Why is SDN censoring AA threads?

[cdmguy]

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I'm new to this site. Why did someone close my AA thread? How are we supposed to talk about anesthesiology if these mods close the threads? I got a lot out of it but now am unable to respond. What's next? Are they going to ban me for discussing my future occupation?

Anyway, I called AA-s PA-As before, that was a mistake (gasp). They are technically PA-B as type 2 physician extenders. Nurses have no business trying to break them off the rest of the physician assistant world by telling them that they are not a PA type profession. We all need to band together. Isolation of an enemy is a war strategy.

JKW thanks for the explanation about regional nerve blocks. So far I have observed epidurals in delivery and general.

During my 30 hours of observation about 3/4 of the CRNAs were helpful but 1/4 were against AAs and commented negatively about them. Further, CRNA leadership is actively lobbying against AA licensing. So judging from their actions, CRNAs definitely deseve to be considered hostile towards AAs.

I"m really surprised to see my other thread closed. Chiropractic does this all the time to prevent criticism but in medicine? Sickening. Is this forum run by nurses or what?

😕

 

[mshheaddoc]

I didn't read your thread, but most likely someone said something and topics were getting out of hand (personal attack, vulgarity, etc). Feel free to read the terms and agreements. 🙄 I'm sure something SOMEWHERE got out of hand that is a no-no per that agreement. Mods are wonderous creatures that at sometimes leaves us wondering ... 🙂

Edit: just read it ... I would contest to have it reopened (you can do that) it was closed for personal attacks btw people I think, as the thread slowly spiraled. Only you and jk were on topic along with that rn person.

 

[cdmguy]

> I would contest to have it reopened (you can do that)

How do you do that?

 

[Skip Intro]

The moderators have determined that they will pre-emptively close any "us" vs. "them" threads, of which most MDA, CRNA, AA comparison threads ineluctably devolve into.

-Skip

 

[mwbeah]

First let me provide a little on my background, I am an nurse anesthetist with a Master's degree in anesthesia nursing from the United States Army Graduate Program in Anesthesia Nursing. I have been deployed to OIF and conducted hundreds of battlefield trauma anesthetics, am well versed and personally place on a daily basis regional techniques (epidurals both lumbar and thoracic, peripheral regional techniques to include lumbar plexus, sciatic, interscalene, supraclavicular, axillary, and several others), and the place invasive lines.

MDAs, CRNAs, and AAs all have a place. The fight and the focus is about money...bottom line. We have all coexisted for decades and for the most part all provide safe patient care (backed up by several retrospective studies). I have much respect for the MDAs and have no ill will against AAs. In the military we collaborate with our MDAs (when appropriate) and we are the "worker-bees" who provide the direct anesthesia care to soldiers, dependents, and retirees.

I have read with much humor the knock on CRNAs in this forum and I can only say that there is much misinformation out there.

Again, all of us have our roles and the community has collaborated for years until recently when a small section of the AANA and ASA have bitterly disputed (again the bottom line....money).

I hope everyone has a great day and hope we can have friendly conversations on this topic.

mwbeah

 

[cdmguy]

I would also like to see everyone working together. Money is no reason to block other providers. Otherwise there would be no nurse practitioners.

 

[MS3NavyFS2B]

MDAs, CRNAs, and AAs all have a place. The fight and the focus is about money...bottom line.

True: the MDA/CRNA fight does relate to renumeration in part...but it's more than just money. Education and training is the crux of the issue in the eyes of physicians.

 

[Skip Intro]

True: the MDA/CRNA fight does relate to renumeration in part...but it's more than just money. Education and training is the crux of the issue in the eyes of physicians.

Personally, I can understand why they are pissed. They perceive themselves as doing at least 90% of the same job as an MDA (which they may, in fact, do) and they feel that they should not have to contribute 50% of the billing for a case to someone who simply strolls between rooms and "observes" them. But, when the **** hits the fan, as it will inevitably do, I think most CRNAs, if they were being completely honest, would want someone at a higher level of legal and medical responsibility for the patient present to share the **** pile. In fact, the CRNA in that instance is not ultimately (please note the qualifier) responsible for the outcome - the MDA is and will be held at a higher accountability level. That's just the way it is, and we all know it.

So, that's the big difference, in a nutshell. People can side-talk and argue around that all they want, but that is the bottom line why MDAs get paid more.

-Skip

 

[MS3NavyFS2B]

Hey, Skip...

I sorta like the idea of strolling around while others do the technical work. I don't, though, really see a difference between me (1) writing orders on a medical floor and leaving the technical issues to others and (2) leaving the maintance of an OR pt to a nurse. I mean, if **** hits the fan, they'll call me...in a similar manner to being called on the floor. Isn't that what nurses are for supposedly, to "care" on this level?

 

[bestiller]

Hey, Skip...

