SRNAs introducing themselves as residents

[j bones]

So this is happening now?

Intern on a somewhat disorganized anesthesia elective. I go in the room for induction and there's an SRNA (which I wasn't aware of). Post induction we do introductions, I introduce myself as an intern in my department. He introduced himself as "oh I'm a resident too! Nurse anesthesia resident"

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[ZzzPlz]

So this is happening now?

Intern on a somewhat disorganized anesthesia elective. I go in the room for induction and there's an SRNA (which I wasn't aware of). Post induction we do introductions, I introduce myself as an intern in my department. He introduced himself as "oh I'm a resident too! Nurse anesthesia resident"

Sounds legit

 

[anbuitachi]

at least he mentioned nurse anesthesia resident, instead of just saying resident. lol

 

[Psai]

In a few short months, he will call himself a residency trained, board certified doctor of anesthesia with a totally straight face. It's the me-too, screw education, intelligence and effort mindset that the elites are using to blur the lines while still causing divisions while they laugh all the way to the bank. The people who will be hurt are the patients while the administrators and insurance companies hide behind our coattails while we take all the blame for their misdeeds.

Everyone and their mothers are doing their best to ape our training in word. Why work hard if you don't have to? Everyone wants to wear a white coat, call themselves doctors and feel like people respect them. Even the floor nurses can do a few day training course they call residency. But the real doctors know who they can actually trust and so do an increasing number of patients.

 

[Man o War]

yes, they even do "fellowships"

 

[deleted171991]

So this is happening now?

Intern on a somewhat disorganized anesthesia elective. I go in the room for induction and there's an SRNA (which I wasn't aware of). Post induction we do introductions, I introduce myself as an intern in my department. He introduced himself as "oh I'm a resident too! Nurse anesthesia resident"

Anesthesiology is one of the few specialties where people can declare or imply having superior credentials without getting fired (like they should).

 

[AdmiralChz]

yes, they even do "fellowships"

Yep, I post about it a lot but my shop had an NP critical care fellowship. They often introduce themselves as ICU (nursing) fellows. Really glad I don't work there anymore, they were exceedingly aggressive and nasty towards residents/real fellows.

My upcoming PP job apparently has SRNA rotators at a couple sites, if any of them introduce themselves as a "nurse anesthesia resident" to me I'll probably just laugh.

 

[acidbase1]

We had a HUGE issue with this at my facility. My attendings freaked out and contacted their program. There then became a debate over the definition/etiology of the term "resident".

Their justification was it made the patients nervous by introducing themselves as "student nurse anesthetist". So the term "resident" was better in the clinical setting. This is a true story. They continued using the term despite the push back from attendings

 

[deleted171991]

We had a HUGE issue with this at my facility. My attendings freaked out and contacted their program. There then became a debate over the definition/etiology of the term "resident".

Their justification was it made the patients nervous by introducing themselves as "student nurse anesthetist". So the term "resident" was better in the clinical setting. This is a true story. They continued using the term despite the push back from attendings

So the medical students should also introduce themselves as residents, just because they make the patients nervous? How about the interns? Oh wait, everybody incompetent should just assume the title of somebody more competent, to con the customer.

Royally idiotic your hospital is. Also, if I were a patient, I would file a complaint with the state boards and the AG, for fraud and huge ethical lapses.

There is a very simple and common-sense rule: everybody should introduce themselves as either the title they have on their badge or the title they are credentialed for.

 

[acidbase1]

RRNA or SRNA for title, What is your opinion? | allnurses

Read this ^^^^

 

[jthedestroyr]

I did a pre op on a 1d old kiddo today. Guess who put the Cvl, art line, lines, intubation, chest tube than wrote the h&p.... The aprn, but the attending co signed the h&p bec they can't admit...... Yet.

We have a nicu/picu fellowship, yet the aprn did this all. Utterly disillusioned with medicine at this point in training.

 

[acidbase1]

So the medical students should also introduce themselves as residents, just because they make the patients nervous? How about the interns? Oh wait, everybody incompetent should just assume the title of somebody more competent, to con the customer.

