RNs intubating

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DermViser said:
Then what's the difference between an Anesthesiologist and a crna? Knowing more anesthetic drugs and their side effects?
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Being able to make and adjust a plan intelligently by using your medical knowledge instead of doing things algorithmically only by watching what other people do. Being able to recognize when a patient is about to die from monitoring subtle signs. Understanding the important details about drugs to optimize patient care. Being able to handle extremely dangerous situations alone and keep the patient alive while you have them open on a table with people inside of them. Knowing more in general about the human body and having a much more thorough education

Just because a textbook exists doesn't mean people will read them or that if they do read them, that they will get the same thing out of it. We have students from the same medical schools taking the same classes and looking at the same resources but end up scoring differently on tests and have differing amounts of knowledge and ability
 
Psai said:
Yeah those kids with inborn errors of metabolism will probably be fine, who cares about branched chain amino acids or galactosemia
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I mean how's their primary care NP gonna pick that up? They don't take biochem...
 
I can barely get nurses to draw blood for me for stat labs or blood cultures any time. I think it's quite presumptuous to assume people are anxious to do new procedures out of their normal routine.

There are nurses that do acute care transport. I think any of those or others in acute setting who want to intubate could do so just as well as any basic physician. You get good at doing stuff like that by doing it. Anesthesiologists are masters of airway management because they have to be. And they've been forced into more sticky situations than any of us.

If they're not around and I need an airway myself. Please just somebody f'n do it.

****. Give me some aggressive nurses who want to do and learn stuff. I'll dance a jig right now.
 
repititionition said:
If you think there is any appreciable clinical difference between an NP and an RN, you need to go hang out in a community hospital -- it's a distinction without a difference. The meat of the two bell curves overlaps substantially.
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Cool...I'm going to hang out a shingle, buy a long white coat and start bringin' in those Benjamins.
 
mimelim said:
We get far fewer access problems from IR than from IC or IN. They are better technically and use ultrasound, ministicks, etc. That having been said, they still can't deal with their own complications and what is worse, if one of their complications come in, they don't see the patient, ever. They don't admit their complications to the hospital, they don't treat the complication, they don't even go see the patient (since they are not involved in their care).
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Yup, it's kind of an embarrassment to the field, and I say that as an eventual radiologist. This is changing with the new generation of IR attendings who maintain clinics and admitting privileges, but it's definitely not the norm outside of places like Miami Vascular.
 
With something like intubating I think it just comes down to organizing care in a way such that the people in your hospital doing the intubating are people who do it frequently. Would much rather have a system set up where the in house RT/CRNA intubates instead of the random outpatient internist who is moonlighting over the weekend.

A more general thought is that its interesting that medicine is one of the few professions/fields where the most educated people on the teams are the ones doing any actual hands on work. Seems in general society has discovered its most efficient for the most educated people to think, make decisions and supervise. While training less educated people to do very specific tasks over and over.
 
Armadillos said:
With something like intubating I think it just comes down to organizing care in a way such that the people in your hospital doing the intubating are people who do it frequently. Would much rather have a system set up where the in house RT/CRNA intubates instead of the random outpatient internist who is moonlighting over the weekend.

A more general thought is that its interesting that medicine is one of the few professions/fields where the most educated people on the teams are the ones doing any actual hands on work. Seems in general society has discovered its most efficient for the most educated people to think, make decisions and supervise. While training less educated people to do very specific tasks over and over.
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That sounds about right, except for surgeons.
 
Psai said:
If you're a medical student you would have covered it
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I did cover it... we were discussing the difference between midlevels and physicians, someone mentioned basic sciences... I asked what part of basic sciences matters, what about biochem?... you mentioned inborn errors of metabolism... and then I was wondering how the independently practicing midlevel (e.g. NP) is managing patients without an in depth knowledge of biochem... ?
 
tdram said:
I did cover it... we were discussing the difference between midlevels and physicians, someone mentioned basic sciences... I asked what part of basic sciences matters, what about biochem?... you mentioned inborn errors of metabolism... and then I was wondering how the independently practicing midlevel (e.g. NP) is managing patients without an in depth knowledge of biochem... ?
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The NP would be like "boy please, save that crap for the ivory tower nerds and scientists. I treat patients not molecules. Holla back!".
 
tdram said:
What exactly do you need to learn basic sciences for?
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This morning a guy that has been getting increasingly preoccupied with medical conspiracy theories posted a long rambling Facebook status about doctors hiding the truth and misdiagnosing hypothyroidism. He included a link to this site: http://www.stopthethyroidmadness.com/2014/02/18/open-letter-to-physicians/. The first bold topic in the “Open Letter to All Physicians from a Nurse about Thyroid Treatment” is a pretty good example of why understanding organic chemistry and biochemistry is useful for accurately educating and treating patients.
 
loris said:
This morning a guy that has been getting increasingly preoccupied with medical conspiracy theories posted a long rambling Facebook status about doctors hiding the truth and misdiagnosing hypothyroidism. He included a link to this site: http://www.stopthethyroidmadness.com/2014/02/18/open-letter-to-physicians/. The first bold topic in the “Open Letter to All Physicians from a Nurse about Thyroid Treatment” is a pretty good example of why understanding organic chemistry and biochemistry is useful for accurately educating and treating patients.
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HAHAHAHAHA

Oh my god...I don't even what....

