this is in response to 'bioncokie's' post under 'Doctor's Frustrations' ,
Let me first say that I think being a crna is a great job. I've been doing it for 5 years now, working in the anesthesia care team model. I work with MDAs daily and I'm glad that they are there. Although some of your comments may be seen as offensive by some of my fellow crnas, you DO have some valid comments. That's what this forum is about. Talking about issues, educating everyone on the experience of crna's and mda's.
It's true that we are NOT as smart as MDs. It's true that we DON'T know the 'medical knowledge' that you do. You're right about our board exams. We aren't nearly tested on our knowledge to the extent physicians are. My crna board exam was only like 80 questions and I had around 3 hours to complete it. I understand your board exams (USMLEs) and Anesthesia boards are way more difficult and time-pressured. You're tested not only on paper, but also in clinical scenarios (like you said in Step 2) and during anesthesia oral boards. It must be very difficult.
I did not feel pressured during either of my board exams (nursing school and anes). We had plenty of time to answer questions. But YOU have to make decisions quickly and those exams prepare you for that. Maybe we should have to take more tests, have more questions, and be 'pressured' by having less time. If 'we' wan't to sit here and try to say we 'do the same things, know the same things' as MDAs do, then we should have to prove it. I calculated all my board exams together. My NCLEX was around 75 questions.. and my CRNA National Cert. Exam (boards) was like 70-100 questions (dont recall exact number). So, I was essentially asked to answer 175 questions to prove myself, not only as a nurse, but also as a CRNA. 175 questions for my entire career. Once I stepped back from this and looked at it.. I was really shocked. MDAs are tested on a completely different level. On behalf of all crnas, i feel we should be tested harder. Maybe we should take the board exam for MDAs and they should take our Nat.Cert.Exam. I think that would answer alot of questions brought up in this forum. But, unfortunately I don't think that would be the best idea.
I have two close friends who went to medical school. I had the unpleasant priviledge to see some of their study materials for their board exams. It really does blow my mind.. how much they had to learn. The shear amount of information that they learn.. it's in a different league. Then they have to show proficiency on numerous USMLEs and Anes boards. There is no way I could learn all that information and answer those board style questions, especially in the short amount of time they have for each question. I graduated number 2 in my CRNA class of 36 students, and I can sure tell you that my classmates would have little or no chance at passing those exams. But that's why I didn't go to medical school. I know my limitations. That's not to say nurses aren't intelligent. But doctors are in a different league, whether you like it or not. They're essentially the top tier students that our nation's universities pump out. That's why society rightfully holds them to a different standard. The're the brightest minds our nation produces. My friend in medschool got his BS degree in chemistry. He graduated summa cum laude. I don't know one nurse who could sit through a physical chemistry/ quantum physics course and pull an 'A'. let alone pull an 'A' in all chemistry courses.
I also found out that 4 of the ICU docs here at my hospital were (are) Anesthesiologist. I asked them how they got where they were. They basically do an extra year in residency in the ICU. They then are qualified to treat patients in the ICU, and in the case here.. our ICU director is an Anesthesiologist. They said there are many MDAs that don't even do the extra year of training but can moonlight in ICUs on the side...
I think I speak for all crnas when I say.. there is no way I could step foot in the ICU, take complete control of treating the sickest and most critical patients in the hospital, and feel like I was doing something right. (even with 12 months of ICU experience after crna residency) I spent 4 years as an ICU nurse. When things went bad, I didn't look to my left and right.. I looked to the phone. I paged the doctor !!
I don't know why crnas get so upset with this issue. Maybe they don't know exactly what MDAs go through, how much they know, the ICU stuff, etc. Maybe crnas don't know how much they really don't know. Well I do. But I'm proud of what I do. We ARE NOT the same as them. We should be proud of who we are. What makes us different makes us unique!! We are UNIQUE. We are SPECIAL !! Rejoice in the fact that we're special !! I love being a crna.
Your type would never take care of my family b/c there will be instances when you need to be prepared to handle any situation b/c your "backup" will not be available.....Your type would let the patient die before making a decision.
I feel pity for you that your training didn't give you the courage to be an independent practitioner
I question the fact that you are a CRNA, by your own accord you have been doing anesthesia for 5 years but yet your profile says RN-BSN. Graduates have been required to hold a master's degree well before your "stated" experience.
I shouldn't say anything, but all this political correctness is killing me! And these threads are the reason I stay away from this forum. First off, we are just as smart as MDA. I am pretty much thru w/ half my CRNA training and am well on my way to completing it (not even a chance I won't finish). I don't see any difference btwn MDA and CRNAs except they went the long route. I intubate/induce/iv access/wake up/vasopressors/etc- they intubate/etc. It is too easy to get seduced by being a "doctor", but most of that is political anyway. Being smart has nothing to do w/ getting into med school. I tried and both times I got bypassed while doctor's sons/daughters got in. Total BS. If I wasn't good enough, why am I now doing what anesthesiologist do (and I got in first shot). That just shows you how political it is (and pretty much all life).
You bring up pressure on written testing. That has nothing to do w/ sitting in an OR doing anesthesia. If I get the right answer the answer is just as right as yours that you came up w/ in half the time (and some ppl finished w/ extra time). Plus, I talk to families after death/codes too. I know how to talk to pt's which doctors don't!