Royally idiotic your hospital is. Also, if I were a patient, I would file a complaint with the state boards and the AG, for fraud and huge ethical lapses.

There is a very simple and common-sense rule: everybody should introduce themselves as either the title they have on their badge or the title they are credentialed for.

What's even funnier is it was a pretty large reputable academic institution

 

[jthedestroyr]

Oh yeah, I seen "clergy interns" and social work "interns" at our hospital too.

 

[deleted171991]

What's even funnier is it was a pretty large reputable academic institution

It's sad. American medicine is not going to hell, it's turning into it.

There is this misplaced egalitarianism, and exaggerated political correctness. Just call a nurse "nurse", and she'll consider it an affront.

 

[deleted171991]

Oh yeah, I seen "clergy interns" and social work "interns" at our hospital too.

That's OK, because "intern" really is a universal word, like "student". As long as there is a specifier before it.

 

[deleted126335]

Medical residents were called that because they actually lived in the hospital. It was expected and required. Interns were called that because you were "interned" there. By that I mean confined or imprisoned. That was the definition that gave rise to the term. Of course this was for the really old timers. Most of whom are gone now.


Sent from my iPhone using SDN mobile app

 

[deleted171991]

They didn't live in the hospital. They lived in a separate wing of the hospital or hospital-supplied housing, the same way many smaller hospitals still offer nearby accommodations for their residents.

Nothing has changed, just the number of hours. Still, the term "resident" implies a physician. And that's why it's trusted by patients. The same way "doctor" is. That's why nurses are working hard at misappropriating them. And that's why we should fight against this, in every single hospital, especially the cacademic ones. The terms "doctor" and "resident", in a clinical setting, should be reserved only for physicians.

 

[nimbus]

I did a pre op on a 1d old kiddo today. Guess who put the Cvl, art line, lines, intubation, chest tube than wrote the h&p.... The aprn, but the attending co signed the h&p bec they can't admit...... Yet.

We have a nicu/picu fellowship, yet the aprn did this all. Utterly disillusioned with medicine at this point in training.

The thing is the nurse practitioner has probably been doing it all day every day for years and is good at it. If it was my baby I'd rather get that person than a fellow.

 

[deleted126335]

Actually they did. At least at one hospital that I did a rotation at. One patient wing used to be where the house staff actually lived...till the hospital built an apartment complex across the street. Either way that is the origin of the terms intern and resident. They basically lived or resided there.


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[jthedestroyr]

It's sad. American medicine is not going to hell, it's turning into it.

Very funny as my wife and I have often talked about how people think the us system is so great, yet they keep lowering the bar for everything.

My friend the fight is only delaying the war we lost. I haven't even finished training but I feel like a complete nurse taking will happen in my life time, but surgery will be the last to go. Specifically plastics, ent, neurosurg will be last to go. Ortho could be the first surgery field they try as many of them do the same surgery over and over.

 

[eggscal99]

Look, if you don't like the way things are going, stop training them. Stop teaching them. If they're supposedly equivalent, have them learn from their own crna educators. And I like to work alone, I don't like to supervise, so I'm not worried about supervising poorly-trained crna.

Complain to your program directors, your chairmen... what's the point of training group A and group B who claim to do the same things and compete with each other? These academic institutions with SRNA programs are nothing but a bunch of sellouts. Nothing but greed and profit-driven agenda.

Back in residency, a few attending prefer to work with CRNA than residents. Why? So they can sign and leave, and sit in their room relax and pursue academic or personal interests. Residents, on the other hand, need to be supervised and taught. Sad. Bunch of lazy a$$ IMHO. the root of CRNA arises from greed and laziness.

 

[bashwell]

Look, if you don't like the way things are going, stop training them. Stop teaching them. If they're supposedly equivalent, have them learn from their own crna educators. And I like to work alone, I don't like to supervise, so I'm not worried about supervising poorly-trained crna.

