Anti-CRNA website= such B.S.!!!! - page 5

Has anyone seen the grossly misinformed website called "Doctor by your side" ???? Website is a complete joke. I was just looking at it and the misrepresentation of MDA's vs. CRNA's is pretty... Read More

  1. Visit  wtbcrna profile page
    0
    Quote from msn10
    wtbcrna


    No, I don't work in a ACT hospital, I teach the CRNA's in a trauma/teaching hospital. We have 8 hospitals in the area that I work and teach. I get to see more than one model, I get to teach in more than one model.

    It is obvious that you are pro-CRNA, you are one. But again, the MD's don't have anymore problem with CRNA's than CRNA's like you have with MD's. This is why I was talking about chips on shoulders. I don't think I have read any thread on this site where you give MD's credit. That either means you haven't worked with enough since you are a newer graduate or you really can't give them credit because they are a threat to you as well. Regardless, your feet are dug in the sand.



    I would too, but fellowship trained MD's are going to do the hardest and most complicated cases and because of them, hospitals can increase their scope of cases they take on. The CRNA won't do the triple re-do bypass with multiple co-morbidities when a fellow is on staff. Most physician practices and hospitals hire these people to advance surgical practice as well as anesthesia. Furthermore, in my experience, fellows actually prefer to work with CRNA's over AA's. Our medical college in town has one of the top rated anesthesia programs in the country. Some of the administrators started buzzing about starting an AA program. The staff physicians at the local hospitals (who were trained as fellows at the college) said they had no desire to work with AA's. They felt that the CRNA's had the proper training AND they valued their experience as nurses in critical care and felt more confident with the CRNA's. One of the cardiac fellows said he would never work with an AA and would leave town if he had to supervise them which is saying a lot since he only supervises when there are no cardiac cases to do which is about 15% of the time for him. The MD's do respect most of the CRNA's here and visa versa so maybe this is just a regional thing and I shouldn't even argue.

    You also mentioned in a previous post that anesthesia is a 'nursing practice' performed by doctors. If that is true, then why can't I ever find a nurse anesthetist in the hospital? I have yet to hear the CRNA's introduce themselves as such. They introduce themselves to the patient by saying "I will be your anesthesia provider today" or "I am the anesthetist." If the CRNA profession truly believes that they are the inventors of the anesthesia then they should be proud that they are nurses. CRNA's should say "I am your nurse anesthetist. Most CRNA's tell me that they no longer practice 'nursing' they practice anesthesia. NP's don't say "I am your internal medicine/family practice provider.


    I have a great deal of respect for CRNA's and call many of them friends. But I am also tired of the doctor bashing on any level. Yes, some docs are frustrating and lazy, but so are some CRNA's. Sometimes getting some of them out of the lounge to do a case is like pulling teeth while the regular RN's see their behavior and feel the same way about them that the CRNA's feel about the MD's.



    Our university has 6 DNP programs, not sure why you referenced this for me, I do understand the program.
    Okay, so you mentioned that you work in a hospital that the MDAs and CA-3 supervise. What kind of practice is it if it isn't an ACT practice?


    "If that were true, and as you say there is no difference in patient safety between a CRNA and MD, then why should the CRNA's have a DNP? If you only need to have 20 minutes a day of training to be a anesthesia provider, lets just get monkeys to do anesthesia. It would cost a lot less and be more entertaining."

    Your quote about asking why CRNAs need a DNP? I posted the response even if your post was more rhetorical than anything else.

    Your localized experiences are just that localized. I always introduce myself as a nurse anesthetist as do most of my fellow CRNAs. You can't take your limited experience with your hospital system and equate to all CRNAs and all anesthesia practices. I spend lots of time talking with CRNAs from all over the US and have been able to work in Delaware, Washington DC, Maryland, and different parts of Alaska as an anesthesia provider. I have a fair grasp of the different practices out there, and the politics involved with each.
    I have no idea why you can never find a CRNA in your hospital unless it is the simple fact that they are all in rooms doing all the work while the MDAs are outside the OR "supervising". I am independent CRNA and we pull solo call. It is more common in my hospital to find a CRNA after hours than an MDA or during the day a lot of times.

    MDAs are not a threat to me. The ASA is a threat to the 120+years of independent practice provided by CRNAs, so in that respect the political entity that is the ASA is a threat to all CRNAs.

    CRNAs never claimed to be the inventors of anesthesia, but we also know it wasn't MDAs.

    Anyone with specialized experience is usually going to perform those specialized procedures. If I had a choice between a cardiac fellow and a CRNA with equal years of experience doing general anesthesia then I would choose the fellow. I would choose a CRNA if they had more experience doing that particular anesthesia than the fellow if that was the case. Fellowship trained MDAs do not allow hospitals to increase their scope of practice any MDA or CRNA with enough experience could do the exact same thing.

