Does it bother CRNA's that MDA's get so much more...? - page 9

Hey guys, I'm not a CRNA yet. I want to be. I just got hired in a MICU/SICU. I was just wondering if it bothered any CRNA's the fact that MDs who practice anesthesia get paid wayy more for doing... Read More

  1. Visit  ssrhythm profile page
    0
    Quote from nohika
    One thing to note is that generally the nursing world funds these studies, so OF COURSE it's beneficial for them to show that they're all equal. Like all research...it should be taken with a grain of salt. As much as we would all love if bias did not exist...it does, and companies tend to not be against twisting their data slightly if it allows them to look much, much better.

    Wow! All research should be taken with a grain of salt? Spoken like a nurse/person who lacks the knowledge, intelligence, and/or desire to truly understand and evaluate research and the data it provides. While you are correct that it is prudent to be skeptical when reviewing and evaluating research data and results, to lump all research into the flawed, biased, and thus useless category is at best lazy and uninformed and at worst, ignorant. There are numerous studies proving that CRNAs and MDAs provide the same services with the same extremely safe and effective standards and outcomes. Nursing and non-nursing related research groups have both published and proven this fact with amazingly little bias. The only study that shows anything to the contrary is an ancient, MD biased study that they have been trying to hang their hats on for years. You are not a CRNA nor are you an MD, yet you speak with such certainty about which you obviously know very little.

    Understand, however, that I am not on here trying to say we should be paid what they are making. Should they be making what they are making? I know some who should be making double and some that I'd pay to stay out of my loved ones' rooms. What we should be making and what they should be making is never the point in these threads; I never post on this subject, but the inaccurate info has driven me to post this. If you are not an anesthetist or an MD, you have no clue what our knowledge base is compared to theirs. You have no clue what is relevant within that knowledge base. I know you think you do, but you don't and you will not from reading the internet or from you day to day observations and conversations.

    I'd just like to challenge the many RNs on here that are posting false info as if it were the Gospel...is this also how you deliver care to your patients? Do you order incentive spirometry when one of your patients spikes a fever? Do you believe that IPPB is actually helpful in treating atelectasis? Do you know what the latest research is regarding everything you do for your patient on a daily basis? Do you know what is the truth or are you assuming that what you were taught or what you learned from your colleagues is true? I fully support people stating their opinions on here and qualifying them as such, opinions. Stating blatantly false info as fact begs the question, why? The possible answers to that question are not pretty.
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  3. Visit  GM2RN profile page
    0
    Quote from ssrhythm
    Wow! All research should be taken with a grain of salt? Spoken like a nurse/person who lacks the knowledge, intelligence, and/or desire to truly understand and evaluate research and the data it provides. While you are correct that it is prudent to be skeptical when reviewing and evaluating research data and results, to lump all research into the flawed, biased, and thus useless category is at best lazy and uninformed and at worst, ignorant. There are numerous studies proving that CRNAs and MDAs provide the same services with the same extremely safe and effective standards and outcomes. Nursing and non-nursing related research groups have both published and proven this fact with amazingly little bias. The only study that shows anything to the contrary is an ancient, MD biased study that they have been trying to hang their hats on for years. You are not a CRNA nor are you an MD, yet you speak with such certainty about which you obviously know very little.

    Understand, however, that I am not on here trying to say we should be paid what they are making. Should they be making what they are making? I know some who should be making double and some that I'd pay to stay out of my loved ones' rooms. What we should be making and what they should be making is never the point in these threads; I never post on this subject, but the inaccurate info has driven me to post this. If you are not an anesthetist or an MD, you have no clue what our knowledge base is compared to theirs. You have no clue what is relevant within that knowledge base. I know you think you do, but you don't and you will not from reading the internet or from you day to day observations and conversations.

    I'd just like to challenge the many RNs on here that are posting false info as if it were the Gospel...is this also how you deliver care to your patients? Do you order incentive spirometry when one of your patients spikes a fever? Do you believe that IPPB is actually helpful in treating atelectasis? Do you know what the latest research is regarding everything you do for your patient on a daily basis? Do you know what is the truth or are you assuming that what you were taught or what you learned from your colleagues is true? I fully support people stating their opinions on here and qualifying them as such, opinions. Stating blatantly false info as fact begs the question, why? The possible answers to that question are not pretty.