Complain to your program directors, your chairmen... what's the point of training group A and group B who claim to do the same things and compete with each other? These academic institutions with SRNA programs are nothing but a bunch of sellouts. Nothing but greed and profit-driven agenda.

Back in residency, a few attending prefer to work with CRNA than residents. Why? So they can sign and leave, and sit in their room relax and pursue academic or personal interests. Residents, on the other hand, need to be supervised and taught. Sad. Bunch of lazy a$$ IMHO. the root of CRNA arises from greed and laziness.

I completely agree with your main message.

Ideally this would be good.

But realistically many PDs and Chairmen don't even have any real power to stop institutions from training future CRNAs. Nor do many attendings. Residents have even less power.

No one wants to train their replacement, but the first residents to speak out would be reprimanded and some even let go from the program. Even attendings are reprimanded. Just see what happened to Dr Elizabeth Ross at UNC for (rightly) saying what she said about CRNAs.

Maybe for this to have any real hope of success is for the vast majority of residents, attendings, PDs, Chairmen, and anyone else who wants to band together, get major media network attention, and publicly protest across the nation, even at the risk of losing their own jobs. (Similar to how junior doctors protested across the UK, though for the junior doctors nothing much really happened, not really, except now more junior doctors are trying to leave the NHS).

However, if they lose their academic jobs, where else can they go? Private groups are apparently being bought out left and right. So what's left? Locums, work for an AMC, or work for a struggling or unfair PP? Not necessarily the best options. Hence the possibility of losing their jobs would be a very real threat. Especially if they have any loans to pay back. My guess is the only ones who would be able to protest would be the ones who don't need their jobs, who have FU money saved up, which would most likely mean the older generation who are already settled in life, yet it's the older generations who are probably less likely to protest.

Otherwise, the other main solution is to let SRNAs/CRNAs train and practice completely independently. Zero support from any anesthesiologists. See how they do. But I don't know how this would realistically happen. And it's not really fair to the patients who have to suffer.

But I hope I'm completely wrong about everything I said.

 

[mmag]

Interesting...
It'll just be a matter of time before nurse anesthesia schools start calling themselves nurse anesthesia residency programs.

RRNA or SRNA for title, What is your opinion? | allnurses

Read this ^^^^

 

[bashwell]

Interesting...
It'll just be a matter of time before nurse anesthesia schools start calling themselves nurse anesthesia residency programs.

It looks like it's already kind of starting to happen! For example, see this article from Columbia University's School of Nursing.

 

[eggscal99]

I completely agree with your main message.

Ideally this would be good.

But realistically many PDs and Chairmen don't even have any real power to stop institutions from training future CRNAs. Nor do many attendings. Residents have even less power.

No one wants to train their replacement, but the first residents to speak out would be reprimanded and some even let go from the program. Even attendings are reprimanded. Just see what happened to Dr Elizabeth Ross at UNC for (rightly) saying what she said about CRNAs.

Maybe for this to have any real hope of success is for the vast majority of residents, attendings, PDs, Chairmen, and anyone else who wants to band together, get major media network attention, and publicly protest across the nation, even at the risk of losing their own jobs. (Similar to how junior doctors protested across the UK, though for the junior doctors nothing much really happened, not really, except now more junior doctors are trying to leave the NHS).

However, if they lose their academic jobs, where else can they go? Private groups are apparently being bought out left and right. So what's left? Locums, work for an AMC, or work for a struggling or unfair PP? Not necessarily the best options. Hence the possibility of losing their jobs would be a very real threat. Especially if they have any loans to pay back. My guess is the only ones who would be able to protest would be the ones who don't need their jobs, who have FU money saved up, which would most likely mean the older generation who are already settled in life, yet it's the older generations who are probably less likely to protest.

Otherwise, the other main solution is to let SRNAs/CRNAs train and practice completely independently. Zero support from any anesthesiologists. See how they do. But I don't know how this would realistically happen. And it's not really fair to the patients who have to suffer.

But I hope I'm completely wrong about everything I said.

