RAND study - anesthesiologist shortage, CRNA surplus

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Taurus

Paul Revere of Medicine
20+ Year Member
Excellent study. 👍

Let's exacerbate the CRNA surplus even more by supporting the AA's. Hit the CRNA's in their pockets. It's hard to be an ungrateful midlevel if you have to worry about putting food on the table.

RAND Corporation Study Anticipates Higher Demand For Anesthesiologists As Americans Grow Older
Article Date: 26 Aug 2010 - 2:00 PDT

A recent study from the RAND Corporation, one of the country's most trusted analytic organizations, finds a current shortage of 3,800 anesthesiologists and 1,282 nurse anesthetists. However, if current trends continue, a dramatic shortage of anesthesiologists and a significant surplus of nurse anesthetists are projected by 2020.

In its baseline projection, assuming demand for services grow at the rate of 1.6 percent annually for both anesthesiologists and nurse anesthetists, the RAND study projects a shortage of close to 4,500 anesthesiologists and a surplus of close to 8,000 nurse anesthetists by 2020. However, if the growth in demand is assumed to be 3 percent to account for the aging population, the RAND study projects a shortage of physician anesthesiologists as high as 12,500 by the end of the decade. In this likely scenario, the surplus of nurse anesthetists by 2020 could be as high as 15,000.

"The projected shortage of anesthesiologists suggests that this country will soon face a gap in anesthesiology services that is just as important to Americans' health as the projected physician gap for primary care services," said Mark A. Warner, M.D., President-Elect of the American Society of Anesthesiologists.

"Health care facilities have indicated that as a growing proportion of their patients become older and sicker, they will need more anesthesiologists providing the full scope of care that patients will need before, during and after their surgeries."

The RAND study also found that anesthesiologists' total work hours are 50 percent more than nurse anesthetists, and these anesthesiologists provide more services to the nation's critically ill patients and those with acute and chronic pain. Anesthesiologists are physicians who oversee the broad range of anesthesiology practices in hospitals and ambulatory surgery centers. Anesthesiologists have years of rigorous training and experience through medical school, internships, residencies and fellowships, and they provide critical knowledge and expertise needed to keep total watch over patients' vital health and intervene when necessary in their most critical hours.


"We're particularly pleased that this study comes from the Rand Corporation," commented Dr. Warner. "The study was not funded by any anesthesia organization, further increasing the integrity of the Rand Corporation's findings and the study's validity. These findings may drive expanded opportunities for young physicians. We will need to train more physicians in anesthesiology to ensure that they are available to provide the complex care needed by the nation's growing elderly and critically ill patients."​
 
If anesthesiologists don't stop encroachment of midlevels, it won't matter if there will be a shortage of them by the end of the decade. This study is excellent, but there needs to be a study which clearly demonstrates the superiority of anesthesiologists over CRNAs.
 
😍
The nice thing about a shortage is more $$ on the table.👍
The opposite also applies.:meanie: Too bad, for them.
I'm not sure how the numbers would change if were covering 4+:1 or there was more widespread independent practice though.
I think that there's some safety in academics as this all sorts itself out, especially if you find an efficient practice with a fair wage.👍
I think that in the short term, 5-10 years, things look quite bright. Beyond that is anyone's guess.
 
The RAND study is encouraging for anesthesiologists. It also doesn't surprise me that there will be a surplus of CRNA's. While the supply of anesthesiology residency slots is closely regulated due to workforce and more importantly, quality issues, there are CRNA mills popping up all over the place. Don't get me wrong, there are many high quality CRNA programs like the University of Pennsylvania that are university-based, but there are many community hospital based programs that are meant to collect tuition and pump out as many grads as possible.
 
If anesthesiologists don't stop encroachment of midlevels, it won't matter if there will be a shortage of them by the end of the decade. This study is excellent, but there needs to be a study which clearly demonstrates the superiority of anesthesiologists over CRNAs.

That's the $64,000 question. How do you stop encroachment? That's not so easy when the NP's and CRNA's are stuffing dollar bills down politicians' pockets. I believe the most effective solutions are economic and the legal system. Even if midlevels somehow convince lawmakers to loosen regulations, getting the privilege to do something does not mean that you're qualified to do it safely without supervision. Most midlevels have the equivalent of 2 years of training and there's just too much to learn in that short period of time to be able to say that you're as qualified as a physician. When they screw up -- notice it's not 'if' because we all know they will screw up at some point because of their inferior training, then they need to get smacked hard with lawsuits and higher malpractice costs. Make it so costly and risky for them to go independent. This is the most effective deterrent to go independent. Create a huge surplus of them so that it drives down their salaries and makes it easy for you to replace them with others when they start demanding changes. Since the groups that are the biggest whiners are nursing, I don't support any advanced nursing practice groups like NP's, CRNA's, and midwives. If you can, you should use PA's and AA's who are regulated by the boards of medicine like physicians are.
 
