Anesthesiologists being replaced by CRNAs???

Specialties CRNA

Published

I was vacationing in the tropics a few weeks ago and met three handsome Anesthesiologists while sun bathing at the pool. We all chatted a little until the topic of our professions came up. I told them I was starting nursing school (ABSN Program) in a few weeks & how excited I was. I then proceeded further by saying I also hope to pursue a graduate degree as a CRNA or NP (note at this point I had no idea these guys were anesthesiologists). Why did I mentioned becoming a CRNA, b/c the stares I got from all three were nothing but pure EVIL STARES! By their looks I knew I said something wrong but had no idea what it was until they told me they were Anesthesiologists & fear that CRNAs were taking away their jobs at a cheaper price, and with the new health care laws just passed its going to get worst for them. This was totally unexpected 'cause all I planned to do that day was to relax by the poolside & sip pina coladas all day! However, they went on trying to convince me of all the reasons as to why I should not pursue a CRNA career & that eventually the national anesthesia board (not sure if this was the organization they mentioned) was no longer going to certify CRNA training and eventually they'll be no more training because there is no longer a shortage of Anesthesiologists. The shocker of this whole conversation was two of the anesthesiologists mentioned, with conviction, they wish they had pursue a CRNA career instead where they would have accumulated less debt with almost the same income or they wish they had chosen another specialty.

I was pretty shocked hearing these remarks & would love to hear your opinions :)

Specializes in Anesthesia.
With all due respect, if a patient wants an unsupervised nurse (solo CRNA) performing his/her anesthesia, that's their choice; I just want to make sure that the patient understands who their anesthesia provider actually is. You are entitled to your own opinion. To be meaningful, supervision means anesthesiologist, nurses supervising other nurses flys in the face of safety as well as the ACT model. Comparing the depth, scope and tenor of an anesthesiologist's education to that of a CRNA is quite ridiculous......Been there, done that (both). I haven't seen anyone who went to med school try to compete with anyone who went to CRNA school and the reference to wars, weapons etc goes over my head entirely. And for your information, this IS my turf too.

1. It is usually the anesthesiologist that leads patients to believe they are going to be the one doing their anesthesia instead of the CRNA. This is especially true in ACT practices. I am always upfront with my patients and tell them that I am a nurse anesthetist (I never introduce myself as a CRNA unless I am sure my patient is familiar with the term), and that I will be doing their anesthesia.

2. The safety argument does not work since all the research shows just the opposite. There is no difference in patient outcomes whether the anesthesia is provided by and independent CRNA or anesthesiologist.

3. I respect anesthesiologists training and went to school with medical students shared some classes with them (I even trained several during their anesthesia rotations during medical school), trained/pulled call right beside anesthesiology residents, but the fact still doesn't change that there isn't some special training that anesthesiologists get that makes anesthesiologists safer providing anesthetic care.

4. It strikes me as funny that anesthesiologists are so highly trained most can quote all the latest research, follow the most up to date research, but steadfastly refuse to believe that CRNAs are just as safe as them when providing anesthesia care. If we were debating any other topic and we had this much research in front of us everyone would agree, but since paychecks and egos are on the line very few MDAs and CRNAs are ever going to agree on this topic. The good thing is though most MDAs and CRNAs get along quite well even where both work together independently.

5. We now have 16 states that have opted out, and even though this is nothing more than a billing issue states that have opted out tend have double the amount of independent CRNAs with no changes in patient outcomes. ACT practices are unnecessary and expensive just behind all MDA only practices as being the most expensive. These type of practices are being replaced with more cost effective practices with no change in safety.

Either way you will keep doing your type of practice I will keep working independently, and we will both be happy in our practices.

6. The Most important thing: MERRY CHRISTMAS and HAPPY NEW YEARS!!! All the best.

Capt E.

Out of curiosity, what are you basing your opinoins of crna's on?

I worked as a CRNA before attending med school.

Everyone is entitled to an opinion, but I see a lot CRNA bashing anesthesiologists just as much or more than I see anesthesiologists bashing CRNA. Been in both sets of shoes. My issue is with unsupervised CRNA practice; I don't think that it's safe. Patients should be told in advance if their anesthesia will be done by an unsupervised nurse and this should be part of informed consent. If a patient wants to accept having an unsupervised CRNA perform his/her anesthesia, that's a personal choice, albeit a bad one IMHO. best wishes to all..

Colonel. D. (wtbcrna-just had to throw that in there even though I'm retired)

What is something that a CRNA 'couldn't handle'? If you say airway, I have seen MDAs who couldn't intubate; if you say complex hemodynamic management, that's 2nd nature to a CRNA because of our ICU experience; diagnosing a pneumo? We can do that AND treat it! Please, do tell what you think a CRNA couldn't handle. I am ACLS trained, just like any doc. I can do a cricothyrotomy or even a trach if I had to...most anesthesia providers (docs included) don't even do that in their career. Get back to me on that would ya?

I did a locums assignment in CA where a world renowned surgeon is on staff. He said that he prefers CRNAs over anesthesiologists. Guess what? There are NO anesthesiologists at that hospital because that's what the surgeons want!

