Thought this might add some controversey

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badgas said:
Will you please, please leave these forums?
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I agree 100%. Conflicted has 74 posts in month and I'd venture to say that 2/3 of them are on combative CRNA vs MD threads like this - threads that are making this forum go right in the crapper.

This is an ANESTHESIOLOGY forum, let's talk about ANESTHESIOLOGY.
 
Actually

If you read all of my posts (which i went back and did) the ones where i was "combative" were always in response to someone attacking me.

Here they are.

I have tried to be professional and add to some discussions as well as educate people about CRNAs. What im met with in the majority of those posts are "go away nurse". Tell me who is at fault there? Who amoung you would not defend yourself and your profession to such attacks?

Before you answer, go ahead and read back through those threads and tell me, who became confrontational and unprofessional off the jump?
 
There is an ignore button that you guys can use. If everyone would use it then the nurse would be lost for good. I have made it clear as to what constitutes banning in my opinion.
 
Conflicted said:
Actually

If you read all of my posts (which i went back and did) the ones where i was "combative" were always in response to someone attacking me.

Here they are.

I have tried to be professional and add to some discussions as well as educate people about CRNAs. What im met with in the majority of those posts are "go away nurse". Tell me who is at fault there? Who amoung you would not defend yourself and your profession to such attacks?

Before you answer, go ahead and read back through those threads and tell me, who became confrontational and unprofessional off the jump?
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call the baylor anesthesia department and tell them how nitecap really feels... go away...
 
Originally Posted by fakin' the funk
Conflicted has 74 posts in month and I'd venture to say that 2/3 of them are on combative CRNA vs MD threads .
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I've read them all and I'd say your math skills are very lacking. None of those posts were attacking, only setting a matter straight. Sounds like it's time for some math and literature remediation. 🙂
 
Having been a major player in the anesthesia world for a long time, there is one thing I am certain of: everything is related to money, power or sex. Leaving the last one alone for the time-being, most of the MD/CRNA conflicts are related to the first two.

Fact: MD anesthesiologists employ and make a lot of money off of CRNAs. Not all, of course, but the ones that do, can make a significant amount of money from their competent CRNAs. It is a common sight in such settings to see the anesthesia lounge full of physicians surfing the net, reading the paper, etc and of course drinking coffee and BSing, while the CRNAs are in the OR gaining respect from the surgeons, the staff and closely watching the patient.

Fact: In many of these "group/medicially directed" settings, the CRNAs who were closely monitored during the day, get very smart after 3:00 pm and are left alone to do the emergencies, OB cases and finish the schedule.

Fact: CRNAs do indeed cover the majority of the rural hospitals in the country, because physician anesthesiologists are not interested in those geographic areas.

Fact: CRNAs work independently every day. I am one of them who works in plastic surgery. The surgeons I practice with do surgery on physicians all of the time and I have never had one (including anesthesiologists) refuse to have me do their anesthesia.

Fact: All of the rhetoric from every direction will be moot with the upcoming debates on health care economics. The future will be different for all of us, so be prepared.

Fact: CRNAs would not be still around (after 100 years) if we were not excellent practitioners. It is as simple as that.

I have been doing clinical anesthesia for years before most of you were born, love it, continue to study it and have a following of happy patients and surgeons. Say, what you want about me, you don't know me, but you may look up and see me when you are having your plastic surgery, and I promise you will have a good and safe anesthesia experience.

yoga crna
 
Can everyone just let this thread and others like it die. I used to come to this sight and find useful and sometimes funny threads. Seems like now all I ever see when I'm here is CRNA vs MD. Nothing ever comes from these threads but whining and pissing contest. Maybe they should start a new forum for CRNA vs MD and keep the more useful threads on this forum.
 
yoga crna said:
Fact: MD anesthesiologists employ and make a lot of money off of CRNAs. Not all, of course, but the ones that do, can make a significant amount of money from their competent CRNAs. It is a common sight in such settings to see the anesthesia lounge full of physicians surfing the net, reading the paper, etc and of course drinking coffee and BSing, while the CRNAs are in the OR gaining respect from the surgeons, the staff and closely watching the patient.


yoga crna
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DUDE..........have you been hanging out in OUR physician lounge?!?
 