You're right. I was a resident and I complained, but I was powerless. I hated my program because I felt that SRNA in some ways had better access to specialty cases and training sites off-limits to residents. As a CA-1 I was always doing general & urology cases, and my SRNA peers would already be doing OB, regional blocks, etc., since they have a shorter clinical training duration. I came out of residency not comfortable with simple things like epidural and blocks. So tons of classmates spent another year in fellowship, OB, regional, ... looking back, CA-1 was a complete waste of time.

I think chairmen have substantial power in steering the direction of the residency. However, at that level, they're just corrupt politicians more interested in generating revenue, promoting research and publication, enhancing the institute's ranking and reputation (often based on research volume), than truly interested in investing in the future of the profession and job competitiveness of individual graduates going into PP.

But you can start from yourself. You can work together, but you don't have to teach them. I gently tell SRNAs they're not very welcomed in my room. If they come, I don't teach much and I don't say much. I cringe when I see attending who like to show off their knowledge base and teach SRNA "residents" how to put in central lines or how to interpret TEE, as if their personal ego depends on it. This profession is a plate of scattered sand, but I do my part. I'm the power of one.

 

[twoliter]

... looking back, CA-1 was a complete waste of time.

I understand the sentiment of the rest of your post, but it's really disturbing if you truly believe this. I imagine at many programs the CA-1 year is full of general/ortho/urology cases without OB, cardiac, regional, etc.

 

[chocomorsel]

The thing is the nurse practitioner has probably been doing it all day every day for years and is good at it. If it was my baby I'd rather get that person than a fellow.

Wow. And that is how we justify training our own replacements. Quite frankly what is the point of being a doctor anymore?

 

[eggscal99]

I understand the sentiment of the rest of your post, but it's really disturbing if you truly believe this. I imagine at many programs the CA-1 year is full of general/ortho/urology cases without OB, cardiac, regional, etc.

my point is, SRNA training does take away some of the training experience, because there're just not enough rotation space for SRNA and CA1-3 to all be doing, for example, OB. Procedural skills depend on practicing, and if you wait till CA-2 to start OB, maybe 2 OB rotations throughout CA2-3, and maybe 2 epidurals on average per day because you have to share, well, it's not enough. If SRNA can progress through their entire clinical training in 16 months, there's no reason why we have to progress slower. A lot of times, you have to do enough of each specialty cases to truly acquire knowledge and procedural skills. You don't learn just by reading about it books. We had several rotation hospitals/sites that are SRNA only, off limits to residents. To me that's unacceptable.

 

[AdmiralChz]

my point is, SRNA training does take away some of the training experience, because there're just not enough rotation space for SRNA and CA1-3 to all be doing, for example, OB. Procedural skills depend on practicing, and if you wait till CA-2 to start OB, maybe 2 OB rotations throughout CA2-3, and maybe 2 epidurals on average per day because you have to share, well, it's not enough. If SRNA can progress through their entire clinical training in 16 months, there's no reason why we have to progress slower. A lot of times, you have to do enough of each specialty cases to truly acquire knowledge and procedural skills. You don't learn just by reading about it books. We had several rotation hospitals/sites that are SRNA only, off limits to residents. To me that's unacceptable.

If it's this big of an issue I'd encourage you and your residency colleagues to document these things appropriately in the annual ACGME survey.

Unfortunately, things at your program sound like they could use a period of probation to help re-orient departmental goals.

 

[Aether2000]

The best institutions should be maintaining some semblance of control over their own personnel to stay within their training and scope of practice, but it is my experience the hyper-liberal mindset of these universities of stupidity is that they believe they can train anyone to do anything. Johns Hopkins reportedly trains nurses to do colonoscopies. Instead of standing for quality, the institutions of higher education are stand for no standards at all.

 

[deleted171991]

The best institutions should be maintaining some semblance of control over their own personnel to stay within their training and scope of practice, but it is my experience the hyper-liberal mindset of these universities of stupidity is that they believe they can train anyone to do anything. Johns Hopkins reportedly trains nurses to do colonoscopies. Instead of standing for quality, the institutions of higher education are stand for no standards at all.

