Thoughts on the CRNA’s you work with?

[Student Doctor 75]

Hi, I know that some people have very strong opinions on this topic so I would like if this remained civil. If you are a doctor or resident I would love to hear how you feel about the CRNA’s that you work with or have worked with. What is your general impression of them? Do you feel they provide safe care? Do they help ease the workload off of physicians? Do you respect the CRNA’s in your workplace and do you trust them? I’m a college student in nursing at the moment (getting my BSN), but I’ve also thought about taking my pre-med requirements because I’m only a few classes away from being eligible to take the MCAT and apply to med school. I’ve always wanted to work in anesthesia and I think both the CRNA route and the Anesthesiologist route look like good career paths. To summarize what I’m asking, how do you feel about working with a CRNA and do you get along with one another? My main concern is that I’ve seen a lot of hostility from people on this website regarding this profession and I didn’t know if that’s how they are truly treated at their job everyday. (So again this discussion isn’t to ask who’s better or cause any fights between these two careers.) Thank you to anyone who decides to leave a comment!

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[Noyac]

Don’t work with them. And hope never to.

 

[Psai]

I don't think about what the janitors do or say unless they suck at their job. It's basically like that except the janitors can't give me a break.

 

[jthedestroyr]

Don’t work with them. And hope never to.

i wish this was the future, but we have been told get use to supervising unless you 1) are lucky to find a job out west or 2) do pain.

hard to respect a profession thats association is out there everyday saying youre not needed and youre equals even though one is a nurse and one is a physician.

 

[psychbender]

In my last life, I worked with a few CRNAs that I really liked. We could discuss patients, our concerns, and when I told them a plan that would address the issues, they followed it. While I much prefer to do my own cases, knowing that I was covering their rooms meant that I would have a generally pleasant day, free of surprises. I also worked with several that would roll their eyes, and just do whatever the hell they wanted, based on what they were taught in the '80s or '90s (or even recently), and I couldn't do anything about it. Covering their rooms meant that I would be swearing a lot more than usual by day's end. In my limited experience, the later outnumber the former, so I plan on taking jobs where I almost never have to supervise or direct CRNAs.

 

[Student Doctor 75]

i wish this was the future, but we have been told get use to supervising unless you 1) are lucky to find a job out west or 2) do pain.

hard to respect a profession thats association is out there everyday saying youre not needed and youre equals even though one is a nurse and one is a physician.

Do you think a nurse anesthetist is useful though? I know that Anesthesiologist do have a more intensive training and that they do go to school for around 4 or 5 years longer than an anesthetist, but do you feel like having a nurse anesthetist take the more routine cases help support the doctor? From what I have read before I assumed that the CRNA would handle the routine cases that weren’t likely to have complications, and that this would free up the anesthesiologist to handle the more intense cases. I’ve seen the argument about the AANA trying to get the right for nurse anesthetist to practice on their own. Honestly if I were to choose the CRNA path I would rather have an anesthesiologist on standby because they do have have the extra schooling to handle those situations that go south. I know that in my state it is still required for a nurse anesthetist to work with a anesthesiologist and I think that is the right decision. I can see the argument to let certain anesthetist practice on their own though because many rural environments have difficulty finding an anesthesiologist or they just do not have the funds to afford to hire one. I’ve read that this is where CRNA’s usually work because they are the cost effective option for these lower budget hospitals.

 

[jthedestroyr]

someone already drank the kool aid

 

[psychbender]

Do you think a nurse anesthetist is useful though? I know that Anesthesiologist do have a more intensive training and that they do go to school for around 4 or 5 years longer than an anesthetist, but do you feel like having a nurse anesthetist take the more routine cases help support the doctor? From what I have read before I assumed that the CRNA would handle the routine cases that weren’t likely to have complications, and that this would free up the anesthesiologist to handle the more intense cases. I’ve seen the argument about the AANA trying to get the right for nurse anesthetist to practice on their own. Honestly if I were to choose the CRNA path I would rather have an anesthesiologist on standby because they do have have the extra schooling to handle those situations that go south. I know that in my state it is still required for a nurse anesthetist to work with a anesthesiologist and I think that is the right decision. I can see the argument to let certain anesthetist practice on their own though because many rural environments have difficulty finding an anesthesiologist or they just do not have the funds to afford to hire one. I’ve read that this is where CRNA’s usually work because they are the cost effective option for these lower budget hospitals.