I hope everyone realizes that we are dealing with ONE troll that has multiple screen names. nitecap, conflicted, yogafruit, or whatever gaylord focker wants to call themself next, just ignore them all so there can be posts with useful information again.
 
yoga crna said:
Fact: CRNAs do indeed cover the majority of the rural hospitals in the country, because physician anesthesiologists are not interested in those geographic areas.
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Fact: CRNAs are subsidized to cover rural areas. This option is not currently available to anesthesiologists but this is a battle being fought in D.C. as we speak to level the playing field.
 
Gern Blansten said:
Fact: CRNAs are subsidized to cover rural areas. This option is not currently available to anesthesiologists but this is a battle being fought in D.C. as we speak to level the playing field.
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Perhaps you can explain how CRNAs are subsidized to cover rural areas. If you are talking about Medicare, hospitals are subsidized, but that may or may not be passed through to CRNAs. Many CRNAs who practice rural hospitals are self-employed and are reimbursed directly by CMS for their professional anesthesia services. I believe this is just a Medicare issue anyway, commercial insurers do not subsidize anyone.

I have many friends who cover rural hospitals 24/7 and are probably underpaid for the responsibility they have. Lots of farm accidents, high risk OB with no pre-natal care, GP's doing surgery, lack of good nursing support staff and no time off. They also handle ICU patients, codes and post-op pain control. They are good and love what they do.

yoga crna

Fact, I have never posted here under any other name. Another fact you got wrong. Arrogance and ignorance are a bad combination.
 
yoga crna said:
Having been a major player in the anesthesia world for a long time, there is one thing I am certain of: everything is related to money, power or sex. Leaving the last one alone for the time-being, most of the MD/CRNA conflicts are related to the first two.

Fact: MD anesthesiologists employ and make a lot of money off of CRNAs. Not all, of course, but the ones that do, can make a significant amount of money from their competent CRNAs. It is a common sight in such settings to see the anesthesia lounge full of physicians surfing the net, reading the paper, etc and of course drinking coffee and BSing, while the CRNAs are in the OR gaining respect from the surgeons, the staff and closely watching the patient.

Fact: In many of these "group/medicially directed" settings, the CRNAs who were closely monitored during the day, get very smart after 3:00 pm and are left alone to do the emergencies, OB cases and finish the schedule.

Fact: CRNAs do indeed cover the majority of the rural hospitals in the country, because physician anesthesiologists are not interested in those geographic areas.

Fact: CRNAs work independently every day. I am one of them who works in plastic surgery. The surgeons I practice with do surgery on physicians all of the time and I have never had one (including anesthesiologists) refuse to have me do their anesthesia.

Fact: All of the rhetoric from every direction will be moot with the upcoming debates on health care economics. The future will be different for all of us, so be prepared.

Fact: CRNAs would not be still around (after 100 years) if we were not excellent practitioners. It is as simple as that.

I have been doing clinical anesthesia for years before most of you were born, love it, continue to study it and have a following of happy patients and surgeons. Say, what you want about me, you don't know me, but you may look up and see me when you are having your plastic surgery, and I promise you will have a good and safe anesthesia experience.

yoga crna
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You make some good points provided they are actually your honest experiences. I would tend to agree that some of the problems in anesthesiology are the doings of the MD/DO's. But, like you said, times do change. There are some very strong candidates currently pursuing the profession on the doctor side. And, from what I can gauge, they intend on practicing in a very different way from that which you describe. So, it goes both ways. Be prepared.

Look, I've met some CRNA students that I KNOW are top notch in terms of their attitudes and professionalism. But, I've also witnessed some SLOBS with union attitudes and blue collar demeanors rivaling those I've seen in the UAW, while waiting in the CRNA lounge for my resident MD to come down and meet me for a shadowing experience. So, let's go easy on the anecdotes, because it, again, goes both ways.
 
I hope everyone realizes that we are dealing with ONE troll that has multiple screen names. nitecap, conflicted, yogafruit, or whatever gaylord focker wants to call themself next, just ignore them all so there can be posts with useful information again.
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Arrogance and ignorance are indeed a bad combination. I know nitecap. Nitecap has vanished from the public eye for sometime now. Besides, he couldn't post with the same eloquence and authority as those above. Perhaps paranoia should be added to arrogance and ignorance....or is it a byproduct? hmmmmmm