Studies of this type have notoriously bad records on accuracy. Anybody remember the Abt report circa 1995?. It concluded that based on one scenario that we didn't need to train another anesthesiologist for a decade.

There are just way too many variables to predict the future with any level of confidence.
 
If anesthesiologists don't stop encroachment of midlevels, it won't matter if there will be a shortage of them by the end of the decade. This study is excellent, but there needs to be a study which clearly demonstrates the superiority of anesthesiologists over CRNAs.

we dont need that study. moreover, it cannot be done..
 
That's the $64,000 question. How do you stop encroachment? That's not so easy when the NP's and CRNA's are stuffing dollar bills down politicians' pockets.

I can stuff more dollar bills down politicians pockets than they can.
 
we dont need that study. moreover, it cannot be done..

Well, that's reassuring. At least there should be a response from the anesthesiologists every time one of their crappy "studies" show equivalence - simply point out the faults in their analysis.
 
No shortage of providers in our town. Surgical volumes are down since the recession hit. With the huge insurance premium increases coming in 2011 and the proliferation of high deductible plans (which causes people to put off healthcare that's not really needed) I don't see an increase in volume anytime soon. We are in the rustbelt where many of the young have already moved away. We are therefore, ahead of most of you in seeing what life will look like with more elderly (we currently are just shy of 40% Medicare).
When one has that much Medicare, what you have to do is hire MORE not fewer CRNAs, as physicians retire/leave. It lowers your cost per room.
 
The time of nurses getting paid 200k+ for 40 hours a week of giving breaks in the room while docs take the liability will soon be over. 👍

Excellent study. 👍

Let's exacerbate the CRNA surplus even more by supporting the AA's. Hit the CRNA's in their pockets. It's hard to be an ungrateful midlevel if you have to worry about putting food on the table.

RAND Corporation Study Anticipates Higher Demand For Anesthesiologists As Americans Grow Older
Article Date: 26 Aug 2010 - 2:00 PDT

A recent study from the RAND Corporation, one of the country's most trusted analytic organizations, finds a current shortage of 3,800 anesthesiologists and 1,282 nurse anesthetists. However, if current trends continue, a dramatic shortage of anesthesiologists and a significant surplus of nurse anesthetists are projected by 2020.

In its baseline projection, assuming demand for services grow at the rate of 1.6 percent annually for both anesthesiologists and nurse anesthetists, the RAND study projects a shortage of close to 4,500 anesthesiologists and a surplus of close to 8,000 nurse anesthetists by 2020. However, if the growth in demand is assumed to be 3 percent to account for the aging population, the RAND study projects a shortage of physician anesthesiologists as high as 12,500 by the end of the decade. In this likely scenario, the surplus of nurse anesthetists by 2020 could be as high as 15,000.

"The projected shortage of anesthesiologists suggests that this country will soon face a gap in anesthesiology services that is just as important to Americans' health as the projected physician gap for primary care services," said Mark A. Warner, M.D., President-Elect of the American Society of Anesthesiologists.

"Health care facilities have indicated that as a growing proportion of their patients become older and sicker, they will need more anesthesiologists providing the full scope of care that patients will need before, during and after their surgeries."

The RAND study also found that anesthesiologists' total work hours are 50 percent more than nurse anesthetists, and these anesthesiologists provide more services to the nation's critically ill patients and those with acute and chronic pain. Anesthesiologists are physicians who oversee the broad range of anesthesiology practices in hospitals and ambulatory surgery centers. Anesthesiologists have years of rigorous training and experience through medical school, internships, residencies and fellowships, and they provide critical knowledge and expertise needed to keep total watch over patients' vital health and intervene when necessary in their most critical hours.


"We're particularly pleased that this study comes from the Rand Corporation," commented Dr. Warner. "The study was not funded by any anesthesia organization, further increasing the integrity of the Rand Corporation's findings and the study's validity. These findings may drive expanded opportunities for young physicians. We will need to train more physicians in anesthesiology to ensure that they are available to provide the complex care needed by the nation's growing elderly and critically ill patients."​
 
You might be surprised - the AANA controls one of the largest healthcare PAC's in the country.

