What is up with CRNA/AA/MDA politics.

  1. I am way not in it but long term, i am aspiring to be a CRNA so i hang out on various boards and i am amazed at what i see. I see MDAs to be talking about having nurses do the mundane work becasue they deserve it after all the hard work they put in. I see AAs saying that they get a better education, though how they come up with that i don't know.

    Why are people, who are supposedly well educated and claim to be adults, so monstrously disrespectful of the work others have done or are doing.

    What's the deal here? and if i successfully complete a program, am i gonna have to hear that kind of nonsense from people in my professional life?
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  2. 80 Comments

  3. by   miloisstinky
    Please do more research. All you will get here are opinions, and this topic has been covered at nauseum (sp), look at previous threads. People are people, opinions are opinions, but one thing stands true......patients come FIRST no matter what your title is, and it all works much better when we fight for them as a team. If you cannot work as a team player, you will have a hard time in the OR, and if it's not you....then let "them" be the ones having the hard time.
  4. by   jwk
    Well said on both posts.
  5. by   pigtails
    Agreed. Please use your own informative mind to figure this one out. I personally have found that; answering the question" Follow the Money," to be very helpful.
    Good Luck,
    Kelley
  6. by   alansmith52
    just get in sit down and hang on tight. becuase this my friend will never go away. I am at a clinical site with medical residents. I love my job, I got a really difficult cervical instability intubation yesterday and I felt very satisfied with the service I provided, I like my job more than I ever have,
    BUT at the end of the day when the med-residents play politics at the OR board it makes me so mad. and I go home angry almost every night. I toss and turn in my sleep. I am fighting them in my dreams.
    and there is nothing I can do about it, but commit my self to support our professional assocation.
  7. by   stevierae
    Quote from alansmith52
    just get in sit down and hang on tight. becuase this my friend will never go away. I am at a clinical site with medical residents. I love my job, I got a really difficult cervical instability intubation yesterday and I felt very satisfied with the service I provided, I like my job more than I ever have,
    BUT at the end of the day when the med-residents play politics at the OR board it makes me so mad. and I go home angry almost every night. I toss and turn in my sleep. I am fighting them in my dreams.
    and there is nothing I can do about it, but commit my self to support our professional assocation.
    Alan--you must be a really excellent CRNA resident, and others must have noticed your quiet competence. I'll tell you why--I have reviewed many cases of difficult intubations due to cervical instability--many of them were awake fiberoptic intubations utilizing SSEP &/or other types of neuromonitoring, placed in the pre-op holding area. Some of them progressed to rapid sequence Fast-Trac (Fas-Trach?--I am not sure if I am spelling that correctly) intubations--when things went downhill, despite all precautions.

    In any case, ALL of them were done by either board certified staff anesthesiologists or, per spinal surgeon's insistence, NEUROANESTHESIOLOGISTS. They were taking NO chances with their patients, as one wrong move during intubation or positioning can result in quadriplegia. Rarely were anesthesiologist or neuroanesthesiologist RESIDENTS allowed to participate--other than to stand by and learn what they could by watching.

    Even then, there were mishaps--hence, they hit my desk, to be reviewed.

    So, I commend you. Somebody is noticing that you do your job quite well, and trusting you implicitly. Don't let the jerks bother you--those that tend to be territorial often have doubts about their own competence (and often with good reason) and are threatened by those who just might outshine them. It happens everywhere, in every field--it happens in my own field (operating room nursing.) They are not worth giving them the time of day, and definitely not worth losing sleep over.

    Or, as we said in the Navy: F*** 'em.
    Last edit by stevierae on Jan 15, '05
  8. by   Tenesma
    stevierae... i don't know what institution you are in, but when i was a resident I did all of the difficult intubations on my own on the neuro/ortho-spine service with the attending in the background (in the beginning with good guiding comments, in the end just there in case i needed an extra pair of hands) - how else do you get ready to perform on your own after residency???

    as far as politics go - (by the way I like how you changed from an SRNA to a resident RNA - very cute, but it ain't no residency)... there will always be politics at any program where there is both a CRNA program and a Anesthesia residency -- there will always be fighting over who gets to do the cooler/better/more interesting case. That, i would assume, is one of the down-sides of doing CRNA training at a program that has a residency as well... However, I have a few CRNA friends who have found ways during their SRNA years to bypass that: they would volunteer to take call and would volunteer to do some of the cases at night that were cases they would normally not be exposed to... they learned TONS from that experience.