regards,
moneyshot
 
Yeah sevo85288, the fact that there will be more crnas than mds who cares? As an anesthesiologist I know I can never in reality be threatened by a crna, b/c like it or not I am not competing with a crna for a position, hospitals will always need anesthesiologists. The fact that there will be a lot more crnas will only serve to diminish their earning capacity, have absolutely no bearing on my earning potential. The hospitals with md groups will always be hiring other md's the fact that the crna pooled has quadrupled will not affect me or any other md. The fact that the crna pool has quadrupled will affect crna income however, ha, ha, ha,ha....oh well it backfired on those fools, they pumped out huge numbers of crnas, now they will, by supply and demand take huge pay cuts, ha, ha, ha, ha, ... they thought they were going to take over the anesthesia market by pumping out huge numbers the only thing they accomplished was to hurt themselves...and I really hope that the AA's get to practice all over the country, lets get rid of all crnas they are nothing but bitter people. They are the same as an md...give me a break. No you are not. The stress of becoming and being a md you have not a clue. The responsibility of going thru the process you could never imagine. When you look at the scope of everything if all that were left were crnas and no more anesthesiologists, the anesthesia world would collapse. Pt care would be extraordinarily compromised. I have no respect for the crnas that come in here and talk down to residents, let them try to do that face to face to an attending anesthesiologist.
 
MeaCulpa said:
I have no respect for the crnas that come in here and talk down to residents, let them try to do that face to face to an attending anesthesiologist.
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Neither do I. I work in NJ where the market is becoming saturated for the CRNAs. Very recently, I had a CRNA who thought he was hot ****. Bad attitude, thought he knew as much as the doctors, always talking bad about other anesthesiologists, etc. Once I got a few complaints too many he and I had a "sit down" during which he tried to pull some sort of shi*ty attitude. Know what? My man is out lookin' for another job! Gotta' toe the line nowadays, nurses........gotta' toe the line!
 
VolatileAgent said:
i think crna's get too much training, personally. it's excessive. i think we should allow regular CC nurses into the OR to help run anesthesia cases. we could have 2-3 critical care nurses chart vitals, teach them the basics about what to watch out for, and to call us if there's a problem. hell, most of them know how to titrate a sedative infusion in the ICU. it's basically the same thing. if they have a problem, they call us.

this is well within a regular nurse's skill set. giving an anesthetic is not practicing anesthesiology. i think we could make this work. i propose we take the initiative upon ourselves as a profession. we don't have to "supervise" everything a nurse does in the ICU. if we give parameters to a nurse to follow, and to chart vitals, i think we could make this happen. we really don't need crna's for the bulk of what we do in the OR either, do we? we'll stick the tube in, we'll set-up the lines, we'll do all the big procedures, they'll be there to help, then we can leave the room to start another case once the anesthetic is running. and they'll have specific parameters to follow, and will simply call us if there's a problem. we just need to be available and to circulate through the room. we do the inductions, with their help, and the wake-ups, with their help, and then in between we can work different teams.

what do you think? who really needs crna's with that level of training if we're there for the critical procedure-parts of a case? when you come to think of it, we just need to back the movement of regular critical care nurses into the OR. after a few months of orientation, they'd get the hang of it. and this would fall under the scope of nursing practice, without a doubt.

i would gladly be all for sponsoring a pilot program of this. i just need willing participants.
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This would be illegal in most (if not all) states due to specified exclusions and limitations in the nurse practice acts.
 
crockett said:
As seen on the www.gaspasser.com site;


Contrast that with the AANA who has figured out that doling out the title of "board certified" to everybody helps their profession. I doubt more than 5% of the CRNAs who sit for the exam fail the written exam.
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Going back at least 15 years, the AANA boards have a consistent first-time pass rate in the upper 80% to very low 90%. There is an anesthesiologist representative on the Council for Certification, and an anesthesiologist is a participating member on the panel which writes board questions.
 
7by11thenout said:
I am board certified.

I am not a member of the ASA. ( Costs too much for my poor self a country military physician 🙂 and they dont fight the AANA they way I want).


So which statistic am I included in or not included in? these are two seperate societies/organizations.

just a thought
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I thought there was a military physician category for ASA membership, with reduced rate.
 
Conflicted said:
Actually

If you read all of my posts (which i went back and did) the ones where i was "combative" were always in response to someone attacking me.

Here they are.

I have tried to be professional and add to some discussions as well as educate people about CRNAs. What im met with in the majority of those posts are "go away nurse". Tell me who is at fault there? Who amoung you would not defend yourself and your profession to such attacks?

