SRNA "Resident"

[FutrrENT]

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I'm a bit counfused here. 😕

Anesthesia, as a profession, is trying to stand up against nurse encroachment in their field, as they well should. You guys are beating your chests, yelling that residency trained physicians are the ones that should be administering anesthesia. (Couldn't agree more!) You are screaming about militant nurses providing inferior care, CRNA mills pumping out an inferior product, and how the residency trained physician anesthesiologist should never be replaced by a cheaper product with less education and training. You (as a group) also lament the lack of knowledge by the public who doesn't know the difference between a CRNA and an MD/DO (do most lay people even know what a DO is?), and how they want the cheapest way to do something, not necessarily the best.

Then, when FutrrENT comes on here and says, that as a patient and a future (potential) surgeon he wants to be cared for by, and work with, physicians only, all he gets is how "we can't do it that way". He is even called "absurd, unprofessional, and unethical". But hey, if you're one of our surgeons, we'll accomodate you. How's that for ethics?!?

You actually have someone buying into your argument, and everyone is slapping him down. He's expressing an opinion, and I bet a good part of that comes from reasoning made after reading these boards. So where's the follow through? Someone actually gets educated and tries to make a decision about their care (or the care of others in their care) and they are told "The patient does not have the right to dictate who renders their care." So much for patient involvement and self education.

What gives? 😕

(FWIW, anesthesia is on my short list of fields I am VERY interested in.)

Actually, my opinion isn't based on what I've read on this forum. It's based on my personal knowledge of medical school as well as my experience working with anesthesiologists and nurse-anesthetists, and witnessing the difference between the two.

 

[FutrrENT]

I don't agree that the worst anesthesiologist is safe. I think the worst in any profession is not safe regardless of the amount and time of training. Now if you were to put the worst anesthesiologist against the worst CRNA, in this case, the amount and time of training could make a difference. But I would still prefer to go with average or above average provider be it MDA or CRNA rather than the worst MDA.

Nobody gives a sh.t what you agree with, nurse. If you want your opinions on the competence of the physicians around you to count, then you need to go to medical school. Until that impossible day, your assessment of any doctor's skill wouldn't be worth the paper it's written on.

Better yet, look at it this way: if a patient ever died under the care of an anesthesiologist, nobody would be calling your dumb CRNA ass to testify as an expert witness.

 

[Mman]

There are many more things that can readily kill a patient in the OR (both surgery and anesthesia wise) than in the ICU.... So, your precious medical education is probably more readily needed in one setting vs. the other....

I believe I've made my points so I'll drop it after this, but...

Is there really more things that can kill an ASA 1 patient having a lap chole in the OR than an ICU full of ASA 4 patients on multiple drips and tenuous vent settings? I mean people drop dead in the ICU all the time. That's what happens. How many people are actually dying in the OR? We do about 30,000 anesthetics a year on the sickest patients you will see and somehow manage to have maybe 2 or 3 people a year die on the table.

In a properly run ACT model, you aren't supervising 4 open AAAs at once. If you have one big case, you might have 1 or 2 other easy rooms with it and you might even be getting helped by your partners with those while you are tied up.

And it's also not like you are only poking your head in the room when you get paged. I'm in the rooms all the time. I pretty much don't ever sit down during the day. I just cruise from room to room with periodic stops in preop and PACU when needed.

 

[Monty Python]

.... is there anything in this world more pathetic than a male nurse? It's akin to being a man and wearing a badge that says you don't have a penis. .....

That comment was really below the belt.




.

 

[scudrunner]

I'll gladly take the title of "ologist" instead of "nurse". I mean, is there anything in this world more pathetic than a male nurse? It's akin to being a man and wearing a badge that says you don't have a penis. There are some professions that aren't intended for men, and nursing is one of them! I hate to break it to the troll who seems to have joined the discussion, but being a male CRNA is still being a nurse.

Dude, your pro-physician anesthesia position is appreciated but you're losing credibility with this statement. Being a nurse, whether male or female, is nothing to be ashamed about. You are way out of line with this type of attitude.

 

[IN2B8R]

I believe I've made my points so I'll drop it after this, but...

Is there really more things that can kill an ASA 1 patient having a lap chole in the OR than an ICU full of ASA 4 patients on multiple drips and tenuous vent settings? I mean people drop dead in the ICU all the time. That's what happens. How many people are actually dying in the OR? We do about 30,000 anesthetics a year on the sickest patients you will see and somehow manage to have maybe 2 or 3 people a year die on the table.

