MDA student vs CRNA

[Med4ever]

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Hey, when doing your residency is it similar to the internship that crna goes through. In all honestly dont you think they are more skilled at what they do then us when we first start out. How is being in an anesthisa residecy differ from being a crna?

 

[UTSouthwestern]

Hey, when doing your residency is it similar to the internship that crna goes through. In all honestly dont you think they are more skilled at what they do then us when we first start out. How is being in an anesthisa residecy differ from being a crna?

There have been a ton of threads on this topic. I would suggest you do a search on this forum and I would ask the moderator to close this thread.

 

[deleted9493]

Sweet Moses, not again. Quick, close it before the CRNA's arrive...

 

[VentdependenT]

These threads will soon be non existent

 

[Zeffer]

These threads will soon be non existent

God bless you radiology month! May I never do another month of IM floors in my entire existence.

Two things we can only hope for.

 

[Tenesma]

med4ever... i think you should stay in Canada...

1) CRNAs don't do an internship
2) 10,000 hours of OR time during anesthesia residency is very different from 1,500 hours of OR time during CRNA training.
3) bite me

 

[NaeBlis]

med4ever... i think you should stay in Canada...

1) CRNAs don't do an internship
2) 10,000 hours of OR time during anesthesia residency is very different from 1,500 hours of OR time during CRNA training.
3) bite me

I like that you itemized the "bite me".

 

[deleted9493]

That's very funny. You just made my day Tenesma.

 

[Med4ever]

Whats with the hostility, it was a simple question, I wish I could get a straight answer. The crna's I have come across all seem to have equivalent knowlege to an mda, and are more part of the anesthesia process then the mda.

 

[Tenesma]

med4ever....

your question was answered in line #2 of my first response to you... but it sounds like you may disagree, so my suggestion for you is to make sure that CRNAs provide all of your and your family's anesthesia.

 

[ether_screen]

The association between OR hours and good anesthesia care has been made on several occasions, and I do agree with this assertion. So when I?m confronted with a choice about who delivers my anesthesia, and it?s between an inexperienced resident or any resident for that matter vs. CRNA with several + years of experience BOTH under MDA supervision? Not a tough choice here?CRNA any day!

 

[VentdependenT]

The association between OR hours and good anesthesia care has been made on several occasions, and I do agree with this assertion. So when I?m confronted with a choice about who delivers my anesthesia, and it?s between an inexperienced resident or any resident for that matter vs. CRNA with several + years of experience BOTH under MDA supervision? Not a tough choice here?CRNA any day!

Go for it! 😴

 

[sethco]

Go for it! 😴

Hey Vent, when are we going to close these posts?

 

[VentdependenT]

As soon as Lee gives me the key.

 

[Skip Intro]

As soon as Lee gives me the key.

... and set yourself free. 😉

-Skip

 

[Skip Intro]

Whats with the hostility, it was a simple question, I wish I could get a straight answer. The crna's I have come across all seem to have equivalent knowlege to an mda, and are more part of the anesthesia process then the mda.

"The person who knows how will always have a job. The person who knows why will always be his boss."

-Diane Ravitch, Commencement Address, Reed College, 1985

 

[Skip Intro]

CRNA's do not know how and are not trained to be a doctor. How many anesthesiologists do you know and have worked with??

I think CRNAs clearly know "how", but many (if not most) do not always know "why" (e.g., they may know how to identify MH and that they are supposed to give dantrolene, but they don't have the depth of training in physiology to completely grasp the physiology behind excitation-contraction coupling in muscle and why specifically dantrolene works in that situation, etc. - and, if dantrolene doesn't work, they start to run out of ideas about why it didn't and are left to try to make the difficult inquiries such as "did I make the right diagnosis", "why is there still myoglobinuria", etc.). That's the difference. CRNAs are technicians, not physicians. Even in the "opt out" states, they are not ultimately responsible to the same legal standard as MDAs for the patient's outcome. Likewise, they just don't have the same depth and breadth of medical training as MDAs, and - especially on the big, complex cases - it shows. Any CRNA who disagrees, on this thread or in the real world, is simply being dishonest.