    I'd just like to point out that "uninformed" and "ignorant" are synonyms, so they can't be at opposite ends of the spectrum.
  4. Visit  Esme12 profile page
    0
    Quote from BCRNA
    CRNAs do not need MD presence for anything. We can function completely independent from them. We have the exact same scope of practice. Crna programs are a minimum of 24 months, most are greater than 27. Two years of experience is preferred as a minimum. Malpractice insurance is almost exactly the same between mda and crna. People should not post information they don't really know anything about. I am proud of being a nurse. My job is the exact same as a MDA, they don't do anything I don't.
    If you read the whole thread before you posted......I have surrendered......
  5. Visit  paindoc profile page
    0
    It is exactly the assertions by BCRNA that will cause MDs across the land to begin jettisoning their CRNAs, whether they have been with the group a long time, or not. The fact is, CRNAs have now engaged in terminology and rhetoric that places them squarely in competition with the anesthesiologists they may be working with. Physicians are not so dense that they cannot see the writing on the wall, and are beginning to take steps to eradicate CRNAs from their groups, either through attrition, or by overt housecleaning. Just FYI.
  6. Visit  wtbcrna profile page
    1
    Quote from paindoc
    It is exactly the assertions by BCRNA that will cause MDs across the land to begin jettisoning their CRNAs, whether they have been with the group a long time, or not. The fact is, CRNAs have now engaged in terminology and rhetoric that places them squarely in competition with the anesthesiologists they may be working with. Physicians are not so dense that they cannot see the writing on the wall, and are beginning to take steps to eradicate CRNAs from their groups, either through attrition, or by overt housecleaning. Just FYI.
    Good luck to them! There isn't enough MDAs or AAs to do all the anesthesia cases in the US. AAs can never replace CRNAs. AAs are totally dependent on MDA supervision. Also, with the possibility of the renewal of a federal opt out with our current economic climate it is MDAs that should be worried about keeping their "supervising" jobs AKA sitting in the lounge drinking coffee.
    VeganCCRN likes this.
  7. Visit  nomadcrna profile page
    0
    We have been in competition for a long, long time. The best thing that could happen is to do away with the "team" approach. Let the market decide who they want to use. The scientific evidence is already on our side that we are just as safe as the MDA. Those lies don't wash anymore.

    Why does a physician feel the need to come to a nurses forum and opine?

    Quote from paindoc
    It is exactly the assertions by BCRNA that will cause MDs across the land to begin jettisoning their CRNAs, whether they have been with the group a long time, or not. The fact is, CRNAs have now engaged in terminology and rhetoric that places them squarely in competition with the anesthesiologists they may be working with. Physicians are not so dense that they cannot see the writing on the wall, and are beginning to take steps to eradicate CRNAs from their groups, either through attrition, or by overt housecleaning. Just FYI.
  8. Visit  paindoc profile page
    1
    I agree....the greedy lazy docs should go. But with CRNAs telling the surgeons, patients, and hospitals that they are at least as good as (if not better than) anesthesiologists, there will be some push back. As reimbursement by Medicare and linked insurers falls, there will be more pressure on the anesthesiologists to engage in self preservation. It will definitely be a war.
    bibibi likes this.
  9. Visit  Xsited2baNurse profile page
    0
    A war? With affordability on the side of the CRNAs, the only ones who would even have the time to show up to the battlefield would be the MDAs. The CRNAs would be too busy in the OR, asking about 1/2 to 1/3 less to be compensated for doing what they're doing.
  10. Visit  nomadcrna profile page
    0
    We have been at war for some time now.
    BTW, we ARE just as good.
    Evidenced based medicine. Look at the peer reviewed studies.
    BTW, what is your background. It says nurse on your profile.

    Quote from paindoc
    I agree....the greedy lazy docs should go. But with CRNAs telling the surgeons, patients, and hospitals that they are at least as good as (if not better than) anesthesiologists, there will be some push back. As reimbursement by Medicare and linked insurers falls, there will be more pressure on the anesthesiologists to engage in self preservation. It will definitely be a war.
  11. Visit  NurseSnarky profile page
    0
    I'm not a CRNA...I'll get that out there now. I've wanted to pursue a degree in the field for some time, so I do know about the politics involved. I've also went toe to toe with a MD over what a CRNA can do, has done (i.e. history), and their huge importance (was told that CRNA's are nothing without an Anesthesiologist).

    My desire to become a CRNA is not the money. I've never sat down and thought it was unfair that an MD gets paid more. MDs get their feathers ruffled that there are so many CRNAs in the profession with many more on the way...it's the old boys club. But CRNAs have been around forever...surgeons wanted nurses to give anesthesia as they would give their undivided attention to the patient during the procedure whereas a resident wanted to pay more attention to the case and doc (1800s).

    As many of us know, a doc does not have to be present or even in the building or even on staff (small rural hospitals) in order for CRNAs to provide anesthesia care. If something goes wrong, it's the surgeon or another doc that gives orders for any problems. It would be the same if something went wrong if a doc was giving anesthesia...the surgeon then ICU doc would take over care. It's hooey plain and simple that an Anesthesiologist is required in some places...and I'll leave it at that.