It's the higher ed industrial complex. They make a ton of money educating these people, both from tuition and from cheap workforce. They couldn't care less about the consequences. All their leaders want is to stay in power and keep pocketing the big money till retirement, so don't expect them to piss against the PC wind.

Everybody is selling out the medical field. Which makes me always wonder why these kids still go through all these sacrifices.

 

[Psai]

my point is, SRNA training does take away some of the training experience, because there're just not enough rotation space for SRNA and CA1-3 to all be doing, for example, OB. Procedural skills depend on practicing, and if you wait till CA-2 to start OB, maybe 2 OB rotations throughout CA2-3, and maybe 2 epidurals on average per day because you have to share, well, it's not enough. If SRNA can progress through their entire clinical training in 16 months, there's no reason why we have to progress slower. A lot of times, you have to do enough of each specialty cases to truly acquire knowledge and procedural skills. You don't learn just by reading about it books. We had several rotation hospitals/sites that are SRNA only, off limits to residents. To me that's unacceptable.

That is really pathetic. I don't have this issue so I can't sympathize but that's total bull****.

 

[eggscal99]

If it's this big of an issue I'd encourage you and your residency colleagues to document these things appropriately in the annual ACGME survey.

Unfortunately, things at your program sound like they could use a period of probation to help re-orient departmental goals.

I did recall some issues with ACGME surveys during residency, what they did was call on an emergency meeting and instead of improving the situation, they blamed the residents for providing false feedbacks and threatened us that if didn't pass the survey our training/credential would all be in jeopardy. Yes, we met the minimum ACGME # requirement. But do I really want to be the physician who barely met the minimum requirement? Sad, but some of these large academic places are more interested in generating profit and cheap labor.

 

[nimbus]

my point is, SRNA training does take away some of the training experience, because there're just not enough rotation space for SRNA and CA1-3 to all be doing, for example, OB. Procedural skills depend on practicing, and if you wait till CA-2 to start OB, maybe 2 OB rotations throughout CA2-3, and maybe 2 epidurals on average per day because you have to share, well, it's not enough. If SRNA can progress through their entire clinical training in 16 months, there's no reason why we have to progress slower. A lot of times, you have to do enough of each specialty cases to truly acquire knowledge and procedural skills. You don't learn just by reading about it books. We had several rotation hospitals/sites that are SRNA only, off limits to residents. To me that's unacceptable.

You should out the program so future applicants can avoid it. At least by PM to those interested. Applicants need to avoid programs with SRNAs. There are plenty of programs that don't train them. Who wants to compete for cases? Even if you don't get good teaching, you will learn if you do enough cases. That's the most important part of residency.

 

[eggscal99]

You should out the program so future applicants can avoid it. At least by PM to those interested. Applicants generally avoid programs with SRNAs. Who wants to compete for cases?

I'd hate to bash a program openly on internet. Maybe they've improved since I graduated, I don't know. But at my current job, I see SRNA getting much, much better OB experience than I did during residency... and I see CRNA earning 300+k (long hours with frequent calls, of course)... and it makes me wonder, does it make sense to invest 4 years of college, 4 years of med school, 4 years residency, 1 year fellowship, and student loans... all for an MD title so I can take care of sicker, higher risk patients with marginally more pay?

 

[eggscal99]

You should out the program so future applicants can avoid it. At least by PM to those interested. Applicants need to avoid programs with SRNAs. There are plenty of programs that don't train them. Who wants to compete for cases? Even if you don't get good teaching, you will learn if you do enough cases. That's the most important part of residency.

If I have to do it again I'd avoid programs with SRNA programs. Your department is clearly more interested in profits and cheap labor.

 

[deleted171991]

Let me fix that for you:

Everyone and their mothers are doing their best to ape our training in word. Why work hard if you don't have to? Everyone wants to wear a white coat, call themselves doctors and feel like people respect them. Even the floor nurses can do a few day training course they call residency. But the real doctors know who they can actually trust and so do an increasing a rapidly decreasing number of patients.

