Anesthesologist and CRNA collaboration

[GregRN]

i've been a lurker on this board for about a year now; not particularly active in participation, but more active in soaking up knowledge from others as i start my nursing career.

i'm interested in a career as a crna and it was the primary reason for pursuing my bsn, a second degree for me. over time i've read as much as possible about the trade, shadowed a number of crna's doing anything from epidurals at the bedside to or cases and have found it to be an excellent fit for what i do well. recently i made the mistake of reading posts on studentdoctor.net in the anesthesiology forum (gasforums.net) and find myself visiting regularly. oops. talk about a downer. the venom spit at crna's is remarkable. it seems every chance they get to bash, lobby against, pad their own pockets, etc., they take it and exploit it. therein lies my reason for this thread.

those of you who have experience as a crna i'm hoping you can provide some insight as to the collaboration and attitudes between mda's and crna's. i suspect that overall it's pretty solid and it's only a very minor group of people who hate crna's as much as they seem to on that "other" board. part of what is tainting my view is that the asa has a huge thumb on anesthesia here in colorado, going so far as to name the governor himself in a lawsuit brought about in response to the medicare "opting out" issue, putting crna's on unequal footing, so to speak.

are crna's respected by mda's or is there a relative lack of respect but both sides ignore it? any other insight you can provide? thanks much for your help.

[GregRN]

I have several questions. First, paindoc - you sound like a MDA!!! What are you doing at ALLNURSES.COM. Are you married or involved with a nurse? You seems like you have so much anger towards CRNA's. Secondly do you personally employ trained monkey off the street. Is that why you try and justify "off the street" anesthesia employees. I don't know what hospital or practice you're involved with but if the hospital, or you and your partners allow RN's or techs to administer an "anesthetic" without formal training then you are endangering the lives of your patients. If you believe anyone off the street can be trained for any job you obviously minimize what CRNA's do in the OR.

Yikes. This is exactly the turn I didn't want this thread to take.

Paindoc, can I safely assume you are an anesthesiologist? If so, I'd like to hear your take on the original question of this thread.

[paindoc]

There is no reply necessary to the rantings of one self proclaimed "Caveman". I assume the moniker is descriptive.

As for CRNAs and MDs...I used to be an anesthesiologist but for the past decade have been a pain physician. I have employed CRNAs in my own company in the past and had a great working relationship with them. CRNAs and MDs have engaged nationwide in warfare tactics from time to time, with each group pouring on their share of gasoline. It actually reminds me of a polite form of what is going on in Iraq at this point.

But overall, most MDs and CRNAs get along well enough together. Militant posturing by either group (eg. CRNAs claiming they can do everything that MDAs can do while blasting AAs for their lack of abilities....... MDs claiming anesthesiology delivery is solely within the realm of the practice of medicine when common sense and current practices nationwide would argue otherwise) is not helpful. It is the militant voices that get most of the attention in the press, but are usually the most emptyheaded, arrogant pricks you would ever want to meet, and realistically don't deserve the time of day. Unfortunately some of these misanthropes have the ear of naive legislative bodies, and continue to cause problems for those of us in the trenches that are simply trying to do a good job with delivery of anesthesia in a team model.

So...can the evil empires work together? Certainly. Can both groups be replaced? In some states they absolutely can by non-physicians/non-CRNAs that don't fight like kids in a playground brawl.

My personal experience with most CRNAs has been very very positive but if my experiences had been based on interactions with some of the more extremists on this forum, then I would have had quite a different view. Fortunately most CRNAs are rational, reasonable, competent, caring individuals that demand the best for their patients.

[deepz]

There is no reply necessary ........I used to be an anesthesiologist ..........

Of course paindoc won't stoop to a dialogue, prefers to lecture, but I'm curious nevertheless -- why'd he quit anesthesia? Sounds like a bit of history we'd all be able to learn from.

??

d

[paindoc]

Ahhhh great question! I started the anesthesia section of a liver transplant program, was involved in more than 20,000 anesthetics, and had extensive experience in neuroanesthesia. I became bored with anesthesia....it is too easy. It can be a great career for some, but when you hit homeruns everytime you step up to the plate, there is no challenge any longer. Chronic pain treatment, unlike OR anesthesiology, does not have such success rates. The diagnostic skills needed, skills to run a business in which patients are not simply fed to you, and therapeutic options are vastly more complex than anesthesiology. Whereas being in an OR chained to an anesthesia machine without control of your lifestyle may appeal to some anesthesiologists, it does not appeal to me. Most CRNAs have a great life delivering anesthesia and have decent working hours. As a pain physician, I select which patients I desire to see, which insurances I deem valuable enough in which to participate, the style of practice, determine who works for me, determine my exact and predictable hours of business, and what surgical and medical treatments I desire to offer. Lovin' it!!

[dfk, RN, CRNA]

Of course paindoc won't stoop to a dialogue, prefers to lecture, but I'm curious nevertheless -- why'd he quit anesthesia?

why?? because it's a job, it sux and it's a JOB that you hate to love and love to hate.. aside from the fact that you get tired of looking at peeps' rotten teeth and nasty breath, even thru the 'impenetrable' masks that are so graciously provided for the givers of gassss ... !!!

[CavemanCRNA]

MDA's and CRNA's can work together to provide the best posible patient care. In our practice, we put aside our political views when we enter the OR. The MDA and CRNA each recognize the other's role and respect each other's expertise and skill. In the outside world we sometimes interact socially but it is brief. Until the ASA and AANA can come together and work out their differences, there will be underlying tension between the two providers.

[subee, MSN, CRNA]

Ahhhh great question! I started the anesthesia section of a liver transplant program, was involved in more than 20,000 anesthetics, and had extensive experience in neuroanesthesia. I became bored with anesthesia....it is too easy. It can be a great career for some, but when you hit homeruns everytime you step up to the plate, there is no challenge any longer. Chronic pain treatment, unlike OR anesthesiology, does not have such success rates. The diagnostic skills needed, skills to run a business in which patients are not simply fed to you, and therapeutic options are vastly more complex than anesthesiology. Whereas being in an OR chained to an anesthesia machine without control of your lifestyle may appeal to some anesthesiologists, it does not appeal to me. Most CRNAs have a great life delivering anesthesia and have decent working hours. As a pain physician, I select which patients I desire to see, which insurances I deem valuable enough in which to participate, the style of practice, determine who works for me, determine my exact and predictable hours of business, and what surgical and medical treatments I desire to offer. Lovin' it!!

Is there any use for a CRNA without prescriptive privileges in a chronic pain practice. I'd like to segue over to chronic pain for my older age career but see no future in it without prescriptive privileges. But nor would I want to become someone else's prescription writing machine. CP would be a challenging area for me - at least intellectually so.