How do CRNAs/SRNAs benefit anesthesiology residents? - page 6

I was searching for information on the Wake Forest CRNA program and happened upon this information on the Wake Forest anesthesiology program. Dr. Royster has an interesting view on how CRNA's/SRNAs... Read More

  1. by   Sheri257
    Quote from loisane
    It isn't that the ASA has used that phrase in print. It is terminology used in conversation, a spoken thing.
    Well, hopefully you can understand my confusion. There have been posts on other threads as well where CRNA's have said the ASA refers to them as "anesthesia nurse." It could easily lead one to believe that the ASA, as an organization, frequently refers to CRNA's in this manner when, apparently, they have not (at least in an official capacity).

    And, as you have pointed out, not all anesthesiologists have referred to you in this manner, instead using the proper title "nurse anesthetist." Is this, perhaps, a problem with some but not all MDA's?

    Last edit by Sheri257 on Jun 16, '04
  2. by   WntrMute2
    Quote from user69
    Quick question for the CRNAs that are practicing now.

    Does a MDA take offince to the term "Anesthesia Doctor"?
    Actually, in the hospital I'm in, a few of the MDAs introduce themselves as just that. All introduce me as a nurse anesthetist if they happen to see the patient first. We all seem to have respect for each other. And, I make sure that they know we work as a team to provide a safe anesthetic, I also let the patient know that I will be sitting by their head keeping them asleep, as pain free as possible and safe (try telling your patients this, you will see a lot of worry and tension leave their faces). BTW, the supervising in my hospital is really just to start the case, they are moving on before the tube is taped. Little or no real direction as to how to run the case, just provide a safe anesthetic.
  3. by   BigDave
    for user69,

    Do all CRNAs hold Masters degrees? Or do some just hold a cert?

    I think all programs are Master's now. I am seeking a post-master's
    certificate program...exact same science/clinical, but not repeating the nursing theory and thesis stuff. Truefully, another nursing theory class
    would kill me!

    The certificate is only for people who already hold the level of degree.
    I do think that there are some NAs (as well as NPs) who have been
    working long enough to have been though a cert-only program??
  4. by   jwk
    Quote from user69
    Do all CRNAs hold Masters degrees? Or do some just hold a cert?
    All current CRNA programs offer at least a Master's Degree. This is a relatively recent requirement for CRNA programs considering their 100 year history. I'm sure someone will correct my numbers if I'm wrong, but I think somewhere between 1/4 and 1/3 of currently practicing CRNA's hold no degree, unless they earned it after their anesthesia certification. There are a lot of CRNA's out there with a 2 year ADN or 3 year hospital nursing program diploma, and a two year nurse anesthesia program certificate.
  5. by   TennRN2004
    I would like to respond to the whole concept of CRNAs/MDAs in the hospital. I just graduated with my BSN and my program obviously is very pro-nursing. I had a very similar conversation to this one with one of my professors, who is a MSN, DNS about how the CRNA program at our school handleded clinicals. The main hospital our CRNAs do clnicals in is a level one trauma/teaching hospital, which has CRNAs and MD residents. I did not want to go to clinical and feel inferior to docs in any way (by that I mean anything from attitudes of others to CRNAs getting the "lesser" OR cases). Her response to me, which I have though a lot on was "Do you want to be a junior doctor? or a senior nurse?" I CHOSE to be a nurse. I AM a nurse. When I go back to school I will become a CRNA, which means I will be an advanced practice nurse. Now, for all my rambling about pro-nursing, does that mean I don't respect MDAs or residents? No, it doesn't, it means I respect the fact that they chose to be doctors, and thier profession is EQUALLY as important as mine. I see doctors as no better than nurses, or vice versa. With regard to TDs posts, the question of why CRNAs want to be recognized as "nurse anesthetists" is because we do provide basically the same care as you (I know it's not identical, but we can compromise here a little). However, you as a MDA get to be recognized and respected as a doctor, while we are just seen as "anesthesia nurses" by some.
    PS TD-I do enjoy reading your posts because as a young, new nurse I feel the bickering between professions needs to end, and the time is now. The new generation of coming nurses and doctors need to meet in the middle and respectfully defend their positions while hopefully enlightening the other side. In short, I think we have a lot to learn from you, but you can learn from us as well. I thinking you posting on this site is a great beginning and applaud you for being so open with us, as it does leave you open to be jumped on (for lack of a better word) by us.
  6. by   TejasDoc
    Quote from TennRN2004
    I would like to respond to the whole concept of CRNAs/MDAs in the hospital. I just graduated with my BSN and my program obviously is very pro-nursing. I had a very similar conversation to this one with one of my professors, who is a MSN, DNS about how the CRNA program at our school handleded clinicals. The main hospital our CRNAs do clnicals in is a level one trauma/teaching hospital, which has CRNAs and MD residents. I did not want to go to clinical and feel inferior to docs in any way (by that I mean anything from attitudes of others to CRNAs getting the "lesser" OR cases). Her response to me, which I have though a lot on was "Do you want to be a junior doctor? or a senior nurse?" I CHOSE to be a nurse. I AM a nurse. When I go back to school I will become a CRNA, which means I will be an advanced practice nurse. Now, for all my rambling about pro-nursing, does that mean I don't respect MDAs or residents? No, it doesn't, it means I respect the fact that they chose to be doctors, and thier profession is EQUALLY as important as mine. I see doctors as no better than nurses, or vice versa. With regard to TDs posts, the question of why CRNAs want to be recognized as "nurse anesthetists" is because we do provide basically the same care as you (I know it's not identical, but we can compromise here a little). However, you as a MDA get to be recognized and respected as a doctor, while we are just seen as "anesthesia nurses" by some.
    PS TD-I do enjoy reading your posts because as a young, new nurse I feel the bickering between professions needs to end, and the time is now. The new generation of coming nurses and doctors need to meet in the middle and respectfully defend their positions while hopefully enlightening the other side. In short, I think we have a lot to learn from you, but you can learn from us as well. I thinking you posting on this site is a great beginning and applaud you for being so open with us, as it does leave you open to be jumped on (for lack of a better word) by us.
    TennRN2004, I want to congratulate you on finishing nursing school. And I agree with you totally, we have a lot to learn from each other, and I have no problem admitting that I can learn a lot from the experience of the CRNAs here and at work and I can learn a lot about anesthesia care from ya'll too.