What's more, I seriously wonder if a CRNA truly has the power to cancel a case in the few "opt-out" states where they aren't required to practice without MDA supervision and where they supposed form their own practice groups. Seems like they don't have a lot of leverage in really determining whether or not the patient is medically cleared, and they certainly cannot order additional tests unless the treating surgeon or OB/Gyn agrees. Seems like you are just setting yourself up for trouble. And, I guess you can always say, "no I won't do the case" and then see how far your private practice goes in getting additional business...

Truth is, many CRNAs are technically great and can start IVs, pass gas, drop tubes, put in a-lines (etc.) with the best of them. This is not the issue. It's the rest of the peri-operative responsibilities that separate MDAs from just being technicians, though.

I'm finishing a rotation at a hospital that does a lot of cardiac. CRNAs are not even allowed near that end of the OR at this hospital - literally. On the other hand, MDAs from other programs come to get their case load. It's just the way it is. You just have to have a lot different, deeper skill set to run the big cases. Anyone can do a MAC or a lap choley. Hell, I've been in the room by myself, for more than a few minutes, on a few of those. Big deal. What we're talking about is sick, sick, sick patients, not the "bread and butter" stuff that any monkey can do (in which cadre of individuals I currently place myself). This is where MDAs separate themselves and rightfully earn the distinction from a CRNA. You may not ever see, per my example above, MH very often (or, if you're lucky, you'll never see it), but if in when you do most would be happy to have an MDA there to help deal with the situation, not the least of which is the patient. Now, CRNAs may be loathe to admit that, but it's true. Don't like it? Then, go to medical school and do a 4-year post-grad anesthesiology training program. Otherwise, don't bitch.

Now, let the flames begin.



-Skip

 

[MS3NavyFS2B]

This is a tired topic on this forum. Sorry...I couldn't resist.
PowerMD weighs in on the topic (previous post):

Originally Posted by powermd
"I love responses from midlevels that attempt to compare the experience of training as a physician to the experience of training as a nurse- as if the two were in any way equal. Physicians are trained from the beginning as decisionmakers who will eventually have to assume total responsibility for patient care. Add to that the fact that competition for med school admission keeps the bar set very high in terms of brains and dedication. Nurses are trained as care-givers with the knowledge that there will always be someone to back them up. I rarely, if ever see the same cavelier attitude from fellow physicians that I see in nurses who think they can do it all. From what I've seen, the bar for admission to the nursing profession is set very, very low. My hospital suposedly has some of the best nursing care in the state. Everytime I hear about this I have to laugh because of what I see on the floors. My god are these people dumb! Perhaps 10% of the nurses I deal with daily know what they're doing and are effective providers of nursing care. The rest are an embarassment to the profession. ICU nurses tend to be brighter and more able, but they still approach patient care from a nursing perspective (care-giving vs. decisionmaking)."

My take on this:
The difference is very difficult to conceptualize from the point-of-view of mid-levels and nurses, especially since many MDs are humble about their academic accomplishments and intellectual prowess. To even think about medical school, one has to go EXTREMELY well in undergraduate college (physics, calc, bio, orgo, gChem etc). The MCAT is the next hurdle...see the pre-med forums on this topic, as it speaks for itself. Yet, this oftentimes still isn't enough for admission to medical school--the 3.95, the 37 on the MCAT, the published study--I personally know someone with these stats that didn't get in from my lab in undergrad (which is usual but not unheard of). Medical school is graduate school of the biomedical sciences basic to medicine for the first two (grueling) years, followed by high-level clinical training in the third and fourth year. Let's not forget that Step 1 and 2 (CK, CS) are required to be taken (and passed) before graduation. After this, the newly minted MDs, prepared to enter ANY specialities residency's training program, need to embark in post-graduate residency training, working with other physicians with expert knowledge in the field (from a decision-maker's perspective, a physician's perspective). To compare a CA resident's training to CNRA training is laughable when one considers what is entails to become a physician (versus CNRA...RNs do NOT have to graduate even undergrad to take the RN exam, and many CNRA programs do not require even a bachelor's degree for admission). It is no wonder that Florida had better outcomes when an anesthesiologist was directly involved with anesthesia. So, let's give physicians the credit that is their due for limiting their college fun, giving up the twenties, and living on loans in the lowest tax bracket until they can actually make some cash...in their 30s-40s.