Before you answer, go ahead and read back through those threads and tell me, who became confrontational and unprofessional off the jump?
Click to expand...

Conflicted I don't know your credentials, but if you're not a physician I respectfully and gently point out to you that this is a physician's forum. Non-physicians such as myself are here to learn, especially from reading resident's threads. I usually post only to provide objective information when another poster is incorrectly presumptive. I respect the fact that I'm a guest here and don't wish to kick the anthill.
 
cfdavid said:
Look, I've met some CRNA students that I KNOW are top notch in terms of their attitudes and professionalism. But, I've also witnessed some SLOBS with union attitudes and blue collar demeanors rivaling those I've seen in the UAW, while waiting in the CRNA lounge for my resident MD to come down and meet me for a shadowing experience. So, let's go easy on the anecdotes, because it, again, goes both ways.
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Agree fully..... the CRNA population has the usual percentage of bad apples and incompetent nimcompoops.
 
MeaCulpa said:
The fact that the crna pool has quadrupled will affect crna income however, ha, ha, ha,ha....oh well it backfired on those fools, they pumped out huge numbers of crnas,.
Click to expand...

Several independent studies demonstrate a coming tsunami of CRNA retirements in the next five to ten years. The 55-59 age bracket is the peak of the bell-shaped curve, most of whom were trained by the military for Vietnam. They're anticipated to retire in droves in the next decade. Despite increased enrollment and graduation rates from CRNA schools, it's projected to barely keep even with retirement rates, much less keep up with increased demand for service caused by the aging Baby Boomer population.
 
yoga crna said:
Having been a major player in the anesthesia world for a long time, there is one thing I am certain of: everything is related to money, power or sex. Leaving the last one alone for the time-being, most of the MD/CRNA conflicts are related to the first two.

Fact: MD anesthesiologists employ and make a lot of money off of CRNAs. Not all, of course, but the ones that do, can make a significant amount of money from their competent CRNAs. It is a common sight in such settings to see the anesthesia lounge full of physicians surfing the net, reading the paper, etc and of course drinking coffee and BSing, while the CRNAs are in the OR gaining respect from the surgeons, the staff and closely watching the patient.

Fact: In many of these "group/medicially directed" settings, the CRNAs who were closely monitored during the day, get very smart after 3:00 pm and are left alone to do the emergencies, OB cases and finish the schedule.

Fact: CRNAs do indeed cover the majority of the rural hospitals in the country, because physician anesthesiologists are not interested in those geographic areas.

Fact: CRNAs work independently every day. I am one of them who works in plastic surgery. The surgeons I practice with do surgery on physicians all of the time and I have never had one (including anesthesiologists) refuse to have me do their anesthesia.

Fact: All of the rhetoric from every direction will be moot with the upcoming debates on health care economics. The future will be different for all of us, so be prepared.

Fact: CRNAs would not be still around (after 100 years) if we were not excellent practitioners. It is as simple as that.

I have been doing clinical anesthesia for years before most of you were born, love it, continue to study it and have a following of happy patients and surgeons. Say, what you want about me, you don't know me, but you may look up and see me when you are having your plastic surgery, and I promise you will have a good and safe anesthesia experience.

yoga crna
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First off nurse, you may think you are working independently but you're not. I don't know what part of the country you are in but not anywhere I would like to live.
Anything out of the ordinary goes on... John edwards will put the plastic surgeons million dollar practice on the front page of the paper and basically shut it down.. He will have to move elsewhere.. He or she must be saving some serious money if he is using a nurse instead of a physician for anesthesia services. I dont know why plastic surgeons want to do that. Beyond me.

i dont care if you have been working for 100 years.. you are still a NURSE.. The more years you work doesnt make you a physician and deserve the same rights as one.. IF you want to be captain GO TO CAPTAIN SCHOOL. make that dedication.

and i doubt highly based on medical economics legislatures will judge physicians to be overtrained to provide anesthesia and dumb it down so any 2 year nurse can accomplish.
 
johankriek said:
First off nurse, you may think you are working independently but you're not. I don't know what part of the country you are in but not anywhere I would like to live.
Anything out of the ordinary goes on... John edwards will put the plastic surgeons million dollar practice on the front page of the paper and basically shut it down.. He will have to move elsewhere.. He or she must be saving some serious money if he is using a nurse instead of a physician for anesthesia services. I dont know why plastic surgeons want to do that. Beyond me.