    In the United States, there have been three challenges brought against nurse anesthetists for illegally practicing medicine: Frank v. South in 1917, Hodgins and Crile in 1919, and Chalmers-Francis v. Nelson in 1936.[19][20] All occurred before 1940 and all were found in favor of the nursing profession, relying on the premise that the surgeon in charge of the operating room was the person practicing medicine. Prior to World War II, the delivery of anesthesia was mainly a nursing function. In 1942, there were 17 nurse anesthetists for every one anesthesiologist.[21] The numbers of physicians in this specialty did not greatly expand until the late 1960s. Therefore, it was legally established that when a nurse delivers anesthesia, it is the practice of nursing. When a physician delivers anesthesia, it is the practice of medicine. When a dentist delivers anesthesia, it is the practice of dentistry. There are great overlaps of tasks and knowledge in the health care professions. Administration of anesthesia and its related tasks by one provider does not necessarily contravene the practice of other health care providers.[22][23] For example, endotracheal intubation (placing a breathing tube into the windpipe) is performed by physicians, physician assistants, nurse anesthetists, anesthesiologist assistants, respiratory therapists, paramedics, EMT-Intermediates, and dental (maxillofacial) surgeons. In the United States, nurse anesthetists practice under the state's nursing practice act (not medical practice acts), which outlines the scope of practice for anesthesia nursing.
    http://en.wikipedia.org/wiki/Nurse_anesthetist


    The history of the CRNA is fascinating to me as I used to believe it was always a physician's job to deliver anesthesia until I delved into the history of it.

    The History of Nurse Anesthetists


    Nurses were the first professional group to provide anesthesia services in the United States. Established in the late 1800s, nurse anesthesia has since become recognized as the first clinical nursing specialty. The discipline of nurse anesthesia developed in response to requests of surgeons seeking a solution to the high morbidity and mortality attributed to anesthesia at that time. Surgeons saw nurses as a cadre of professionals who could give their undivided attention to patient care during surgical procedures. Serving as pioneers in anesthesia, nurse anesthetists became involved in the full range of specialty surgical procedures, as well as in the refinement of anesthesia techniques and equipment.
    http://www.anesthesiapatientsafety.c...ce/history.asp


    Good info here:

    http://www.aana.com/brieflookhistory.aspx

    And finally a review on a must read book:

    This review is from: Watchful Care: A History of Americas Nurse Anesthetists (Hardcover)
    One of the most effective ways to devalue a profession, or any group for that matter, is to ignore their history. Anesthesia texts written for primarily a physician audience have for decades systematically avoided mention of the considerable contributions made to the specialty of anesthesia by Nurse Anesthetists. This book tackles, and successfully masters the task of tracing the development of anesthesia as a nursing specialty from the 19th century to the 1980's. The author also chronicles the multiple, albeit unsuccessful, attempts of organized medicine to stifle the development CRNA's, the profession that has been providing the majority of anesthesia care to Americans for over a century. The book is a "must read" for anyone, nurse, physician or patient, who has an interest in the subject of anesthesia. It is worth the search to find the "out of print" work. Hopefullly, it will be reprinted!
    http://www.amazon.com/Watchful-Care-...5&sr=8-1-spell

    The book is available at the AANA website.
  12. Visit  wtbcrna profile page
    0
    Quote from NurseSnarky
    I'm not a CRNA...I'll get that out there now. I've wanted to pursue a degree in the field for some time, so I do know about the politics involved. I've also went toe to toe with a MD over what a CRNA can do, has done (i.e. history), and their huge importance (was told that CRNA's are nothing without an Anesthesiologist).

    My desire to become a CRNA is not the money. I've never sat down and thought it was unfair that an MD gets paid more. MDs get their feathers ruffled that there are so many CRNAs in the profession with many more on the way...it's the old boys club. But CRNAs have been around forever...surgeons wanted nurses to give anesthesia as they would give their undivided attention to the patient during the procedure whereas a resident wanted to pay more attention to the case and doc (1800s).

    As many of us know, a doc does not have to be present or even in the building or even on staff (small rural hospitals) in order for CRNAs to provide anesthesia care. If something goes wrong, it's the surgeon or another doc that gives orders for any problems. It would be the same if something went wrong if a doc was giving anesthesia...the surgeon then ICU doc would take over care. It's hooey plain and simple that an Anesthesiologist is required in some places...and I'll leave it at that.



    http://en.wikipedia.org/wiki/Nurse_anesthetist


    The history of the CRNA is fascinating to me as I used to believe it was always a physician's job to deliver anesthesia until I delved into the history of it.



    http://www.anesthesiapatientsafety.c...ce/history.asp


    Good info here:

    http://www.aana.com/brieflookhistory.aspx

    And finally a review on a must read book:



    http://www.amazon.com/Watchful-Care-...5&sr=8-1-spell

    The book is available at the AANA website.
    I totally agree with you on most accounts, but in small rural hospitals it is often going to be the CRNA who takes care of the patient in ICU when it is there patient and something goes wrong. We will write the orders/give meds/adjust the vent settings etc. until the patient is stabilized or can be transported.

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