A glimpse in this enigmatic topic is provided by Mike327:

Originally Posted by Mike327
"I'm unique, I think. At least I am here. I'm an ICU nurse with six years on the job. I'm also a third year med student. I see it from both sides now. More than once I've worked in the day as a med student and the night as a nurse in "the unit". A few observations, please read them all before you get all uptight, there's something here for everybody:

#1: NURSES HAD TO FIGHT LONG AND HARD FOR RESPECT

Don't forget where nursing as a 'career' came from. Young doctors would do well to ask that 30+ year nurse what the job was like in the 60's. Nursing was considered by docs to be a small step up from maid work (nursemaid, look it up) Nurses were expected to stand when the Docs entered the room. If the nurse was using the chart, the doc grabbed it. There was a giant class difference between the well-to-do doctor and the poor nurse that had to work because she couldn't get married. As feminism changed American culture, nursing changed with it.

Nurses had to fight like mad to be considered an important part of medicine. Today nurses tend to be better paid, more men (like me) are nurses, and nurses have much more of a voice. But, respect is a very sensitive issue for nurses. And the 'bad' years out number the 'good' years by a fair margin.


#2: NURSES ARE NOT DOCTORS
Nope, not even close. I'm so so sorry fellow nurses, for what I'm about to say, but nursing school was REALLY REALLY EASY. It is nothing compared to medical school. I went into 3rd year thinking it would be a snap, I've done critical care medicine for six years right? WRONG!!!!! The complexity is beyond compare. All that experience with 'nursing diagnosis' doesn't do jack-S**T when you need to find an antibiotic that works and won't kill their kidneys. Yes, I've watched 100's of central line placements, I could probably do it with minimal supervision. But I was wrong to think that that was all there is to this job. Sure, 'physician extenders' can be trained, in a narrow scope, to do pieces of the physicians job. But ONLY a doctor has the training to put it all together. I never understood, as an ICU nurse, the weight of responsibility that goes into being a doctor. You are the one patients look to to make the decisions. And, try as you might to listen to the nurses around you, patients will blame the doctor for the outcomes, not the nurse.

I feel it now, when I have 10+ patients to round on with a resident breathing down my neck, grading me... Deciding if I'm honors material... I need honors, I have 120,000$ in student loans, I want anesthesia and it's getting competitive...AND THAT F***ING NURSE DIDN'T TOTAL UP THE I&Os!!! Now I'm behind while I chase them down to get the numbers. Now I look disorganized... honors is slipping away...

#3: DOCTORS ARE NOT NURSES

So my GI Bleeding, Parkinsons patient needs a bowel prep for colonoscopy, and I write 'Prep for colonoscopy' and sign the preprinted order sheet. I come in the next day and, as if by magic, the patients ready to go. Ok... DOCTORS have no clue what that involves. None... Sorry fellow med students, but you need to stand there and watch this happen. Just once do a bowel prep on an immobilized Parkinsons patient. Thread that NG tube while they swear at you, then spend the next 10 GO***MN hours shoving fluid up that tube while you clean up those foal smelling BMs that are so big they run off the bed. Then try not to strangle that F**KING med student that comes in at 6am and complains that your other patients DON'T HAVE ANY I&OS CHARTED!!! And, DA**IT that parkinsons patient still isn't clear for the scope!!!

Doctors and Nurses are an odd combination: same patients, different problems. So, generally its best to stay off your high horse, 'cause you really don't have it so bad."

 

[ultraconsrvativ]

This is a tired topic on this forum. Sorry...I couldn't resist.
PowerMD weighs in on the topic (previous post):

Originally Posted by powermd
"I love responses from midlevels that attempt to compare the experience of training as a physician to the experience of training as a nurse- as if the two were in any way equal. Physicians are trained from the beginning as decisionmakers who will eventually have to assume total responsibility for patient care. Add to that the fact that competition for med school admission keeps the bar set very high in terms of brains and dedication. Nurses are trained as care-givers with the knowledge that there will always be someone to back them up. I rarely, if ever see the same cavelier attitude from fellow physicians that I see in nurses who think they can do it all. From what I've seen, the bar for admission to the nursing profession is set very, very low. My hospital suposedly has some of the best nursing care in the state. Everytime I hear about this I have to laugh because of what I see on the floors. My god are these people dumb! Perhaps 10% of the nurses I deal with daily know what they're doing and are effective providers of nursing care. The rest are an embarassment to the profession. ICU nurses tend to be brighter and more able, but they still approach patient care from a nursing perspective (care-giving vs. decisionmaking)."

