Are CRNAs ashamed of being nurses?

[loisane]

I thought I would start a new thread to respond to the comment that some CRNAs act like they are ashamed of being nurses.

It might surprise some of you "younger" folk that there has been (for lack of a better phrase) bad blood between nurse anesthesia and mainstream nursing. At least, I hope it surprises some of you. Because I think both sides have been making efforts to mend those fences, and I think we have accomplished much in this regard.

So when I see young CRNAs/SRNAs bristle at the suggestion that they would be ashamed of their nursing roots, I smile. That is a good thing. It means we are shedding some of the baggage of the past, and good riddance to it.

On the other hand, it is part of our history, and we would best not forget about it, but understand it and learn from it. The book "Watchful Care" by Bankert tells the story better than I can. I know, some of you are sick of hearing me push this book. But until each and every one of you read it, expect to keep hearing me talk about it!

When nurse anesthetists decided to form a professional organization, they approached the ANA, and were rejected. Organized nursing said we were not "real nurses". Even though that took place decades ago, it continues to influence our behavior and attitudes today. Nursing and nurse anesthesia didn't really trust each other, so to feel like they were on the same side was just really out of the question. The prevailing view was that going into anesthesia was "leaving nursing". They looked down on us for doing it. And, yes, some nurse anesthetists embraced that by gloating that they had risen to a level above nursing.

There are remnants of this mutual distrust everywhere. Some of you have had to deal with nurse managers who were less than supportive of your desire to go to anesthesia school. Yes there are issues about training people who are just going to leave, jealousy, envy of the earning potential, etc. But I believe it is explained by these strong historical roots as well.

Somewhere along the line, both our professional organizations realized this mutual animosity was only hurting both of us. Nurse anesthesia is the most powerful of nursing specialties, in terms of legislation and lobbying power. We are the leaders among the specialties, the first to get individual billing rights, etc. Nursing has much to benefit by being our ally.

And despite all of nurse anesthesia's successes, we are met with increasing opposition and the threat of losing the ground we have gained. Mainstream nursing is 2.7 million strong. RNs constitute the largest group of all health care professionals. We can be much more effective, for all of our goals, if we work together.

I can really see an improvement since programs were required to grant master's degrees. More and more of our programs are now in schools of nursing. I personally believe that is contributing to our improved relationships.

So if someone with a decade or two's experience in ICU and/or anesthesia says they have known some CRNAs who are ashamed of being a nurse------yeah, that is probably the truth. Is that attitude common? Not as much now as it used to be. And should be getting increasingly more rare as we move toward the future. A future that is bright with promise for continued development of all nursing and its specialties.

loisane crna

[Trauma Tom]

I did not realize this problem existed. Thanks for the information. I have ordered the book and will try to read it soon. I start CRNA school on Monday, June 7th so I might take some time finishing the book. For those interested AANA has the book in their bookstore. It is rather difficult to find it elsewhere unless you want to pick up a used copy. Thanks Loisane CRNA. As usual you are a wealth of information.

Trauma Tom

I thought I would start a new thread to respond to the comment that some CRNAs act like they are ashamed of being nurses.

It might surprise some of you "younger" folk that there has been (for lack of a better phrase) bad blood between nurse anesthesia and mainstream nursing. At least, I hope it surprises some of you. Because I think both sides have been making efforts to mend those fences, and I think we have accomplished much in this regard.

So when I see young CRNAs/SRNAs bristle at the suggestion that they would be ashamed of their nursing roots, I smile. That is a good thing. It means we are shedding some of the baggage of the past, and good riddance to it.

On the other hand, it is part of our history, and we would best not forget about it, but understand it and learn from it. The book "Watchful Care" by Bankert tells the story better than I can. I know, some of you are sick of hearing me push this book. But until each and every one of you read it, expect to keep hearing me talk about it!

When nurse anesthetists decided to form a professional organization, they approached the ANA, and were rejected. Organized nursing said we were not "real nurses". Even though that took place decades ago, it continues to influence our behavior and attitudes today. Nursing and nurse anesthesia didn't really trust each other, so to feel like they were on the same side was just really out of the question. The prevailing view was that going into anesthesia was "leaving nursing". They looked down on us for doing it. And, yes, some nurse anesthetists embraced that by gloating that they had risen to a level above nursing.

There are remnants of this mutual distrust everywhere. Some of you have had to deal with nurse managers who were less than supportive of your desire to go to anesthesia school. Yes there are issues about training people who are just going to leave, jealousy, envy of the earning potential, etc. But I believe it is explained by these strong historical roots as well.