I sorta like the idea of strolling around while others do the technical work. I don't, though, really see a difference between me (1) writing orders on a medical floor and leaving the technical issues to others and (2) leaving the maintance of an OR pt to a nurse. I mean, if **** hits the fan, they'll call me...in a similar manner to being called on the floor. Isn't that what nurses are for supposedly, to "care" on this level?

MS3POR2D2,
I doubt anybody would be calling a 3rd year(ie "you") if the "****" hit the fan. Unless they need someone who can't start an IV, a-line, or insert a central line or unless it literally hit the fan as in a patient had a bowel movement on a fan in which case a 3rd may be involved w/ clean-up! Wait until you actually have "MD" behind your name before you step up onto that pedestal. Even then you will find that there is a pecking order in the world of medicine and anesthesiology doesn't rate very high. I know that there are some on this board who talk the talk about telling a surgeon off. That may be true about 1% of the time or w/ a surgeon just out residency but I have yet to see an MDA young and old alike not drop a stack in their pants and tuck tail like a beat dog when a CV or neuro surgeon decides to tear into anesthesia, and 99% the MDA takes his/her medicine like the good scavenger that they are living off of the surgeons kills and the CRNAs work. In the eyes of other medical specialities the MDA over the last few decades has fallen victim to their own poor work ethic soaking up the TV & food in the lounge while the work gets done. It's no wonder they rank a little above chiropractors and are fighting to prove the need for their existence. 🙂

 

[utlonghorn50]

Bestiller, I guess I am going to be getting paid 300K a year to do nothing according to you. Man, this is going to be a tough life. I wish someone would trade places with me.

 

[cdmguy]

>I know that there are some on this board who talk the talk about telling a surgeon off. That may be true about 1% of the time or w/ a surgeon just out residency but I have yet to see...

I've seen it after only 45 hours of observation in the local OR. A MDA caught a surgeon's undiagnosed pneumocephalus and saved a little girl's life who otherwise would have died in surgery. I watched him question a nurse anesthetist who was clueless.

A lot more respect is in order here.

 

[jwk]

I know that there are some on this board who talk the talk about telling a surgeon off. That may be true about 1% of the time or w/ a surgeon just out residency but I have yet to see an MDA young and old alike not drop a stack in their pants and tuck tail like a beat dog when a CV or neuro surgeon decides to tear into anesthesia.

Maybe that's true in your department, but not mine. We stand our ground, and those surgeons who continue to be verbally abusive are referred to MANDATORY anger management counseling OR lose their privileges. It's a great thing and is very effective! They can act like reasonable adults and continue to practice surgery at our hospital, or they can act like children and be offered the opportunity to take their business elsewhere. Ooops, I'm off topic - maybe this would be a good topic for another thread! 😀

 

[MS3NavyFS2B]

MS3POR2D2,
I doubt anybody would be calling a 3rd year(ie "you") if the "****" hit the fan. Unless they need someone who can't start an IV, a-line, or insert a central line or unless it literally hit the fan as in a patient had a bowel movement on a fan in which case a 3rd may be involved w/ clean-up! Wait until you actually have "MD" behind your name before you step up onto that pedestal. Even then you will find that there is a pecking order in the world of medicine and anesthesiology doesn't rate very high. I know that there are some on this board who talk the talk about telling a surgeon off. That may be true about 1% of the time or w/ a surgeon just out residency but I have yet to see an MDA young and old alike not drop a stack in their pants and tuck tail like a beat dog when a CV or neuro surgeon decides to tear into anesthesia, and 99% the MDA takes his/her medicine like the good scavenger that they are living off of the surgeons kills and the CRNAs work. In the eyes of other medical specialities the MDA over the last few decades has fallen victim to their own poor work ethic soaking up the TV & food in the lounge while the work gets done. It's no wonder they rank a little above chiropractors and are fighting to prove the need for their existence. 🙂

They why does my pager go off when **** hits the fan? Obviously, you aren't in medicine. Granted, medical students aren't the final word (or even the initial word), but who said we were? We're training to be at the top, and--to that end--we're trained to act like it, so we're on the pager, taking call for the team. Anyway, I was speaking as if I WERE the attending in hypothetical situation, which you seemed to have missed.

The reason attending MDAs don't say much to surgeons is simple: they're laughing...all the way to the bank, since they usually make WAY more $$ than surgeons. Man, those lights are HOT and STANDING...for hours...sucks, not to mention seeing pts pre-op, post-op, follow-up. Those surgery guys (bless their hearts) are at the hospital FOREVER, from like 5 AM until whenever. They have reason to be pissed, so let them "vent." Neurosurg folks--man, they're cool and smart, but 7-8 years in residency?

