All CRNAs need to READ this

Jun 20, 2007 01:16 AM

by janecristensen

this is in response to 'bioncokie's' post under 'Doctor's Frustrations' ,

Let me first say that I think being a crna is a great job. I've been doing it for 5 years now, working in the anesthesia care team model. I work with MDAs daily and I'm glad that they are there. Although some of your comments may be seen as offensive by some of my fellow crnas, you DO have some valid comments. That's what this forum is about. Talking about issues, educating everyone on the experience of crna's and mda's.

It's true that we are NOT as smart as MDs. It's true that we DON'T know the 'medical knowledge' that you do. You're right about our board exams. We aren't nearly tested on our knowledge to the extent physicians are. My crna board exam was only like 80 questions and I had around 3 hours to complete it. I understand your board exams (USMLEs) and Anesthesia boards are way more difficult and time-pressured. You're tested not only on paper, but also in clinical scenarios (like you said in Step 2) and during anesthesia oral boards. It must be very difficult.

I did not feel pressured during either of my board exams (nursing school and anes). We had plenty of time to answer questions. But YOU have to make decisions quickly and those exams prepare you for that. Maybe we should have to take more tests, have more questions, and be 'pressured' by having less time. If 'we' wan't to sit here and try to say we 'do the same things, know the same things' as MDAs do, then we should have to prove it. I calculated all my board exams together. My NCLEX was around 75 questions.. and my CRNA National Cert. Exam (boards) was like 70-100 questions (dont recall exact number). So, I was essentially asked to answer 175 questions to prove myself, not only as a nurse, but also as a CRNA. 175 questions for my entire career. Once I stepped back from this and looked at it.. I was really shocked. MDAs are tested on a completely different level. On behalf of all crnas, i feel we should be tested harder. Maybe we should take the board exam for MDAs and they should take our Nat.Cert.Exam. I think that would answer alot of questions brought up in this forum. But, unfortunately I don't think that would be the best idea.

I have two close friends who went to medical school. I had the unpleasant priviledge to see some of their study materials for their board exams. It really does blow my mind.. how much they had to learn. The shear amount of information that they learn.. it's in a different league. Then they have to show proficiency on numerous USMLEs and Anes boards. There is no way I could learn all that information and answer those board style questions, especially in the short amount of time they have for each question. I graduated number 2 in my CRNA class of 36 students, and I can sure tell you that my classmates would have little or no chance at passing those exams. But that's why I didn't go to medical school. I know my limitations. That's not to say nurses aren't intelligent. But doctors are in a different league, whether you like it or not. They're essentially the top tier students that our nation's universities pump out. That's why society rightfully holds them to a different standard. The're the brightest minds our nation produces. My friend in medschool got his BS degree in chemistry. He graduated summa cum laude. I don't know one nurse who could sit through a physical chemistry/ quantum physics course and pull an 'A'. let alone pull an 'A' in all chemistry courses.

I also found out that 4 of the ICU docs here at my hospital were (are) Anesthesiologist. I asked them how they got where they were. They basically do an extra year in residency in the ICU. They then are qualified to treat patients in the ICU, and in the case here.. our ICU director is an Anesthesiologist. They said there are many MDAs that don't even do the extra year of training but can moonlight in ICUs on the side...

I think I speak for all crnas when I say.. there is no way I could step foot in the ICU, take complete control of treating the sickest and most critical patients in the hospital, and feel like I was doing something right. (even with 12 months of ICU experience after crna residency) I spent 4 years as an ICU nurse. When things went bad, I didn't look to my left and right.. I looked to the phone. I paged the doctor !!

I don't know why crnas get so upset with this issue. Maybe they don't know exactly what MDAs go through, how much they know, the ICU stuff, etc. Maybe crnas don't know how much they really don't know. Well I do. But I'm proud of what I do. We ARE NOT the same as them. We should be proud of who we are. What makes us different makes us unique!! We are UNIQUE. We are SPECIAL !! Rejoice in the fact that we're special !! I love being a crna.

LuvMyGamecocks · Jun 20, 2007, 08:32 AM

Re: All CRNAs need to READ this

Originally Posted by janecristensen

It's true that we are NOT as smart as MDs.

I know my limitations. That's not to say nurses aren't intelligent. But doctors are in a different league, whether you like it or not.

I don't know one nurse who could sit through a physical chemistry/ quantum physics course and pull an 'A'. let alone pull an 'A' in all chemistry courses.

Well I do. But I'm proud of what I do. We ARE NOT the same as them. We should be proud of who we are. What makes us different makes us unique!! We are UNIQUE. We are SPECIAL !! Rejoice in the fact that we're special !! I love being a crna.

I understand fully what your point of view is, and I agree 100%.

But, the tone of several things in your post (all quoted above) IMO suggest that nurses "settle" for "just being a nurse." I could VERY well sit through a physical chemistry/quantum physics course/whatever you throw at me and pull out an 'A'. Is it a matter of intelligence? Partially. The difference is in the motivation. I'm not willing to give away 8-12 years of my life...MDs are.

