Not trying to stir up bad ideas, but......

paindoc · Nov 27, 2006

Oh really? Pray tell what "fellowship programs"? I am not aware of any.

I know of no other profession that considers working in a job without any educational credit to be part of their training. Critical care nursing is just that...it is a job. If it is an academic construct, then there would be requirements, specific studies, classes, and most importantly, a degree or college credit. Did you really receive college credit for working in a job that had no specific academic educational requirements?

CRNAs are well trained and do not need to denigrate their profession or their education by attempting to prevaricate about the amount of their specific training (2 years of nursing undergrad and 2 years of CRNA master's degree training). Most RNs are not accepted into the BSN program until the second year of college. Four years is plenty of training for what CRNAs do. I would trust a CRNA completely to provide intubations, and even to place a-lines, but not on your life would I let a CRNA prescribe an antifungal agent, diagnose a renal disorder, or prescribe chemo.....they are not trained for this but a NP might be.

CRNAs should be proud of who they are and what they do.

FYI, I absolutely am aware of what CRNAs do as I have had them in my corporation and have trained them in academic situations.

subee, MSN, CRNA · Nov 27, 2006

Oh really? Pray tell what "fellowship programs"? I am not aware of any.
I know of no other profession that considers working in a job without any educational credit to be part of their training. Critical care nursing is just that...it is a job. If it is an academic construct, then there would be requirements, specific studies, classes, and most importantly, a degree or college credit. Did you really receive college credit for working in a job that had no specific academic educational requirements?
CRNAs are well trained and do not need to denigrate their profession or their education by attempting to prevaricate about the amount of their specific training (2 years of nursing undergrad and 2 years of CRNA master's degree training). Most RNs are not accepted into the BSN program until the second year of college. Four years is plenty of training for what CRNAs do. I would trust a CRNA completely to provide intubations, and even to place a-lines, but not on your life would I let a CRNA prescribe an antifungal agent, diagnose a renal disorder, or prescribe chemo.....they are not trained for this but a NP might be.
CRNAs should be proud of who they are and what they do.
FYI, I absolutely am aware of what CRNAs do as I have had them in my corporation and have trained them in academic situations.

Pain Doc: Four years of undergrad has been required since (I'm not sure - 1985?). I'm not sure what your point is. What CRNA wants to treat your toe fungus or do anything else besides adminster anesthesia? Have you had personal experience with a CRNA who wants to prescribe chemo? Please explain what your point is because I don't understand why you are going on about someone practicing outside their boundaries. As for critical care experience not coming out of academia - there are certainly plenty of nurses with graduate school degrees in critical care who teach other critical care nurses and design the exam for critical care certification. Would you want to be care for my a doc who didn't undergo a residency? Residencies don't have uniform, prescribed components - people go through them because they would be quite useless without any experience! Critical care nurses do have academic requirements - it's called a nursing degree and a license. Many large hospitals require BSN - is that not a requirement from which one could expect minimum competence. I've looked on the internet specifically for post-master's degree programs in pain management. There are a few out there but not designed for CRNA's in particular. They exist to provide pain management through out the hospital and home care situations for patients with acute or terminal pain conditions.

deepz · Nov 27, 2006

http://www.cottagehospital.org/pdfs/CottageChatSummer.pdf

paindoc · Nov 27, 2006

My points are:

1. There are no fellowship programs for CRNAs in pain management. There are some courses available, but these are not fellowships. Fellowships are sanctioned by an accreditation agency or board....CRNAs have none availble in pain management.

2. A BSRN does not take 4 years of classes in nursing. General education classes do not count and constitute approximately half the curriculum in most schools. Typically a BSRN has 2 years of training in nursing. That is quite sufficient.

3. Working in an ICU may be a prerequisite for CRNA school just as having some experience in a hospital or medical field is a prerequisite for going into medicine. However, I would not consider time working as an orderly, cardiac monitoring tech, or nuclear technician as being part of formal medical education or training unless it came specifically with a certificate sanctioned by a medical school or accreditation body. Working as an ICU nurse may be part of education, but it is certainly not a formal part of CRNA training, otherwise it would simply be included in the CRNA curriculum. Part of what one learns when working in a job is valid, but much of it is not unless the job has formalized requirements for education such as residency programs in medicine. There are absolutely requirements that must be met by each medical resident or surgical resident or anesthesiology resident that are formal, and adopted by the ACGME. There are also formal requirements for a fellowship program in pain.

4. My point regarding scope of practice is that CRNAs are great at what they do, but should not feel they have to resort to hyperbole regarding their CRNA education (7 years???? BS!!!!) Using those yardsticks for education, MDs would have 13-15 years of "training" and if they happened to work at the local nursing home all throughout high school, they would have even more. So my suggestion if CRNAs wish to be taken seriously would be to can the grotesque hyperbole regarding the many years of training they have, drop the inferiority complex, stop trying to compare yourselves to other nurses demeaning them for their perceived inferior education compared to yours, and be what you are....damned good practitioners of anesthesia. That is something of which to be extremely proud.

deepz · Nov 28, 2006

....... if CRNAs wish to be taken seriously would be to can the grotesque hyperbole .......