    As far as I'm concerned, the issue of 'anesthesia nurse' vs. 'nurse anesthetist' is answered for me. I understand ya'll's viewpoint on the issue, it is a reasonable request, and I have no problem making sure to address you and refer to you as nurse anesthetists.

    I don't understand exactly what your professor meant ... junior doctor vs senior nurse. Did he/she mean junior doctor as in resident, or junior doctor as in someone who doesn't know very much? I don't know, you know the conversation, in its context. Anyway, please elaborate.

    Now, I do want to address something, only if to make you think about something a little, if you haven't already, and maybe you have. You said you chose to be a nurse, you are a nurse, and you want to be a CRNA. I applaud you for your accomplishments and your dreams. You have conquered difficult training and you have plans for even more rigorous training in the future. I guess I'm interested, since you're so young (I'm young too, we're probably very close in age, I imagine), why chose being a CRNA over being an anesthesiologist? (I promise, I'm trying to ask this question in the least loaded way possible) Is it because you really want to be a CRNA, with everything that it means to be a CRNA now, or is it because you want to be in the anesthesia field, but don't want to spend 4 years in medical school and 4 years as a resident?

    I guess what I'm saying is this. If you want to practice anesthesia with the rights, priviledges, respect and recognition of an anesthesiologist, go to medical school and finish a residency in anesthesiology. And if you want to be a CRNA, with all the rights, priviledges, respect and recognition of a CRNA, by all means, good luck, it's a worthly and impressive goal also. But to me, it seems wrong, if you train to be a CRNA and then try to legislate your way to being treated like an anesthesiologist.

    Good luck, I look forward to hearing what you think about all this. And no worries, I knew coming into this that being 'jumped on' what part of the gig.

    TD

    P.S. Deepz ... D.O.A. huh? Doctor of anesthesia. Dream on buddy. I know what kind of fun you have with the whole 'A$A' thing, I can only imagine what you would do with DOA. Alas, your dream will never be a reality.
  7. by   deepz
    Quote from TejasDoc
    ..... to me, it seems wrong, if you train to be a CRNA and then try to legislate your way to being treated like an anesthesiologist.....

    OMG. Can't change a leopard's spots. Can we really have a free and open conversation, grounded in the here and now, if your preconceptions keep getting in the way? Legislate our way into exactly what, doctor? CRNAs've been doing the heavy lifting for over a hundred years now already. We are not doctor wannabees, just anesthetists. It seems you don't distinguish between the two. Perhaps you still believe general anesthesia 'cures' asthma?

    ?
  8. by   TejasDoc
    Quote from deepz
    OMG. Can't change a leopard's spots. Can we really have a free and open conversation, grounded in the here and now, if your preconceptions keep getting in the way? Legislate our way into exactly what, doctor? CRNAs've been doing the heavy lifting for over a hundred years now already. We are not doctor wannabees, just anesthetists. It seems you don't distinguish between the two. Perhaps you still believe general anesthesia 'cures' asthma?
    Someone is a little touchy, don't you think?

    You yourself have not been doing anything for a 100 years, so stop saying it as though you have.