I'm not surprised.

That's why I donate a lot more money than any CRNA donates.

I love the crazy AANA psychos that they introduce to our CRNA students on their first day to start sucking money out of them while they are still students. I just let them know they can donate whatever they want and I will give 10x more.
 
I think the important thing to take from this study is that a group of independent researchers have determined that anesthesiologists function at a higher capacity than CRNA's. There may be overlap in some functions but a CRNA cannot replace an anesthesiologist entirely. The researchers did not listen to the propaganda from the AANA and instead went to the hospitals and took a look for themselves to see the differences. This should give us hope that hospital decision-makers will make similar conclusions.

Here's the actual study.

We need to help throw the supply-demand curve for CRNA even more out of whack by having more states approve AA legislation and opening more AA programs. CRNA's don't compete directly with anesthesiologists but they do with AA's. This is why we need to fully support the AA's. The opportunity to go from defense to offense is now.
 
I'm not surprised.

That's why I donate a lot more money than any CRNA donates.

I love the crazy AANA psychos that they introduce to our CRNA students on their first day to start sucking money out of them while they are still students. I just let them know they can donate whatever they want and I will give 10x more.

Do you mean the AANA "Resident" RNAs?😉

They are told in their B.S. required Political Class (an actual class required to graduate) they are equal, Independent Providers who must fight and donate lots of money or we (aka the ASA) will destroy them.
 
I think the important thing to take from this study is that a group of independent researchers have determined that anesthesiologists function at a higher capacity than CRNA's. There may be overlap in some functions but a CRNA cannot replace an anesthesiologist entirely. The researchers did not listen to the propaganda from the AANA and instead went to the hospitals and took a look for themselves to see the differences. This should give us hope that hospital decision-makers will make similar conclusions.

Here's the actual study.

We need to help throw the supply-demand curve for CRNA even more out of whack by having more states approve AA legislation and opening more AA programs. CRNA's don't compete directly with anesthesiologists but they do with AA's. This is why we need to fully support the AA's. The opportunity to go from defense to offense is now.


The AANA "master plan" is to flood the market and get quasi Independence and/or increased ratios of MD to CRNA. This will mean more work for CRNAs (AAs aren't eligible for ratios greater than 4:1) and of course, many more dues paying AANA members. Build it/Graduate them and the dream will come.

The AANA is going for broke on this gamble. Produce thousands more CRNAs, open hundreds of new programs and hope the PACs plus/minus ObamaCare law will create lots of new job opportunities for them while displacing MD/DOs and AAS.

Only a fool would count the AANA down and out yet. Perhaps, their gamble will pay off.
 
im_a_broke_ass_fool_with_no_money_hat_.jpg
 
How do you guys predict this will affect AA's? Won't they also have a hard time getting jobs since, as Taurus mentioned, AA's compete directly with CRNA's for jobs? Also, it seems like it would be important to consider the fact that (as far as I have seen) there aren't any job openings that specifically want to hire an AA instead of a CRNA, so it seems like if this affects CRNA's, it would also directly affect AA's.
 
How do you guys predict this will affect AA's? Won't they also have a hard time getting jobs since, as Taurus mentioned, AA's compete directly with CRNA's for jobs? Also, it seems like it would be important to consider the fact that (as far as I have seen) there aren't any job openings that specifically want to hire an AA instead of a CRNA, so it seems like if this affects CRNA's, it would also directly affect AA's.

If there's a surplus of CRNA's, obviously it will affect all anesthesia midlevel groups like AA's. However, I would predict that it would affect CRNA's more adversely than AA's because I'm sure there are many, many groups out there that would like to have 50/50 mix of CRNA's and AA's or even tilt more in favor of AA's. So that means more demand for AA's than CRNA's in the future. I think the CRNA's are underestimating the level of contempt anesthesiologists have for them. As the tables are turned as they are being now, the CRNA's will face the full fury of the anesthesiologists and pay a heavy price for their past tactics. Other medical groups have been watching what's happening to anesthesiology and there is a lot of astonishment and disgust for CRNA's. So it will be very interesting to watch what happens if a surplus of CRNA's does indeed develop.
 