You have read incorrectly. Whether a case is performed by a CRNA or a physician, the patient's insurance is charged the same. The only cost savings may be realized by the hospital, as they feel that they can siphon off more of the CRNA's fees to their own pockets than the physician's. Also, Medicare pass-though allows rural hospitals to have the federal government assume some of the cost of keeping CRNAs on staff, but those same funds cannot legally be used for physicians. So, rural hospitals have a large financial incentive to hire solo-CRNAs, as they get to have the government subsidize the nurses' salaries, and get to pocket a large portion of the anesthesia professional fees.

 

[jwizle]

Is it just me or does it seem like student doctor 75 is a CRNA posing as a student? The questions you have been answered many times over, no need for this useless thread

 

[kidthor]

Yes - he/she is a troll.

The thread should be closed...

 

[Student Doctor 75]

Is it just me or does it seem like student doctor 75 is a CRNA posing as a student? The questions you have been answered many times over, no need for this useless thread

No I’m sorry if it seems that way. At the moment I’m a nursing student who’s just trying to figure more out about this career and how doctors feels about it. In my initial question I explained all of the details. Also I had tried looking for threads that talked about this, but they were usually about who is the better choice or about the salary or whether or not to call them doctor. That wasn’t the point of this thread. I wanted to ask a doctors opinion of how they felt working with CRNA’s. I was trying to avoid any arguments and just focus on personal thoughts about the profession. It’s hard to find a thread where one side isint bashing the other lol.

 

[nimbus]

I know a couple of anesthesiologists who thought so highly of CRNAs that they married one. I still have fond memories of the CRNAs who worked in my training program and am always glad to see them when I run into them. Among the entire spectrum of people that I know, they are near the top.

 

[Student Doctor 75]

You have read incorrectly. Whether a case is performed by a CRNA or a physician, the patient's insurance is charged the same. The only cost savings may be realized by the hospital, as they feel that they can siphon off more of the CRNA's fees to their own pockets than the physician's. Also, Medicare pass-though allows rural hospitals to have the federal government assume some of the cost of keeping CRNAs on staff, but those same funds cannot legally be used for physicians. So, rural hospitals have a large financial incentive to hire solo-CRNAs, as they get to have the government subsidize the nurses' salaries, and get to pocket a large portion of the anesthesia professional fees.

I see, I was unaware of most of that. When I had said the CRNA helped saved money I meant what you just said, but I guess it didn’t come out right. But the rest of that I was unaware of. I had thought it was cheaper for patients as well. I also didn’t know about the federal government subsidies for CRNA’s. Again I know some people think I’m here to just cause trouble, but I promise I’m just here to learn more about the topic. Thank you for the input and teaching me about that.

 

[pgg]

Like the song says, Men go crazy in congregations but they only get better one by one.

 

[Man o War]

I dont work with them anymore, but did for a long time.
Many are overconfident and underprepared when something bad happens. They frequently overdose opioids, which is a result of their algorithmic training. They frequently make clinical decisions which I see from CA 1s or 2s, and we don't let those people practice independently. I hate the position that they should be able to do straightforward cases independently. I've seen plenty of straightforward cases go left, and fast. A healthy mom who suddenly crashes during childbirth is no place for a CRNA with no doc to back them up. That patient and her family deserve better.
Sometimes the best thing that can happen is a good "scare" to remind them of all of this. The young males fresh out of CRNA school tend to be the worst, too cocky for their own good. They always got extra scrutiny from me as a rule. Some of them learn after these encounters, many do not.
If you end up going the CRNA route, do your patients a favor and recognize your limitations as a nurse anesthetist. Your schools generally do not do a good job of instilling this.

 

[nimbus]

Sometimes the best thing that can happen is a good "scare" to remind them of all of this. The young males fresh out of CRNA school tend to be the worst, too cocky for their own good. They always got extra scrutiny from me as a rule. Some of them learn after these encounters, many do not.
If you end up going the CRNA route, do your patients a favor and recognize your limitations as a nurse anesthetist. Your schools generally do not do a good job of instilling this.

Both this and the gun thread makes me think that young males are the worst people on earth. The dumbest and most impulsive and most insecure.

 

[dhb]

Both this and the gun thread makes me think that young males are the worst people on earth. The dumbest and most impulsive and most insecure.