i dont care if you have been working for 100 years.. you are still a NURSE.. The more years you work doesnt make you a physician and deserve the same rights as one.. IF you want to be captain GO TO CAPTAIN SCHOOL. make that dedication.

and i doubt highly based on medical economics legislatures will judge physicians to be overtrained to provide anesthesia and dumb it down so any 2 year nurse can accomplish.
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You guys are too funny. You may not like yoga's facts as she presents them, but she's pretty accurate about the real world. Although she and I are miles apart on some political issues (AA/CRNA obviously), she is far more knowledgable about the politics and practice issues than you give her credit. I know who she is - she's no dummy.
 
The_Sensei said:
Neither do I. I work in NJ where the market is becoming saturated for the CRNAs. Very recently, I had a CRNA who thought he was hot ****. Bad attitude, thought he knew as much as the doctors, always talking bad about other anesthesiologists, etc. Once I got a few complaints too many he and I had a "sit down" during which he tried to pull some sort of shi*ty attitude. Know what? My man is out lookin' for another job! Gotta' toe the line nowadays, nurses........gotta' toe the line!
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not that long ago, we had a crna at our institution who was fired on-the-spot for a similar circumstance. it was the result of ignoring a junior attending's mandate to be present during an induction of a very sick kid. this particular crna had 20+ years experience... and 20+ years of developing a very bad attitude. he didn't think he had to take an order from a junior attending. he pushed the kid into the room. he called the attending, who was waking-up a patient in another room. then he got impatient. then he got angry. finally he proceeded against our institution's policy. result? he lost his job.

now, he has to explain why he left to his next employer, not ever being able to get a reference. how's it going to look not getting a reference from a placed he'd worked for years?
 
trinityalumnus said:
This would be illegal in most (if not all) states due to specified exclusions and limitations in the nurse practice acts.
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huh? nurses already do this everyday. they titrate potent narcotic drips in icu's. they monitor and record patient's vital functions. i'm not talking about them doing anything different than they are already doing in intesive care units all over the country.

the physician would be there to conduct and directly supervise all critical portions of the case, and the nurse would be there to monitor the patient and report any changes to the physician. the physician would then order and direct any necessary changes in the plan. this is no different than what goes on in all other critical care areas in the hospital. why do we need a separate, distinct crna training program in the first place with too much autonomy given to the graduates?

mine is a great idea, and i look forward to starting a pilot program soon.
 
Volatile

You are a *****. I look forward to when you get spanked in real practice as you clearly have no clue about the real world.

BTW, Nice quote, except that legally, Anesthesia IS the practice of nursing.
 
VolatileAgent said:
huh? nurses already do this everyday. they titrate potent narcotic drips in icu's. they monitor and record patient's vital functions. i'm not talking about them doing anything different than they are already doing in intesive care units all over the country.

the physician would be there to conduct and directly supervise all critical portions of the case, and the nurse would be there to monitor the patient and report any changes to the physician. the physician would then order and direct any necessary changes in the plan. this is no different than what goes on in all other critical care areas in the hospital. why do we need a separate, distinct crna training program in the first place with too much autonomy given to the graduates?

mine is a great idea, and i look forward to starting a pilot program soon.
Click to expand...


Like I indicated 50 posts ago - you can't get paid for it. RN's (if they're not CRNA's) can't administer anesthesia, and you can't bill for it because you're not present. That's called insurance fraud.
 
Conflicted said:
Volatile

You are a *****. I look forward to when you get spanked in real practice as you clearly have no clue about the real world.

BTW, Nice quote, except that legally, Anesthesia IS the practice of nursing.
Click to expand...

A resident once told me: Anesthesia is the practice of nursing, while anesthesiology is the practice of medicine.
 
jwk said:
Like I indicated 50 posts ago - you can't get paid for it. RN's (if they're not CRNA's) can't administer anesthesia, and you can't bill for it because you're not present. That's called insurance fraud.
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who says i wouldn't be present? define present. of course i'd be present, readily available, and supervising, just as i am when i'm supervising patient care in an icu. i may not be always physically right next to the patient, but i'm present and will make all the critical patient care decisions. the nurse isn't administering the anesthesia, i am. all they are doing is assisting in carrying out nursing functions, just as they would be in the icu.

i think this is a novel idea. now, do i think patient's would go for it? maybe not. then again, at present i don't think the majority of them realize that, when it happens, a nurse anesthetist is providing any portion of their anesthetic - regardless of who's supervising. want to take that one to task too? what's the patient's perception?

and, start with the california regulations and show me anywhere it says that a nurse anesthetist can administer anesthetic agents without the direction of a physician. crna's are nurses with additional procedural skills and knowledge about what and when to provide an anesthetic, and not necessarily the how and why. you are NURSES! laws and regulations make no specific, separate distinction of your ability to independently practice anesthesiology. you always - read that again - ALWAYS must be legally supervised by and work under the aegis of a licensed physician, dentist, or podiatrist.
 