Somewhere along the line, both our professional organizations realized this mutual animosity was only hurting both of us. Nurse anesthesia is the most powerful of nursing specialties, in terms of legislation and lobbying power. We are the leaders among the specialties, the first to get individual billing rights, etc. Nursing has much to benefit by being our ally.

And despite all of nurse anesthesia's successes, we are met with increasing opposition and the threat of losing the ground we have gained. Mainstream nursing is 2.7 million strong. RNs constitute the largest group of all health care professionals. We can be much more effective, for all of our goals, if we work together.

I can really see an improvement since programs were required to grant master's degrees. More and more of our programs are now in schools of nursing. I personally believe that is contributing to our improved relationships.

So if someone with a decade or two's experience in ICU and/or anesthesia says they have known some CRNAs who are ashamed of being a nurse------yeah, that is probably the truth. Is that attitude common? Not as much now as it used to be. And should be getting increasingly more rare as we move toward the future. A future that is bright with promise for continued development of all nursing and its specialties.

loisane crna

[kestrel1121]

I too have ordered the book bec it's been mentioned so often here and not by just Loisane. I have to say that all of the CRNAs I have been aquainted with seem to be proud of their nursing background (there is one who is older who dismisses it but he's been CRNA for 30yrs). I know all of our CRNAs don't hesitate to help us CVICU RNs settle in a postop pt by hooking up to the monitor, help turning to get off OR linen/repositioning etc. I do know a new grad RN whose sole purpose is to get ICU exp and goto CRNA school but wants really NOTHING to do as an RN (felt that butt wiping, emtying trash at end of day, turning etc was beneath him and that is while only working as a nurse intern!!). All in all, I think the CRNAs I know value their nursing exp and background and are not ashamed of it. Of course, my question would be, Why would they be!?!?!

[Passin' Gas]

I have been a nurse for 20 years and a CRNA for 10 years of that 20. Anesthesia is an extension of the nursing I did initially....and I grew up through the ranks...nurses's aide, LVN/LPN, BSN, then anesthesia school. As a nurse's aide I figured if I could handle emptying bedpans and other less than desirable tasks, the rest would be easy in comparison. There is a tendency to dwell on the whole bedpan/excrement/emesis issue. If one is able to offer care to another person and attempt to maintain their dignity, in for what most people is a very humiliating situation, THAT is nursing care.

The best relationships between myself as a CRNA in PACU, OR, ICU, and floor nurses thrive on mutual respect. Professionalism and politeness goes a long way in gaining mutual respect with individuals on both sides. The Primadonna approach to "I need this now!" in less than urgent situations fosters environments of animosity. In my experience, positive interpersonal interactions between RNs in the different areas of the hospital and ambulatory facilities are our (CRNAs) best PR strategies to gain support from other nursing groups.

I've read Watchful Care three times in the last 10 years. It reminds me of where our profession has been, what it is, and where it is going. If you don't know where you've been, it's hard to know where you're going. Whenever I can, I give a brief rundown on nurse anesthesia. There was an article in Dallas magazine about a plastic surgeon and bad outcomes. Read it in the grocery aisle and held up the line a few seconds searching out the surgeon's name. Apologized, stating I did anesthesia in Dallas for some plastic surgeons and wanted to know if I recognized the individual. Opened a discussion with the grocery checker and the person in line behind me about nurse anesthesia. "I'm a Certified Registered Nurse Anesthetist, I administer anesthesia in hospitals and ambulatory surgery centers. Actually, nurses have been administering anesthesia for over 100 years since the doctors were more interested in the surgical procedure....etc. Yes, I assess the patient before surgery, administer the anesthesia, monitor the patient during the procedure, wake them up ensuring they will be comfortable and transfer care of the patient to the PACU nurse." (I had a lot of groceries and time to chat. Ended up buying the magazine due to guilt from holding up the line a few seconds)

EVERY CHANCE I GET I talk about nurse anesthesia and our history, what we do, what we are responsible for, what is our education, what we do on a daily basis.....

The OR is a teamwork environment....we all do (CRNA, surgeon, OR nurse, scrub tech) what needs to be done to get the patient taken care of. Circulator's out of the room, I open suture for the surgeon, plug in the suction, adjust lights; the circulator brings me the next bag of IV fluid when it's running low without my having to ask, will get drugs from pharmacy when asked without disgruntlement (for lack of better descriptor). Succinctly: I help you, you help me, the patient is taken care of, on to the next case.

