[Dixiedi]

Originally Posted by stevierae

You are absolutely wrong here, DixieDi. CRNAs are held to EXACTLY the same standards of care that anesthesiologists are held to.

To the surgeon, the anestsiologists are support staff.
I'm not arguing that the surgeon was right. Just that, very likely, from his point of view, he probably was right.

I personally think both were wrong to even have "noticed" what the daughter said. It was not important in the situation and surely was not proessional for the Doc to have thrown in his 2 cents.

[gaspassah]

in my humble opinion i believe this discussion revolves around semantics and how the statements are presented in conversation.
yes every single person is support staff if the patient is the center of attention as deepz mentioned.
however if you reread the first post the doc was implying the crna was his/her support person for anesthesia

SHortly later, daughter again referred to CRNA as 'doctor' (she was most likely not processing any info given due to the stress). Here the MD stepped in and corrected the daughter by stating he is not a doctor he is one of our support staff.(direct quote)

the doctor stating he is one of OUR support staff. anesthesia support staff. clearly condecending.
i for one would have been upset. every person providing services should be treated as a professional. i try to treat the techs, housekeeping circulators etc like professionals every day. it's not hard to do.
the doc could have simply stated this person is a crna, i'm a doctor we will be working together to provide your dad with the best anesthesia care possible. that would be more a team approach than a hierarchial one.
d

[alansmith52]

I think its all just classic.
the doc said, did and acted as he was trained to do. (cant you hear them in your minds ear in class, "you are the one in charge, you take on the liablity, no one cares about the patient as much as you.. you... you.. you..)
I also think we are all support staff to somebody including the (gasp) surgeon.
some of our collegues simply choose to follow the father of medicines (lucifer) paradigm and choose to elevate themselves above their "brothers" I don't mean for this to be religous. really I don't. It shouldn't be.
the most natural instict of a competitor is to raise himself above his "enemy" and thats what this guy did. and many before him have done.
I like what was mentioned earlier.. "consider the source"
one night on the unit we had an emergent reintubation. the MDA came in. I was excited I talked to him and tried glean perls of wisdom durring the short time I had with him. finally he broke down and said " you want to be a CRNA don't you" I said "yes". he said "oh, so your one of those guys that wants to be a doctor without going to medical school". durring a very formative time in my early nursing he helped me to form an opinoin of MDA's. He showed me the true nature of our field (health care) in general.
the trick for all of us is to not let our natural insticts take over. this is very difficult for me but I recognize its value.

[probable cause]

nurses are most certainly support staff. do hou have to feel like you're more important than that?

[gaspassah]

nurses are most certainly support staff. do hou have to feel like you're more important than that?

yes, yes i do.
d

[forane2001]

yes dixie di. if you are ever named in a lawsuit see where the buck stops!!! Crna's are delivering anesthesia. with or without an MDA around. I have a friend that works in a hospital with 3 crnas and 1 mda. each anesthesia provider runs his own room!!. So the idea that CRNA's cant' do anything without MDA is BS. So to all out there that believe CRNA's cant perform--get over yourself.

Originally Posted by stevierae

You are absolutely wrong here, DixieDi. CRNAs are held to EXACTLY the same standards of care that anesthesiologists are held to.

[stevierae]

Originally Posted by forane2001

yes dixie di. if you are ever named in a lawsuit see where the buck stops!!! Crna's are delivering anesthesia. with or without an MDA around. I have a friend that works in a hospital with 3 crnas and 1 mda. each anesthesia provider runs his own room!!. So the idea that CRNA's cant' do anything without MDA is BS. So to all out there that believe CRNA's cant perform--get over yourself.

Exactly. I did a travel assignment at Kaiser Oakland, and I've done travel assignments in more than one rural hospital. At Kaiser Oakland, the CRNAs are independent practitioners--PERIOD. The anesthesiologists have their OWN rooms--CRNAs are EQUALS, not "support staff." it's just as likely that an anesthesiologist would ask advice of a CRNA as it is that a CRNA would consult with an anesthesiolgist. And, at some of the rural trauma centers at which I worked, there WERE no anesthesiologists--just CRNAs.

Oh--and even at medical centers that have both types of anesthesia provider; where anesthesiologists are "supervising" CRNAs during the day--see how quickly they vanish at 5 o'clock and on the weekends, especially when there are OB epidurals to be done well into the wee hours...

[London88]

Dixie

Just a little FYI about the surgeon viewing anesthesia as support staff. I do not know if you have worked in the OR environment, but are you aware that anesthesia can cancel sugery if they do not believe the patient is fit for surgery, and the only way the surgeon can overcome this is to declare the surgery an emergency and document it as such. Point being made is that the anesthesia provider is not support staff wether it be a CRNA or MDA and that both providers can put surgery on hold when necessary.

[saskrn]

Originally Posted by kestrel1121

I know this is a sensitive topic to all. My question refers to how would all of you handle this situation that actually occurred in a pt's room preop. I am most interested in how NOT to overreact but to correct the impression left on the pt and family by the MD. What happened:

Pt being prepped somewhat 'emergently electively'. Pt and family present. OR crew, CRNA providing anesthesia for pt and MDA in room all together reviewing procedure, prepping to roll to OR. pt daughter (distressed and acting inappropriate by flirting with all males present in room) at one point made the mistake of referring to the CRNA as 'Doctor'. CRNA politely corrected pt daughter by giving a short explanation of his role/title to daughter.I dont remember exactly what he said but it was basically 'I'm a nurse anesthetist and I'll be giving your dad the anesthesia to get him to sleep for surgery'. SHortly later, daughter again referred to CRNA as 'doctor' (she was most likely not processing any info given due to the stress). Here the MD stepped in and corrected the daughter by stating (direct quote)

Oh, he is not the doctor, he is just one of our support staff.

The CRNA did not say anything about this. I was a lot annoyed and began wondering if the CRNA is 'support staff' how does she (the MDA) view nurses etc she works with??How would all of you have responded to assert your role and also not ruffle the MD's feathers?? Not trying to be inflammatory just want diplomatic responses!

My husband, who is also an RN, often says that the CRNA's he has met seem to have forgotten that they are still RN's....

[sonessrna]

Originally Posted by deepz

Dixie, and those docs Dixie refers to, would seem to be stuck in the era about 1950 when medical care functioned like a wheel that revolved around the physician. Nowadays we put the emphasis where it belongs: with the patient at the center of it all. And all of us -- docs, CRNAs, other nurses and staff -- we are all among the patient's support staff.

Still, such condescending putdowns directed at coworkers are uncalled for.

deepz

You are so right....everyone who comes in contact with the patient is their support staff.