The CRNA's can lobby for the states to change the laws.
But the CRNA's can't force you to train them like if there are future anesthesiologists. Train CRNA's to the bare minimum standards that is appropriate for a midlevel anesthesia provider. Not one bit more.
This is their Achilles' Heel and they know it. Here's a CRNA venting his anger over this.
You have posted a more insightful and timely viewpoint than you can realize. This topic has had much discussion lately...here as well as on other online CRNA forums and has included many respected viewpoints from SRNAs to members of the AANA BOD and program directors. I am going to paste my comment from another online discussion here also. This is an 'out of the mouthes of babes" moment in more ways than one. I expect you will be quoted across the discussion groups (in a good way). The fact that an SRNA is even in the position of having to ask these questions is indicative of a major failing in our current anesthesia programs. Many of us have been screaming about it for too long. Here is my take;
"I beleive that you touch on something that is the PRIMARY, SINGLE MOST IMPORTANT
objective to be completed in order to protect the quality of SRNA education,
provide the absolutely essential first step foundations for programs before they
can take any serious steps towards preparing students for independent practice,
and once and for all address the single, organized, concerted effort of
substance available and very purposefully used and discussed by and for
anesthesiologists to control CRNA practice.
I am talking about clinical experience for placement of central lines,
epidurals, spinals and nerve blocks.
We know that students frequently complain about or relate their woe-full lack of
experience in these skills due to supposed competition with residents or plain
refusal of clinical sites to allow them to participate. Anyone who thinks this
is by accident, or that there really are just to many residents to allow them to
participate, need only spend a little time on the student doctor network in the
chat rooms, and reading the ASA statements on these skills.
I am here to tell you that anesthesiologists and the ASA are engaged in an
active, organized and very passionate scheme to prevent SRNAs from obtaining
proficiency in these procedures, with the stated goal to actually prevent SRNAs
from being taught the skill, or participating in the teaching of these skills.
This is not done by whispered innuendo or propagated in member only chat rooms.
Rather the SDN participants, attendings, residents and medical students,
frequently, freely, openly and passionately discuss, encourage and aggressively
advocate doing everything they can to prevent the teaching of these skills. ASA
guidelines reject CRNA performance of these procedures.
Their campaign has been a resounding success. a few days ago in an online
discussion involving SRNAs a thread was created by an SRNA asking whether these
skills were actually important anyway. A debate on the answer ensued. YES...a
DEBATE. After watching the back and forth a bit I pointed out the above
mentioned ASA scheme and noted that the fact that a debate could even seem
appropriate spoke volumes. The answer, without room for debate without
detracting from the profession, is YES, they are absolutely positively
important. Can you imagine a group of residents having the debate?
We are full service anesthesia professionals. These skills are the minimmum
acceptable for education as a competent provider who claims the right to
practice and bill independently, provide anesthesia in any anesthesia setting,
and provide all manner of anesthetics. We have allowed a subtle, insidious and
effective clandestine conspiracy to take hold to the point that we don't even
give it a second thought. The ASA does...over and over and over, repeating it
via their members passionately and often.
Until this is aggressively addressed through the programs, we are accepting MDA
active interference with the proper training of our students on a national
level, and for no reason, and despite the fact that we could easily take steps
to rectify it."
The SRNA discussion I mentioned took place on here about a month ago. It is repugnant that ANY SRNA is meeting case or procedure requirements by OBSERVING someone else doing them. In fact I beleive it is unethical, unprofessional and without exception should NEVER be an accepted practice if a program wants to remain accredited. This is NOT meant to be a reflection on SRNAs, nor is it to cause them angst. But it IS, I beleive, one of THE most important issues our profession faces...if not THE most important. If not rectified it can do more damage than losing an opt-out, and if it IS rectified we have little to worry about when facing practice questions similar to opt outs in the future. And the solution is not entirely difficult. Make it happen or your university program will not be re accredited. We will be better off with less graduates properly educated than numbers who are relegated to second class students in the eyes of their programs.
As for what SRNAs can do? BE the squeaky wheel. Get pissed if a resident is sent into your room to do your spinal or epidural. complain to the program director and medical director. NEVER look happy about it. You are paying an assload of money for an education...and that education is to INCLUDE these experiences...they represent that it DOES in order to be accredited so they can take your money. Educating you is NOT A FAVOR they are doing you. REPORT programs to the Council on Accreditation that want you to watch or undertake a menial task yet claim a procedure or case as having been performed (feel free to wait until the day after you graduate..but DO IT).
This crap REALLY pisses me of anymore....