Grotesque hyperbole? You think you know grotesque hyperbole? Have you yourself done 300,000 cases, doctor?

animal farm.html

!

subee, MSN, CRNA · Nov 28, 2006

My points are:
1. There are no fellowship programs for CRNAs in pain management. There are some courses available, but these are not fellowships. Fellowships are sanctioned by an accreditation agency or board....CRNAs have none availble in pain management.
2. A BSRN does not take 4 years of classes in nursing. General education classes do not count and constitute approximately half the curriculum in most schools. Typically a BSRN has 2 years of training in nursing. That is quite sufficient.
3. Working in an ICU may be a prerequisite for CRNA school just as having some experience in a hospital or medical field is a prerequisite for going into medicine. However, I would not consider time working as an orderly, cardiac monitoring tech, or nuclear technician as being part of formal medical education or training unless it came specifically with a certificate sanctioned by a medical school or accreditation body. Working as an ICU nurse may be part of education, but it is certainly not a formal part of CRNA training, otherwise it would simply be included in the CRNA curriculum. Part of what one learns when working in a job is valid, but much of it is not unless the job has formalized requirements for education such as residency programs in medicine. There are absolutely requirements that must be met by each medical resident or surgical resident or anesthesiology resident that are formal, and adopted by the ACGME. There are also formal requirements for a fellowship program in pain.
4. My point regarding scope of practice is that CRNAs are great at what they do, but should not feel they have to resort to hyperbole regarding their CRNA education (7 years???? BS!!!!) Using those yardsticks for education, MDs would have 13-15 years of "training" and if they happened to work at the local nursing home all throughout high school, they would have even more. So my suggestion if CRNAs wish to be taken seriously would be to can the grotesque hyperbole regarding the many years of training they have, drop the inferiority complex, stop trying to compare yourselves to other nurses demeaning them for their perceived inferior education compared to yours, and be what you are....damned good practitioners of anesthesia. That is something of which to be extremely proud.

Admission for master's in CRNA requires a BACHELOR'S DEGREE In NURSING. No, you cannot apply for school without that four years. Not the point that only two years or so of those classes are in nursing because you are completing a lot of pre-req's the first two years. Then you have to have AT LEAST one year of ICU experience. Then you go for 24-36 months for master's. How does that not up to at least 7 years? No, experience as ICU nurse does not count as credit. It is required so that they don't have to teach you how to read a 12 lead EKG or what the numbers mean. It is required that you have already acquired these skills so they don't have to waste their time teaching them to you. You can duke it out with someone else re: pain "fellowships". I haven't found any. Oh yes, we don't say it takes seven years at least to become CRNA because we feel inferior, its because its a simple answer to a simple question.

Trauma Columnist · Nov 28, 2006

Informal education occurs at many levels and I think that once you stop learning, you stop being. I would venture a guess that we all learn something new each day and if we don't, we stagnate.

paindoc · Nov 28, 2006

The statement "It requires at least 7 years to become a CRNA" is completely true. What is not true is an attempt to mislead the public by saying CRNAs have 7 years education as a CRNA. CRNAs have 4 years total education as a CRNA, 2 extra years taking non-nursing courses, and a year's work requirement thrown in. MDs do not say it takes 14 years to become a doctor: it takes 4 plus an additional 4-5 specific training in residency.

But suit yourself...if it floats your boat to say you have 20 years education to become a CRNA (Kindergarden + 12 years primary and secondary school + 4 years undergrad + one year of work + 2 years CRNA school) then great!!! Or if you get continuous nursing education credit each year and have been out of CRNA school for 10 years, then you now are up to 30 years education to be a CRNA.

KannRN · Nov 30, 2006

The statement "It requires at least 7 years to become a CRNA" is completely true. What is not true is an attempt to mislead the public by saying CRNAs have 7 years education as a CRNA. CRNAs have 4 years total education as a CRNA, 2 extra years taking non-nursing courses, and a year's work requirement thrown in. MDs do not say it takes 14 years to become a doctor: it takes 4 plus an additional 4-5 specific training in residency.
But suit yourself...if it floats your boat to say you have 20 years education to become a CRNA (Kindergarden + 12 years primary and secondary school + 4 years undergrad + one year of work + 2 years CRNA school) then great!!! Or if you get continuous nursing education credit each year and have been out of CRNA school for 10 years, then you now are up to 30 years education to be a CRNA.

I've been following this thread for as long as it has been going. Please, Paindoc, tell us more about yourself, your professional background, education and what exactly is your title? Your responses have certainly raised a lot of hair around here and I for one am very interested in knowing what your background is to be so self assured and direct about CRNA practice and education.

versatile_kat · Nov 30, 2006

But suit yourself...if it floats your boat to say you have 20 years education to become a CRNA (Kindergarden + 12 years primary and secondary school + 4 years undergrad + one year of work + 2 years CRNA school) then great!!! Or if you get continuous nursing education credit each year and have been out of CRNA school for 10 years, then you now are up to 30 years education to be a CRNA.

:rotfl: That's pretty funny ...

paindoc · Nov 30, 2006

I am what my moniker says. 20 years experience in anesthesiology/pain medicine....not impressed by how many degrees a person has nor how many letters they can cram after their names even though if I listed all my credentials they would fill an entire line. What is important is that CRNAs are in an excellent profession and should be proud of "CRNA". There is no need to compare yourselves to MDs via education, years of training, or job attributes. You chose to be a nurse for a reason and for most, it was not because you could not have become a doctor- it was because you did not want to do so. So that is the reason for my diatribe against exaggeration of credentials/training....there is no need for that.

Trauma Columnist · Nov 30, 2006

You should always be proud of your credentials, but not necessarily so proud that you don't know when you are out of your league. Although not a CRNA, I am an APN (CNS) and feel that I can contribute a lot to patient care. However, do I feel I should do a CABG? Nope...however, I have the tools to refer my patients to the appropriate medical professional (be that an MD or another APN). The end result is not what we can do, but rather knowing what we should be doing.