[loisane]

Originally Posted by Tenesma

thanks loisane - but i was being facetious... (i was hoping to prove alan's point that MDs are useless ) here is the reason why the bases get more ventilation:

Glad to hear it was facetious on your part, but believe me there is confusion out there about this. It is the number one issue in basic respiratory that I get asked about. I'd bet my bottom dollar there are people out there right now reading both our posts over and over until the light bulb clicks on.

Here's hoping we have both contributed to less confusion.

loisane crna

[lifeLONGstudent]

"over and over until the light bulb clicks on."


If my head would just quit spinning maybe I could see the light from the bulb.... .........MAN, you guys are smart.

[gaspassah]

alan... what is your point? how are those things funny? and by the way, the apex does get more ventilation in the upright spontaneously ventilating patient...

thanks loisane - but i was being facetious... (i was hoping to prove alan's point that MDs are useless )

hey tenes,,,are you sure youre not just covering now, did you go look it up to be sure?

[teemarie]

Originally Posted 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.

u know what they r haters... some people have nothing better to do with their time but talk bad about someone else.. ignore them and u will be the better person.. what works for me is to pray-- there is a GOD in heaven.. leave it in his hands.. and do ur job

[susswood]

Not only can I not believe where this thread has gone, I can't believe God actually has HANDS! Man, that is wild! Is there a picture of this phenomenon?

[teemarie]

Originally Posted by susswood

Not only can I not believe where this thread has gone, I can't believe God actually has HANDS! Man, that is wild! Is there a picture of this phenomenon?

well, u obviously do not believe in God and that is ur choice , but who r u to say what God is and is not, r u God... well.. i guess u made that clear

[deepz]

[quote=Trauma Tom]......As for the comment about the curdle zone:

Anesthesia is, after all, the Curdle Zone, where the cream of nursing rises to mingle with the dregs of medicine.

I feel that this does nothing to promote our collaboration ........................


Ah, I see, T Tom: you consider yourself a collaborator. Well then. We all know how the French underground dealt with the likes of them!

Personally, in all seriousness, I don't see this BB being here to promote collaboration with anesthesiologists. I am a pro-CRNA activist. This forum is called the "nurse anesthetist (CRNA)" forum. While I have no idea how politically active you may be now, I do hope history is one of your academic subjects there in Atlanta; the A$A has a long history of shaking the hand of their friend, the CRNA, while simultaneously kicking him/her in the butt.

According to Joseph Fielding, hypocrisy and affectation are the only two traits truly worthy of ridicule. I call a spade a spade, a poser a poser.

I don't hesitate to say the emperor has no clothes.

deepz

[Trauma Tom]

Deepz,

Yes you are correct, one of the definitions of collaboration is:

1. act of cooperating traitorously with an enemy.

However, a more thorough definition of collaboration includes the following definition as well:

2. The interaction among two or more individuals that can encompass a variety of actions, such as communication, information sharing, coordination, cooperation, problem solving, and negotiation.

I prefer the positive definition of collaboration, as opposed to the negative. While I am fully aware of the ASA's history in dealing with CRNA's, I am hopeful that the future will be more positive and that the experiences of the past will not be repeated. I am not naive enough to think that the past could not happen again, however I am not going to limit my expectations on events of the past. I prefer to keep and open mind and work towards the goal of providing the best anesthesia care for our patients. I do not think collaboration with anesthesiologists, or for that matter, any healthcare provider is contrary to that goal. And while I recognize the ASA's history in dealing with CRNA's, that does not mean all anesthesiologists prescribe to or agree with the ASA's past actions. I do consider my self pro-CRNA, and I do recognize this is a CRNA forum. However, I do not think referring to "anesthesiologists as the dregs of medicine" makes you any more of a pro-CRNA activist, than a CRNA who wishes to collaborate with anyone willing to improve the anesthesia care of our patients.



[quote=deepz]

Originally Posted by Trauma Tom

......As for the comment about the curdle zone:

Anesthesia is, after all, the Curdle Zone, where the cream of nursing rises to mingle with the dregs of medicine.

I feel that this does nothing to promote our collaboration ........................


Ah, I see, T Tom: you consider yourself a collaborator. Well then. We all know how the French underground dealt with the likes of them!

Personally, in all seriousness, I don't see this BB being here to promote collaboration with anesthesiologists. I am a pro-CRNA activist. This forum is called the "nurse anesthetist (CRNA)" forum. While I have no idea how politically active you may be now, I do hope history is one of your academic subjects there in Atlanta; the A$A has a long history of shaking the hand of their friend, the CRNA, while simultaneously kicking him/her in the butt.

According to Joseph Fielding, hypocrisy and affectation are the only two traits truly worthy of ridicule. I call a spade a spade, a poser a poser.

I don't hesitate to say the emperor has no clothes.

deepz

[athomas91]

while i would like to agree with the positism...i again agree w/ deepz...because we all know it comes down to $$$$$$$.

[loisane]

If we're going to talk about collaboration, I have to jump in with both feet. This is a topic near and dear to my heart. And one I probably know dangerously too much about, so someone might have to remind me to shut up when you have heard enough!

Yes collaboration does have a dual positive/negative meaning. This was quickly recognized by this bright bunch <g>. The most significant thing I have learned about collaboration between nurses and physicians, is that each side has a very different perception of just what constitutes collaboration.

Nurses have been studying this for over three decades. There was a seminal work published in 1967 that coined the phrase "Nurse/Doctor game", that described how nurses got doctors to order what patients needed by convincing the doctors that it was their idea. Multiple studies have followed. Recently, there is even a little being published by the medical community.

In all these studies, no matter what the setting, or how collaboration is measured, there is one consistent trend that (to me) is quite striking. There is a difference in the level of collaboration occuring depending upon whether the answer is coming from the participating nurse or the physician. Physicians think there is more collaboration occuring than do the involved nurses.

I think nurses have spent way too long on the goal of "getting physicians to collaborate". We aren't going to make headway on this until we figure out why the two disciplines see things so differently. We keep trying to devise ways to get them to do something, that they think they are already doing. We have to get on the same page, and start talking the same language.

Here is my theoretical explanation. There are actually different forms of collaboration. The type most nurse think of is "interdisciplinary" in which the involved parties work together from postions of equal power. Physicians view collaboration as "multidisciplinary", in which the involved parties work together, but final authority rests with the physician.

Granted, most of this work has been done in "basic nursing", but the studies done in ICU setting show the same patterns. Until specific studies are done in anesthesia, this is the information we have to build on. While CRNAs might view collaboration differently than other nurses, I think there is not much reason to think anesthesiologists will be that different from other physicians. Indeed, that might be a reason for the level of conflict in our specialty. The 'ologists don't really see us as different from other non-specialized nurses, while CRNAs perceive the difference to be quite significant.

I don't intend to sound like I am accusing physicians of being self centered, and not playing fair. I think their attitude is grounded in their professional belief system. Medicine has a strong value that the patient is their personal responsibility. They have a personal relationship with that individual patient. Their value system mandates that the patient "deserves" physician participation in every aspect of the patient's care. For the physician to share that responsibility with other health care team members does not fit their value system.

(None of this is to discount the influence of money, governmental regulations, etc. That is just another discussion, for another time. For that discusssion I will wear my "Political/professional activist" hat. Right now I have on my "Abstract thinker/academic/researcher" hat.)

Better get off the soapbox now. For those of you that find this as interesting as I do, I hope to be continuing this discussion in more public venues in the (hopefully) forseeable future!

loisane crna