If there's a surplus of CRNA's, obviously it will affect all anesthesia midlevel groups like AA's. However, I would predict that it would affect CRNA's more adversely than AA's because I'm sure there are many, many groups out there that would like to have 50/50 mix of CRNA's and AA's or even tilt more in favor of AA's. So that means more demand for AA's than CRNA's in the future. I think the CRNA's are underestimating the level of contempt anesthesiologists have for them. As the tables are turned as they are being now, the CRNA's will face the full fury of the anesthesiologists and pay a heavy price for their past tactics. Other medical groups have been watching what's happening to anesthesiology and there is a lot of astonishment and disgust for CRNA's. So it will be very interesting to watch what happens if a surplus of CRNA's does indeed develop.

I wouldn't be so sure about having both CRNA's and AA's in the same group. Many CRNA's I know are so anti-AA that they will refuse to let them take over a case of theirs! I'm sure there are groups where CRNA's and AA's work harmoniously together, but I would imagine these are few in number. Any group trying to hire AA's will run up against a wall when the CRNA's all threaten to quit. The tightening job market will probably change this a little, but CRNA's are definitely going to stick with their guns and resist any integration of AA's into a practice. The CRNA's honestly believe (or are brainwashed by the AANA to believe) that AA's are significantly inferior and are a danger to patient care. Some CRNA's believe erroneously that an AA has to be directly supervised by an anesthesiologist in the same room at all times, much like a medical student would be supervised. I have not personally worked with any AA's, but I imagine that they are the functional equivalent of CRNA's (or junior residents). While the integration of AA's into our practices is more congruent with our interests, I think the politics makes it an uphill climb.
 
I wouldn't be so sure about having both CRNA's and AA's in the same group. Many CRNA's I know are so anti-AA that they will refuse to let them take over a case of theirs! I'm sure there are groups where CRNA's and AA's work harmoniously together, but I would imagine these are few in number. Any group trying to hire AA's will run up against a wall when the CRNA's all threaten to quit. The tightening job market will probably change this a little, but CRNA's are definitely going to stick with their guns and resist any integration of AA's into a practice. The CRNA's honestly believe (or are brainwashed by the AANA to believe) that AA's are significantly inferior and are a danger to patient care. Some CRNA's believe erroneously that an AA has to be directly supervised by an anesthesiologist in the same room at all times, much like a medical student would be supervised. I have not personally worked with any AA's, but I imagine that they are the functional equivalent of CRNA's (or junior residents). While the integration of AA's into our practices is more congruent with our interests, I think the politics makes it an uphill climb.

I will gladly hire AA-s over CRNA-s.
BTW - I bet that this study gave some nightmares to the AANA terrorist organization.
Thank you Taurus!
 
I wouldn't be so sure about having both CRNA's and AA's in the same group. Many CRNA's I know are so anti-AA that they will refuse to let them take over a case of theirs! I'm sure there are groups where CRNA's and AA's work harmoniously together, but I would imagine these are few in number. Any group trying to hire AA's will run up against a wall when the CRNA's all threaten to quit. The tightening job market will probably change this a little, but CRNA's are definitely going to stick with their guns and resist any integration of AA's into a practice. The CRNA's honestly believe (or are brainwashed by the AANA to believe) that AA's are significantly inferior and are a danger to patient care. Some CRNA's believe erroneously that an AA has to be directly supervised by an anesthesiologist in the same room at all times, much like a medical student would be supervised. I have not personally worked with any AA's, but I imagine that they are the functional equivalent of CRNA's (or junior residents). While the integration of AA's into our practices is more congruent with our interests, I think the politics makes it an uphill climb.

That's the beauty of having a surplus of CRNA's. If a few holler and scream about AA's being hired (and there's always a few militant ones in every group), fire them and replace them with the CRNA's and AA's who are desperately trying to find a job.

It's hard to be ungrateful to have your job when you have to worry about putting food on the table. It's basic survival instinct. CRNA's may not like AA's getting hired, but they probably care more about having ANY job at all. The law field now is a perfect example. Lawyers from non-top tier schools are so desperate to find anything, including working for $10/hour or even free for a year to get experience.

I hope people now understand why I've been pushing for AA's and why the AANA has been so vehemently opposed to them. It's the duty of every anesthesiologist out there to create demand for AA's.
 
If there's a surplus of CRNA's, obviously it will affect all anesthesia midlevel groups like AA's. However, I would predict that it would affect CRNA's more adversely than AA's because I'm sure there are many, many groups out there that would like to have 50/50 mix of CRNA's and AA's or even tilt more in favor of AA's. So that means more demand for AA's than CRNA's in the future. I think the CRNA's are underestimating the level of contempt anesthesiologists have for them. As the tables are turned as they are being now, the CRNA's will face the full fury of the anesthesiologists and pay a heavy price for their past tactics. Other medical groups have been watching what's happening to anesthesiology and there is a lot of astonishment and disgust for CRNA's. So it will be very interesting to watch what happens if a surplus of CRNA's does indeed develop.

