Quote from yoga crna
Go to Sleepy,
PLEASE, PLEASE, PLEASE do not use the word "Supervise" when dealing with CRNAs. Supervision is for students, not for CRNAs. The wording "medical direction" is also a misnomer, but it is slightly more acceptable than supervise.
I administer anesthesia without any physician telling me what to do. Certainly, I have discussions with my surgeons about the surgical/medical/anesthesia management of the patient. I don't tell them what sutures to use and they don't tell me how to do anesthesia. Fortunately, I don't practice with anesthesiologists, although I have administered anesthesia to many in my "unsupervised practice".
In my opinion, if you need to be supervised, after you become a CRNA, your education was unsatisfactory.
You are so right, yoga. This is why I like to work in CA, where, when a CRNA is doing anesthesia, he or she is generally doing it as an independent practitioner. If there is an anesthesiologist in the facility, he has his or her own room and responsibilites. He or she is glad to consult with any CRNA who asks, but he does not intrude unasked into their cases. In fact, younger anesthesiologists are just as likely to ask the advice of more experienced CRNAs.
Now, here is an experience that I have had in Oregon that made me more than a little uncomfortable--anesthesiologists who tell the patient "We" (meaning he and the CRNA who he is supposedly "working with" that day) "work as a team. We'll be doing your anesthesia together." However, he is there for induction, and he comes back (maybe, and then only after being repeatedly paged) for extubation and emergence from anesthesia.
Why not tell the patient the truth? That the CRNA is the anesthesia provider, and he is there, if needed, in a consulting role? If that's even the proper term? Why the deception?
Here's one that made me even more uncomfortable--one anesthesiologist likes to "jokingly" tell patients, "I'm his baby sitter today." Then if the patient looks panicked or puzzled, he laughs and says, "Just kidding! We work as a team!! I'm supervising him!" (Again, there for induction, not seen again until extubation--and STILL the wrong term!) Talk about passive aggressive!
I have no idea what the CRNAs say to him about the inappropriateness of that comment, or if they just consider the source and let it roll off their backs like water off a duck's back. Never seen a confrontation in front of a patient; can't say that I think one would be appropriate or professional.