In a properly run ACT model, you aren't supervising 4 open AAAs at once. If you have one big case, you might have 1 or 2 other easy rooms with it and you might even be getting helped by your partners with those while you are tied up.

And it's also not like you are only poking your head in the room when you get paged. I'm in the rooms all the time. I pretty much don't ever sit down during the day. I just cruise from room to room with periodic stops in preop and PACU when needed.

Not to beat this horse to death, but you seem to want to utilize false analogies to suit your point of view. A proper question would have been: is an ASA-4 patient better served through one on one MD care, or is that patient better cared for in an ACT model, while running around supervising other rooms? If you were that ASA-4 patient, under which care model would you rather be? We both know the answer to that question. Like I have stated before: I have worked in both models of care, the ACT model is not safer as you claim it to be. Nothing that you have written thus far supports that.

 

[FutrrENT]

Not to beat this horse to death, but you seem to want to utilize false analogies to suit your point of view. A proper question would have been: is an ASA-4 patient better served through one on one MD care, or is that patient better cared for in an ACT model, while running around supervising other rooms? If you were that ASA-4 patient, under which care model would you rather be? We both know the answer to that question. Like I have stated before: I have worked in both models of care, the ACT model is not safer as you claim it to be. Nothing that you have written thus far supports that.

Again, I'm going to admit that I haven't studied the data directly, but simple logic would be enough to conclude that the ACT model is not as safe as the MD model. How could it possibly be?

In the ACT model, you are depending on a few things to take place: 1. the CRNA to practice competently, 2. the CRNA calling for the anesthesiologist when something goes wrong rather than trying to troubleshoot the problem themselves, 3. the anesthesiologist being able to supervise four CRNA's adequately, which itself depends on not having four cases become complicated. Whereas the MD only model gives the patient direct, expert care, dependent only on the anesthesiologist doing his job properly.

 

[IlDestriero]

Not to beat this horse to death, but you seem to want to utilize false analogies to suit your point of view. A proper question would have been: is an ASA-4 patient better served through one on one MD care, or is that patient better cared for in an ACT model, while running around supervising other rooms? If you were that ASA-4 patient, under which care model would you rather be? We both know the answer to that question. Like I have stated before: I have worked in both models of care, the ACT model is not safer as you claim it to be. Nothing that you have written thus far supports that.

Got to agree with the B8R. My staffing model ranges from solo provider to 1:1 with a fellow to 1:2 with CRNAs/residents. What you get depends on case planning, luck, and add ons. We're rarely 1:3, and usually only to help people get out early if cases are winding down and not going to the PICU/NICU. I also spent several years as a direct care provider. (solo)
The patients are definitely best cared for 1:1 or solo by me. Most real world groups are 1:3 or 1:4 all the time. That's the reality. It may be safe and efficient, but there's no way it's safer for anyone. When you're there all the time you see everything, anticipate, etc. No urgent pages to deal with issues that you would have seen coming if you were present the whole time.

 

[FutrrENT]

Dude, your pro-physician anesthesia position is appreciated but your losing credibility with this statement. Being a nurse, whether male or female, is nothing to be ashamed about. You are way out of line with this type of attitude.

I know that's a vey politically-correct position to take, but you don't really believe that, do you? I mean, what father would want his son to grow up to be a nurse?

 

[jwk]

I know that's a vey politically-correct position to take, but you don't really believe that, do you? I mean, what father would want his son to grow up to be a nurse?

You really are clueless on so many levels.

 

[jwk]

Again, I'm going to admit that I haven't studied the data directly, but simple logic would be enough to conclude that the ACT model is not as safe as the MD model. How could it possibly be?

In the ACT model, you are depending on a few things to take place: 1. the CRNA to practice competently, 2. the CRNA calling for the anesthesiologist when something goes wrong rather than trying to troubleshoot the problem themselves, 3. the anesthesiologist being able to supervise four CRNA's adequately, which itself depends on not having four cases become complicated. Whereas the MD only model gives the patient direct, expert care, dependent only on the anesthesiologist doing his job properly.

Yet this happens every day in practices all over the country. Remember the REALITY is that there CAN'T be an anesthesiologist personally administering every anesthetic in this country.

