CRNA Threat - page 2

by samirish | 22,109 Views | 70 Comments

I read the following post on a student doctor's forum: "Agreed. CRNA's and nurses in general aren't the smartest group of people out there. The CRNA backlash has already begun. In response to CRNA's push for autonomy,... Read More


  1. 0
    Quote from NickB
    Seems to me that MD's support PA's and AA's more than NP's or CRNA's because the PA's and AA's are like their little puppy dogs. They get them from inception and teach them their base knowledge how they want it taught to them. NP's and CRNA's start with a completely different base set of knowledge and come into the picture with much more clinical experience and thus, more of their own ideas and techniques. Being an MD by itself demonstrates a person's propensity to be in control. PA's and AA's are much more controllable and it's to be expected that MD's will have an issue with NP's and CRNA's because they feel less in control. My ...

    All I can say is wow, this is really what you think of PA's? You really need to research the role of a PA before you start calling us "little puppy dogs". The clinical rotations for PA's will usually be around 2000/hrs +/-, NP programs hover around 500 +/-and there is continued debate on where it should be for NP's. Then general consensus is minimum of 500hrs. PA students will have minimum 2000hrs HCE prior to entering a program, NP's require 2yrs as a RN which will average to little over 2000hrs. Most PA's applying for school will exceed the 2000hrs, my class average is around 7000 with my HCE at 35,000hrs. PA school is INTENSIVE, I studied more in the 1st 2 weeks of PA school than I did the entire time in Nursing school. To me, nursing school was a joke compared to PA school and I went to a school with a >50% attrition and 99% first pass rate on boards. Out of my class of 62 only 1 did not pass 1st time. Most every NP worked in some capacity during school, VERY few PA's worked and nobody in my class works. I currently spend 36hrs per week physically in class, 3-5 hours per day studying and 10hrs each for Sat/Sun. I will spend 35-45hrs weekly studying. In nursing school, read notes about an hour before class.

    Talk to some PA's before you call them puppies, that's pretty insulting and just really shows your ignorance.
  2. 2
    I'm sorry but apart from the post which was insulting, I find it hard to fault them.

    Nurses get mad when medical assistants refer to themselves as nurses or perform nursing type duties.

    Likewise these doctors, get upset with a CRNA who wants to ride roughshod. A handshake is fast becoming an elbow hug. If they(CRNA) want the prestige, pay and other benefits that come with the position, then they need to spend the time.

    It's unfair.
    morphed and BluegrassRN like this.
  3. 1
    Quote from Malenurses
    Whats an AA?
    an AA is an anesthesia assistant; similar to a PA
    Chin up likes this.
  4. 0
    Quote from WolfpackRed
    an AA is an anesthesia assistant; similar to a PA
    I would kind of find it hard to believe that an AA is similar to a PA.

    A PA has precriptive authority and school is not exactly short nor non-intensive.

    Last I checked an AA could only earn about $30K a year...a PA..about triple that amount.
  5. 1
    Quote from BabyLady
    I would kind of find it hard to believe that an AA is similar to a PA.

    A PA has precriptive authority and school is not exactly short nor non-intensive.

    Last I checked an AA could only earn about $30K a year...a PA..about triple that amount.
    sorry, I will clarify as I think you are confusing anesthesia tech with anesthesia assistants.
    The AA involves a graduate level education and works under the supervision of a MDA. I cannot speak to the salary of the AA as I am not aware of it but check the website:

    http://anesthesiaassistant.com/
    Chin up likes this.
  6. 0
    What cracks me up is that I believe nurses initiated anesthesiology in the OR-I just don't understand why this has become such a big problem.

    As for PAs-there are good ones and bad ones; however I believe the debate regarding clinical hours may/can be valid when the NP is a new grad with no experience. As for my program in FNP, my clinical is 1000 hours and I have been an ER nurse for >5 years. Under most circumstances experience nurses who become NPs have not only a clniical edge, but the inherant sense of what is sick and how it affects the patient. That skill takes time to develop-clinical hours are truly not practice. Additionally, the misconception that PAs and NPs are the same keeps lingering and I don't know why. They aren't even close to being the same and there really isn't any comparison. Hopefully, NPs will earn the right to work independently with a defined scope of practice.

    As to the comments of nursing school being easy, you didn't attend mine. Sure there are schools that dumb down to pass students. 25% of of my nursing 1 classmates bit the dust, with only 77 graduating out of a starting class of 144. Of that 77, 21 were readmits to the program (1 strike another chance, 2 strikes you were out!). I am pretty smart, suffice it say I am qualified to join Mensa and I studied my behind off to maintain an A average. Unless the writer is uber brilliant, I find it difficult to believe any program was an hour of studing prior to class. "Just saying"......

    As to the comments regarding Doctors wanting to be in charge, I totally agree. My child who has been attending a professional program just informed me he would rather be a doctor. Why? Because he wants to be at the top of the food chain. His current pathway, pharmacy. Truthfully, if I wasn't the age I am, I would seriously consider medicine as I am of that same line of thought and think I would have been a good doctor, then again many of the critical care nurses with whom I work would've been great doctors.


    M
  7. 1
    It's a student doctors' forum. How based in reality are our student nurse forums? They are young, optimistic, and full of themselves, as are most youthful, unexperienced newbies.

