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Resident vs. Anesthesia Nurse
Started by BLADEMDA
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I forgot to add "none of the above" as a choice.😀
So, any Moderators want to assist me in changing the poll to include "none of the above"?
Thanks.
So, any Moderators want to assist me in changing the poll to include "none of the above"?
Thanks.
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Pro,
But, you need to remember that the passenger isn't always paying for the trip.
Since it's a free ride you get what the govt. says you get.
But, you need to remember that the passenger isn't always paying for the trip.
Since it's a free ride you get what the govt. says you get.
None of the above
SRNA's View
Anesthesiologist's View
Anesthesiologist's View
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So, there are no residents out that who believe SRNAs receive "similar" training at their institution?
How about Line placement or Regonal skills? If the answer is still "no" shouldn't we as a profession document these "facts" in a study?
How about Line placement or Regonal skills? If the answer is still "no" shouldn't we as a profession document these "facts" in a study?
Looks like so far I'm the lone "SRNAs are prepared to practice solo upon graduation" voter. The caveat is that I came from a military program, and the military does in fact often deploy them to practice solo soon after graduation. They even do the full gamut of regional, though many fewer reps than the residents. They pick up a few lines here and there but again far fewer than residents.
CRNAs often point to the military as evidence of safe independent practice because an explicit goal of their training within the military is preparation for independent practice ... within the constraints and circumstances of military practice, which obviously (to us) doesn't equate too well to the civilian world. But I think of all the AANA's weak and specious arguments, the one stemming from independence in the military has at least a shadow of truth to it.
Awesome ProReal! My brother was an F-16 pilot in the airforce. When someone asks me about the difference between an anesthesiologist and a nurse anesthetist, I use the analogy of a fighter pilot versus someone who flies Cessnas. Who would you want flying your plane? I'll take my chances with Cpt. Sully!
👍👍👍
👍👍👍
CRNAs fly remote controlled toy planes.
Proreal lands the burning space shuttles. 👍
Proreal lands the burning space shuttles. 👍
So, why does the military need you? They have Solo CRNAs. Why pay for your medical school scholarship? It seems like the Navy should stipulate that Med Students choosing Anesthesiology need to pay back those scholarships with interest.🙄
Ready to practice solo on healthy ASA 1 soldiers? Are Navy CRNAs ready to practice solo on ASA 4 patients?
I love how CRNAs claim that they "practice independently on the world's sickest patients, our military", and that somehow justifies their civilian indep practice.
There are so many things wrong with that statement..and besides, why should the military deal with sub-standard medical care delivered by non-physicians?
I wish my patients had only 4x the past medical history of the average active duty military service member.
I doubt they have ever had to manage a 700 lb patient with CHF, CAD, COPD, DM2, PVD, liver dysfunction and emergent upper GI bleed who is gasping for breath. The average patient at our institution is pushing an ASA 3 these days and I almost have to stop the presses when we get an ASA 1.
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Because it's not all healthy 20-year-old Marines in the best condition of their lives with traumatic injuries.
Outside of deployed austere environments, we see family members and retirees. Odd how after 40 or 50 years those 20-year-old Marines often pick up 100 kg, CAD, OSA, COPD, ... I can only speak to my experiences at one of the big Navy hospitals, but there all CRNAs were assigned a consultant anesthesiologist and were required to discus ASA 3/4 cases with them. It wasn't really independent practice even though it's widely claimed as such.
I don't think even that degree of independent practice is appropriate, but the military does in fact diligently attempt to prepare them for solo work, with varying degrees of success. Anyway, I don't mean to hijack this thread with a rehash of this thread.
Coastie said:
That's exactly what I was getting at
- it's unquestionably the healthiest patient population on the planet
- actual, truly independent practice is generally confined to deployed locations (again, the healthiest of the healthy) and to a limited extent, OB here at home
Finally, to clarify a couple points -
1) While military programs do make the effort to prepare SRNAs to practice solo upon graduation (what your poll asked), and then actually credential them to practice solo under certain circumstances, I personally disagree with that. But the fact is that the military's operational needs could not be met without them. The error is in drawing parallels between military and civilian CRNA practice.
2) Military CRNAs are IMO more consistently trained and substantially better on average than civilian CRNAs. I'd venture that the great majority of them are in the top quartile of CRNAs nationwide.
The AANA looks to the military as a shining example, and why not? Of course they'll point to the best of their members, exaggerate what they actually do, and use that story to argue for independent practice rights for the bottom-quartile strip-mall-trained CRNAs.
1) While military programs do make the effort to prepare SRNAs to practice solo upon graduation (what your poll asked), and then actually credential them to practice solo under certain circumstances, I personally disagree with that. But the fact is that the military's operational needs could not be met without them. The error is in drawing parallels between military and civilian CRNA practice.
2) Military CRNAs are IMO more consistently trained and substantially better on average than civilian CRNAs. I'd venture that the great majority of them are in the top quartile of CRNAs nationwide.
The AANA looks to the military as a shining example, and why not? Of course they'll point to the best of their members, exaggerate what they actually do, and use that story to argue for independent practice rights for the bottom-quartile strip-mall-trained CRNAs.
You're preaching to the choir. I would like nothing more than to get rid of Tricare, reverse the downsizing of military medical facilities, pull back all the sick/old patients being deferred to civilian care, hire world-class talent at fair market wages, and make military medicine more like it was 30 years ago.
There just isn't any money. But at least Marines aren't buying their own body armor and ACOGs like so many were back in 2004 ...
I would also entertain that those who go through the military programs are also wired differently than those who go through civilian programs, and of higher quality.
A significant number are prior service enlisted, where attention to detail and precision are drilled into their heads from basic training, and in order to get your commission to go to nursing school, you *have* to keep that attention going *and* respect the chain of command, as they are writing your letters. A lot have spent time in the field doing work with the very people they are giving gas to, so there is a vested interest in watching out for your own. One of my favorites was a frakking SEAL corpsman, who did a tour in Vietnam, of all places. That's a lot of hardwiring for respect, teamwork, and precision. And when push came, he would defer to the anesthesiologist working with him without hesitation.
What I have seen, that effort on the civilian side just isn't there in such a degree. I can't see any consistency that the quality of applicants to these programs can be anywhere as high as they are in the applicants going through the military schools.
The interesting thing about polls like this is that if you asked the same question to some militant SRNAs within these programs, they'd say they receive equivalent training, do the tough cases, do all their own lines, and they train just as long and come out equally prepared for practice as an anesthesiology resident. There is nothing we can do when pride gets in the way of reality.
I saw the poll, exactly my point.