My take on this:
The difference is very difficult to conceptualize from the point-of-view of mid-levels and nurses, especially since many MDs are humble about their academic accomplishments and intellectual prowess. To even think about medical school, one has to go EXTREMELY well in undergraduate college (physics, calc, bio, orgo, gChem etc). The MCAT is the next hurdle...see the pre-med forums on this topic, as it speaks for itself. Yet, this oftentimes still isn't enough for admission to medical school--the 3.95, the 37 on the MCAT, the published study--I personally know someone with these stats that didn't get in from my lab in undergrad (which is usual but not unheard of). Medical school is graduate school of the biomedical sciences basic to medicine for the first two (grueling) years, followed by high-level clinical training in the third and fourth year. Let's not forget that Step 1 and 2 (CK, CS) are required to be taken (and passed) before graduation. After this, the newly minted MDs, prepared to enter ANY specialities residency's training program, need to embark in post-graduate residency training, working with other physicians with expert knowledge in the field (from a decision-maker's perspective, a physician's perspective). To compare a CA resident's training to CNRA training is laughable when one considers what is entails to become a physician (versus CNRA...RNs do NOT have to graduate even undergrad to take the RN exam, and many CNRA programs do not require even a bachelor's degree for admission). It is no wonder that Florida had better outcomes when an anesthesiologist was directly involved with anesthesia. So, let's give physicians the credit that is their due for limiting their college fun, giving up the twenties, and living on loans in the lowest tax bracket until they can actually make some cash...in their 30s-40s.

A glimpse in this enigmatic topic is provided by Mike327:

Originally Posted by Mike327
"I'm unique, I think. At least I am here. I'm an ICU nurse with six years on the job. I'm also a third year med student. I see it from both sides now. More than once I've worked in the day as a med student and the night as a nurse in "the unit". A few observations, please read them all before you get all uptight, there's something here for everybody:

#1: NURSES HAD TO FIGHT LONG AND HARD FOR RESPECT

Don't forget where nursing as a 'career' came from. Young doctors would do well to ask that 30+ year nurse what the job was like in the 60's. Nursing was considered by docs to be a small step up from maid work (nursemaid, look it up) Nurses were expected to stand when the Docs entered the room. If the nurse was using the chart, the doc grabbed it. There was a giant class difference between the well-to-do doctor and the poor nurse that had to work because she couldn't get married. As feminism changed American culture, nursing changed with it.

Nurses had to fight like mad to be considered an important part of medicine. Today nurses tend to be better paid, more men (like me) are nurses, and nurses have much more of a voice. But, respect is a very sensitive issue for nurses. And the 'bad' years out number the 'good' years by a fair margin.


#2: NURSES ARE NOT DOCTORS
Nope, not even close. I'm so so sorry fellow nurses, for what I'm about to say, but nursing school was REALLY REALLY EASY. It is nothing compared to medical school. I went into 3rd year thinking it would be a snap, I've done critical care medicine for six years right? WRONG!!!!! The complexity is beyond compare. All that experience with 'nursing diagnosis' doesn't do jack-S**T when you need to find an antibiotic that works and won't kill their kidneys. Yes, I've watched 100's of central line placements, I could probably do it with minimal supervision. But I was wrong to think that that was all there is to this job. Sure, 'physician extenders' can be trained, in a narrow scope, to do pieces of the physicians job. But ONLY a doctor has the training to put it all together. I never understood, as an ICU nurse, the weight of responsibility that goes into being a doctor. You are the one patients look to to make the decisions. And, try as you might to listen to the nurses around you, patients will blame the doctor for the outcomes, not the nurse.

I feel it now, when I have 10+ patients to round on with a resident breathing down my neck, grading me... Deciding if I'm honors material... I need honors, I have 120,000$ in student loans, I want anesthesia and it's getting competitive...AND THAT F***ING NURSE DIDN'T TOTAL UP THE I&Os!!! Now I'm behind while I chase them down to get the numbers. Now I look disorganized... honors is slipping away...