There are so many types of "providers" that it makes the patients' heads' spin. That's the whole purpose of it: confusing people to the level that they won't refuse non-physicians anymore, because they just won't recognize them. Just yesterday I could see on the face of one of my patients that he didn't understand why he needs both a CRNA and an anesthesiologist, what our respective roles were.

I hate conspiracy theories, but this is clearly one of them, with the American healthcare corporations behind it.

 

[nimbus]

Let me fix that for you:

There are so many types of "providers" that it makes the patients' heads' spin. That's the purpose of it. Just yesterday I could see on the face of one of my patients that he didn't understand why he needs both a CRNA and an anesthesiologist, what our respective roles were.

That's because they don't need both. It's redundant.

 

[deleted171991]

That's because they don't need both. It's redundant.

That's right... in your world. In mine, you need both to make more money as their employer.

However, my point was that patients have so many (types) of people taking care of them nowadays, that they have no idea who's who and who does what. Especially when those who shouldn't wear white coats do, and the opposite. Once upon a time, there were doctors and nurses, period. Now you have so many (worthless) titles, all designed to make little people feel important and make the patient accept them (instead of doctors).

 

[pgg]

Wow. And that is how we justify training our own replacements. Quite frankly what is the point of being a doctor anymore?

Don't get depressed or demoralized by the things other people are getting away with.

Being a doctor has never been about mechanical skills and procedures. Not even surgery - though obviously those skills are important.

Being a doctor is about the practice of medicine. Not just the knowledge to know how to do a procedure, but the knowledge to know when to do them, when not to do them, how to manage complications. Risks and benefits when the water is muddy. Broad and deep knowledge base to see non-obvious risks before they become dangers.

The point of being a doctor is providing the best care to our patients. The fact that some other people are doing some of the things we do, for (possibly) comparable hourly wages, after a lot less training, doesn't alter the point of being a doctor. We are what we are because we cared enough about being the best we could be, and we had the talent and drive to make it happen.



Also, chicks, money, power, and chicks.

 

[nimbus]

Don't get depressed or demoralized by the things other people are getting away with.

Being a doctor has never been about mechanical skills and procedures. Not even surgery - though obviously those skills are important.

Being a doctor is about the practice of medicine. Not just the knowledge to know how to do a procedure, but the knowledge to know when to do them, when not to do them, how to manage complications. Risks and benefits when the water is muddy. Broad and deep knowledge base to see non-obvious risks before they become dangers.

The point of being a doctor is providing the best care to our patients. The fact that some other people are doing some of the things we do, for (possibly) comparable hourly wages, after a lot less training, doesn't alter the point of being a doctor. We are what we are because we cared enough about being the best we could be, and we had the talent and drive to make it happen.



Also, chicks, money, power, and chicks.

I agree with everything you say. And sometimes what the patient needs are monkey skills. If my baby needed monkey skills I'd want the person with the best monkey skills, doctor or nurse. That's all I'm saying.

 

[pgg]

I agree with everything you say. And sometimes what the patient needs are monkey skills. If my baby needed monkey skills I'd want the person with the best monkey skills, doctor or nurse. That's all I'm saying.

That's fair

What's disturbing is a NP making the decision to place lines or intubate. A physician should be directing care.

It matters less who's doing the procedure. Although if there are fellows around, a good training program will afford them the opportunity to do as many as they need, even if there's a skilled monkey around who can do it faster.

 

[teeva]

Being a doctor is about the practice of medicine.

*was*

American medicine is all currently all about flow charts, protocols, checklists, quality measures, quotas, minute by minute data tracking, surveys, patient satisfaction scores, preauthorizations, and hourly convincing oneself not to walk out the door and do something else in life.

Anesthesiology is somewhat removed from all that, thankfully. For now.

 

[pgg]

*was*

American medicine is all currently all about flow charts, protocols, checklists, quality measures, quotas, minute by minute data tracking, surveys, patient satisfaction scores, preauthorizations, and hourly convincing oneself not to walk out the door and do something else in life.

