Anesthesologist and CRNA collaboration - page 2

i've been a lurker on this board for about a year now; not particularly active in participation, but more active in soaking up knowledge from others as i start my nursing career. i'm interested... Read More

  1. by   GregRN
    Quote from UTRN2005
    While the debate of CRNAs/AAs/MDAs is all fine and well, I'm interested to hear responses that are pertinent to the original question. Thank you.
    Reading between the lines it seems that collaboration between the groups is fine so long and no one talks about the provervial elephant in the room. Everyone sees it, no one wants to talk about it, but when it's brought up they all have plenty to say about it.

    Don't ask, don't tell I guess. That's what's been displayed here so far, unless others have experienced otherwise.
  2. by   dfk
    Quote from deepz
    In a nutshell!

    MDAs have no problem whatsoever with CRNAs and AAs, so long as the underlings kiss the ring and make the money while the overlords eat donuts and watch CNBC in the lounge Lazeeboy.

    !
    hey deepz, in response to this, i also have to add that, during their shift, especially at post-induction and emergence, the anesthesiologists follow the ABCs of sustaining life... that's airway, bagel, coffee.. i sort of wouldn't mind that "responsibility"...
  3. by   deepz
    It's a power thing, Greg. The docs hold the hire-and-fire power in most departments; they attend the committee meetings, they glad-hand the administrators, while we stay hidden down the bowels of the OR (so to speak), hidden where we are most profitable. The best-kept secret in American healthcare. And that's no accident.
  4. by   SigmaSRNA
    Quote from deepz
    It's a power thing, Greg. The docs hold the hire-and-fire power in most departments; they attend the committee meetings, they glad-hand the administrators, while we stay hidden down the bowels of the OR (so to speak), hidden where we are most profitable. The best-kept secret in American healthcare. And that's no accident.