MDAs are lazy? Well, I'm not sure there exists an MDA that went in gas because they wanted to work 80 hours/week as a attending (like surgeons). In fact, MDAs don't, but get paid as if they do...which is grrrrrreatttt! Pharmacology, physiology, anatomy, great hours, and BANK. I bet my kids (when I have some) will thank me, as will my wife. Heck, I'll even have TIME to enjoy my summer home! They're not lazy...they're smart!

Inner monologue: [hours from 6-2...teetime at 2:30ish...probably get home by 6ish for din din (unless my round takes longer, in which case I'll have family meet me a the country club for din din)...I think I'll work 4 days this week, total, without call...but next week I'll get to be on L&D (pretty cool to be involved in that)...etc....good life]
oops, I said that aloud

Don't forget: physicians are physicians. People leave speciality X and come to the promised land ALL THE TIME. Immigration relative to emmigration in gas is HUGE, which says something (fill in the blank).

Don't hate...haha.

 

[Jeff05]

MS3POR2D2,
I doubt anybody would be calling a 3rd year(ie "you") if the "****" hit the fan. Unless they need someone who can't start an IV, a-line, or insert a central line or unless it literally hit the fan as in a patient had a bowel movement on a fan in which case a 3rd may be involved w/ clean-up! Wait until you actually have "MD" behind your name before you step up onto that pedestal. Even then you will find that there is a pecking order in the world of medicine and anesthesiology doesn't rate very high. I know that there are some on this board who talk the talk about telling a surgeon off. That may be true about 1% of the time or w/ a surgeon just out residency but I have yet to see an MDA young and old alike not drop a stack in their pants and tuck tail like a beat dog when a CV or neuro surgeon decides to tear into anesthesia, and 99% the MDA takes his/her medicine like the good scavenger that they are living off of the surgeons kills and the CRNAs work. In the eyes of other medical specialities the MDA over the last few decades has fallen victim to their own poor work ethic soaking up the TV & food in the lounge while the work gets done. It's no wonder they rank a little above chiropractors and are fighting to prove the need for their existence. 🙂

nice dude. i'm guessing this post was a joke/poke. jesus, you really got my blood pressure goin for a minute. wheew...
otherwise, i'm concerned. life is too short to be so bitter and categorical, which you are. re-read your post and if you really believe any of the above, i feel really sorry for you/you're a huge d@uchebag.

 

[MechE]

I'm new to this site. Why did someone close my AA thread? How are we supposed to talk about anesthesiology if these mods close the threads? I got a lot out of it but now am unable to respond.

I know what you mean. I tried to start an AA thread earlier to find out what AA's can do in the OR and everyone on this forum turned it into an MD vs. CRNA vs. AA vs. the rest of the world argument. It was very annoying.

 

[Skip Intro]

The moderators have determined that they will pre-emptively close any "us" vs. "them" threads, of which most MDA, CRNA, AA comparison threads ineluctably devolve into.

-Skip

See what I mean...

I should replace Sylvia Browne as a regular guest on Montel Williams and start charging for my prognostications.

-Skip

 

[LTbulldogs]

They why does my pager go off when **** hits the fan? Obviously, you aren't in medicine. Granted, medical students aren't the final word (or even the initial word), but who said we were? We're training to be at the top, and--to that end--we're trained to act like it, so we're on the pager, taking call for the team. Anyway, I was speaking as if I WERE the attending in hypothetical situation, which you seemed to have missed.

The reason attending MDAs don't say much to surgeons is simple: they're laughing...all the way to the bank, since they usually make WAY more $$ than surgeons. Man, those lights are HOT and STANDING...for hours...sucks, not to mention seeing pts pre-op, post-op, follow-up. Those surgery guys (bless their hearts) are at the hospital FOREVER, from like 5 AM until whenever. They have reason to be pissed, so let them "vent." Neurosurg folks--man, they're cool and smart, but 7-8 years in residency?

MDAs are lazy? Well, I'm not sure there exists an MDA that went in gas because they wanted to work 80 hours/week as a attending (like surgeons). In fact, MDAs don't, but get paid as if they do...which is grrrrrreatttt! Pharmacology, physiology, anatomy, great hours, and BANK. I bet my kids (when I have some) will thank me, as will my wife. Heck, I'll even have TIME to enjoy my summer home! They're not lazy...they're smart!

Inner monologue: [hours from 6-2...teetime at 2:30ish...probably get home by 6ish for din din (unless my round takes longer, in which case I'll have family meet me a the country club for din din)...I think I'll work 4 days this week, total, without call...but next week I'll get to be on L&D (pretty cool to be involved in that)...etc....good life]
oops, I said that aloud

Don't forget: physicians are physicians. People leave speciality X and come to the promised land ALL THE TIME. Immigration relative to emmigration in gas is HUGE, which says something (fill in the blank).

Don't hate...haha.

That is beyond hilarious!

 

[tkim]

closing.