I did the anesthesia for one of the hospitalists at my former hospital. He was fine with that and he could have had an anesthesiologist if he wanted! In PACU, he told me how wonderful he felt! So, you are just blowing hot air based on zilch. You seem to have a problem that you chose a field that highly overlaps with an advanced practice nurse. You should have chosen surgery or another field to feel more like a 'real doctor'.

tirade of untruths? it's common sense that unsupervised nurses should NOT be providing ANY anesthesia care..........

Obviously you are incorrect. Tell that to the multitude of medical staff credentialing committees that grant privileges to CRNAs to work solo. If you did your homework, you would see rather that your assertions are 'uncommon'.

Specializes in Anesthesia.
Everyone is entitled to an opinion, but I see a lot CRNA bashing anesthesiologists just as much or more than I see anesthesiologists bashing CRNA. Been in both sets of shoes. My issue is with unsupervised CRNA practice; I don't think that it's safe. Patients should be told in advance if their anesthesia will be done by an unsupervised nurse and this should be part of informed consent. If a patient wants to accept having an unsupervised CRNA perform his/her anesthesia, that's a personal choice, albeit a bad one IMHO. best wishes to all..

Colonel. D. (wtbcrna-just had to throw that in there even though I'm retired)

Happy to know even the military couldn't change your mind....lol.

Specializes in Anesthesia.
Everyone is entitled to an opinion, but I see a lot CRNA bashing anesthesiologists just as much or more than I see anesthesiologists bashing CRNA. Been in both sets of shoes. My issue is with unsupervised CRNA practice; I don't think that it's safe. Patients should be told in advance if their anesthesia will be done by an unsupervised nurse and this should be part of informed consent. If a patient wants to accept having an unsupervised CRNA perform his/her anesthesia, that's a personal choice, albeit a bad one IMHO. best wishes to all..

Colonel. D. (wtbcrna-just had to throw that in there even though I'm retired)

The simple fact that anesthesiologists go around and tell patients that it is not safe for CRNAs to provide anesthetic care is bashing CRNAs when all the research shows just the opposite. Do you go up to your patients and tell I wouldn't let Dr. X surgeon do my surgery because I think he/she is unsafe based on my opinion?

Again there is absolutely no proof to your accusations. I hope you weren't a military trained CRNA and still have this kind of attitude that would be disservice to all military CRNAs that have worked independently for decades.

Patients are clueless...that's like letting them make the decision that they want a Johnson and Johnson total knee rather than a Zimmer knee because they have 'heard of Johnson and Johnson'.

I think the whole "nurses supervising nurses" being unsafe quote says it all. Your saying that like just being a nurse makes us unsafe. Or just less by our very nature. I have met more dangerous physicians than I have nurses. It all depends on the person, and knowing your scope of practice and personal skills.

I did a locums assignment in CA where a world renowned surgeon is on staff. He said that he prefers CRNAs over anesthesiologists. Guess what? There are NO anesthesiologists at that hospital because that's what the surgeons want!

I did the anesthesia for one of the hospitalists at my former hospital. He was fine with that and he could have had an anesthesiologist if he wanted! In PACU, he told me how wonderful he felt! So, you are just blowing hot air based on zilch. You seem to have a problem that you chose a field that highly overlaps with an advanced practice nurse. You should have chosen surgery or another field to feel more like a 'real doctor'.

Your have a lack of respect for anesthesiologists; I'm glad that your posts speak for themselves. "Blowing smoke"? I doubt it; I have seen both side quite clearly and I do not attack anesthesia nurses....FYI, almost every nursing field overlaps my own; I'm just not as insecure as you seem to be. Please notice that I state my opinion and do not "trash" anyone...Yep, as a nurse I had a few times where I performed the anesthetic for a doc and they were grateful.....Same as a physician, just much safer practice. You disrespect speaks volumes about your own insecurity; I'm comfortable with my profession and my candle doesn't burn any brighter if I try to blow another person's candle out. I would never call a CRNA anything but a "real" nurse..in fact they are, at the core, nurses and that's nothing to be ashamed of. Please keep posting; you are proving my points quite eloquently.

Specializes in Anesthesia, Pain, Emergency Medicine.

Well, evidence based medicine at its best. Before you open your mouth, you might check. Peer reviewed studies show no difference in outcomes between CRNA, MDA or supervised CRNA.

You might also want to tell all the rural towns that have CRNA only anesthesia that they can't do surgery any longer.

So anyway, what you "think" does not matter. The evidenced based medicine DOES matter and it disagrees with you.

Have a nice day,

Ron Ray

Everyone is entitled to an opinion, but I see a lot CRNA bashing anesthesiologists just as much or more than I see anesthesiologists bashing CRNA. Been in both sets of shoes. My issue is with unsupervised CRNA practice; I don't think that it's safe. Patients should be told in advance if their anesthesia will be done by an unsupervised nurse and this should be part of informed consent. If a patient wants to accept having an unsupervised CRNA perform his/her anesthesia, that's a personal choice, albeit a bad one IMHO. best wishes to all..

Colonel. D. (wtbcrna-just had to throw that in there even though I'm retired)

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