    Please don't label me as a sellout for asking this question because I love what I'm training to become but, where exactly do we want the MDAs to be? If they are in our O.R. room all the time, we say they are controlling. If they kick it in the lounge and let us do our thing, we call them lazy. So where do we want them?
  5. by   skipaway
    Quote from SigmaSRNA
    Please don't label me as a sellout for asking this question because I love what I'm training to become but, where exactly do we want the MDAs to be? If they are in our O.R. room all the time, we say they are controlling. If they kick it in the lounge and let us do our thing, we call them lazy. So where do we want them?
    I know, it's a connundrum...I'd like them out of the legislative buildings where they're trying their hardest to control our practice. I want them to mind their own business and do what they're trained to do whether it's in the OR or with CRNAs/AAs.
  6. by   wtbcrna
    Quote from SigmaSRNA
    Please don't label me as a sellout for asking this question because I love what I'm training to become but, where exactly do we want the MDAs to be? If they are in our O.R. room all the time, we say they are controlling. If they kick it in the lounge and let us do our thing, we call them lazy. So where do we want them?
    As soon to be SRNA this summer. I am kinda hoping that they will be like any other specialist.. doing their own thing with their own cases and ready to be consulted if needed. Maybe that is a little too much to ask for....
  7. by   xyhartnurs
    Quote from SigmaSRNA
    Please don't label me as a sellout for asking this question because I love what I'm training to become but, where exactly do we want the MDAs to be? If they are in our O.R. room all the time, we say they are controlling. If they kick it in the lounge and let us do our thing, we call them lazy. So where do we want them?
    Can't we all just get along!? :1luvu:
  8. by   goof1552
    Quote from airrn
    Interesting statement here. You imply that their is no statistical difference between AA's who have to be supervised by an MD and CRNA's who can and do practice independently. Sounds to me like you just admitted the ASA argument stating CRNA's should be supervised is totally invalid! Is this what you meant?
    Just a thought - if anyone was in the Chicago area this last year or so they heard about an issue in a dentists office. A young girl died after a procedure, from what can best be deciphered as diffusion hypoxia. Guess why that happened? Diffusion hypoxia should never kill anyone unless they are not being cared for properly. This was the case in the dentists office. The dentist did as you stated above and hired some girl of the street to be his "monitoring tech" and she killed the small girl. She did not do it maliciously, however when she was on the stand she did not know what anesthetic had been used, what a blood pressure cuff was, or even how to count respiratory rate. In other words the tech was probably a high school drop out IMO. This dentist has lost his license forever due to his following your line of thinking. Granted AA's will not do this, but it underscores the danger that path leads to........
    Last edit by goof1552 on Feb 18, '07 : Reason: Oops! Quoted the wrong person - sorry, but you get the point! :)
  9. by   jwk
    Quote from goof1552
    Just a thought - if anyone was in the Chicago area this last year or so they heard about an issue in a dentists office. A young girl died after a procedure, from what can best be deciphered as diffusion hypoxia. Guess why that happened? Diffusion hypoxia should never kill anyone unless they are not being cared for properly. This was the case in the dentists office. The dentist did as you stated above and hired some girl of the street to be his "monitoring tech" and she killed the small girl. She did not do it maliciously, however when she was on the stand she did not know what anesthetic had been used, what a blood pressure cuff was, or even how to count respiratory rate. In other words the tech was probably a high school drop out IMO. This dentist has lost his license forever due to his following your line of thinking. Granted AA's will not do this, but it underscores the danger that path leads to........
    You're comparing "some girl off the street" that "was probably a high school drop out" to the dangers of an AA with a master's degree in their field?
  10. by   sorrento
    The collaboration between MD's and CRNA's, in my opinion, depends on the "culture" lived in the departement. At my hospital CRNA's and MD's work together and generally respect each other. The goal of a good collaboration is the patient's savety. Mostly, both professions see each other as partners with a common goal: best practice for the patient.
    I speak of "mostly" because there are a few MD's that think CRNA's are only there to help and step in when it is convenient to them, but it is a very small number.
    The question is not who has done what kind of schooling, but what kind of best practice for the patient are we providing.
  11. by   CavemanCRNA
    I have several questions. First, paindoc - you sound like a MDA!!! What are you doing at ALLNURSES.COM. Are you married or involved with a nurse? You seems like you have so much anger towards CRNA's. Secondly do you personally employ trained monkey off the street. Is that why you try and justify "off the street" anesthesia employees. I don't know what hospital or practice you're involved with but if the hospital, or you and your partners allow RN's or techs to administer an "anesthetic" without formal training then you are endangering the lives of your patients. If you believe anyone off the street can be trained for any job you obviously minimize what CRNA's do in the OR.
  12. by   GregRN
    Quote from CavemanCRNA
    I have several questions. First, paindoc - you sound like a MDA!!! What are you doing at ALLNURSES.COM. Are you married or involved with a nurse? You seems like you have so much anger towards CRNA's. Secondly do you personally employ trained monkey off the street. Is that why you try and justify "off the street" anesthesia employees. I don't know what hospital or practice you're involved with but if the hospital, or you and your partners allow RN's or techs to administer an "anesthetic" without formal training then you are endangering the lives of your patients. If you believe anyone off the street can be trained for any job you obviously minimize what CRNA's do in the OR.
    Yikes. This is exactly the turn I didn't want this thread to take.

    Paindoc, can I safely assume you are an anesthesiologist? If so, I'd like to hear your take on the original question of this thread.
  13. by   paindoc
    There is no reply necessary to the rantings of one self proclaimed "Caveman". I assume the moniker is descriptive.
    As for CRNAs and MDs...I used to be an anesthesiologist but for the past decade have been a pain physician. I have employed CRNAs in my own company in the past and had a great working relationship with them. CRNAs and MDs have engaged nationwide in warfare tactics from time to time, with each group pouring on their share of gasoline. It actually reminds me of a polite form of what is going on in Iraq at this point.
    But overall, most MDs and CRNAs get along well enough together. Militant posturing by either group (eg. CRNAs claiming they can do everything that MDAs can do while blasting AAs for their lack of abilities....... MDs claiming anesthesiology delivery is solely within the realm of the practice of medicine when common sense and current practices nationwide would argue otherwise) is not helpful. It is the militant voices that get most of the attention in the press, but are usually the most emptyheaded, arrogant pricks you would ever want to meet, and realistically don't deserve the time of day. Unfortunately some of these misanthropes have the ear of naive legislative bodies, and continue to cause problems for those of us in the trenches that are simply trying to do a good job with delivery of anesthesia in a team model.
    So...can the evil empires work together? Certainly. Can both groups be replaced? In some states they absolutely can by non-physicians/non-CRNAs that don't fight like kids in a playground brawl.
    My personal experience with most CRNAs has been very very positive but if my experiences had been based on interactions with some of the more extremists on this forum, then I would have had quite a different view. Fortunately most CRNAs are rational, reasonable, competent, caring individuals that demand the best for their patients.

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