I agree in entirety. When the time comes for anesthesiologists to again have some leverage, the CRNAs will suffer the most. Much more than AA's, which haven't been antagonistic towards the profession, at least in public as well as in lobbying..... I personally imagine they would (and should) be rewarded for this.

cf
 
I know that money is a very "un-PC" consideration when it comes to working in health care, but how low do you think anesthetist salaries will drop as a direct consequence of the CRNA surplus? Taurus mentioned that law grads are grateful for make-ends-meet jobs paying 10 bucks an hour. I doubt anesthetist starting salaries will drop that low, but do you think it's only a matter of time before they hit $50-60k?
 
As a practicing anesthesiologist, and a proud member of the ASA who contributes to ASAPAC every year, it pains me to have to write these words. And it really isn't Dr. Hannenberg's fault that his arguments are so anemic. We anesthesiologists are so busy in our ivory towers trying to understand the molecular basis of lung ventilation in the name of patient safety that we have failed to see the soul of anesthesiology is being hijacked by the nurses. While the AANA is cranking out multiple papers per year on why they are at least equivalent to MDAs for less cost, we haven't produced a study demonstrating the value of anesthesiologists in today's health care environment. The nurses only need to prove they provide care as well as doctors to have an advantage, because if all else being equal, the deciding factor will be cost, their ultimate trump card. If that situation should come to pass, the only way we anesthesiologists can stay gainfully employed is if we lower ourselves to an equivalent salary. That will indeed be a sad day for anesthesiology.


http://www.blog.greatzs.com/2010/08/asa-president-defends-anesthesiologists.html
 
As a practicing anesthesiologist, and a proud member of the ASA who contributes to ASAPAC every year, it pains me to have to write these words. And it really isn't Dr. Hannenberg's fault that his arguments are so anemic. We anesthesiologists are so busy in our ivory towers trying to understand the molecular basis of lung ventilation in the name of patient safety that we have failed to see the soul of anesthesiology is being hijacked by the nurses. While the AANA is cranking out multiple papers per year on why they are at least equivalent to MDAs for less cost, we haven't produced a study demonstrating the value of anesthesiologists in today's health care environment. The nurses only need to prove they provide care as well as doctors to have an advantage, because if all else being equal, the deciding factor will be cost, their ultimate trump card. If that situation should come to pass, the only way we anesthesiologists can stay gainfully employed is if we lower ourselves to an equivalent salary. That will indeed be a sad day for anesthesiology.


http://www.blog.greatzs.com/2010/08/asa-president-defends-anesthesiologists.html

do you actually think crnas can practice independently without increase in morbidity and mortality? are you serious? If you are serious.. you havent seen them in action. They have flawed logic, less than adequate skills and if anything out of the ordinary happens they cannot adjust adequately. They will look to surgeons for advice and.. ehem... need i say more. We dont need a study. seriously.. all you have to look at is.. the safety of anesthesia and surgery 5o years ago.. and look at it now.. Who do you think is responsible?
 
do you actually think crnas can practice independently without increase in morbidity and mortality? are you serious? If you are serious.. you havent seen them in action. They have flawed logic, less than adequate skills and if anything out of the ordinary happens they cannot adjust adequately. They will look to surgeons for advice and.. ehem... need i say more. We dont need a study. seriously.. all you have to look at is.. the safety of anesthesia and surgery 5o years ago.. and look at it now.. Who do you think is responsible?

We know that while there are some solid CRNAs out there, some are dangerously obtuse. Their culling process is inadequate. At times I think they would certify a potato if it had the right number of eyes.

Most of us in opt-out areas have probably lost count of the number of times we've bailed out independent CRNAs during a case, or been quietly "curbsided" by independent CRNAs who didn't know what to do, or witnessed independent CRNAs get manipulated/browbeat/cajoled/intimidated by a surgeon to do something we wouldn't, or been called in on our #2 or #3 call nights to handle an ICU patient because the surgeon wanted a doctor and not an independent CRNA ...


We know this, but the people who write the laws don't. Patients, by and large, are either barely aware that the person giving them their anesthesia might not be a physician, or believe they have no choice in the matter.