    I don't ritually bash MDAs and I have a lot respect for them as anesthesia colleagues, but that doesn't mean I believe MDAs should ever supervise CRNAs or have any say so in CRNA practice. There is no reason for it, and only ends up costing the taxpayers and individuals more money.

    MDAs and CRNAs should both do their own cases, and if one of them has specialized training in a certain area then they should do the majority of those cases.
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  3. Visit  nomadcrna profile page
    1
    There are NO foreign trained CRNAs practicing in the US. To practice here YOU MUST attend a US CRNA school.

    You are obviously not a CRNA or you would not even consider this.

    You say you teach CRNAs, I assume a general fluff nursing class, obviously not anesthesia related.

    I am amazed that a non-crna would come here and try to tell us how we compare to the mda or how we are able to practice.



    Quote from msn10
    ??????

    http://ifna-int.org/ifna/news.php

    Right hand side of page
    Last edit by nomadcrna on Oct 26, '11
    wtbcrna likes this.
  4. Visit  msn10 profile page
    1
    There are NO foreign trained CRNAs practicing in the US. To practice here YOU MUST attend a US CRNA school
    Yes, I know. That wasn't the point of my post. MD's can't practice either in the states unless they go though as US residency. Nurses and doctors can train in other countries for schooling (BSN and medical school), but their anesthesia residencies or AP schooling has to be done here. That is the point.

    You say you teach CRNAs, I assume a general fluff nursing class, obviously not anesthesia related.
    I don't think ACLS, advanced physiology, and applied biostatistics & epidemiology were fluff classes (my courses) but I don't think CRNA's have any fluff classes. They are well educated, well trained individuals and when we create DNP curriculums, we try to eliminate as much fluff as possible.

    I also don't think the PhD nurses who teach advanced pharmacology, bioethics, and management and leadership course consider their classes fluff either. You don't have to be a CRNA to teach non-anethseia courses, in fact, it is usually better to have someone with experience and education in those areas to teach them.

    I am amazed that a non-crna would come here and try to tell us how we compare to the mda or how we are able to practice.
    That is an interesting comment considering a BSN is the original OP. It is okay for a non CRNA to say bad things about MD's However, when someone challenges a statement, someone who teaches all types of students and creates curriculums and has to compare programs constantly to keep up to date on as much as she can, and someone who promotes the practice of nursing anesthesia...well that person is not capable of making comparisons? So only CRNA's are allowed to talk about anesthesia? That to me is unfair.

    As an educator, people are constantly evaluating my work. I get student evals at the end of every single class, seminar, CEU I teach. I am constantly trying to hone my skills and keep up with "the real world" of medicine so my students can be prepared. Do you think that every person that evaluates me or compares me to another teacher has a degree in nursing education with a focus on curriculum development? Do you think that all those people are experts in nursing theory and advanced adult learning techniques? Obviously not, just because I have those degrees and they don't doesn't mean their opinions are not valid. In fact, I can learn a great deal from them as well. Most important is perception. I want to hear their feedback, it makes me a better teacher.

    You and wtbcrna can get upset, that is fine. But all I am saying is their are differences in training and there are differences in practice. Just like their are differences in ADN and BSN training. Is one nurse better than another? No. But there are differences in training.

    I go to an NP because I like how she practices within her profession. I like her better than the MD I saw for many reasons. Does she have as much training as the MD or the same type? Nope, but I choose her. She doesn't seem to be upset that a non FNP made that comparison.
    aeron0228 likes this.
  5. Visit  wtbcrna profile page
    0
    MSN10,

    What exactly is the difference in practice between MDAs and CRNAs? How does an MDA put the tube in differently than a CRNA? What magic knowledge lets physicians make different decisions from CRNAs? Your view of practice comes from ACT/supervised practices if your views are consistent with what they teach SRNAs at your school then we know where not to recommend students to go to.

    I still don't see all this physician bashing that you claim in practically every post either.
  6. Visit  msn10 profile page
    1
    How does an MDA put the tube in differently than a CRNA?
    Nothing, when teaching ACLS, I don't teach med students any differently than I would an ICU nurse. That is not what I am talking about. The anesthesiologist went to medical school and does (USUALLY) a 1 year internal med rotation. CRNA's go to nursing school and need working experience. They are taught differently. Furthermore, MD's have fellowships, as of yet, CRNA's can't really specialize. Many CRNA's in our state go into rural practice so they do not work in an ACT model. They are independent. But they are also not USUALLY doing newborns with gastroschisis or a AAA. the 'harder' stuff very often gets done by an MD only or in a ACT model. Also, I am not about to tell you that I am showing the CRNA student about decision making in the OR.

    I know you went to a military program, and I truly wish there was more of the military program philosophy meshed into traditional nursing and CRNA programs. My niece is a CRNA from the military. She has great experience and ideas, however, on the mainland (as I am sure you see) curriculums are different.