#3: DOCTORS ARE NOT NURSES

So my GI Bleeding, Parkinsons patient needs a bowel prep for colonoscopy, and I write 'Prep for colonoscopy' and sign the preprinted order sheet. I come in the next day and, as if by magic, the patients ready to go. Ok... DOCTORS have no clue what that involves. None... Sorry fellow med students, but you need to stand there and watch this happen. Just once do a bowel prep on an immobilized Parkinsons patient. Thread that NG tube while they swear at you, then spend the next 10 GO***MN hours shoving fluid up that tube while you clean up those foal smelling BMs that are so big they run off the bed. Then try not to strangle that F**KING med student that comes in at 6am and complains that your other patients DON'T HAVE ANY I&OS CHARTED!!! And, DA**IT that parkinsons patient still isn't clear for the scope!!!

Doctors and Nurses are an odd combination: same patients, different problems. So, generally its best to stay off your high horse, 'cause you really don't have it so bad."

Yawn

 

[ether_screen]

Do you guys truly believe that CRNAs don?t understand the physiology behind excitation-contraction coupling or the pathophys involved in MH? Maybe if you understood more about what nurse anesthesia education entails, we wouldn?t have to have these discussions.

 

[gaseous]

I still can't believe everyone is STILL arguing back and forth on this topic.

Read my SIG!

Do you all cruise this site hoping that this topic will arise so you all can defend your position with all your might.

The unfortunate consequence is that all of this back and forth just makes both sides look bad.

Just agree to disagree and move on!

 

[ultraconsrvativ]

Do you guys truly believe that CRNAs don?t understand the physiology behind excitation-contraction coupling or the pathophys involved in MH? Maybe if you understood more about what nurse anesthesia education entails, we wouldn?t have to have these discussions.

Don't waste your time, you're never going to reason with some of the insecure MDAs that frequent this forum. Whether they realize a CRNA's capabilities or not is really not the issue. Even if they do realize it (and I'm guessing deep down they do because, after all, their med school training makes them superior beings incapable of having a knowledge deficit about such things) they will likely not admit it, as it doesn't serve to advance their ego or their long term job security.

 

[VentdependenT]

Shall we keep kicking the hell out of a dead horse or would you all like to continue this nonsense?

 

[Wahoowa]

It amazes me that professionals are so vulnerable to such a sore topic. All of the CRNA's and anesthesiologists I have worked with have been very professional, have respect for the two different roles, and are careful not to overstep their boundries. This thread is a waste of time and thought.

 

[Sensei_Sevo]

It amazes me that professionals are so vulnerable to such a sore topic. All of the CRNA's and anesthesiologists I have worked with have been very professional, have respect for the two different roles, and are careful not to overstep their boundries. This thread is a waste of time and thought.

I agree..........as long as the CRNAs realize that the MDAs are their bosses, everything will be okay. Nothing is going to change this.............Jeez. 😴

 

[jwk]

I agree..........as long as the CRNAs realize that the MDAs are their bosses, everything will be okay. Nothing is going to change this.............Jeez. 😴

And it's comments like this that just add fuel to the fire. You MAY be the boss (and you might not be depending on the state), but you ain't the "masstah"!

Let it go already!

 

[MS3NavyFS2B]

Don't waste your time, you're never going to reason with some of the insecure MDAs that frequent this forum. Whether they realize a CRNA's capabilities or not is really not the issue. Even if they do realize it (and I'm guessing deep down they do because, after all, their med school training makes them superior beings incapable of having a knowledge deficit about such things) they will likely not admit it, as it doesn't serve to advance their ego or their long term job security.

I have some time today, so I'll entertain the above commentary directed toward your colleague (ie, could have be privately advanced) yet posted publically here on the forum.

It's funny you mention the insecurity topic. I recently personally witnessed a CNRA introduce himself to a patient as "one of the anesthetists," cleverly omiting the fact that he was a NURSE anesthetist...with the full knowledge that patients will assume anesthetist is synonymous with anesthesiologist--heck, even I was dooped for a second, especially since he was wearing a long white coat, traditionally reserved for physicians only (another topic in itself). I had to chuckle because what could be his intentions? To intentionally decieve patients into thinking he was a physician, perhaps to lessen the patient's anxiety of having a nurse do his anesthesia vs. a doctor? This is possible because you hear patients calling CNRA's "doctor" all the time, WITHOUT the nurse correcting the patient. Maybe he was trying to distinguish himself from the nurse that changes his bed-pan (yet, psychiatrists, internists, surgeons, dermatologists, etc. all refer to themselves by their proper title, "doctor"). Or, well, maybe the nurse just...well...forgot--which is comforting; hopefully, he didn't forget the induction agent.

