Denied by patient

Specialties CRNA

Published

Have you ever been denied by a patient simply because of the fact that you are a nurse and not a doctor?

How do you introduced yourself to your patient? I've heard CRNAs introduce themselves as their anesthesia provider rather than nurse anesthetist simply for that reason.

I'm curious to hear from CRNAs. Thanks

Specializes in ER, Trauma ICU, CVICU.

I am very proud of the fact that I am a nurse, and if I give an awesome anesthetic, I don't want the MDA to get credit for it. If they don't want a CRNA, so be it... they can take their chances with the guys who spend the majority of their time looking at a board and drinking coffee.

Specializes in Anesthesia.

I have had one or two patients that have come in insisting on being treated only by an anesthesiologist. We always assign them to anesthesiologist if one is available.

It usually falls into one of two categories if these patients insist on this: 1. They have some family member that is a physician that told them they should only be taken care by anesthesiologist for X reason or 2. The patient has read some diatribe on the internet about CRNAs and now thinks only anesthesiologist can properly take care of them.

I always introduce myself as, "Hi I am X the nurse anesthetist". I think it is deceiving for any type of anesthesia provider or student/resident to not plainly introduce themselves to the patient.

I know some CRNAs will vaguely introduce themselves as an anesthesia provider, and some AAs refer to themselves as anesthetists to sound more like CRNAs. Similarly, anesthesiology residents will often leave off any mention that they are residents when introducing themselves to patients.

Specializes in Nephrology, Cardiology, ER, ICU.

We recently had the unfortunate occasion to have a very ill grandchild. She underwent a bronch, then craniectomy, then peg/trach, then bronch all separate procedures. She was cared for in a level one tertiary 900 bed hospital. And...cared for brilliantly by all her providers. When anesthesia made post procedure rounds I was in the room on a couple of occasions.

Correctly identifying yourself is the keyword here.

If they don't want a CRNA, then I guess give them a MDA and AA. Have a good sleep.

NEXT!

Specializes in CRNA, Finally retired.

If pt. asks for an MD and I'm at ambulatory location, I just tell the patient that they can have an MD but they will have to wait until the other 3 or 4 rooms are done and the MDA is available; or they can go to the mothership hospital where staffing is more flexible and request an MDA. In the hospital, the ACT group would sometimes tell them, "this is the way we do it here" and leave the ball in patient's court or, if they did get them an MDA, they would get the most inexperienced one that looked very young:).

Where I work patients are told, by the anesthesiologist, it is a CRNA doing the anesthetic. The MD gets paid less for doing a single case. If they supervise they get the equivalent of twice the amount of a single anesthetic. Patients are not given the choice.

When I had my twins and found out I was having an emergency c section, I asked for an MD. The CRNA came in and gave me IV push meds and graciously told me what they were. Now I laugh about the MD at the head of the table and the OB waiting to cut. Remember , I'm an OR nurse and the DH is an MD. I hear " I'm ready if you are and the other said ok I'm ready". You say go when you are ready! If I hadn't been so sleepy, I would have said "ok I say GO". I woke up soon to hear the residents at the back table discussing if my girls were identical as indicated by their placenta . My girls were quickly taken to the NICU. We are so blessed they received no residual effects from prematurity and are now MDs themselves.

If I ever get surgery, I'm going to ask for a CRNA. If they don't have one, then... oh well.

Specializes in CRNA, Finally retired.
Where I work patients are told, by the anesthesiologist, it is a CRNA doing the anesthetic. The MD gets paid less for doing a single case. If they supervise they get the equivalent of twice the amount of a single anesthetic. Patients are not given the choice.

No, the MDA does not get reimbursed for 100% of cases when supervising 2 CRNA's. They take a decrease proportionate to the number of CRNA's they are supervising.

Specializes in Anesthesia.
No, the MDA does not get reimbursed for 100% of cases when supervising 2 CRNA's. They take a decrease proportionate to the number of CRNA's they are supervising.

I think what BCRNA was saying is that it is more profitable for MDAs to supervise, which it generally is rather than doing their own cases. MDAs get 50% of anesthesia billing for up to 4 cases when "supervising" CRNAs.

wow, interesting

+ Add a Comment