Anesthesiologists being replaced by CRNAs???

[MONEJA783]

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 :)

[linearthinker, DNP, RN]

I am in a state that requires MDA supervision. That amounts to policy and procedure manuals signed by the single MDA employed by the hospital system and whom is housed at the facility headquarters. To my knowledge, the MDA has never set foot in any of the 6 hospitals where he or she is "supervising" the CRNAs. So in effect, in this neck of the woods, yes, CRNAs have taken over. It would be impossible to have a MDA at your case here. Very occasionally, a patient requests one and is told they have to transfer about 2 hours away to the university med center. In my limited experience with this scenario, most patients seem to be more attached to their surgeon, and I am not aware of anyone actually switching hospitals systems and surgeons b/c of this issue.

FWIW

[in2b8ix2b8]

Something I can't stand is how some anestesiologists will say "do you want a nurse to do your anesthesia". They try to make it sound like the surgeon just started shouting on his was down the hall, hey I need to do a surgery, is there any nurse who wants to jump in and do the anesthetic. Like just any nurse could jump in and do it, making it sound like the nurse has no real training to do it. I am nurse, I also have a graduate degree and am highly trained to do anesthesia. It is demeaning to my profession to make it sound like some untrained nurse might do an anesthetic. I should be referred to as a nurse anesthetist when a mda references us to the public. To tell the public some nurse is doing anesthesia is a form of fear mongering, a political ploy for people who usually have no real evidence to support their claim.

I guess my biggest complaint is it impunes my education and ability to try and lump me in with "just nurses". How would physicians feel if someone kept implying they had the skills of a medical student instead of an experienced physcian in whatever field they were in. That is the best analogy I could think of for this situation. I am very proud to be a nurse, but I do not like it when people use the term to try and take away from my accomplishments. Implying I have no training or education in anesthesia.

Semantics and presentation are all the MDAs (some hate being called MDAs, by the way! hehehe:lol2:, they are an M.D. just like a CT surgeon is, no need to differentiate with the 'A', so they grumble) have to instill fear in the unknowing public. That being said, they are pathetically grasping at straws to elevate their own interests. Hospitals wouldn't hire us, credential us as a member of their medical staff and grant us all the same privileges as an MDA if evidence showed that we are dangerous. Surgeons would not go for that and we all know that surgeons are the $$ makers and have a strong voice and influence. I do believe, however, that there are individuals (both MDAs and CRNAs) who are dangerous but you can't label an entire profession based on certain individuals. CRNAs are providers and members of the medical staff whereas the regular RNs are employees who do not have the skill set we have, do not have provider numbers for billing, etc...but MDAs want to blur the picture and make it appear as if Nancy Nurse, who just gave a bed bath, is now going to give someone's anesthesia a whirl. That tactic is very transparent but it's all they have. Funny story: While at a locums assignment, I was asked to go give one of the locums MDAs a lunch break. When I went in his room and offered lunch, he was so rude, nasty and indignant...I am a doctor, doctors don't take breaks...I said, "Well, it makes no difference to me, do you want lunch or not?" And the little jerk eventually decided to take lunch! His ego was bruised...fact of the matter, no one really cared if he was a doc or a CRNA, whether he took lunch or not...it only mattered to him. At another locums assignment, my attending (a locums) offered me lunch and when I returned, mayhem had broken out...another attending was in my room helping my attending dig out of a big hole. When the dust settled, the surgeons later told me that I could not leave again if that meant the locums MDA would be covering for me! The ETT had migrated and the anesthesia doctor didn't diagnose it and the patient started to really decompensate. So there you go! Those 'MD' initials didn't help my attending one bit! We have one of the best professions in the world!

[in2b8ix2b8]

Then you don't even understand the act model. CRNA are nurses, anesthesiologists are physicians. A few misguided CRNA seem to think that they can "work solo"...they can't and it's dangerous; some do in some areas and they "get away with it" (just like most drunk drivers "get away with it". "supervision of a medicare formality"? Any CRNA who thinks that they are in any way, shape or form "equal" to an anesthesiologist is experienceing a dangerous delusion.

"A few misguided CRNAs seem to think that they can 'work solo'"...Let me be the bearer of bad news: thousands of CRNAs DO work solo, and no, it's not dangerous, as studies show that we 'get away with it' in equal numbers that our physician colleagues 'get away with it'. We work solo because there is a need for our anesthesia services. We go through the credentialing process and any peer review process just as an MDA would. As far as thinking 'in any way shape or form' that CRNAs are 'equal to an anesthesiologist', first of all, I don't consider being an anesthesiologist the gold standard of the anesthesia profession. I never insinuate that I am a physician, why would I? The gold standard for me is vigilance, thoroughness, continuing education, personal ethics, and good patient outcome. If I can achieve that with every anesthetic that I render, who cares what my title/'label' is??!! How arrogant of you to think that a CRNA would even want to be equated with an MDA. We are anesthesia providers and yes, MDAs are anesthesia providers, too...so, we have that in common but I am 100% satisfied that I am a CRNA and 100% satisfied that I am not an anesthesiologist!

[subee, MSN, CRNA]

I'm sorry but 24/7 but you are the one who needs to "give it a rest." I believe in SCIENCE. You, on the other hand, believe in OPINION ABOVE KNOWLEDGE. Research, so far, indicates that M & M statistics are the same; difference in provider is statistically insignificant. That is because what we do isn't rocket science 90% of the time. The other 10% of the time (ahem....this is where you do come in) require something akin to rocket science. Remember, it's OPINION ABOVE KNOWLEDGE; not the other way around. Have a great day.

[stanman1968]

No we do not know that, the research does not support that, history does not support that.

[oncall24/7]

once again, patient safety is thrown to the wind by nurses who want to act as solo anesthesia providers.......sort of makes one ashamed of ever being a nurse..................stop looking at your own economic interests and focus on patient safety

[elkpark]

once again, patient safety is thrown to the wind by nurses who want to act as solo anesthesia providers...

"Once again," please provide some evidence that this is the case, beyond your obviously strong and sincere opinion ...

[subee, MSN, CRNA]

Somebody, PLEASE close this thread. It just keeps going nowhere. It needs to be dead.

[in2b8ix2b8]

Every time I administer an anesthetic, patient safety is my sole focus; thank you for your reminder to 'focus on patient safety', though, your reminder is quite unnecessary! Good patient outcomes, happy surgeons...awesome! The fact that our surgeons don't care if it's because of a CRNA or an MDA, priceless!