Pain Management CRNA

Specialties CRNA

Published

So I found an interesting link on the AANA webpage, and I was curious what the group thought about it. I guess the AANA is currently trying to develop guidelines for fellowship programs in pain management for CRNAs.

http://www.aana.com/accreditation/ms_word/021604_draft2.doc

That link leads to a Word document, download and open at your own risk.

So I'll be the first to admit that I thought pain management medicine was the domain of physicians. I think I might have read somewhere on this board that CRNAs do this in rural areas, but maybe someone can clarify.

Does anyone know if hospitals give priviledges to CRNAs for interventional pain management? Would a CRNA in this capacity be able to write prescriptions for medications taken at home? Do CRNAs during their training receive exposure to chronic pain management?

Is this going to open up another turf battle? But now with PM&R, psychiatry, neurology, AND anesthesia?

Maybe this will pan out to be an interesting thread, I'm interested in your opinions.

TD

Specializes in Anesthesia.
Yet another really offensive comparison of CRNA's to slaves ......

If you are so really offended by posts on this CRNA board, I'd suggest that old axiom, Doctor: If you don't want to know, don't ask. If you don't want to read such comparisons, then *don't* read them. Surely you'll not find them on the Student Doctor Network or other places where your prejudices will not be challenged.

BTW ... We don't need no stinking badges.

deepz

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If you are so really offended by posts on this CRNA board, I'd suggest that old axiom, Doctor: If you don't want to know, don't ask. If you don't want to read such comparisons, then *don't* read them. Surely you'll not find them on the Student Doctor Network or other places where your prejudices will not be challenged.

BTW ... We don't need no stinking badges.

deepz

It's a ridiculous comparison, and if you would ever use such a comparison in a setting that wasn't anonymous like this message board, people would think you were ridiculous. It's ridiculous that you would defend it, though at 60, you'd know better than I the oppression that African Americans lived under in this country ... I don't think there's a hospital anywhere that makes CRNAs drink from a different water fountain. Though who knows what's going on in Durango ...

Unfortunately, there's no way for me to filter out nonsense messages and comments. I read some interesting things from time to time on this board, if I have to read some garbage now and again, well, that's just the cross I have to bear.

BTW, you're welcome to wear clean badges.

TD

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This is an entirely different issue. You're working from "standing orders"

Yes, but the nurse is liable and responsible for intitiating the standing orders, as a professional nursing judgment.

If there is an untoward occurance as a result of initiating a standing order, the nurse is responsible.

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It's a ridiculous comparison, and if you would ever use such a comparison in a setting that wasn't anonymous like this message board, people would think you were ridiculous. It's ridiculous that you would defend it, though at 60, you'd know better than I the oppression that African Americans lived under in this country ... I don't think there's a hospital anywhere that makes CRNAs drink from a different water fountain. Though who knows what's going on in Durango ...

Unfortunately, there's no way for me to filter out nonsense messages and comments. I read some interesting things from time to time on this board, if I have to read some garbage now and again, well, that's just the cross I have to bear.

BTW, you're welcome to wear clean badges.

TD

As a student nurse doing my clinical rotations, I was surprised to find that the "nurses' lounge" was in a tiny cramped room next to a dirty utility room. There were plumbing problems, and the room smelled like sewage. The smell attracted bugs. The room was plain disgusting.

The nurses had complained for years, but had been unable to get the problems addressed.

One day, I inavertently wandered into the "doctor's lounge".

I was stunned to see before me a large, lushly furnished, opulent room. Velvet drapes, tapestries on the walls, richly upholstered chairs. There was a buffet lunch laid out. Included in this buffet were fresh crab cakes, steamed oysters, smoked salmon, bottles of Perrier water, and more.

If this is not example of the nurses "drinking from a different water fountain" what is?

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i agree - nurses lounges are horrible and need a lot of improvement. The financial reason behind the hospital not ponying up more money for nursing lounges is that nurses don't bring in the bucks to the hospital system. However, now with the crazy nursing shortage, it is amazing what some of the facilities the nurses are getting. Even their parking is better than most of the docs!!!

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In my 12 years as a nurse, I have yet to see nurses' parking, or anything else, even come within the same solar system as what the docs get.

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That's just Gotosleepy spreading more misinformation like usual. Pay no attention. He's just silly ignorant.

Donn C.

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Excellent arguement Hello Nurse.

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I liked it. and I was the one being called a dummy (in jest)

I think likening nurses to other oppressed groups is a perfect comparison.

In the nazi prison camps jews were put in charge of other jews. (read victor frankle "mans search for happiness") in this same way I think that phycians who theoreticly should be on our side, have selfishly only elevated themselves to practice some sort of dominion over the rest of allied health.

go sleepy I find no fault.

:)

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Specializes in Anesthesia.
..... who knows what's going on in Durango ...