Let's kill them all preventively

 

[WholeLottaGame7]

Both this and the gun thread makes me think that young males are the worst people on earth. The dumbest and most impulsive and most insecure.

I wouldn't say "worst," but "most likely to kill or be killed" (in various aspects of life), then yes.

 

[WholeLottaGame7]

Hi, I know that some people have very strong opinions on this topic so I would like if this remained civil. If you are a doctor or resident I would love to hear how you feel about the CRNA’s that you work with or have worked with. What is your general impression of them? Do you feel they provide safe care? Do they help ease the workload off of physicians? Do you respect the CRNA’s in your workplace and do you trust them? I’m a college student in nursing at the moment (getting my BSN), but I’ve also thought about taking my pre-med requirements because I’m only a few classes away from being eligible to take the MCAT and apply to med school. I’ve always wanted to work in anesthesia and I think both the CRNA route and the Anesthesiologist route look like good career paths. To summarize what I’m asking, how do you feel about working with a CRNA and do you get along with one another? My main concern is that I’ve seen a lot of hostility from people on this website regarding this profession and I didn’t know if that’s how they are truly treated at their job everyday. (So again this discussion isn’t to ask who’s better or cause any fights between these two careers.) Thank you to anyone who decides to leave a comment!

You should not make a decision based on what other people think of you; make it based on what is going to bring you the most happiness.

If the prospect of potentially having to follow someone else's plan irks you, or if you're always going to wonder if there's something more out there, or you're just really motivated to get a more detailed understanding of medicine, be a doctor. If none of those things apply to you, be a CRNA.

And that's not to say that doctors are happier or are better people; many, if not most of the CRNAs I know are great individuals and are happy to have gone the shorter, cheaper route that has less responsibility and fewer hours, because that's what they wanted.

 

[Man o War]

Both this and the gun thread makes me think that young males are the worst people on earth. The dumbest and most impulsive and most insecure.

That's funny, I was one of those once I think. Medical training and that short white coat does a pretty good job of beating our egos to a bloody pulp. You are constantly reminded what a scab you are in those early years.
I wonder if female anesthesiologists experience this with the male CRNAs- or is it just an alpha male phallus measuring contest type of thing....

 

[AdmiralChz]

In residency we did two months of a modified supervisory rotation for CRNAs/AAs, which was very helpful to get an idea of what it was like in PP. I was fortunate to work with mostly awesome CRNAs/AAs then, and every morning they had to present a quick (1 or 2 liner) plan for approval by the attending. It was my experience that a minority were very difficult to work with and refused to take direction, and they were almost always locums providers. We had one CRNA who was very vocal about getting her (online) DNP and constantly referring to it despite being easily the weakest anesthetist in the department and not taking direction well.

In her case and for others who didn't take direction well, we got creative. Troublemakers were routinely assigned to unfavorable areas such as preops, trauma (typically spent giving breaks), NORA like neuro IR/endo and our most cantankerous surgeons. Overtime (time and a half) was never granted to these providers, either. In this way, those individuals didn't stay in the department very long which was more than OK with us.

 

[IlDestriero]

At my shop if you refused to follow direction you better be polishing up your resume because you’ll be needing it soon. Militants need not apply.
It really is our way or the highway, and they know that when they’re hired. Set reasonable expectations up front and everyone is happy. But you have to hold the line.
Of course there’s no need to micromanage most of what they want to do. LMA vs ETT, sevo or iso or des, morphine vs dilaudid, deep or awake extubation, who cares?
There are many places they can go if they want to be more independent. I don’t care about that either. Good bye and good luck.


--
Il Destriero

 

[2Fast2Des]

That's funny, I was one of those once I think. Medical training and that short white coat does a pretty good job of beating our egos to a bloody pulp. You are constantly reminded what a scab you are in those early years.
I wonder if female anesthesiologists experience this with the male CRNAs- or is it just an alpha male phallus measuring contest type of thing....

I think the beating down of the ego and respect for hierarchy is another thing that differentiates us. For them there is none of that. Its just "we do the same things as doctors in less time therefore we are same and better." Their lack of perspective of the overall picture is what is troubling, and the fact that attendings roll over and don't stand up for the field and their place is what empowers them even further, because attendings don't want to rock the boat.