Next, who was the smart one I finished my BSN and was working (earning $50,000+), while your going thru med school (making nothing). After 4 years in the ICU, I've seen many interns ask me (yes, me!) questions there first couple months. Then a month goes by and they get cocky and stop asking. Learning thru experience is much easier than all that "knowledge". If the HR goes down give Atropine, bp down- give dopamine, that is almost half the prob's in the ICU---solved!!!!!
Now CRNA school is teaching me the rest: airway protection, preop, ABG, if in doubt then LMA-- again most prob's solved!!!! It is so much easy, when you take it step by step and don't burn bridges w/ the patient. We have been told, that spending twice the time w/ a pt (extra 5-10 min) will prevent the majority of lawsuits. If there is any prob's an MDA isn't even needed!!! YOu know what you have other ppl to give input --surgeon/circulator/etc. At least i'm not too arrogant to know 2 heads are better than 1.
Next, I've seen studies that say we have similar M/M than MDAs (that means just as good in my books) if not better. And don't give me the harder cases line. Most of the harder cases the surgeon runs, and if he doesn't the cardiopartly bypass does the job!
Secondly, I didn't waste all that time w/ loans (I was making $) and studying stuff I don't need to know to do the same work as an MDA. More money, less loans, same job= Smarter path. And hey, I don't want to take your stupid test (again smarter path) that is why I chose nursing (and am proud of it). Answering questions on a test (written at that) doesn't make you (them) smarter.
Sorry if it's long-winded but the sooner they realize this the better. Guys don't let anyone tell you they are better than you, b/c we are truly better than them as providers and whole human beings! If I misspelled/misspoke I'm open for a civil discussion about it. Thanks.
PS We learn the same amount in less time= we are smarter!! (I dare you to explain that one)
I understand fully what your point of view is, and I agree 100%.
But, the tone of several things in your post (all quoted above) IMO suggest that nurses "settle" for "just being a nurse." I could VERY well sit through a physical chemistry/quantum physics course/whatever you throw at me and pull out an 'A'. Is it a matter of intelligence? Partially. The difference is in the motivation. I'm not willing to give away 8-12 years of my life...MDs are.
ANYONE's limitations should bedefined by themselves. Because someone is in the nursing field shouldn't suggest that they are limited in what they can achieve in their education. It is a choice...one that you, myself and many, many others are happy to have made.
Can I PLEASE assume that the first line is one that I've taken out of context? MDs are given a far greater amount of material in school to learn than nurses, but that makes them more knowledgable...NOT smarter.
However, if someone seriously made all those statements about nurses how could any nurse agree!! I agree with kmm. Sometimes the political correctness on this board is highly annoying. Stick up for yourselves, nurses!! The road to being a nurse is not easy, and for sure the job is not either.
I don't think this is a serious post. At best it is sarcasm and at worst it is someone trying to start some trouble. My guess is that it was intended to be funny - because it was hysterical. I love this kind of humor.
I am an "ologist" as some of you say and I have noticed that CRNA's training is more than adequate. I look at them as equals and with as much knowledge and experience as myself. The training/experience they receive is essentially equal to our own. Their actions speak multitudes to their quality and intelligence. I have seen many CRNA's and MDA's over my time and always have considered them equal on the whole. I respect the training they have rec'd and their experience is invaluable. MDA's do not receive the experience that CRNA's do prior to practicing and never will. The slights that they receive from others more than motivates them to make up for their perceived lack and more than overtake all (or many) MDA's that I have worked with. Take this for what its worth, but I will rename nameless to avoid any backlash from my fellow coworkers who believe otherwise. I have enjoyed working w/ many great CRNA's and it has been an honor to me to see you guys do it humbly too. You all have given Anesthesiology a good name!
this is in response to 'bioncokie's' post under 'Doctor's Frustrations' ,
But YOU have to make decisions quickly and those exams prepare you for that. Maybe we should have to take more tests, have more questions, and be 'pressured' by having less time.
I paged the doctor !!
It's true that we are NOT as smart as MDs. It's true that we DON'T know the 'medical knowledge' that you do. We should be proud of who we are.
We are SPECIAL !! Rejoice in the fact that we're special !! .
I agree about oral boards...I think we should raise the bar a little, especially in the light of all the solo practices that are being offered to new grads...however, if I am ever a proctor to oral crna boards (and I beleive any MDA who would be a proctor to these boards would agree) and sense a lack of self worth in a candidate because they beleive they are "just" a crna, they will fail. It will be just as important for the candidates to know their limits, however, when the stuff hits the fan, self doubt and lack of courage can kill as easily as arrogance.
I encourage our profession to scrutinize our new graduates to find this balance.
And yes, I do rejoice in the fact that we are ssssssspecial, and as smart as our well educated anesthesiologists!
CerebralCRNA
36 Posts
Your type would never take care of my family b/c there will be instances when you need to be prepared to handle any situation b/c your "backup" will not be available.....Your type would let the patient die before making a decision.
I feel pity for you that your training didn't give you the courage to be an independent practitioner