So TD has now become a stalker as well as a troll? Be cautious, TD, searching through my trashcan for souvenirs; never know what you'll encounter.

BTW, you're welcome to wear clean badges.

So then ... I guess you're not a classic movie buff? Treasure of the Sierra Madre? Never mind.

deepz

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'Stalker' deepz? No not quite. But I have a keen sense of smell, and I'm able to follow the scent of BS from one website and to another. It's not rocket science.

Hellllllo Nurse, I agree, there is a huge difference in the sub-standard nursing lounge and the opulent physicians lounge. I think it's awful that the nursing staff is given such a horrible facility. I just don't think it's the same as the civil rights movement and "drinking from a different water fountain", in the civil rights sense of it. The difference isn't obviously clear, and you may or may not agree with me, but here's what I think.

In the civil rights sense of it, you were black, you were treated unfairly, and there was really no escaping it. You, if you don't like the nursing lounge, and feel SO strongly about it, can just quit. No oppression, no being forced into submission, nothing. Just quit ... find another job that treats nurses better. OR, and I can only imagine the **** storm I am opening up by even suggesting this, go to medical school, finish a residency, and then go ahead and enjoy the opulent physicians lounge. That option, while being a lot of work to enjoy a lounge, is also available to you.

Blacks couldn't just quit being black, and they definitely couldn't just go to school and become white through education. So do I think the nurses lounge you describe is awful? Yes I do. Do I think the physicians should get a beautiful lounge the the nurses a hell hole? No, awful idea. I just don't think it's comparable to the civil rights movement. No, no way, no how. You're not an oppressed people, you described a crummy lounge, that's all.

You can only imagine how I feel about the Nazi holocaust thing that Alan Smith mentioned. Soon I'm going to have to read a comparison of the treatment of CRNAs to the genocide of Native Americans.

TD

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Tejas,

I do not think that being a nurse today and being a black person in the old South is the same thing.

I was using the example of the two lounges to illustrate how in many places, nurses really are treated as second class citizens. In many ways, we really are relegated to a different drinking fountain.

When I stumbled into the physician's lounge, I was a naive student. The disparity in the two lounges spoke volumes. It really crystalized for me what I had been suspecting for quite some time, based on what I had observed. Docs are treated like kings, nurses like serfs.

I really felt like "The Little Match Girl" standing out in the cold, peering in at a Christmas feast that I could never be invited to share in.

This is more that just a problem of a crummy lounge. To a degree, nurses are oppressed.

I have left jobs because abuse of nurses by physicians was tolerated there.

I have been screamed at by docs. Once, a doc called me a "f#$%ing whor$" because I called him at 0300 to get a pt's pain med orders increased. (This was at the hospice where we had standing orders, but the pt chose to stay w/ his primary doc, who did not have standing order privileges).

The disparity between how nurses and docs are treated, and what type of behaviors are seen as acceptable from each is vast.

I have read several journal articles on studies that have concluded that abusive treatment by physicians and hospitals is a major factor in many nurses leaving specific jobs and leaving nursing altogether.

A few weeks ago, I posted on a physician's bb, asking members what they thought we could do as nurses and docs to improve our working relations, communication and collaboration, in order to improve pt care, and our working environments. The docs and students there ripped me to shreads.

I am encouraged by the fact that you are even on this board, and are wanting to communicate with nurses. There have been docs and med students who have come here (and to my own nursing web site bb) just to hurl a few put-downs, and then leave.

I really want to know- is there any mention in medical school of what nurses really do, what our education entails, and on how nurses and docs can best work together?

The nursing "shortage" is bound to have a great impact on physicans and their profession. Does the medical community concern themselves with how they can avert these problems and what their role is in retaining nurses?

Where I work now, the docs are courteous. They do, however, constantly push the nurses do things that are beyond our scope of practice, and are really their responsibility. These docs are the owners of the company where I am employed.

There would be no need for the new disruptive physician behavior laws, "code pink" practices, nurse-to-pt ratio laws, etc. if nurses were not treated as second class citizens.

According to The Dept of Labor, Bureau of Labor Statisics, there is actually a surplus of nurses, not a shortage. Recent figures show that their are approx 500,000 currently licensed registered nurses in The U.S., who are not working as nurses. Recent figures estimate the number of nurses needed to fill all nursing job vacancies in The U.S. is 400,000.

I have been a nurse for 12 years. I know many nurses who have left nursing or are looking to leave it. I have personal knowledge and plenty of anecdotal evidence that has convinced me that poor treatment of nurses by hospitals and docs, and lack of respect and regard for nurses are the primary reasons that so many nurses are leaving nursing.

Do you have any thoughts or opinions about this? Are physicians concerned about the nursing "shortage", nurses leaving nursing and how this will impact their practices and the state of pt care?

I would really be interested in hearing your thoughts on this.

http://www.nursingpower.net/abuse/verbal_abuse_docs.html

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