Published Oct 26, 2002
I've been thinking of ways in which CRNA's might "gain more respect" from the mainstream medical community (MDA's in particular). The parallel which occured to me was of all things home schooled students. You see initially years ago public school educators loudly decried the inadequacy of home school education (they still do but with considerably less credibility). One thing which has helped to change the "perception" of home schooling are the consistently high performance of home schooled students on such things as spelling bees, geography competitions, and SAT/ACT scores. It has now reached the point that many Ivy league institutions actively recruit home schooled students.
So I asked myself how might CRNA's go about demonstrating a similar competency? ONE way could be the creation of "games" which test in a competitive environment the contestents ability with regard to ALL aspects of anesthesia. There would be both "practical" and written components to my dream games measuring competencies from patient accessment to life saving trauma management from an anesthesia perspective. The games would be open to ALL anesthesia professionals both CRNA's and MDA's. There would be very substancial cash prizes (say 100K for first prize) but the main reward would be professional pride. Funding could be facilitated via spocers such as Discovery Health (it would make a decent show on that channel) and fees from contestents (which might be paid by employers seeking positive publicity in many cases).
Firefighters, policemen, mechanics, and even barbecue aficionados have such competition, why not anesthesia professionals? If MDA's want to claim such profoundly superior skills and allege that entrusting CRNA's with anesthesia responsibility places patients lives in danger (as they are in some political races across the nation), let them put their skills where their mouths are. Maybe they will be proven correct, but I predict that CRNA's would more than hold their own in such competition.
I got a better idea, lets put on the boxing gloves and the last one standing wins!!
roland... you gotta be kidding me... anesthesia games? if this is the best you can come up with so that you can add grandeur to being a CRNA then this is pretty weak. You seem to forget that anesthesia is about patient care, not games...
gowkout... based on previous postings of yours i quickly realized you were just kidding - it gave me a good chuckle.
of MANKIND during the cold war in the form of strategic simulations (indeed we still do although most people don't realize it). All of the professions that I listed which have "competitions" are also serious business (as the recent case in Washington D.C. illustrates this is espcially true of the police). While its true that I list a specific and somewhat factitious purpose for these games (the point of proving equality with MDA's is mostly hyperbole but it is in fact a COMPONENT of MY intentions for the competition). However, without regard to the aforementioned purposes such competition could have a plethora of other positive influences:
I. It would attract attention to an area of practice both for dotors and nurses. By presenting the "best and brightest" in the field it would tend to naturally facilitate an interest among undergraduate students who were both pre-nursing and pre-med.
II. It could provide addtional incentives to hone one's skills to the very highest levels (heck it might even be enough to inspire me to give up my surf board which I intend to be enjoying on my off days if I become a CRNA). In almost EVERY aspect of the human experience that has ever been measured competitive "gaming" has tended to maximize performance. Perhaps that why our military is CONSTANTLY engaging in such "games" as anyone with such a background can attest.
III. In addition such a competition might provide a forum where the latest anesthesia techniques could be presented, and analyized in a spirit of friendly (but intense) competition.
I didn't see in your reply specific criticisms of my proposal. Instead, you seemed to proffer something of a blanket dismissal that bordered on an outright ad hominem attack. Such terse, pejorative statements do indeed effectively disparage ideas, but they do so at the expense of furthering intellectual dialogue. Such tactics are the hallmark of those who prefer sharp rhetoric over logic, and the wit of fallacy to the intellectual rigor of factual analysis. Of course in your case I'm am confident that this was not intended to be the case. Perhaps if you find the idea or my presentation lacking you could offer your opinions as to specifically WHY. Given such feedback perhaps modifications could be made that might serve to ameliorate your concerns. This is a serious proposal which I believe could ultimately result in significant benefits to the profession ultimately contributing to improvements in patient care.
Actually, I have to agree with Tenesma on this one, for a number of reasons.
Right at the top of the list, "Anesthesia Games" sounds silly. Hear me out. We (MDA's and CRNA's) are professionals, who worked their butts off to get where we are. We all have some kind of advanced degrees. You don't see lawyers holding "law games." You don't see psychologists holding "shrink games" (except with thier own patients). The point is, we are not firefighters, policemen, or US Army Rangers. The test is not in some "game" but in how we do our anesthetics day to day.
Second, whether you like it or not, most MDA's and CRNA's would eschew such games. I know I would. I don't have time, I don't have the desire, and I don't see any benefit. There is something of a rift between CRNA's and MDA's right now, though at the level of the trenches, the rift is not NEARLY as deep as the ASA and AANA would have the public beleive it is. Actually, at the level of the trenches, its more of a minor disagreement, with no impact on work or personal relationships at all. In any event, the remedy for this rift is not to have Alec Trebeck host some kind of "Anesthesia Jeopardy." I don't have the answer, but I know this ain't it.
Kevin McHugh, CRNA
At the national conference, there is a night of "college bowl" pitting student teams against each other. Fun, but pretty poorly run. I don't think I want to see much more than that. We don't need to divide the two groups. Our national bodies do enough of that as has been said before.