A proper introduction might be something like this: "I'm nurse anesthetist Barb Ituate, and I'll be assisting Dr. Gas with your anesthesia and comfort before, during, and after your surgery. It's nice to meet you." In some states CNRAs can work independently, so he might say something like that articulated by another fellow poster in addition to a proper introduction: "In this state, nurses and doctors do anesthesia. [At this point, if in FL, for example, citing the data for outcomes is appropiate for informed consult, which is the LAW.] Who would you prefer do your anesthesia?"

As for job security, humm...yeah, another interesting
topic. Keeping the history of anesthesia in mind, it is important to recognize that the MAJOR reason for the development of mid-levels was the LACK of the supple of anesthesiologists relative to the demand. And, let's face it, there are some very basic procedures, like ECT anesthesia, that can be done with only minimal physician supervision. Cost containment is really a secondary issue, since patients seem to rather a physician doing anesthesia versus nurses, and hospitals seem to rather MDAs versus CNRAs as a matter of liability (see Florida study, and yes, CNRAs, everyone makes mistakes, but--invariably--the incidence of mistakes is directly proportional to level of training). Like a fellow poster asserted, it's very dangerous to dumb-down medicine...even in such a procedure as "routine" as ECT; however, risk of doing so is sometime acceptable to patients (but some would argue, natually, that it's NEVER acceptable to receive inferior care), so long as there is physician trained in anesthesiology nearby.

I recently saw an MDA job posting in TX starting at $650,000 to join a group of staff anesthesiologists. I bet their insecure...but it's about whether they're going to Hawaii or Barbados, buying the 5 or 6 bedroom house, or buying a speed-boat or yaht. Even if Kerry wins and gets his way with medicine--the morbidity and mortality during procedures will increase accordingly...and hospitals will get tired of mistakes leading to lawsuits, accordingly.

Give me a break! There is NOTHING for MDAs to be insecure about, either intellectually, financially (or otherwise)!

Retorical questions: Radiology techs can take the XRAY, but can they read it and understand it? "Nurse clinicians," the newest brand of mid-level, can take a history, but can they interpert it? Surgical PAs can hold the retractors, but can they do the CABG? Make up your own list--it's fun!

 

[MS3NavyFS2B]

And it's comments like this that just add fuel to the fire. You MAY be the boss (and you might not be depending on the state), but you ain't the "masstah"!

Let it go already!

Wait a second [double checking forum to see if this is the right place]... 😎 yup, seems like this is a graduate medical forum specifically aimed at MDs (and DOs), and their counterparts in training (med students) interested in anesthesiology.

Not to fear, though...there are nursing forums, EMT forums, and forums for other ancillary staff.

Just letting you know! 👍

 

[jwk]

Wait a second [double checking forum to see if this is the right place]... 😎 yup, seems like this is a graduate medical forum specifically aimed at MDs (and DOs), and their counterparts in training (med students) interested in anesthesiology.

Not to fear, though...there are nursing forums, EMT forums, and forums for other ancillary staff.

Just letting you know! 👍

"Student Doctor Network Forums Usage Policies

The Student Doctor Network is dedicated to developing and maintaining a friendly online community, where members of all ages and backgrounds feel relaxed and comfortable."

 

[jwk]

I have some time today, so I'll entertain the above commentary directed toward your colleague (ie, could have be privately advanced) yet posted publically here on the forum.

It's funny you mention the insecurity topic. I recently personally witnessed a CNRA introduce himself to a patient as "one of the anesthetists," cleverly omiting the fact that he was a NURSE anesthetist...with the full knowledge that patients will assume anesthetist is synonymous with anesthesiologist--heck, even I was dooped for a second, especially since he was wearing a long white coat, traditionally reserved for physicians only (another topic in itself). I had to chuckle because what could be his intentions? To intentionally decieve patients into thinking he was a physician, perhaps to lessen the patient's anxiety of having a nurse do his anesthesia vs. a doctor? This is possible because you hear patients calling CNRA's "doctor" all the time, WITHOUT the nurse correcting the patient. Maybe he was trying to distinguish himself from the nurse that changes his bed-pan (yet, psychiatrists, internists, surgeons, dermatologists, etc. all refer to themselves by their proper title, "doctor"). Or, well, maybe the nurse just...well...forgot--which is comforting; hopefully, he didn't forget the induction agent.