    as far as the original poster goes - in the professional world (once you graduate with your CRNA) this won't be an issue, because you can choose what kind of work environment you want to be in.... If you want to be in an all-CRNA practice in a rural setting and never have to deal with MDs and AAs, you can do that.... However, if you choose to be in a major tertiary/quarternary referral center full of MDs, don't be surprised when politics become an issue...
  9. by   stevierae
    Quote from Tenesma
    stevierae... i don't know what institution you are in, but when i was a resident I did all of the difficult intubations on my own on the neuro/ortho-spine service with the attending in the background (in the beginning with good guiding comments, in the end just there in case i needed an extra pair of hands) - how else do you get ready to perform on your own after residency???

    as far as politics go - (by the way I like how you changed from an SRNA to a resident RNA - very cute, but it ain't no residency)... there will always be politics at any program where there is both a CRNA program and a Anesthesia residency -- there will always be fighting over who gets to do the cooler/better/more interesting case. That, i would assume, is one of the down-sides of doing CRNA training at a program that has a residency as well... However, I have a few CRNA friends who have found ways during their SRNA years to bypass that: they would volunteer to take call and would volunteer to do some of the cases at night that were cases they would normally not be exposed to... they learned TONS from that experience.

    as far as the original poster goes - in the professional world (once you graduate with your CRNA) this won't be an issue, because you can choose what kind of work environment you want to be in.... If you want to be in an all-CRNA practice in a rural setting and never have to deal with MDs and AAs, you can do that.... However, if you choose to be in a major tertiary/quarternary referral center full of MDs, don't be surprised when politics become an issue...
    I was just copying verbatim what Alan's title says--"Resident RNA"--I know that CRNAs do not do a "residency," but I simply wrote his title as he did--do nurse anesthetists write "RNA" until they obtain certification? I am sorry for my faux pas; I simply have never seen "Resident RNA" or even "RNA" before--have only worked with CRNAs and anesthesiologists. I was not attempting to be cute--I am far more professional than that.

    As an operating room nurse, I have worked in teaching institutions all over Northern CA and Oregon. The review work I was speaking of came via my role as a legal nurse consultant, and those cases were from various hospitals nationwide.

    I am familiar with the issues. I have even witnessed the petty arguments over who-is-better-private-anesthesiologists-or-HMO-anesthesiologists, in the '80s when HMOs were trying to phase out the highly paid private anesthesiologists. Now those HMOs have CRNAs--something that the private anesthesiologists swore would happen only "over their dead bodies!!" They had to change with the times.

    I was only giving Alan a compliment, anyway. (Were you, prehaps, addressing HIM here regarding the "Resident" RNA vs. "SRNA" issue?)
    Last edit by stevierae on Jan 15, '05
  10. by   gaspassah
    since this was brought up, can someone provide a well accepted definition of what a "residency" is?
    d
  11. by   Tenesma
    the term resident comes from Hopkins from long ago - when residents would actually live in the hospital... And up to the recent 80 hour work week rule, it felt like we lived in the hospital because we rarely made it home
  12. by   An Yogi
    Some programs use Resident Registered Nurse Anesthetist as the title during the clinical phase of the program. The term recognizes the learner as a professional RN (i.e. Bachelor's degree and licensed RN). It also removes the stigma of 'student' which is not palatable to some patients.

    An Yogi
    Last edit by An Yogi on Jan 15, '05
  13. by   gaspassah
    ah i get it.
    i usually refer to myself as a nurse anesthetist in training. i dont use resident because i like to differentiate myself from medical residents and i dont like student for the very reason an yogi stated, it just sounds more professional to me.
    d
  14. by   alansmith52
    this is classic, here he is trying to seperate the men from the boys.
    A residency is by definition " a period of advaced trainning" we are residents we do a residency. yeah its shorter, be cause we don't need years of learning how a hosptial works. you might say your years in the ICU and on th floor are a residency. its an apprenticeship.
    its funny to me how these medical residents (clinical doctorates) what to oppress us constantly when without us they would be unable to produce the product of anesthesia.
    for example at my clinical residency site we run 17 operating rooms every day. 15 out of 17 operating rooms are staffed by RRNA's this leaves about 15 medical residents free to A) rotate out, B) do research or C) their favorite watch sport center.
    they need us and they hate us.
    the isssue is that they think we are undereducated or "not educated like them"
    the fact is that CRNA's when they graduate have about 13000 hours of Diadactic instruction and MDa's have about 3000 hours of diadactic instruction. they are expected to learn on their own by meshing their one hour of class/week, thier own reading and clinical experince. so at the end of the day they are not all the same. some study and some don't. most actually are not even board certified. only 40% of them can pass their oral boards.
    Last edit by alansmith52 on Jan 16, '05

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