this thread has been much nicer than others. At least we are all for the most part nicely stating what we have to say.

what is the topic? or should i say point from your standpoint?
 
jetproppilot said:
Are you requesting cover fire, Lieutenant?

i am at rendezvous point charlie, requesting extraction. LZ is hot, I repeat LZ is hot!
 
My radar is picking up 2 bogies coming up on my flank. Go GO GO Im locked in. SleepMaster firing 1.

Threepeas can you please enlighten me on how many CRNA are independent contractors and are directly threatening MD work. No you cant b/c you have no clue. You are aurguing your point that a few soon to be residents here bucked u up about. Less than 3,000 of the over 30,000 CRNA's are contracting and some of these folks are still working in a MD group though contracting to the group.

Jet and several others here that are actually practicing not training have failed to mention a direct theat to their jobs. They denied CRNA's were trying to get their jobs or work. Not one person here can name an area where CRNA's are putting Anesthesiologists out of work. However almost everyone here can name a place outside of academia and narrow minded residencies with no private pract exp. where the 2 professions work well together, where they are all for the most part happy and making good money.

I admit the threat I feel toward AA's are similar. I know of no places that CRNA's are out of work at present s/t AA's. On the contrary there are tons of CRNA positions open in the AA states. Its not that bad and we are all not at to get you guys I promise. Yeah I realize you are thinking about the future as I also am.maybe that is why we are more paranoid and trigger happy than Jet and the other AARP members.
 
TheSleepMaster said:
My radar is picking up 2 bogies coming up on my flank. Maverick locked in.

Threepeas can you please enlighten me on how many CRNA are independent contractors and are directly threatening MD work. No you cant b/c you have no clue. You are aurguing your point that a few soon to be residents here bucked u up about. Less than 3,000 of the over 30,000 CRNA's are contracting and some of these folks are still working in a MD group though contracting to the group.

Jet and several others here that are actually practicing not training have failed to mention a direct theat to their jobs. They denied CRNA's were trying to get their jobs or work. Not one person here can name an area where CRNA's are putting Anesthesiologists out of work. However almost everyone here can name a place outside of academia and narrow minded residencies with no private pract exp. where the 2 professions work well together, where they are all for the most part happy and making good money.

I admit the threat I feel toward AA's are similar. I know of no places that CRNA's are out of work at present s/t AA's. On the contrary there are tons of CRNA positions open in the AA states. Its not that bad and we are all not at to get you guys I promise.

your tone has changed. reminds me of someone...hmmmmmm...
anyway, whether CRNAs are threatening or not threatening MDAs jobs is completely not the point, and i havent mentioned it once. If you are not threatening MDs jobs that doesnt make it right. if one CRNA practices anesthesiology w/o some form of doctor supervison that makes me mad. Nurses practicing medicine autonomously is not the standard of care the general public has come to expect through out the milleniums.
 
threepeas said:
what is the topic? or should i say point from your standpoint?

Read my first post. I think it is sad that our professional relationships between nursing and medicine have come to the point that you guys need a secret club on here. You all are a valuable resource, and I enjoy coming here to learn. Just wanted to point out to some of the up and coming anesthesiologists that we can have a good relationship.
 
SilverStreak said:
Read my first post. I think it is sad that our professional relationships between nursing and medicine have come to the point that you guys need a secret club on here. You all are a valuable resource, and I enjoy coming here to learn. Just wanted to point out to some of the up and coming anesthesiologists that we can have a good relationship.

CRNAs are a guest on this forum, but they havent always acted like it. You may be different but it only take a few to ruin something good. anyways the quality of forum will not change. MDAs and CRNAs get along everyday at work, just not so much when it comes to debating the degree and method CRNAs are trying to advance their profession.
 
god this forum is so much more fun than studying renal pathology and focal sclerosing glomerulonephritis and the electron microscopy presentation for the step 1 boards. what a great study distraction. thank you for the debate and multiple study breaks.
 
TheSleepMaster said:
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.


As much as I hate these threads... dude, you've got it backasswards. The ASA is not out to screw nurse anesthetists. I like CRNAs. We are trying to keep things the same. You guys have a pretty sweet gig, and if you ask me, you'd serve yourself better by not rocking the boat. It's the actions of your proffesional orginization that cause some of the attitudes you see from people. If you feel threatened, it's because sometimes when you push the pendulum too far one way, as a reaction it will swing too far the opposite way. Leave well enough alone. Don't bite the czar that feeds you.
 
This issue has been discussed multiple times.

Closing thread before it bursts into flames.
 
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