I don't know what else to do beyond giving money to the ASAPAC.
 
we haven't produced a study demonstrating the value of anesthesiologists in today's health care environment.


We are Losing this fight. The AANA is gearing up its membership for less supervision and more independence.

Blade
 
we haven't produced a study demonstrating the value of anesthesiologists in today's health care environment.


We are Losing this fight. The AANA is gearing up its membership for less supervision and more independence.

Blade
www.anesthesiapa.org
 
We know that while there are some solid CRNAs out there, some are dangerously obtuse. Their culling process is inadequate. At times I think they would certify a potato if it had the right number of eyes.

Most of us in opt-out areas have probably lost count of the number of times we've bailed out independent CRNAs during a case, or been quietly "curbsided" by independent CRNAs who didn't know what to do, or witnessed independent CRNAs get manipulated/browbeat/cajoled/intimidated by a surgeon to do something we wouldn't, or been called in on our #2 or #3 call nights to handle an ICU patient because the surgeon wanted a doctor and not an independent CRNA ...


We know this, but the people who write the laws don't. Patients, by and large, are either barely aware that the person giving them their anesthesia might not be a physician, or believe they have no choice in the matter.

I don't know what else to do beyond giving money to the ASAPAC.

I would never work in that kind of environment. If you are independent, i want nothing to do with the situation. Dont call me, dont consult me, call the surgeon and the hospital administrator and the legislatures when your patient is blue, doesnt have a bp etc you cant have your cake and eat it too. If the surgeons want us involved we work in the anesthesia care team model and we direct the care. Everyone deserves the medical expertise of a physician not a pseudo clown crna.
 
Bump. Can any resident or attending chime in on some of the predictions made in this thread?
 
Bump. Can any resident or attending chime in on some of the predictions made in this thread?

That study was originally done about 5 years ago. The ASA is currently funding a followup survey conducted by the RAND corp. Hopefully the majority of people solicited will respond so they will have some good data to work with. I'm interested to see the results.

As far as the original study, one thing I have noticed is the CRNA market seems to be tightening. I've had quite a few locum CRNA's tell me they have had a tough time finding permanent work, especially in desirable locations. I know the physician market is tightening, but it seems that at least for now, most grads are able to find permanent jobs with reasonable pay. But these are just limited observations I've made during residency.
 
Hope this is true. I give a ton to the asapac. I would love physician driven anesthesia. Btw those of you in opt out states need to STOP BAILING OUT THE NURSES!!! What impetus is there then for doctors to be in charge??? Or PUBLICIZE these events!!
 
Or ethical. A patient's dying, but we're not supposed to help because it might score some political points? That's not what I signed up for.

Alternative: Keep bailing nurses out --> no one ever realizes these assassins are running around out there --> profession becomes shell of its former self with majority nurses providing care with minimal/no oversight because its no longer lucrative/reasonable for top notch trainees to go into anesthesia, the government wants it anyway, and joe public has his head so far up his ass convinced he's getting "reduced costs" he can't see straight --> eventually there aren't enough physicians around to bail nurses out, or there is no legality/hospital regulation requiring oversight --> tons of patients get worse care anyway...so what is the actual benefit?

Don't get me wrong, I love anesthesiology, and I couldn't be more excited about starting residency. I don't have a great answer either, I get it, it's hard to put the horse back in the barn, I guess I'm just pissed enough to say F it, give me the calls, give me the late nights doing b&b cases (can always work on finesse and timing), whatever will reduce patient exposure to these clown-shoe, lipstick-gorillas that think they can do your (and my future) job with less than half the training. I know, I know, wait til you grow up junior, it's easier to say than do (wife, kids, life) - but jesus, I'm in MICU, we had to emergently tube a guy tonight, and right afterwards the "critical care" NP rolls in, takes one look at a quite obviously intubated/mechanically ventilated patient and asks me, serious and indignant as all hell, "why don't you have a NASAL CANNULA on this patient?" 😕😕😕
f*ckin' A, that cannot be the future of medicine
 
Btw those of you in opt out states need to STOP BAILING OUT THE NURSES!!! What impetus is there then for doctors to be in charge??? Or PUBLICIZE these events!!

This is scary. I sure hope it isn't my life or my parents' lives being sacrificed for others to score professional gains.
 
Ethical?? If you are not involved, why open yourself up to liability and everything that comes along with the crna f*ck up?? And these events should be catalogued, published and presented. But if you keep bailing them out, it will never change and you actually give credence to the idea of 5-10 rooms and being the fireman.