Anesthesiology is somewhat removed from all that, thankfully. For now.

All that crap has been heaped upon us by clowns who don't have patient care foremost in their minds, to put it in polite way.

But the important part of doctoring is still there. We have the same duty and obligation to patients as we always had. The profession is harder than it used to be, and maybe less rewarding depending on one's practice environment. And yes, our MBA overlords and ambitious eye-clawing shoulder-chippy underlings are a problem.

But the core of what a doctor is hasn't changed.

 

[Man o War]

This is very institution dependent, so choose wisely med students. Both places I trained the CRNAs were always griping that they never got the good cases, didn't get to touch the TEE probe, etc. I can't imagine the hell that would've rained down had one of them referred to themselves as a resident.

 

[bashwell]

All that crap has been heaped upon us by clowns who don't have patient care foremost in their minds, to put it in polite way.

But the important part of doctoring is still there. We have the same duty and obligation to patients as we always had. The profession is harder than it used to be, and maybe less rewarding depending on one's practice environment. And yes, our MBA overlords and ambitious eye-clawing shoulder-chippy underlings are a problem.

But the core of what a doctor is hasn't changed.

Unfortunately the core of what a clown is hasn't changed either!

 

[CardioDad]

Dear Lord,

Please spare me from any surgery or procedure requiring anesthesia until I wake up dead in my bed. If your will dictates otherwise, I beg of you that I am in the hands of an anesthesiologist and not some 'well-practiced' nurse, no matter the accompanying acronym. Even though another post on this board talks about the extinction of professional courtesy and the inability (or unwillingness) of said anesthesiologist to honor a request that they sit the case, I pray that I get a perhaps-rusty DOCTOR instead of some da*n nurse. (Request: not Joan Rivers' level of rusty.)

It is said that "Jesus wept" and I have the meme to prove it. I'd simply like to say that I do, too. Bless all of the doctors who have to put up with the BS that has become the practice of medicine. God help us all...

Your humble patient, whose in-network hospital is UNC, though her life-long PP physicians have been bought by Duke and, therefore, are no longer in-network. Please speak to Beelzebub about the choices he gave me via his servant, BCBS,

CardioDad

 

[pgg]

This is very institution dependent, so choose wisely med students. Both places I trained the CRNAs were always griping that they never got the good cases, didn't get to touch the TEE probe, etc. I can't imagine the hell that would've rained down had one of them referred to themselves as a resident.

Very true

We train SRNAs, and being a military hospital part of our mandate is to train them to a certain level of independent safety, because they may be sent forward to austere locations with staffing that may not include anesthesiologists.

(That decision has been made by Big Army/Navy/AF and well beyond our control or even influence.)

Even so, our ACGME-accredited residency program is not affected by their presence. Resident case assignments are first priority, and SRNAs get what's left over. They arrange rotations at other institutions to get their exposure to cardiac, neurosurgery, and to round out their peds time.

Any program that puts a SRNA in a case when there is a resident available who would benefit from that case, is wrong. This should be reported to ACGME and it should be a focus of their program reviews. If resident education isn't the top priority behind patient care, that place shouldn't have a residency program at all.

 

[psychbender]

Yep, I post about it a lot but my shop had an NP critical care fellowship. They often introduce themselves as ICU (nursing) fellows. Really glad I don't work there anymore, they were exceedingly aggressive and nasty towards residents/real fellows.

My upcoming PP job apparently has SRNA rotators at a couple sites, if any of them introduce themselves as a "nurse anesthesia resident" to me I'll probably just laugh.

PM me where this is, if you don't mind, so I can avoid it when looking for post-fellowship jobs.

Sent from my SM-G930V using Tapatalk

 

[Mad Jack]

Oh yeah, I seen "clergy interns" and social work "interns" at our hospital too.

Those are real internships in the traditional sense. Internship is typically an unpaid or lowly paid educational/experience position and such things have been called that forever. Resident is a medical specific term, however, and should not be coopted.