ANYONE's limitations should bedefined by themselves. Because someone is in the nursing field shouldn't suggest that they are limited in what they can achieve in their education. It is a choice...one that you, myself and many, many others are happy to have made.

Can I PLEASE assume that the first line is one that I've taken out of context? MDs are given a far greater amount of material in school to learn than nurses, but that makes them more knowledgable...NOT smarter.

*gonzo1* · Jun 20, 2007, 09:10 AM

Re: All CRNAs need to READ this

The only problem I have with what you are saying is you imply that a person becomes a nurse or something other than a doctor because they are not as smart as the person who chooses to become a doctor. This is so wrong.
Many of the people I work with are smart enough to become doctors, but for diverse reasons choose a different career path.
Not every brilliant person has the money or time available to go to med school.
The biggest difference between a CRNA and a doctor is the amount of time spent on the education.
I think it is wonderful that we have the option to become CRNAs and they function extremely well, however I think you do a grave injustice to your fellow CRNAs when you imply that they are not smart enough to be doctors and so chose the path of less resistance.
I am not a CRNA, I am an ER nurse. I did not go to school for nursing until I was nearly fifty.
I worked for over twenty years in another field. My family and friends say that I am smart enough to be a doctor, but I have no desire to be a doctor. The role of nurse and doctor are very different. The fact that both disciplines work together the way they do allow us to provide excellent care.
I can say this because I work at a hospital where nursing input and corroboration with the MD is considered crucial. This is one of the reasons the hospital I work at is a top 100 hospital and has won many awards over the years.
Please go back and read your post. Perhaps you didn't really mean to say the "smart" people become doctors and the "less" smart people become everything else.
It is wonderful that you hold MDs in such esteem and from my experiences they deserve it. But "brilliant" people become CRNAs and nurses too.

hbgwan · Jun 20, 2007, 10:12 AM

Re: All CRNAs need to READ this

You make some very valid and good points. However, I think there is one thing that should be addressed. You're right in saying that doctors and CRNAs have different jobs. One has much more extensive training than does the other. But many doctors need to realize that even though they have much more training, have a higher degree of responsibility and are higher on the social ladder, that doesn't give them the excuse to treat everyone else like crap. Period.

But great post! I enjoyed reading it.

TrudyRN · Jun 20, 2007, 10:52 AM

Re: All CRNAs need to READ this

I am very upset that you are downing yourself and your fellow nurses/CRNA's. If you feel unprepared for your job, how can you do it? If you've been doing it for 5 years, successfully, you must be doing it well enough.

What do you mean, you could never be a doctor? I think that a lot of nurses are great physician material, they just couldn't get into school or took the first opening for school.

It really steams me to hear a nurse criticize other nurses, I must say. Maybe you are a doctor in disguise???? And do you honestlly think that just any doctor can walk into any ICU and take charge of a problem? Well, they can't. There are specialties, with some docs AND NURSES who are specialists in that particular specialty.

There are plenty of nurses who have to hand hold the docs and teach them plenty of stuff.

Just who do you think is at the bedside day and night, who does the doc rely on to see and hear and deal with what is happening while the doc is off duty? Who is responsible if a doc's incorrect orders reach the patient?

Please rethink this. It's nice that you think highly of them but there is no need to put yourself or other nurses down.

mrsalby · Jun 20, 2007, 12:40 PM

Re: All CRNAs need to READ this

"I don't know one nurse who could sit through a physical chemistry/ quantum physics course and pull an 'A'. let alone pull an 'A' in all chemistry courses. "

I agree with most of your post. I do not agree with nurses not being as smart. I believe there are nurses out there that are as intelligent as any MD or MDA, they only chose a different career or path.

I am a nurse that is 8 classes away from a biochemistry degree and 4 classes away from my RN to BSN degree. I have "A's" in all my chemistry classes. So now you know one nurse that has made As in his or her Chem classes. My goal is to become a CRNA

" think I speak for all crnas when I say.. there is no way I could step foot in the ICU, take complete control of treating the sickest and most critical patients in the hospital, and feel like I was doing something right. (even with 12 months of ICU experience after crna residency) "

I believe you are over generalizing here and through some of your post. There are some very intelligent nurses out there who could manage the sick patients. I know some RNs in the ICU who manage very well, One of my charge nurses in the ICU fields many questions about procedures and patient care management from the MDs themselves.

"Well I do. But I'm proud of what I do. We ARE NOT the same as them. We should be proud of who we are. What makes us different makes us unique!! We are UNIQUE. We are SPECIAL !! Rejoice in the fact that we're special !! I love being a crna.

You should be proud, you worked hard to get where you are and yes you are unique as is every one else. You have been trained to do what you should do within the level of your licensure. MDAs respectively. Everyone plays his or her part in the "Big Game." It is important for everyone to recognize his or her role and not discredit others for theirs. Learning opportunities are everywhere, reach out and grab them and own them. If some CRNAs are having difficulty with the MDAs role, then they need to educate themselves on the differences or go back to school to become an MDA or keep quiet.