I agree with Tenesma and Kevin on this one.
Roland... i have to commend you on your command of the english language to put forth your arguments. Flowery prose however still does little to prove your point.
Your collection of postings on this board seem to consistently try to bolster medical equivalency between the CRNA and the MD - and this grand idea of "anesthesia games" is your latest attempt.
Aren't you content with becoming a CRNA and providing safe and effective anesthesia care? This may be a generalization, but people like you continue to provide the backbone for what Kevin McHugh calls the rift between MDs and CRNAs... that is mainly only visible at the political level, and in maybe a few rare instances at the hospital level (and those are mainly due to insecurities and job dis-satisfaction).
At anesthesia conferences - open to both CRNAs and MDs, there are workshops where both can hone their skills, there are discussion groups to increase knowledge, there are presentations and posters to gain insight.... maybe that is where you should start? any anesthesia "games" would be totally unfair because you are throwing against each other two totally differently trained professionals, and would do nothing but to create a bigger rift and more discontent among CRNAs.
Now if the ASA and the AANA could hold joint conferences that would be a whole lot better - and yes, we might even learn from each other...
sensiblitites (I would say liberal but I probably lack the foundation for such a statement). The "games" would be open to individuals both CRNA's and MDA's and would be in the spirit of challenging competition. Thus, MDA's would be competing against other MDA's as much or more than CRNA's (the converse would also hold true). In any case it appears that I will have to wait until I can invest my own money to bring such dreams to fruition.
Furthermore, just to set the record straight I don't seek equivalence between MDA's and CRNA's. The "model" I support is direct "supervision" by "MDs" as opposed to the direct medical direction model, (which was the focus of the Philadelphia study which purported to demonstrate greater survival for patients under such direct MDA care). I would submit however that MDA's as a group are seeking to alter the status quo in a direction more favorable to the outcome which they desire. That's fine its really "just business", but CRNA's need to take note and strike back with a little passion. Elitism has no place in this profession or any other and if "anesthesia olympiacs" would be beneficial then they should be supported.
The problem is, Roland, that you have not in the least demonstrated how the "anesthesia olympiad" would be beneficial. Tenesma, myself, and others have all demonstrated that they would be at best, a waste of time.
From what I have gathered from your other posts, I believe you are not yet a CRNA, but plan on becoming one. I would like to pin you down on who and what you are (for example, are you an RN yet?). But, lets just say you want to become a CRNA. After you do so, you work a 70 hour week then tell me how excited you, and your family, are about preparing for your anesthesia games.
Now, I have not personally met Tenesma, but from the nature of his posts, I believe I could work with him. There are places in this debate where he and I agree. There are other places where he and I disagree (I know, Tenesma, try to contain your disappointment). But, this minor disagreement would affect our personal and/or professional relationship not at all. That's the point I have been trying to get across. Down where the rubber meets the road, many of us, CRNA's and MDA's are scratching our heads, trying to figure out why there is so much fuss at national levels. Yes, there is some disagreement, but we are making a mountian out of a molehill.
We don't need "Anesthesia Games" to prove who is the better anesthesia provider. We don't need "Anesthesia Games" to "settle the dispute." In fact, these games would have no hope of doing so. We don't need competition among anesthsia professionals. We need cooperation, we need collaboration, we need to focus on where we agree, rather than where we disagree.
By the way, when you do become a CRNA, and decide to fund such games, let me know how great the level of participation is among both MDA's and CRNA's. I think you are in for a great disappointment.
One other point, just for you to think about, Roland. There are at least two people on this board who practice anesthesia every day that have told you this "Anesthesia Games" is not a great idea. By your own admission, you have not even applied for anesthesia school yet. You have in effect told us both that we were full of it, and it was still a great idea.
Just a suggestion. Lose the attitude. You will be perceived by your instructors in anesthesia school as a know it all, and dangerous, since you seem to understand anesthesia better than people who really do it for a living. Just a suggestion.
not even an RN. However, to disparage my viewpoints based upon my status as a student is simply an argument from authority, a clear logical fallacy (consider that Arrhenius, Einstein and many others made major contributions to science while still students, although I don't claim such abilities the point still holds). I often write my public officals with my input and proposals it is fortunate they don't write me back admonishing me to keep my opinion to myself until I am elected! Is that what you are suggesting? I can assure you to a point of near metaphysical certainty that there is nothing that I will learn in the future that will change my viewpoint on this particular issue.
In addition, my proposed "games" would be entirely voluntary. Thus, if you didn't have the time or were not so inclined to partcipate there would be no onus upon you to do so (this is also the case with the police and fire games which I referenced in my initial post above). Furthermore, I did offer specific "reasons" why these "games" could be beneficial to the profession. Now it may be that you find those reasons insufficient or invalid but they were put forth. Finally, let me point out that at no point have I "analyzed" your or Tenesmas collective posts and attempted to make any characterizations as to your motives or capabilities. Please afford me the same courtesy and stick to the point being discussed in a given thread. In any case thanks for the input.
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