    Once they get out into the real world and actually have to collaborate with others without someone constantly covering their back, most of them will think differently. Because nursing and medicine have evolved to be competitive in some arenas, there is, of course, going to be conflict. Yet the basis for that conflict is the fact that medical school is expensive and physicians expect a certain level of reimbursement; this creates a large number of positions for which there are no physicians. Hence the mid-level practitioners. Some physicians and physicians-in-training complain about them and their reimbursement, their education and position, but the reality of the situation is that our medical establishment cannot function without these mid-levels. How many physicians are banging down the doors to work at rural hospitals and clinics for 60-100K a year? Areas of need would simply go without, rural and underserved populations would have even less health care access if it weren't for mid-levels. Even in the most affluent and prestigious of practices, you will find RNs, NPs and PAs, because they are a necessity in today's health care economy. And most physicians recognize this; that's why they employ them and work with them...if NPs and PAs are so terrible, why do they have jobs? Why do physicians continue to work with them?

    I do agree with some of the sentiment; NP programs are not all equal, not even close. I wish they were *all* held to a high standard, as were *all* nursing programs. I work with nurses whose brains put many physicians to shame, and nurses who are so lacking in smarts and common sense, it's shocking and terrifying they finished high school, much less a college program.
    Chin up likes this.
  8. 10
    Quote from BabyLady
    I'm sorry, if the CRNA wants complete autonomy, then he/she needs to go to medical school for upteen years and become an anesthesiologist.
    They do have the autonomy - it's called independent practice, and no, the surgeon is not liable for the CRNAs actions...the CRNA is. There are plenty of places in America where CRNAs are practicing independently and autonomously. CRNAs can practice independently in all 50 states. That's part of the beauty of the profession, one can choose what type of practice environment they want to work in - independent, supervised, medically directed, and/or ACT. Obviously there are many variations on the theme, but the choice is there.

    Quote from Katie5
    I'm sorry but apart from the post which was insulting, I find it hard to fault them.

    Nurses get mad when medical assistants refer to themselves as nurses or perform nursing type duties.

    Likewise these doctors, get upset with a CRNA who wants to ride roughshod. A handshake is fast becoming an elbow hug. If they(CRNA) want the prestige, pay and other benefits that come with the position, then they need to spend the time.

    It's unfair.
    I don't think it's unfair that an anesthesiologists makes an average of 2-3 times what a CRNA makes. Society rewards physicians for their long term commitment to education. CRNAs are reimbursed the level that society deems appropriate and based on the complexity and potential dangers of anesthesia. It's a fair wage no doubt. Go shadow an someone performing anesthesia and attempt to appreciate the the complexity and potential dangers and how that gets managed with (most of the time) multiple co-morbidities. Anesthesia looks easy because the nurses and physicians (and AA's) are really good at what they are doing, but there is not much easy about it. To add to that, anesthesia school is no "cake-walk" either...just sayin'.

    I also don't think any CRNAs are out looking for any particular "prestige" and I am not sure of these "other benefits" that you mentioned. The primary concern is that nurse anesthetists want to be able to practice to their defined scope of practice without having their practice rights restricted, and there just happens to be some physicians that find that threatening.

    One last thing, nurses didn't start anesthesia (can't remember who posted that, or something to that extent). Nurses were selected and trained to provide anesthesia (back in the late 1800's) because there was no money (reimbursement) in it (unless the surgeon was feeling generous) and other physicians did not care about learning a specialty that they could not get paid for. When anesthesia became eligible for reimbursement, physicians again took interest - they invented a "new" term called anesthesiology. And, yes, they did much to advance the science and technology of anesthesia that we enjoy today. Do they have more medical training - yes. Is all of it applicable to delivering anesthesia - lots of debate (on both sides about that one). There is no doubt that anesthesiologists have excellent training, knowledge, and skills which can (and are) invaluable in many circumstances, but don't underestimate the knowlege and expertise of CRNAs either. And, yes, I am aware that everyone has come across a bad CRNA, they are out there - same goes for anesthesiologists (and every other specialty, profession, field, etc.)

    Bottom line - CRNAs have a defined scope of practice, and they just want to be allowed to practice within that scope how they choose - everyone else does. When another group attempts to restrict that practice, CRNAs fight back. The defense of nurse anesthesia over the past century has helped pave the way for advanced practice nursing that we see today. We stand on the shoulders of giants...please remember that.

    later,

    griff
    kabfighter, NurseKitten, SRNA4U, and 7 others like this.
  9. 0
    Quote from WolfpackRed
    sorry, I will clarify as I think you are confusing anesthesia tech with anesthesia assistants.
    The AA involves a graduate level education and works under the supervision of a MDA. I cannot speak to the salary of the AA as I am not aware of it but check the website:

    http://anesthesiaassistant.com/
    I have been informed not to place links in my posts. Kinda wondering how all these other folks seem be able to do it.

    ?????
  10. 0
    Quote from BabyLady
    I'm sorry, if the CRNA wants complete autonomy, then he/she needs to go to medical school for upteen years and become an anesthesiologist.
    Agreed! A CRNA is a CRNA and an Anesthesiologist is an anesthesiologist! You can't have less schooling and a different curriculum and expect to compare yourself to an MD!


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