Conflicted said:
Volatile

You are a *****. I look forward to when you get spanked in real practice as you clearly have no clue about the real world.

BTW, Nice quote, except that legally, Anesthesia IS the practice of nursing.
Click to expand...
A resident once told me: Anesthesia is the practice of nursing, while anesthesiology is the practice of medicine.
Click to expand...

well, the quote in my tagline is already pretty clear about anesthesiology being the practice of medicine, not nursing.

so, ask yourself: who's the real *****?
 
volatile.

You are in for an eyeopener and an ego bruising when you hit the real world. "Anesthesiology" and "Anesthesia" are defined as the exact same thing legally. That being said, BOTH are the practice of Nursing and Medicine.

You dont have to like it, however, its a fact.
 
Conflicted said:
volatile.

You are in for an eyeopener and an ego bruising when you hit the real world. "Anesthesiology" and "Anesthesia" are defined as the exact same thing legally. That being said, BOTH are the practice of Nursing and Medicine.

You dont have to like it, however, its a fact.
Click to expand...

Here's another one: anesthetist is a nurse, while anesthesiologist is a doctor.
 
Conflicted said:
volatile.

You are in for an eyeopener and an ego bruising when you hit the real world. "Anesthesiology" and "Anesthesia" are defined as the exact same thing legally. That being said, BOTH are the practice of Nursing and Medicine.

You dont have to like it, however, its a fact.
Click to expand...

Here's another one: anesthetist is a nurse, while anesthesiologist is a doctor.😛
 
I think its hillarious that anyone with 6,7,8, or 12 years of college education could stoop down to child's play. But it happens in politics every day and everywhere. Ever watch the dem. vs rep. bull**** on FOX news? They all look like Effing *****s. LOL

Guess what? Mines bigger than yours!!!!
 
VolatileAgent said:
a crna ..... finally he proceeded against our institution's policy. result? he lost his job.

now, he has to explain why he left to his next employer, not ever being able to get a reference. how's it going to look not getting a reference from a placed he'd worked for years?
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As should be the case any time a policy is contravened in any job setting, irregardless of location or credentials.
 
VolatileAgent said:
huh? nurses already do this everyday. they titrate potent narcotic drips in icu's. they monitor and record patient's vital functions. i'm not talking about them doing anything different than they are already doing in intesive care units all over the country.

the physician would be there to conduct and directly supervise all critical portions of the case, and the nurse would be there to monitor the patient and report any changes to the physician. the physician would then order and direct any necessary changes in the plan. this is no different than what goes on in all other critical care areas in the hospital. why do we need a separate, distinct crna training program in the first place with too much autonomy given to the graduates?

mine is a great idea, and i look forward to starting a pilot program soon.
Click to expand...

I applaud your initiative and enthusiasm, but there are a few real-world hurdles in the way.

1. State law. Titrating drugs in the ICU is not the same as giving an anesthetic in an anesthetizing location. The law discriminates between these functions and allows/prohibits specific behaviors to specific categories of credentialed folks. If you have the mojo to rewrite legislated statutes I stand in your shadow.

2. Reimbursement, as JWK mentioned.

3. Malpractice coverage.

4. Credentialing, based on 1, 2, and 3 above.

5. The feds.
 
Conflicted said:
Volatile

You are a *****. I look forward to when you get spanked in real practice as you clearly have no clue about the real world.

BTW, Nice quote, except that legally, Anesthesia IS the practice of nursing.
Click to expand...

