The AANA, the ASA, and the SDN

It seems like about once every six or eight months, someone goes over to the Student Doctor Network and finds some particularly inflammatory remarks about nurse anesthetists. Then, we get a thread here with a title like "Look at What Those Nasty Guys Are Saying about Us!"

Okay, everybody take a deep breath, step back and relax. First, realize that Student Doctor Network is just that; a forum for STUDENT doctors. Just as we did when we were student nurses and student CRNA’s, they are bound to run into things during their education that will surprise them, and perhaps frustrate them. They need a place to go vent about these things. Add to that the fact that new residents in anesthesia have only what they have been taught to go by. If they're taught that nurse anesthetists are mean, evil and out to take the practice of anesthesia away from physicians, then they're going to start out with a bias against CRNA’s. That bias will show up in their posts. But in continuing their residency, most physicians find that nurse anesthetists are an important part of the anesthesia care team.

Frankly, I'm sick to death of the arguments between CRNA’s and anesthesiologists, particularly since these arguments are promulgated by our professional organizations. Down here in the trenches, nurse anesthetists and anesthesiologists get along quite well. I have found that most anesthesiologists I have worked with prefer to work in a collaborative environment, particularly when presented with complex or difficult cases. Having the initials CRNA or MD behind your name does not guarantee that you know everything. Most CRNA’s and MD’s are more than happy to hear other viewpoints. Generally, I have found the more experience you have, the more willing you are to listen to other viewpoints.

As to some of the most inflammatory comments made, don't worry about it. Generally, these people will do more harm than good for their "cause." If the American Society of Anesthesiologists were to completely get their way, and place all nurse anesthetists under the medical direction of anesthesiologists, there are a number of hospitals that would have to close down. Surgeons at these hospitals would find themselves without a place to practice. As a result, the ASA would quickly find themselves at odds with the American Hospital Association, and the American College of Surgeons. Smaller hospitals, with just a few OR’s generally cannot afford to hire an anesthesiologist to supervise the two or three nurse anesthetists that they have on staff. Were there suddenly to be a nationwide requirement as desired by the ASA, these hospitals would have to shut down their operating rooms. I know this for a fact, because I have worked at hospital like that. And should that hospital have to close it’s OR’s, the hospital itself would likely have to close within about six months.

The short version is don't worry about what's posted at the ISDN. Just as we need a place to vent, so do physicians. If an anesthesiologist goes on the board and refers to nurse anesthetists in a derogatory manner, let it go. Frankly, we need a lot less infighting and a lot more cooperation.

Kevin McHugh