 

[Man o War]

I think the beating down of the ego and respect for hierarchy is another thing that differentiates us. For them there is none of that. Its just "we do the same things as doctors in less time therefore we are same and better." Their lack of perspective of the overall picture is what is troubling, and the fact that attendings roll over and don't stand up for the field and their place is what empowers them even further, because attendings don't want to rock the boat.

Absolutely. I actually think it's the opposite in the nursing world. CRNAs are held up on a pedestal by fellow nurses, so many can't deal with it when they go out to work and have to answer to someone. I've seen some monster sized egos from CRNAs, it's really quite crazy. You'd think they were surgeons.

 

[pgg]

I think the beating down of the ego and respect for hierarchy is another thing that differentiates us. For them there is none of that.

I don’t know about that.

Nurses are easily the worst group in the hospital when it comes to hierarchy, seniority, pecking order, and petty authority games.

Honestly, they’re legendary for it.

The ones who go on and become advanced practice nurses of one flavor or another, whether NP or CRNA or something else, and especially the male ones, often look down on ordinary nurses, and we all know that many ordinary nurses resent the midlevels.

If I had to go out on a limb and identify one thing that’s fundamentally different between our hierarchy and theirs, I’d have to say ours is very much merit based, while theirs is very much seniority based.

Nurses eat their own in a way that even the most malignant residency programs don’t.

 

[Student Doctor 75]

Well I’ve gotten a lot of replies and input from everyone so I wanted to say thank you! It was nice to see everyone’s different viewpoints on the subject. There’s a lot for me to think about here in the next year or so, but I think I’m going to try and go to medical school. I still think both professions are good choices and that each side has their positives and negatives, but I think med school is going to be the right path for me. I do enjoy the science behind the medicine and I want to be able to know as much as I can about it so that I never fail a patient. So again thank you to everyone for contributing to this thread and good luck with wherever you are at in your schooling or life at the moment!

 

[nimbus]

Well I’ve gotten a lot of replies and input from everyone so I wanted to say thank you! It was nice to see everyone’s different viewpoints on the subject. There’s a lot for me to think about here in the next year or so, but I think I’m going to try and go to medical school. I still think both professions are good choices and that each side has their positives and negatives, but I think med school is going to be the right path for me. I do enjoy the science behind the medicine and I want to be able to know as much as I can about it so that I never fail a patient. So again thank you to everyone for contributing to this thread and good luck with wherever you are at in your schooling or life at the moment!

And many people change their mind in Medical school. You might end up a dermatologist or an ophthalmologist. I’m biased but I think it’s a good decision.

 

[Psai]

Well I’ve gotten a lot of replies and input from everyone so I wanted to say thank you! It was nice to see everyone’s different viewpoints on the subject. There’s a lot for me to think about here in the next year or so, but I think I’m going to try and go to medical school. I still think both professions are good choices and that each side has their positives and negatives, but I think med school is going to be the right path for me. I do enjoy the science behind the medicine and I want to be able to know as much as I can about it so that I never fail a patient. So again thank you to everyone for contributing to this thread and good luck with wherever you are at in your schooling or life at the moment!

Good luck, it's a tough road with an increasingly questionable reward

 

[Iso4ane]

Residency is a weird place, as someone halfway through it, I can see where I've been and where I want to be. It's a weird feeling to know that you know a lot, but at the same time not much at all.

 

[Mat007]

I don’t know about that.

Nurses are easily the worst group in the hospital when it comes to hierarchy, seniority, pecking order, and petty authority games.

Honestly, they’re legendary for it.

The ones who go on and become advanced practice nurses of one flavor or another, whether NP or CRNA or something else, and especially the male ones, often look down on ordinary nurses, and we all know that many ordinary nurses resent the midlevels.

If I had to go out on a limb and identify one thing that’s fundamentally different between our hierarchy and theirs, I’d have to say ours is very much merit based, while theirs is very much seniority based.

Nurses eat their own in a way that even the most malignant residency programs don’t.

Totally agree with this. I'm a CRNA and when I got out of nursing school I was treated so poorly you'd think I had done something to these nurses in a previous life. Truer words haven't been spoken.

 

[chocomorsel]

Totally agree with this. I'm a CRNA and when I got out of nursing school I was treated so poorly you'd think I had done something to these nurses in a previous life. Truer words haven't been spoken.

Hopefully things are better and you don’t treat your juniors the same way. Yes, nurses can be malignant to each other. Been there done that.
But have experienced malignancy in both medicine and nursing. Evil, egotistical people are everywhere!