The generally held opinion is that anesthesia, when administered by CRNA, is part of the practice of nursing. When given by a physician it's the practice of medicine.

http://www.aana.com/Resources.aspx?...enuTargetType=4&ucNavMenu_TSMenuID=6&id=2465&

http://www.aana.com/resources.aspx?...MenuTargetType=4&ucNavMenu_TSMenuID=6&id=187&
 
VolatileAgent said:
who says i wouldn't be present? define present. of course i'd be present, readily available, and supervising, just as i am when i'm supervising patient care in an icu. i may not be always physically right next to the patient, but i'm present and will make all the critical patient care decisions. the nurse isn't administering the anesthesia, i am. all they are doing is assisting in carrying out nursing functions, just as they would be in the icu.

i think this is a novel idea. now, do i think patient's would go for it? maybe not. then again, at present i don't think the majority of them realize that, when it happens, a nurse anesthetist is providing any portion of their anesthetic - regardless of who's supervising. want to take that one to task too? what's the patient's perception?

and, start with the california regulations and show me anywhere it says that a nurse anesthetist can administer anesthetic agents without the direction of a physician. crna's are nurses with additional procedural skills and knowledge about what and when to provide an anesthetic, and not necessarily the how and why. you are NURSES! laws and regulations make no specific, separate distinction of your ability to independently practice anesthesiology. you always - read that again - ALWAYS must be legally supervised by and work under the aegis of a licensed physician, dentist, or podiatrist.
Click to expand...

Each state nurse practice act is slightly different. I can only speak factually about my home state's and assume the other 49 acts are relatively similar.

My state law categorizes CRNAs apart from generic RNs by specifically-worded enabling legislation in paragraph after paragraph of detailed legalese. RNs and CRNAs have differing authorizations and prohibitions, etc. In the eyes of state legislatures, Boards of Nursing, insurance companies, malpractice carriers, and Medicare/Medicaid there is a world of difference between "nurses" and CRNAs.

The states also have differing levels of supervision/direction requirements.

No state mandates anesthesiologist supervision of CRNAs. Roughly half the states require (generic) physician/dentist supervision. (According to a pharmacist friend, that's sometimes at the back-door urging of the state board of pharmacy and usually is due to interpretation of narcotic regulations. Most CRNAs don't have DEA numbers).

The other ~50% of the states allow (by intent or lack of prohibition) fully independent CRNA practice.
 
salmonella said:
Here's another one: anesthetist is a nurse, while anesthesiologist is a doctor.😛
Click to expand...
In the UK and Canada (among others) an anaesthetist is a physician.
 
We're not talking about the UK, though, where chiropractors are called "osteopaths" and physicians aren't even called doctor.

LOL, dude
 
ecCA1 said:
We're not talking about the UK, though, where chiropractors are called "osteopaths" and physicians aren't even called doctor.

LOL, dude
Click to expand...

Physicans not referred to as doctor in the UK? Thats new to me. You may want rethink that. Damn surgeons have caused so much confusion.

Point is, of course, whether it is anaesthetist or anesthesiologist, the name is irrelevant and signifies nothing. A physician who trains in anesthesia will always be different than a nurse who trains in anesthesia, whether or not there is any difference in title. But I really dont like taking part in these silly debates about doctors vs nurses as it does, in fact, belittle doctors to defend their training against those with equal mechanical ability but limited knowledge base for decision making
 
aredoubleyou said:
Physicans not referred to as doctor in the UK? Thats new to me. You may want rethink that. Damn surgeons have caused so much confusion.

Point is, of course, whether it is anaesthetist or anesthesiologist, the name is irrelevant and signifies nothing. A physician who trains in anesthesia will always be different than a nurse who trains in anesthesia, whether or not there is any difference in title. But I really dont like taking part in these silly debates about doctors vs nurses as it does, in fact, belittle doctors to defend their training against those with equal mechanical ability but limited knowledge base for decision making
Click to expand...

Surgeons in UK are referred to as "Mr or Ms" Just go to any British medical website and you will see. This is a British traditional custom. Back in the middle ages, surgeons were called "barber-surgeons" and therefore they were not considered doctors. Only internal medicine people were considered "real doctors" back then. Over the centuries, they have kept the tradition of not referring to surgeons as "Dr." They make this distinction very clear: an interventional cardiologist would be called "Dr" even though he/she spends majority of time doing procedures just like surgeons.

In fact there are other interesting differences between UK and US medical systems: attendings are called "consultants"; Staff physicians are often called "Medical Officers"; ER is called "A & E" which stands for accident and emergency; you receive MBBS or MBChB degrees; Instead of calling "School of Medicine", they say "Faculty of Medicine."
 
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