So - assuming you are NOT in an all-MD practice. You have a choice - a real ACT practice where an anesthesiologist directs the care and is personally involved with every case (as in the 7 rules of TEFRA), a practice where an anesthesiologist simply "collaborates" with nurse anesthetists (their new favorite term) may or may not be there or even available when **** hits the fan, or an all-CRNA practice. You make the call.

 

[scudrunner]

I know that's a vey politically-correct position to take, but you don't really believe that, do you? I mean, what father would want his son to grow up to be a nurse?

Yes, that is what I believe... along with most everyone else. Nursing is a very respectable career for a guy and a helluva lot better than some of the alternatives. Not everyone wants to be, or for that matter can be, a doctor.

 

[FutrrENT]

Yet this happens every day in practices all over the country. Remember the REALITY is that there CAN'T be an anesthesiologist personally administering every anesthetic in this country.

So - assuming you are NOT in an all-MD practice. You have a choice - a real ACT practice where an anesthesiologist directs the care and is personally involved with every case (as in the 7 rules of TEFRA), a practice where an anesthesiologist simply "collaborates" with nurse anesthetists (their new favorite term) may or may not be there or even available when **** hits the fan, or an all-CRNA practice. You make the call.

What exactly does "collaborates" entail?

 

[scudrunner]

This is at USC



Fall Semester
ANST 500
INTD 572
ANST 501
ANST 502
Courses4 days/week;
6 Fridays/semester

Spring Semester
ANST 503
ANST 504
ANST 505
Courses 2 days/week;
3 days clinical residency

Summer Semester
ANST 506
ANST 507
Courses 1 day/week;
4 days clinical residency YEAR 1

Human Anatomy
Systems and Integrated Physiology
Pharmacology of Anesthesia Practice
Principles of Anesthesia Practice I

Total


Advanced Pharmacology of Anesthesia Practice
Pathophysiology Related to Anesthesia Practice
Clinical Residency in Nurse Anesthesia I

Total


Advanced Principles of Anesthesia Practice II
Clinical Residency in Nurse Anesthesia II

Total

3units
4 units
4 units
4 units

15 units


3 units
4 units
3 units

10 units


4units
2 units
6 units


Fall Semester
ANST 508
ANST 509
ANST 510
Courses 1 day/week;
4 days clinical residency

Spring Semester
ANST 511
5 days/week

Summer Semester
ANST 512
ANST 513
5 days/week
YEAR II

Research: Investigative Inquiry
Advanced Clinical Residency in Nurse Anesthesia I
Professional Aspects for Nurse Anesthesia

Total


Advanced Clinical Residency in Nurse Anesthesia II

Total

Research Integration: Capstone Experience
Advanced Clinical Residency in Nurse Anesthesia III

Total


2 units
3 units
3 units

8 units


4 units

4 units

1 unit
1 unit

2 units



ANST514
YEARIII (optional)*

Specialty Fellowship



2units

 

[24858]

I would rather my son be a teacher than a nurse. Would you want your daughter to be a pro wrestler or pro weightlifter? I mean if it happened you would try to be supportive, but like ENT man said, no one would want it. If your a male become a PA, but a nurse? C'mon, that is so emasculating it isnt even funny.

 

[24858]

Most of the CRNAs I worked with are fat little ladies that are unmarried. Or these weirdo guys that if you talk to them you start to realize they are semi insane.

 

[24858]

I mean seriously why do you think these male CRNA ***** want to get PhD's? Not so they can tell the patients, but so when they go to a dinner party they can boldly proclaim, I'm a DOCTOR!!!! Its gotta be pretty limp dick telling people at a party, yeah I am a male nurse, I couldnt get into med school cuz I'm ******ed and lazy, but I swear I am just as good as any DOCTOR, and I bet you wouldnt want a doctor to do your anesthesia, RIGHT? I'm just as good as a DOCTOR, right? You believe me right? Wahahaha....

 

[Arch Guillotti]

I'll gladly take the title of "ologist" instead of "nurse". I mean, is there anything in this world more pathetic than a male nurse? It's akin to being a man and wearing a badge that says you don't have a penis. There are some professions that aren't intended for men, and nursing is one of them! I hate to break it to the troll who seems to have joined the discussion, but being a male CRNA is still being a nurse.

This is silly. I know plenty of male nurses who are just regular guys. We all like to make fun of the murses but for goodness sakes I think you are taking this just a little too far.


With that said this thread has degenerated far enough and I am closing it.