All CRNAs need to READ this

[janecristensen]

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.

[droopy1592]

It's true that we are NOT as smart as MDs.

and

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.

Myself and a nurse that's presently in Duke's CRNA school pulled all As in all of our Chemistry classes, easily. We even tutored the students that were "top of the class" headed for Med school and Pharm school. One's career path doesn't decide your level of ability or intelligence. It may correlate with your level of dedication or intelligence, but it doesn't automatically make one better or more capable than someone that's chosen a "lesser" career.

There is an Emory U AA student that was originally a Cardio Thoracic ICU PA. When a patient in the Maternity OR coded , he was running the show, not the docs... it was his experience, not just his education, that saved that patient's life. An experienced advanced practitioner can hold their own against anyone.

I agree about the education, but with specialization, much more is learned with seasoning.

[janecristensen]

Let me first say thank you all for the supporting comments. For those of you who doubt my job title, I could care less. Not worth my time to discuss here. One of my colleagues referred me to this site last week. She said to watch out for some of the postings. She said she was often turned off by what some of you say. However, I was doubtful. I was going to try to prove her wrong. Like I said earlier, I was hoping this would be a forum to discuss these issues... to open the lines of communication and education regarding our roles.

But, it was bitter sweet, and only because of a FEW bad seeds. The bitterness can be cut with a knife its so thick. I mean how long to you have to keep repeating the same ol' "we know as much as them" stuff. YOU DONT! you never will. ACCEPT IT! Be proud to be a crna. We're different, we're special. As soon as we accept this, we all become winners. It really is pathetic. It makes us, the majority of CRNAs, look weak, bitter, pathetic and jealous. I mean give me a break!! I thought this was a dead issue, and for most of you it seems to be so. But there are still a few like 'kmm' that stick out like a sore thumb. I'm sorry you feel that way, but go back and read your post again, carefully. Don't you see it?? PLEASE refrain from writing those types of comments in public places where people can read it. You are bringing our profession down. You're not in the top tier.. accept it. be proud to be a crna! We love our job. We're special. dont forget that! you seem to always forget that.

Again, thank you for all those encouraging posts and emails I've received over the past few days. It's nice to know the majority still has their heads on straight. However, I think I'll visit this site 'thread' less often. Keeping my distance from those types always makes me look good and respectable, and I hope the rest of you will do the same.

My department is gearing up for a crna seminar this fall in arizona. Our department will be giving 3 presentations. I will be giving one of them, specifically talking about these very issues, mainly what I brought up earlier in my first posting. We need to continue to spread this knowledge, communicate and close those information gaps. The support here in the metro for this 'progressive' talk is outstanding amongst colleagues.. as opposed to the 'kmm' regression rhetoric which we would all like to see disappear.

I will not be discouraged, and I hope you aren't either! Anyways, good luck to all in your careers!! Hope to see you soon!

[skipaway]

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!

First post.....thank you.

[EmeraldNYL, BSN, RN]

.... and if the poster really is a CRNA, well then I am ashamed that they are a fellow member of my profession.

Oh, and no doc I know sat through quantum physics-- it is not required for med school admissions! You can be an English major and get into med school as long as you have the required courses.

[platon20]

Uhhhh med schools dont accept AP credits.

[emmycRN]

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 kind of attitude encourages teamwork and professional pride, unlike the discouraging words of the OP.

Thank you for your kindness and respect of the nursing profession.

[Howie149]

Yeah, I am thinking the OP is not a CRNA. Way too much lingo used by MD's.

There is also many things said that is common on the SDN forums.

Just calling it the way I see it.

[no-pain]

You are bringing our profession down.

I think by your comments YOU are brining the CRNA profession down!

My department is gearing up for a crna seminar this fall in arizona. Our department will be giving 3 presentations. I will be giving one of them, specifically talking about these very issues, mainly what I brought up earlier in my first posting.

What are the 3 presentations? Since the majority of CRNA's and CRNA students on this site probably wont be able to attend maybe you could provide us with the outline of your presentation. What is the date of the presentations? Maybe some here might be able to attend. If you really are a CRNA I truly feel sorry for you and what your life must be like to feel LESS THAN. It is unfortunate that you feel the way you do about the CRNA profession. You might benefit from going to a Tony Robbins seminar!

[kendel]

My Son Had A Problem With His Eyes, It Was Red And Inflamed Every Other Month

I Took Him To See The Eye Doctor 2 Different Times And Neither Of Them Could Figure Out Why He Eyes Were Red And Inflamed

So I Did The Research My Self I Went On The Internet An Drealized From My Own Research That It Was Either Bacterial Or Viral Conjuctivitis

I Gave Him Tobradex And It Went Away

Problem Solved

So Not All Doctors Are Smart Or Knowledgable

Some Times All It Takes Is Common Sense

And I Did That Not Being A Doctor Or Nurse

[aDDctd2sBUX]

My 2 Cents:

Majory - Electrical Engineering, GPA: 3.49; Paramedic/RN student.

I agree with some of the previous replies. I know I could handle medical school, but I am pursuing CRNA as my ultimate educational goal simply as a function of time and dollars. When I finish RN school in less than a year I can command a decent salary. After a year in the SICU, I plan to apply to CRNA school. 60k+ in one year and 200k/yr in 4 years certainly is more appealing than another 7-10 yrs of making a meager salary.

[aDDctd2sBUX]

Would I rather Be an MDA than a CRNA yes.

Do I consider it selling out to go the CRNA route just because it takes less time? yes.

Do I really care when im making 250K+ in way less time? No.

Its all in what you want and what you are willing to sacrifice. Just be content with your choices. If you wanna be an MD then go to medical school plain and simple. With so many med schools in the carribean pretty much anyone with a brain stem can enroll.

[subee, MSN, CRNA]

Would I rather Be an MDA than a CRNA yes.

Do I consider it selling out to go the CRNA route just because it takes less time? yes.

Do I really care when im making 25 Its all in what you want and what you are willing to sacrifice. Just be content with your choices. If you wanna be an MD then go to medical school plain and simple. With so many med schools in the carribean pretty much anyone with a brain stem can enroll.

aDDctd: Because you're so young, you're excused for this post. Been giving community hospital anesthesia for over 20 years. Think the anesthesia team concept serves the patient very well, despite disagreeing with the payment system. In hospitals like mine where the large majority of the cases are bread and butter, see no reason for MDA to be present for all inductions - just need to have one present in the OR area. However, for those of us grownups who received our APSF newsletter this week, the Letter to the Editor re: anesthetizing patients s/p PCI's demonstrates very loudly when the MDA becomes an absolute necessity. These patients demonstrate how complicated and vexing are the consequences to post PCI placement and toleration for surgical bleeding. Resolving...no, ATTEMPTING so resolve this question involves other specialities besides anesthesia and even the uber-educated can't figure it our for now. My generation will patiently (bad pun) hand over our own bodies to research these answers. My guess is that 90% of the anesthetics administered daily could be done by a CRNA with minimal physician involvement. However, to constantly try to pump yourself up with labels like "unique" and "special" is a stupid waste of time. There's a lot of work that needs to be done in the OR and we're around to do it and we do it pretty damn well because most patients don't require a mental powerhouse but someone who combines a reasonably sophisticated education with common sense. Not that there's anything WRONG with that!