A proper introduction might be something like this: "I'm nurse anesthetist Barb Ituate, and I'll be assisting Dr. Gas with your anesthesia and comfort before, during, and after your surgery. It's nice to meet you." In some states CNRAs can work independently, so he might say something like that articulated by another fellow poster in addition to a proper introduction: "In this state, nurses and doctors do anesthesia. [At this point, if in FL, for example, citing the data for outcomes is appropiate for informed consult, which is the LAW.] Who would you prefer do your anesthesia?"

As for job security, humm...yeah, another interesting
topic. Keeping the history of anesthesia in mind, it is important to recognize that the MAJOR reason for the development of mid-levels was the LACK of the supple of anesthesiologists relative to the demand. And, let's face it, there are some very basic procedures, like ECT anesthesia, that can be done with only minimal physician supervision. Cost containment is really a secondary issue, since patients seem to rather a physician doing anesthesia versus nurses, and hospitals seem to rather MDAs versus CNRAs as a matter of liability (see Florida study, and yes, CNRAs, everyone makes mistakes, but--invariably--the incidence of mistakes is directly proportional to level of training). Like a fellow poster asserted, it's very dangerous to dumb-down medicine...even in such a procedure as "routine" as ECT; however, risk of doing so is sometime acceptable to patients (but some would argue, natually, that it's NEVER acceptable to receive inferior care), so long as there is physician trained in anesthesiology nearby.

I recently saw an MDA job posting in TX starting at $650,000 to join a group of staff anesthesiologists. I bet their insecure...but it's about whether they're going to Hawaii or Barbados, buying the 5 or 6 bedroom house, or buying a speed-boat or yaht. Even if Kerry wins and gets his way with medicine--the morbidity and mortality during procedures will increase accordingly...and hospitals will get tired of mistakes leading to lawsuits, accordingly.

Give me a break! There is NOTHING for MDAs to be insecure about, either intellectually, financially (or otherwise)!

Retorical questions: Radiology techs can take the XRAY, but can they read it and understand it? "Nurse clinicians," the newest brand of mid-level, can take a history, but can they interpert it? Surgical PAs can hold the retractors, but can they do the CABG? Make up your own list--it's fun!

Note to VentdepenT - ya know, it's really hard not to take the bait on these kinds of posts! 🙂

 

[ultraconsrvativ]

Note to VentdepenT - ya know, it's really hard not to take the bait on these kinds of posts! 🙂

You aint lying brother!! Some of these CRNA/MDA threads resemble the Jerry Springer show. I'm still hungry, I might have to bite at some of that bait.

Don't you just know that MS3NavyFS2B is just sitting on the edge of his chair beating his chest dying to let the world know he is superior to all others who provide patient care. That gives him his a sense of significance.

 

[UTSouthwestern]

DIE THREAD! DIE! For lack of moderator control, I can at least try to put a curse on this thread. 😀

 

[MS3NavyFS2B]

"Student Doctor Network Forums Usage Policies

The Student Doctor Network is dedicated to developing and maintaining a friendly online community, where members of all ages and backgrounds feel relaxed and comfortable."

Exactly right! It does say that--great work! But...isn't the title of this website the "Student Doctor Network' (yeah, we can read, too!). Indeed. Now, in this age of everyone wanting-in on what physicians earned, the founders of this site were nice enough to be inclusive of ancillary staff and design forums to accommodate them. Don't abuse their kindness...



Feel free to suggle-up with a cup-o-joe in another, more appropiate forum. A pre-medical forum may be most appropiate since you see interested in medicine!

 

[jwk]

DIE THREAD! DIE! For lack of moderator control, I can at least try to put a curse on this thread. 😀

But it's SOOOOOOOOOO much fun.....

Tell ya what - y'all turn your heads, and me and a couple of others will have fun with MS3. 😀

 

[ultraconsrvativ]

But it's SOOOOOOOOOO much fun.....

Tell ya what - y'all turn your heads, and me and a couple of others will have fun with MS3. 😀

I'm in.

 

[tkim]

Closing - and I will be summarily closing any more CRNA vs. anesthesiologist threads whenever I see them.