    Really though, isn't that what's happening deepz? You think you do what an anesthesiologist does, just as well. Yet the anesthesiologist makes more money, gets more respect, and isn't in a position to be supervised, etc. (I know someone out there is going to say that they are a CRNA and are the only person within a 100 miles that does anesthesia, so they get plenty of respect, are never supervised, do pediatric hearts and make a gazillion dollars a year. Don't. I know you exist, I'm generalizing.) So you have 2 options, you can go to school and train to be an anesthesiologist, which will gain you all the before mentioned things, or you can try to legislate changes to get what an anesthesiologist has. I'm just trying to state facts.

    I didn't call you a 'wannabe'. I never said anesthesia cured asthma, though I think I made a reference to the post that did. I think you might just be angry I call you out on your D.O.A. fantasy. Sorry.

    TD
  9. by   Athlein1
    Is it because you really want to be a CRNA, with everything that it means to be a CRNA now, or is it because you want to be in the anesthesia field, but don't want to spend 4 years in medical school and 4 years as a resident?
    How presumptuous this statement is! It implies that we secretly wish to be physicians, but we found a way to skirt the rigors of med school and residency. So, we are taking this shortcut - the nurse anesthesia profession.

    Here is another angle to the question you asked about career paths. For those of us with families, outside interests, and life goals that do not center around what goes on inside the walls of a hospital, the nurse anesthesia path is a far superior choice. Post-baccalaureate, you can spend a couple of years in the ICU making good money and getting a great foundation for your future anesthesia practice. Then, gut it out in an anesthesia program for two and a half years. Thereafter, you have entered a profession that offers autonomy, flexibility, intellectual stimulation, and enough financial remuneration so that you can support your family and enjoy all that free time for which you have worked so hard.

    Makes me wonder why anyone with an interest in anesthesia would choose to spend more than a decade, and tens of thousands of dollars (if not hundreds) to become an anesthesiologist!

    You think you do what an anesthesiologist does, just as well. Yet the anesthesiologist makes more money, gets more respect, and isn't in a position to be supervised, etc.
    Surgeon: Anesthesia, what the hell are you doing over there? Sleeping? The patient is not relaxed. I can't operate if the patient is not relaxed.
    Anesthesiologist: The patient is pretty relaxed.
    Surgeon: You don't know what the hell you are doing. You are not a real doctor.
    (Granted, the surgeon who said this is a real piece of work)

    I've seen plenty of disrespect of anesthesiologists from surgeons and other physicians. Could it be that some of these physicians consider anesthesiologists to be "just anesthesiologists" in the same manner than some anesthesiologists consider CRNAs to be "just anesthetists"?
    Last edit by Athlein1 on Jun 17, '04
  10. by   deepz
    Quote from TejasDoc
    ..... I think you might just be angry I call you out on your D.O.A. fantasy. ......

    Angry? WTF. Quite the ... interesting ... manner of argument you display. Perhaps you might re-read post #64 in this thread in its entirety. It's a joke, doctor; a mere attempt to demonstrate the bias in your reasoning, not my fantasy. Whose ox is being gored means views will often be predetermined by your starting point.

    Early in your training for your career, as you apparently are, one might hope you'd be more open to multiple viewpoints and less accepting of the A$A boilerplate. Much of their BS doesn't stand up to examination, even so basic a point as 'ASA, since 1905.' Typical exaggeration. Incorporated in 1937. But they needed something to pre-date the AANA in 1931. Oneupmanship, ego-driven, what do we call it?

    You don't play second fiddle in the OR, you say; you play a 'different' fiddle? Is that your M-Deity shining through?

    ?
  11. by   TennRN2004
    I see reading my post now it wasn't very clear on the whole senior nurse/junior doctor thing. What I meant is that by choosing to be a CRNA we are not trying to "legislate our way into being treating like an anesthesiologist". If that was the case, then we as nurses would feel like junior doctors- because we are more than a floor nurse, but yet less than a doc. By choosing to be a CRNA we are choosing to be advance practice nurses, CRNA is the summit of the nursing profession and so we are senior nurses. Does that make sense?
  12. by   TennRN2004
    On the issue of going back to school for CRNA vs. MDA I can 100% tell you why my choice is to stay in the nursing profession and not become a MDA. Let me start by saying We do have a med school about 2 hours from here and if I decided that was what I wanted to do, then yes my husband and son would move and sacrifice and struggle to see me go to med school. However, I choose not to do that because the entire philosophy of medicine and nursing have different fundamental assumptions. I believe the nursing philosophy and base my practice on the following.

