Pulmonologists pushing prop for Endo!

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One downside of the current market is that people are just finding alternative solutions to get their cases done.

Plastic surgery office I know of nearby went from anesthesiologist to solo CRNA to now “sedation rn”
 
nycitygas said:
One downside of the current market is that people are just finding alternative solutions to get their cases done.

Plastic surgery office I know of nearby went from anesthesiologist to solo CRNA to now “sedation rn”
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makemoney2024 said:
And at one place they ask for us even for an external cardioversion. It's mind-boggling. I don't know why the anesthesia chief allows this absolute nonsense and waste of resources.
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We do cardioversions every day. A little propofol, eyes batting, zap, done. BTW it's illegal for RNs to administer propofol to non-ventilated patients in my state.
 
makemoney2024 said:
Except you still need the staff!!! How is this difficult to comprehend? And personally for me, short cases on the computer are painful.
I know they are easy, but spreading us into places that we aren’t needed doesn’t help this shortage.
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Cause we make em dance to our tune... we do em when we're ready so everything tee'ed... sometimes less than 1 minutes work
 
jwk said:
BTW it's illegal for RNs to administer propofol to non-ventilated patients in my state.
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Same, some cards do it but if they're ever investigated they can lose everything...
A gi doc lost his pants over it
 
What's wild to me is I hear about these stories and at the same time I know plenty of places where CRNAs are pushing 2 of versed for eyes and waiting around all day.

nycitygas said:
One downside of the current market is that people are just finding alternative solutions to get their cases done.

Plastic surgery office I know of nearby went from anesthesiologist to solo CRNA to now “sedation rn”
Click to expand...

I don't really believe in this "shortage causing X" type stuff. An anesthesiologist was making 200 an hour in 2018 now makes 250 an hour, inflation adjusted no difference. Someone getting some plastic surgery done previously was cool with 300 bucks but now is outraged at 375 6 years later? So clearly the only solution is to hire an RN for 50 an hour to push 10 of versed and 300 fentanyl and hope nothing bad happens. Sure.

It's like people forget what a real shortage looks like. During covid nurses were making 6-7k a week, routinely. ECMO up to 10k a week. That's a shortage that can drive people to do weird stuff. A shortage where inflation adjusted pay goes up like 0-10% over a period of 6 years isn't it.

A friend was looking into building a house and got some really pricey bids. The reason given was that lumber was super expensive. Meanwhile lumber is cheaper (without adjusting for inflation) than 6 years ago. People are just seeing what they can get away with.
 
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jwk said:
We do cardioversions every day. A little propofol, eyes batting, zap, done. BTW it's illegal for RNs to administer propofol to non-ventilated patients in my state.
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They don’t need propofol. They need Versed and Fentanyl and no more than 2cc each for most of them. It adds to a very large load between GI and Cardiology that I have to preop and post op. Not to mention the EP cases I have to do medical direction on.
 
makemoney2024 said:
They don’t need propofol. They need Versed and Fentanyl and no more than 2cc each for most of them. It adds to a very large load between GI and Cardiology that I have to preop and post op.
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If I have it done, I want propofol. From a patient's perspective, propofol (in the right hands) is far superior for during the procedure and for the recovery period, in my opinion.
 
makemoney2024 said:
They don’t need propofol. They need Versed and Fentanyl and no more than 2cc each for most of them. It adds to a very large load between GI and Cardiology that I have to preop and post op. Not to mention the EP cases I have to do medical direction on.
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All the more reason to use propofol. This is a 15 minute time commitment tops, including getting propofol from the drug machine. Versed and fentanyl is absolute overkill for what is literally a one-second procedure.
 
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jwk said:
All the more reason to use propofol. This is a 15 minute time commitment tops, including getting propofol from the drug machine. Versed and propofol is absolute overkill for what is literally a one-second procedure.
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Assuming you meant to say "versed and fentanyl," I agree. The recovery time will be too long for my liking. Plus, most of the patients who need DCCV are elderly and I hate giving midazolam to elderly patients, especially when it is in the doses needed to make them comfortable for a DCCV.
 
makemoney2024 said:
They don’t need propofol. They need Versed and Fentanyl and no more than 2cc each for most of them. It adds to a very large load between GI and Cardiology that I have to preop and post op. Not to mention the EP cases I have to do medical direction on.
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Too long acting drug for too short of a procedure.
 
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Gern Blansten said:
Assuming you meant to say "versed and fentanyl," I agree. The recovery time will be too long for my liking. Plus, most of the patients who need DCCV are elderly and I hate giving midazolam to elderly patients, especially when it is in the doses needed to make them comfortable for a DCCV.
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What’s that dose? Not very much.
 
jwk said:
All the more reason to use propofol. This is a 15 minute time commitment tops, including getting propofol from the drug machine. Versed and propofol is absolute overkill for what is literally a one-second procedure.
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I have given 2 and 1 to young patients and they did fine. An old person may just need a little versed and tiny dose of fentanyl. They don’t pass out. They just get a little sleepy. Like cataracts which also takes about 10 minutes with the fast surgeons.
Anyway, there are multiple ways to skin a cat.
 
Gern Blansten said:
No, his actual pants. They were his favorite corduroys, too...😉

JK. They could have meant monetary loss or license. Not sure.
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Off topic but why does your account always say on hold? I have been here six months now and it's always been on hold. On hold for what specifically?
 
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