    I am not going to go through all of your posts and cut and paste, but IMO your posts make it sound like you have very little respect for MDA's. If you could just give me some examples of why you think they are valuable to the practice of anesthesia I will retract that statement.

    You also stated that I had a 'very limited experience' in what I do. I respect your training and you experiences, but I don't think your experiences are limited, I would appreciate the same respect. All your life experiences are important in what you do. I am not a CRNA, but you are not a professional nursing instructor. We have a lot to learn from each other and a lot to offer the nursing profession. I teach nurses and doctors alike. I think I have some wonderful and meaningful experiences. If I am wrong in some information I provided then I will gladly admit it and change it. But you have limited exposure to who I am and what my experiences are. I teach in an ACT model but have worked in an MD only model. I am also creating a curriculum for large rural health care networks. You say your experience comes from working in some institutions and talking to people. I think both learning experiences are valid and meaningful.
    aeron0228 likes this.
  7. Visit  nomadcrna profile page
    0
    You have very little credibility, sorry. Any CRNA can see you have no clue about CRNA practice.
    Time to correct you again. There are pain fellowships CRNAs go through. So once again you have no clue about CRNA practice.
  8. Visit  msn10 profile page
    0
    There are pain fellowships CRNAs go through. So once again you have no clue about CRNA practice.
    Never said anything about pain fellowships. Let me spell out what I was saying. MD's have multiple fellowships and can specialize. The CRNA's do not have all of those fellowships, hence they can't really specialize. They just don't have the equivalents. Although now, with the DNP's they will have the foundation for fellowship curriculum development to dovetail onto the DNP training.

    You have very little credibility, sorry.
    My publications and experiences give me credibility with those I work with and meet. I don't think you can say who is credible without understanding their full CV.

    By your theory, you cannot be credible either when comparing programs because you have not attended medical school and you are not an education specialist. I am speaking from an educator standpoint. I stood up for CRNA's by writing to the OP's referenced site. It is been an interesting experience sticking up for CRNA practice and then getting bashed by CRNA's. Being a CRNA does not make you an expert in everything anesthesia. If I am not credible than I guess I will no longer have to be a CRNA advocate. NEVER once did I say that CRNA's aren't competent, just different training. If you had the exact same training, there would be no difference in licensure.

    Done with the thread, I am on a business/conference trip and I have an early morning class to teach to a number of medical professionals who seem to like what I can contribute.
  9. Visit  wtbcrna profile page
    1
    Quote from msn10
    Nothing, when teaching ACLS, I don't teach med students any differently than I would an ICU nurse. That is not what I am talking about. The anesthesiologist went to medical school and does (USUALLY) a 1 year internal med rotation. CRNA's go to nursing school and need working experience. They are taught differently. Furthermore, MD's have fellowships, as of yet, CRNA's can't really specialize. Many CRNA's in our state go into rural practice so they do not work in an ACT model. They are independent. But they are also not USUALLY doing newborns with gastroschisis or a AAA. the 'harder' stuff very often gets done by an MD only or in a ACT model. Also, I am not about to tell you that I am showing the CRNA student about decision making in the OR.

    I know you went to a military program, and I truly wish there was more of the military program philosophy meshed into traditional nursing and CRNA programs. My niece is a CRNA from the military. She has great experience and ideas, however, on the mainland (as I am sure you see) curriculums are different.

    I am not going to go through all of your posts and cut and paste, but IMO your posts make it sound like you have very little respect for MDA's. If you could just give me some examples of why you think they are valuable to the practice of anesthesia I will retract that statement.

    You also stated that I had a 'very limited experience' in what I do. I respect your training and you experiences, but I don't think your experiences are limited, I would appreciate the same respect. All your life experiences are important in what you do. I am not a CRNA, but you are not a professional nursing instructor. We have a lot to learn from each other and a lot to offer the nursing profession. I teach nurses and doctors alike. I think I have some wonderful and meaningful experiences. If I am wrong in some information I provided then I will gladly admit it and change it. But you have limited exposure to who I am and what my experiences are. I teach in an ACT model but have worked in an MD only model. I am also creating a curriculum for large rural health care networks. You say your experience comes from working in some institutions and talking to people. I think both learning experiences are valid and meaningful.
    Really with all your personal experience you think that nurse anesthetists and MDAs are taught anesthesia differently. We often have the exact same instruction and we use the exact same textbooks. Medical and nursing school are totally different. Anesthesia education is basically the same. MDAs residency is longer and they usually spend more time in speciality areas outside of the OR. Their educational strength is usually their better/longer education in pathophysiology, but that difference has never equated to better outcomes in the OR.

    There isn't one surgery that you have mentioned that there isn't CRNAs somewhere doing those exact same surgeries.

