[deepz]

Originally Posted by Dayray

.......Right now medicine greatly overshadows nursing. Physicians make more money and have the confidence of the public behind them. ........

Actually, the average CRNA salary exceeds the average FP or pediatrician, much to the doctors' consternation.

And opinion polls consistently are showing the public's confidence in nurses to above their confidence in physicians.

deepz

[BEA72]

I've been lurking around for a while viewing the discussions on this forum. There is some great info on this board for CRNA's, SRNA's, RN's etc. Political and clinical. I think it is beneficial to have a place to vent about the CRNA/MDA debate. The discussion may get heated, but as long as everyone avoids the personal attacks, I say carry on.

I am a 1st year SRNA, but I've done some research on the CRNA/MDA debate and I have some opinions about it. I read the AANA and the ASA websites, and I read the threads over on SDN from time to time because they have some informative CRNA vs MDA discussions. Some of the residents and MDA's have GOD complexes and seem to despise CRNA's, but some of them are more realistic and know CRNA's will always be needed and utilized.

Like almost everything else, it's all about money and control. CRNA's will never completely get out from under the thumb of the MDA's, but MDA's will never completely control anesthesia or nurse anesthetist. The ASA and AANA must know this. They've tried to play nice, but they have competing interest.

MDA's will say that CRNA's are not qualified to administer anesthesia independently, but they do it all of the time without an increase in negative outcomes. When I read some of the posts on SDN, I don't think they have a clue about the amount of training and education we go through. My own family doesn't completely understand what I'm doing, or how much additional education it takes to be a CRNA. Physicians have more education and more training, but I do not need that level of education and training to provide safe anesthesia.

Are MDA's overqualified? Is anesthesia the realm of nursing?
I believe providing anesthesia is a blend of nursing and medicine. MDA's titrate meds, manage airways, start IV's, administer blood products, monitor hemodynamics etc. CRNA's treat symptoms, make independent decisions, perform invasive procedures, run codes etc. These functions overlap. Some MDA's are spreading the notion that CRNA's are following a list of standard orders without knowing why they are doing something or giving something.

I will not graduate if I don't know why I am doing something or giving something, and I definitely will not pass boards.

CRNA's have had to fight for many years to be where they are today. I think one of the biggest problem with the profession, is the level of misunderstanding by the healthcare community, fellow nurses, and the public. I would recommend that anyone wanting to enter nurse anesthesia read the book "Watchful Care: A History of America's Nurse Anesthetist" by Marianne Bankert. It's required reading in my program.

I make sure I tell all of my patients that I am a nurse anesthesia student, and then I explain what that is. Many of the CRNA's I have worked with in clinicals do not explain who they are to the patient. They just say they are with the anesthesia department.

We've got a long way to go.

[ivypetals]

Well, I have met nice people and mean people. I am finishing my BSN and applying in May for CRNA school. I am very lucky in that I found an MDA that loves to teach....my clinicals have become an internship...so I guess it depends on the person you are talking with and their attitude.

[Kiwi]

Great post BEA! You make some good observations. It shows that you aren't treating you masters degree as a means to an end, which is smart. I want to repost some more insight from members on this board (don't know if you've read these posts or not).

Regarding the SDN:

http://allnurses.com/forums/f16/the-...dn-116727.html

There are some fair anesthesiologists who post on SDN, but some members (primarily med studnets) have no clue. Case-in-point, take this med student who got terribly offended when a CRNA asked him and his instructor to leave the room because they were talking too loud:

"I saw a senior CRNA actually told the director of anesthsiology and me, the rotator to get out of her room because the teaching was too loud...I'll respect you as a NURSE because you have the skill we need, not because the years of academic education you have. Know your limit, respect your superior, or you won't find a job...My exposure with CRNA is short. Any longer I'd be ashamed to be a MD in the department even as a rotator. It reflects the disaster it could be heading to if anethesiologists aren't doing something about it. Do u think if I stayed in the department I would see the magic change of aggressive behaviors among these CRNA? No. It won't negate what I have seen even in short period of two wks.... It should have never happen, not even for one day... Imagine, a scrub nurse telling a general surgeon to get our of HIS/HER room, it would be the end of his career...know your limit, and respect your superior...Only after their aggressive behavior are warned and checked, we can rest assured and be friends. After all, friendship means mutual respect."

This student took the request to leave the room very personally. I bet he doesn't have a clue on what precordials are, and the subtle changes that can be heard without loud talking in the background. I have to wonder if this is the case. When you mentioned "GOD complex", I wanted to show you the ridiculous post where the words "superior" and "respect" are overused.

[BEA72]

I agree with you ether. It's mostly the residents and students on the SDN site that fan the flames. It's amazing how arrogant they can be. Although, I shouldn't be to surprised. I've worked with physicians for the last 8 years . One day they will be out in private practice, and hopefully they will understand the importance of CRNA's in that practice.

They can choose to work with us or not, but the number of nurse anesthetists graduating from anesthesia schools are increasing:

I found an interesting piece of info in the CMS Medicare Part B Update Final Rule: Agency Language on Anesthesia Teaching Rules

"...there has been an increase in the number of nurse anesthesia programs from 83 programs in 2000 to 105 programs projected for 2006. The number of nurse anesthesia graduates has surged from 1075 nurse anesthetist in 2000 to 2035 projected for 2006."...

Strength in numbers

[bandit788]

Originally Posted by bryanboling5

See the newest feel-good-about-your-doctor commercial by the AMA. It has a mother and her young daughter thanking the MD who took care of the girl in the NICU years ago. No mention of the round the clock nursing care. I'm sure the MD did do a lot of good, but how about equal time?

Was it a resident in the commercial? They called back after the NICU nurse paged them??? Showbiz!

[TexasCCRN]

BEA as well as on SDN and here enjoy your posts! TXANESTHETIST/TEXASCCRN

Keep it up. Folks like you are good for the profession. Power in #'s is right. Where are you in school at if you don't mind. You can PM me if you would like.

TX

[TexasCCRN]

I didn't read back to see who originally posted this bit of info, but does it suprise anyone that the med errors are lower for these QMA's. (Don't know if this statistic is right?) If all you had to do as a nurse was come in and pass meds error rates would be nill! Come on!

[rn-tam2]

I had not heard about this position until reading these posts. It sounds like you have some pretty good training under your belt-good for you. I was curious after reading your med error statistic what your position entails exactly. Is passing meds the main thing you do or are there other jobs as well? Do you do IV and IM and PO and GT meds or just certain kinds? I would be curious also to know what type of RN staffing is prevalent in Indiana. My guess is that if the med errors are so prevalent with RN's in the hospital, the staffing is probably inadequate. As you realize RN's hold responsibility for many varied duties not just medications. If they had only one thing to do I'm sure there error rate would be very low as well. Perhaps having QMA's is helpful if the RN staffing is inadequate.

[hanah7475]

I am an RN who works SICU, and I have had opportunity to talk with anesthetists about this subject. It seems that the resentment shared by some is that they (the MD's) feel that they went to school for a very long time and endured alot while they were in school. It irritates them that the association for CRNA's is all about equal pay for equal work, and they feel that someone whom for whatever reason did not have the disipline to go the course as they did does not deserve equal pay. It made me take a minute to listen, since I too was premed at one time, but did not have the "disipline" to stay focused on the goal. I do think that the time put into the credentials should account for more.