I can only imagine her horror when some well educated reader informed her that the top molecule is, in fact, molecularly identical to T4, save for the addition of Na to increase absorption. O-chem 101 right here folks.

Oh and I guess we should trust the "large body of thyroid patients who, for decades, have reported having a very “normal” TSH lab test while having very obvious symptoms of hypothyroidism" instead of, you know, the physicians who have the actual numbers for their labs.
 
loris said:
This morning a guy that has been getting increasingly preoccupied with medical conspiracy theories posted a long rambling Facebook status about doctors hiding the truth and misdiagnosing hypothyroidism. He included a link to this site: http://www.stopthethyroidmadness.com/2014/02/18/open-letter-to-physicians/. The first bold topic in the “Open Letter to All Physicians from a Nurse about Thyroid Treatment” is a pretty good example of why understanding organic chemistry and biochemistry is useful for accurately educating and treating patients.
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There is no defending that.
 
calvnandhobbs68 said:
HAHAHAHAHA

Oh my god...I don't even what....

I can only imagine her horror when some well educated reader informed her that the top molecule is, in fact, molecularly identical to T4, save for the addition of Na to increase absorption. O-chem 101 right here folks.

Oh and I guess we should trust the "large body of thyroid patients who, for decades, have reported having a very “normal” TSH lab test while having very obvious symptoms of hypothyroidism" instead of, you know, the physicians who have the actual numbers for their labs.
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You should read the part of the comments where one of the readers advises another looking for care - "most patients avoid all endocrinologists because they will hold you hostage to your TSH"
 
TriNurse said:
There is no defending that.
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People were complaining about Dr. Oz in the other thread and how his license should be revoked -if that's the case I think there is no question in my mind that this lady needs her RN license revoked as well for spreading this type of nonsense. After all, nurses are the most trusted profession in every survey. People like her can do a lot of damage.
 
loris said:
This morning a guy that has been getting increasingly preoccupied with medical conspiracy theories posted a long rambling Facebook status about doctors hiding the truth and misdiagnosing hypothyroidism. He included a link to this site: http://www.stopthethyroidmadness.com/2014/02/18/open-letter-to-physicians/. The first bold topic in the “Open Letter to All Physicians from a Nurse about Thyroid Treatment” is a pretty good example of why understanding organic chemistry and biochemistry is useful for accurately educating and treating patients.
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Jesus right off the bat with number one, looking like an idiot to anyone who has taken ochem
 
I can't imagine that there's any hospital where nurses have enough autonomy to make the decision to intubate a patient outside of the most extreme situations. Even then, I'd rather have a RT, whose entire career is basically centered around managing airway and ventilation, dropping a tube than an RN.

But procedure-wise, intubation itself isn't really tremendously technical, and it definitely doesn't require 4 years of med school and 3+ years of residency.

Writing for paralytics and managing vent setting on the other hand...
 
Psai said:
Jesus right off the bat with number one, looking like an idiot to anyone who has taken ochem
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Welcome to America where people with no formal training in what they are talking about are hailed as heroes.

The same crap is evident in all of these random diet books. Before the internet, we would walk by and laugh. Now, we can read comments and see that other people are believing it. Ignorance has never been so apparent until now. We're in an age where credibility just isn't worth anything. The line between opinion and fact has never been so blurred. It's unfortunate.
 
LiamNeesons said:
Welcome to America where people with no formal training in what they are talking about are hailed as heroes.
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Hey now, that's not entirely true, she is a nurse after all.... and we all know nurses are doctors now too...
 
Psai said:
Let's not disrespect nurses, especially as med students
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it's a joke, lighten up. joking is all we can do as med students because absolutely no one, including nurses, respects us.
 
knowing HOW to intubate well takes a few weeks

learning WHEN to intubate takes longer

managing the complications associated with intubation takes even longer

i can't imagine a scenario where a nurse would have to intubate
 
Sublimazing said:
knowing HOW to intubate well takes a few weeks

learning WHEN to intubate takes longer

managing the complications associated with intubation takes even longer

i can't imagine a scenario where a nurse would have to intubate
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Hopefully I can in about 3-4 years...in med school.
 
maxxor said:
Yup, it's kind of an embarrassment to the field, and I say that as an eventual radiologist. This is changing with the new generation of IR attendings who maintain clinics and admitting privileges, but it's definitely not the norm outside of places like Miami Vascular.
Click to expand...
😵
 
loris said:
This morning a guy that has been getting increasingly preoccupied with medical conspiracy theories posted a long rambling Facebook status about doctors hiding the truth and misdiagnosing hypothyroidism. He included a link to this site: http://www.stopthethyroidmadness.com/2014/02/18/open-letter-to-physicians/. The first bold topic in the “Open Letter to All Physicians from a Nurse about Thyroid Treatment” is a pretty good example of why understanding organic chemistry and biochemistry is useful for accurately educating and treating patients.
Click to expand...

Oh lawd. Clearly just trying to sell some T3 instead of the evils of T4, erhmagerd.
 
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