    I am not here to prop up MDAs egos or reputations that is what the ASA and SDN are for.

    There is nothing about an MDA internist year that really helps with anesthesia school, if you don't believe me ask the physicians that you work with how much it helped them and what exactly did they learn in that year that specifically related to anesthesia.

    I have taught for years. I have been an ACLS, PALS, and BLS instructor. I regularly precept all kinds of students in the OR including physicians/med students/pharmacists/OMFS/EMT/SRNAs etc. I am also currently working on my DNAP so I can teach SRNAs in the didactic portion as well as the clinical portion. Just like you I don't post all my experiences or education on here. I am not sure what you meant by the mainland unless you're referring to living in Alaska. We don't usually refer to living in Alaska as not living on the mainland. We are still attached to the "mainland".

    The curriculums are only different in military and civilian schools in the programs that choose to make it that way. There is no forbidden clinicals or knowledge that military SRNAs are taught that cannot or hasn't been integrated into civilian schools. Military nurse anesthesia stresses independence and teaches accordingly. All the military bases I know of welcome civilian students, and military anesthesia students spend a significant portion of their training at civilian institutions.

    You have downplayed the research and the ability of nurse anesthetists to function independently with the same outcomes as MDAs in practically every post. The responses that you get are going to be in accordance with those types of posts. You teach biostatistics, but you discredited all of the nurse anesthesia safety research in one fell swoop by making the suggestion since some of it was funded by the AANA it must be skewed and then you wonder about some of the responses you get.

    Unlike you I see and work in the politics of anesthesia everyday. For every harsh word that is said about MDAs by CRNAs you can bet there 100x worse being/has been said by MDAs/ASA. You can look on the ASA websites/magazine and see the degratory stuff that is posted about CRNAs all the time. Anything I have said is mild in comparison.
    NRSKarenRN likes this.
  10. Visit  wtbcrna profile page
    0
    Quote from msn10
    Never said anything about pain fellowships. Let me spell out what I was saying. MD's have multiple fellowships and can specialize. The CRNA's do not have all of those fellowships, hence they can't really specialize. They just don't have the equivalents. Although now, with the DNP's they will have the foundation for fellowship curriculum development to dovetail onto the DNP training.



    My publications and experiences give me credibility with those I work with and meet. I don't think you can say who is credible without understanding their full CV.

    By your theory, you cannot be credible either when comparing programs because you have not attended medical school and you are not an education specialist. I am speaking from an educator standpoint. I stood up for CRNA's by writing to the OP's referenced site. It is been an interesting experience sticking up for CRNA practice and then getting bashed by CRNA's. Being a CRNA does not make you an expert in everything anesthesia. If I am not credible than I guess I will no longer have to be a CRNA advocate. NEVER once did I say that CRNA's aren't competent, just different training. If you had the exact same training, there would be no difference in licensure.

    Done with the thread, I am on a business/conference trip and I have an early morning class to teach to a number of medical professionals who seem to like what I can contribute.
    To be fair: when something is posted/written on these blogs it is often hard to completely understand where the person is coming from and misunderstandings are easy to come by.

    I hope you have a nice trip....no sarcasm meant.
  11. Visit  CRNA-DNP profile page
    1
    I think the differences in training is mainly medical school vs. Nursing school. MDA's learn more 'medicine' which helps them with H&P's if they have to do them. They are also good resources for medical advice, but I am the one sitting in the room all day long. I don't mind the ACT model I work in, but I hate when they say they have to be there for induction and then selectively pick the cases to supervise after 7pm. Either supervise or don't. Medicare isn't a piggy bank. End of the day, I really don't have an issue with the docs, I like the ones I work with and I just got out of school last year so I am still green. However, they have their issues, we have ours. As long as I get to still practice without too much interference from anyone else I am good.

    I had CRNA's, MD's and MS teachers in school. I learned the most from the good teachers, not necessarily those with the most experience.

    BTW, does anyone know how to change the 'nursing specialty' section. That was my previous work.
    NRSKarenRN likes this.
  12. Visit  Xsited2baNurse profile page
    0
    4 years of med school= catching up to the 4 years of school dedicated primarily to medicine, microbiology, and patient care that a BSN delivers. 4 year residency in anesthesia=2 to 3 years CRNA school + at least 1 year in ICU learning how to properly monitor patients requiring intensive care. Also, let's not forget that a CRNA hopeful usually has to do extra prep work for admission to a program. S/he has gen chems 1 and 2, organic chemistry, sometimes biochemistry, sometimes physics (which may or may not require Calculus I), and always statistics. CRNAs are very well prepared for administering anesthesia, hence why studies suggest no difference in care/outcome between a CRNA and an MDA.

    what a lame website.
    Last edit by Xsited2baNurse on Dec 5, '11


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