    I was told repeatedly in nursing school "medicine is the study of treating disease, nursing is the study of how the disease affects the person". Nursing has a wholistic approach to patient care. When I walk in a pts room I see the interactions between the patient, the disease, the family- it is all interconnected and must be considered as I provide care. MOST (I stress most) docs go into the room and do not care about anything but the heart or lung and do a minimal assessment of the pt at best. Some don't do an assessment at all, but look at the nurses notes and copy what the nurse charted about the pt. The doc walks in the room and says "I'm DR. ______..." and has usually a formal unequal relationship where the doctor is in control and the pt is dependent upon the doctor. I as a nurse walk in and within a few minutes I'm on a first name basis with the pt, the spouse, and whoever else is in the room.

    Just this week I can give you a few experiences I've had that make me want to stay in nursing by being a CRNA. One of my pts is brain dead on the vent, with absolutely no chance of recovery. The docs come in and tell the family this and then walk out. It is the nursing staff who explains all the medical jargon, why the pt will not recover, and deal with all the tears and emotions the family has. In another room, one of my patients is dying from cancer, and we feel the pt won't make it through the shift. We call the family they are out of town but on their way. I as the nurse go in to comfort the patient, hold the pts hand until the family gets there. Now I ask you, how many doctors do you see who have this much interaction with the pt? Most I know would be above holding a dying pts hand. Again, I am saying most, not all.

    Your professional education teaches you (if I'm wrong here correct me) in a philosophy that makes you distant from human interactions between you and the pt. Pts become "the heart in bed 7". My professional education teaches me that the human interaction is the basis of my existence as a nurse. I am constantly watching, observing not only the pts medical condition, but helping emotionally as well. If I chose to and become a MDA, I would miss this essential link between me and the pt, because as a doc, I would think in terms of "treatment" and compartamentalize the pt.

    I LOVE my job and I go home and everyday and know I've made a difference. Why? Because I feel good about what I do, but also because the pt and families tell me so. Now, I know that docs do make a difference as well, but who does the patient know and have a closer relationship with?

    So, I have a question for you now. I want to know honestly if you think being a MDA is superior to being a CRNA? Why? I know there is the supervision thing you have that CRNAs must be supervised by MDAs. (I wonder though if they really need supervision or if it is similar to how I think on nurse practioners in that FNPs are fully capable of treating and writing prescriptions. But they have to be cosigned in most states by a MD. Now why is this? Maybe it is because docs want to keep that power over us (nurses) because if all of a sudden we can do something independent without them then the MD profession is threatened by us. I am not being bitter here, that is just my oppinion from what I've seen in clinical areas.) So, do I think CRNAs need supervision? Absolutely not. If they do, then why are there rural areas where CRNAs are the only anesthesia providers for 100 miles as you said earlier. We are capable of being independent, but I think that very independence threatens your profession, and so you want to think we need to have you supervise for your own security.
  13. by   TejasDoc
    Quote from deepz
    Angry? WTF. Quite the ... interesting ... manner of argument you display. Perhaps you might re-read post #64 in this thread in its entirety. It's a joke, doctor; a mere attempt to demonstrate the bias in your reasoning, not my fantasy. Whose ox is being gored means views will often be predetermined by your starting point.

    Early in your training for your career, as you apparently are, one might hope you'd be more open to multiple viewpoints and less accepting of the A$A boilerplate. Much of their BS doesn't stand up to examination, even so basic a point as 'ASA, since 1905.' Typical exaggeration. Incorporated in 1937. But they needed something to pre-date the AANA in 1931. Oneupmanship, ego-driven, what do we call it?

    You don't play second fiddle in the OR, you say; you play a 'different' fiddle? Is that your M-Deity shining through?

    ?
    Deepz,

    You're just a tough guy to have a discussion with - partially because of childish things like 'A$A', but mostly because you say things that either aren't really true, or only partially true, don't ever give references, and then when somone calls you on it (see post about the # of board certified anesthesiologists) you ignore it.

    Because you believe the things you write does not so much bother me. You're only one person, lots of people have beliefs that aren't true. But you're a senior experienced nurse anesthetist. The people on this board probably look to you for your opinion and knowledge.

    So you're right, the American Society of Anesthesiologists was not formed in 1905. Their website it pretty clear on that.

    http://www.asahq.org/aboutAsa/history.htm

    Here's another pretty good page, it gives you more details, if you're interested.

    http://www.nyssa-pga.org/society_hist.html

    And it wasn't the AANA in 1931. http://www.aana.com/archives/imagine...4imagine97.asp
    The group that would become the AANA was founded in 1931, but called something else. But you did have 'national' or 'american' in your name from the get go, congratulations.

    'M-Deity' --> Wow, are these all original, or is there a website that posts these for people to use? I just don't think what we do is the second most important thing happening in the OR. General anesthesia may not be the reason why people come to the OR, but modern surgical practice as it exists today owes itself to our ability to keep patients alive and make them unconscious and insensible to pain.

    TD

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