What is your stance on physician anesthesiologist?

[vector2]

I appreciate your critique. SRNA was sold to me as a senior crna who has been rotating at our institution for a while. Covered OB a few times.

Certainly have other airway equipment available. IIRC, it wasn’t “supposed” to be a difficult one. I don’t think the patient selection was poor. My biggest grip was and still is the fact that the CRNA stood there even after the second try. But yes, ultimately I am on the hook, and I don’t like it.

Nowadays if the CRNA isn't assisting the second the SRNA starts struggling I just say "let me see" and do it myself. I save teaching how to troubleshoot an airway for when I am supervising residents.

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[chocomorsel]

Nowadays if the CRNA isn't assisting the second the SRNA starts struggling I just say "let me see" and do it myself. I save teaching how to troubleshoot an airway for when I am supervising residents.

Hip check.

 

[ValentineD]

I appreciate your critique. SRNA was sold to me as a senior crna who has been rotating at our institution for a while. Covered OB a few times.

Certainly have other airway equipment available. IIRC, it wasn’t “supposed” to be a difficult one. I don’t think the patient selection was poor. My biggest grip was and still is the fact that the CRNA stood there even after the second try. But yes, ultimately I am on the hook, and I don’t like it.

Ah, it seems like the CRNA is at fault for not intervening in this situation. I don't give second tries and I am pretty hands on with correcting poor technique. I also make all the trainees use a videoscope until we've worked with them a few times and they've demonstrated competency. Some never progress beyond the videoscope. It keeps both me and the attending (and the surgeon tippy-tappying their foot) happy that way.

 

[D P356]

At a previous practice, there would be an occasional couple of srnas. I was in the office and the crna of a specific case came in and sat down. I said “who’s giving you a break?”
“No one, srna is in the room.”
That got a quick and profound “No.” That wasn’t happening with me directing the case.

 

[ValentineD]

At a previous practice, there would be an occasional couple of srnas. I was in the office and the crna of a specific case came in and sat down. I said “who’s giving you a break?”
“No one, srna is in the room.”
That got a quick and profound “No.” That wasn’t happening with me directing the case.

I feel like many anesthetists think that a trainee needs to learn to "fly on their own." Which is true, but they can do that with me in the room. I remember I was doing a case, I think it was a posterior cervical fusion. I told the student "This is your case, the goal here is for me to do as little as possible." So I sat back in the corner and watched. A while into the case, "Uhhh Valentine..." I looked over the drapes and I could've done a swan dive into that incision. The surgeon was panicking because they couldn't get the bleeding under control. Called the anesthesiologist to inform them of the situation, no answer. Had to send the student to find ANY anesthesiologist. Luckily one of the surgeon's partners was operating across the hall and they came in and tag-teamed it until they got the situation under control. Patient did great but they had no major comorbidities, just a liter and some change lighter in a handful of minutes. I cannot imagine ever leaving a trainee alone. Could've been a terrible terrible outcome with a stranded trainee.

 

[IMGASMD]

I feel like many anesthetists think that a trainee needs to learn to "fly on their own." Which is true, but they can do that with me in the room. I remember I was doing a case, I think it was a posterior cervical fusion. I told the student "This is your case, the goal here is for me to do as little as possible." So I sat back in the corner and watched. A while into the case, "Uhhh Valentine..." I looked over the drapes and I could've done a swan dive into that incision. The surgeon was panicking because they couldn't get the bleeding under control. Called the anesthesiologist to inform them of the situation, no answer. Had to send the student to find ANY anesthesiologist. Luckily one of the surgeon's partners was operating across the hall and they came in and tag-teamed it until they got the situation under control. Patient did great but they had no major comorbidities, just a liter and some change lighter in a handful of minutes. I cannot imagine ever leaving a trainee alone. Could've been a terrible terrible outcome with a stranded trainee.

How do you get from pre-med to crna in less than 5 years?

 

[ValentineD]

How do you get from pre-med to crna in less than 5 years?

Me personally? I am a CAA not a CRNA.

I have many gripes with the profession but as an old geezer it was a more logical pathway versus medical school. I do have my gripes with profession, there are certainly knowledge gaps that can only be paved over by doing your time in the medical school + residency salt mines.