Congrats to you on your achievements!

badgernurse · Jun 20, 2007, 01:33 PM

Re: All CRNAs need to READ this

I think you're going to take a lot of heat on this one. I would do it myself but I think you're post is a joke.

CRNA2BKY · Jun 20, 2007, 02:03 PM

Re: All CRNAs need to READ this

Thank you for this wonderful post. I think you really hit the nail on the head: CRNA's are not MD's, but they do serve a purpose, and they do their jobs well. I'm hoping to become a crna someday. I'm in an ABSN program now and have about 45 more weeks to go. Then, do my time in an ICU, and apply to crna programs. It was nice to see your post comparing md's, and giving them their due credit. I think most crna's think like you do, and know that crna's have a very important job, and they do it really well, but they are not md's, and they don't pretend to be md's. Congrat's on all your accomplishments. I hope to be in your shoes someday.

rninwch · Jun 20, 2007, 02:44 PM

Re: All CRNAs need to READ this

OK, first I am not a CRNA...simply a soon to be NP student, and I have no idea what thread this may have started from, but there were a few things in your post that I can't keep from commenting on.

1. "It's true that we are NOT as smart as MDs."

I disagree entirely, I know plenty of nurses I would consider smarter than some MDs, and visa versa. Just because you don't know something, doesn't mean you aren't as smart as someone else.

2. "Maybe we should take the board exam for MDAs and they should take our Nat.Cert.Exam."

Now, hold on there. CRNAs are nurses trained to do anesthesia, the key word being nurses. MDAs are MDs with special schooling in anesthesia. The keyword here is MD. That means not only are they required to be competent with the whole anesthesia thing, but they have to be competent docs as well.
A nurse is not a doctor...occasionally our roles overlap, but one cannot replace the other. So why would a nurse (advanced practice or not) take a MDA board exam???

3. "The shear amount of information that they learn.. it's in a different league."

Yep, that's cause they are MDs!

4. "My friend in medschool got his BS degree in chemistry. He graduated summa cum laude. I don't know one nurse who could sit through a physical chemistry/ quantum physics course and pull an 'A'. let alone pull an 'A' in all chemistry courses."

Umm, well I happen to have taken a quantum physics course, and while I didn't get an 'A', I did manage a B+, which was the highest grade in my class...and I aced chemistry, biochem and patho...all of which were on the premed track, so does that mean I should have been a doctor?? You may as well start the old, "boys are better at science and math" crap...I don't buy it. Call me a science geek if you want but this girl could probably kick some serious doctor butt in a physics discussion.

5. "I think I speak for all crnas when I say.. there is no way I could step foot in the ICU, take complete control of treating the sickest and most critical patients in the hospital, and feel like I was doing something right."

Of course not...once again an MDA is an MD first, you're not, so of course you can't do that. We have all kinds of docs moonlighting in our ER: family docs, MDAs, OB/GYNs, heck we even have general surgeons down there from time to time. They can do it because they are MDs (or DOs). Any advanced practice nurse realizes that you can't go flip-flopping around. An FNP, must do family medicine (ok, so that one is a bit broad), Midwives provide basic gyn care as well as care for healthy pregnant women, Pediatric, neonatal adult NPs can only provide care in that field, a neonatal NP can't go around doing family medicine because she/he doesn't have a lisence for that. An MD can practice as a doctor where and how he/she chooses.

Just because someone isn't an MD, doesn't mean they aren't as smart or smarter than an MD. I work in a small rural hospital and I'm hear to tell you that we can't find an MDA or MDA group to work here (not enough $$ and too much call). We ONLY have CRNAs (and no they don't even have an MDA consultant), the group is excellent and they do ALL the anesthesia in our hospital. I couldn't ask for a better bunch of people to work with. You are right MDAs and CRNAs are different...but they both provide the same kind of care.

RNFPC · Jun 20, 2007, 05:21 PM

Re: All CRNAs need to READ this

Well... I respect your achievement of becoming a CRNA, but I'm disappointed with your post. Let me tell you why:

*Knowledge does not equal intelligence/"smartness" - A physician/MDA has knowledge not intelligence. Receiving your MD is a demonstration of knowledge not intelligence. Are they intelligent? yes. Are they more intelligent than anyone else? not necessarily.

*Some of us are not nurses because we are not "smart" enough to be physicians. Some of us have chosen this path for a variety of reasons.

*I am not your average paramedic or nurse, but I will say this: As someone who has always scored in the 98-99 percentile on standardized tests, as someone who entered schools with nearly 3 semesters worth of credit that I earned in high school, and as someone who went back to nursing school and finished with a 3.9 while working 76+ hours per week, I am absolutely insulted by your suggestion that as a nurse (and as someone who's goal is to become an CRNA) that I am not as intelligent or as smart as a physician.

*Your attitude that regarding your own profession serves to hold back nursing as a whole. Why do we have to fight our own to be recognized as intelligent?!

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All CRNAs need to READ this

All CRNAs need to READ this

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