Bottom line: Do unto others as they would do unto you. Honor those you work with by respecting their expertise, they will, in turn respect the expertise you have in your specialty.

[trakstar]

No only do I agree but I could not have said it better. Well Done.

[nec]

loisane,

I start nurse anesthesia school in scranton,pa in aug and i just wanted you to know that the program requires us to read the book before we start in aug, i did not start it yet but i look forward to reading it nec :)

[yoga crna]

Loisane,

You brought up a great subject. I have always been proud of my nursing roots and am sure that I am a better anesthetist because of it. The extra care given to patients, holding their hands during cataract surgery, real concern for patient anxiety and individualized care are a few of the nursing skills I bring into my everyday practice.

I have distaste for many aspects that seem to be prevalent in nursing--constant complaining, being negative instead of positve about their own profession, a lack of professionalism, perceived powerlessness leading to passive agressive actions and a major disconnect between nursing educators, administrators and clinicians.

As a CRNA, I can be independent, professional, constantly stimulated intellectually, well paid and well respected. I don't like arrogant CRNAs (or anyone else), those who haven't kept current in the profession and those who lack the confidence to practice without an anesthesiologist directing them,

I like taking the best out of both and expressing my distain for some what I don't like.

Yoga

[RN34TX]

I share the same distaste you have about nursing "...constant complaining, being negative instead of positve about their own profession..." but why do you think that those aspects of nursing exist?

I'm asking you because the only nurses I run into who share your views are not working as "regular staff floor nurses". They always seem to be in positions like management, clinical educators, infection control, head of this or that department, or one of the hot specialties like CRNA.

"...As a CRNA, I can be independent, professional, constantly stimulated intellectually, well paid and well respected..." That's great and you more than deserve it. But don't you think that if the vast bulk of nurses could say the same thing about their jobs like you do, perhaps they wouldn't be so negative and complaining?

Believe me, I'm not cutting on you as a CRNA, I have the utmost respect for someone in your position. I looked into the local program. I have the grades and the ICU experience, but no drive/ambition to go through a rigorous program like that!! Too lazy I guess.

I'm just saying that I think it's easy for for those nurses in more elite non-staff floor nurse positions to call everyone else whiners and complainers.

For a change I would like to hear from regular staff nurses -- ICU, med/surg, etc. who think that nursing complains too much and is too negative about the profession and can say the same great things about their job like you do.

I like where I'm at right now, but I'm very cautious when people ask me if I recommend nursing as a profession to enter.

[loisane]

loisane,

I start nurse anesthesia school in scranton,pa in aug and i just wanted you to know that the program requires us to read the book before we start in aug, i did not start it yet but i look forward to reading it nec :)

What a great idea! Thanks for sharing this, I am going to suggest it to the program directors that I know.

loisane crna

[loisane]

What great discriptions of NURSE anesthesia Yoga and Passin'Gas have given us. It is attitudes like theirs that distinguishes us from other types of anesthesia providers.

Yoga and RN34Tx both raise legitimate issues. Nursing does have a negative, "eat our young" attitude. And our best and brightest do tend to advance themselves to positions where they are more distant from "traditional" nursing roles.

This is the very dichotomy that got us into trouble. The internal back-biting and fractionization of nursing.

But it doesn't have to be that way. Nurse anesthesia is better when we embrace our nursing heritage, instead of denying it. And nursing is better when they embrace us as a part of nursing, instead of denying us membership.

It may seem obvious to us. But there were many people who feared this "return to nursing". After all, nurse anesthesia had established itself as an autonomous, independent practice. If we embrace nursing, that could threaten that position. It was said that identifying with nursing would move us backward, not forward.

My view is that we should work toward just the opposite. Returning nurse anesthesia to nursing should STRENGHTEN nursing, not weaken anesthesia. Let's empower other APNs to gain the scope of practice we have. I'm a big dreamer, I think there are other nursing roles that could eventually develop into APN positions.

In my vision for the future of health care, even the bedside nurses are empowered with professionalism and respect. In fact, I believe nursing is what could save our entire American health care delivery system, and get it out of the mess it is in!

OK, I know it is a pretty wild dream. But you don't get big unless you dream big. It's going to take a while to get us there, one step at a time. This is what motivates me, to contribute to our profession, and improve things for all of nursing.

loisane crna

[Qwiigley, BSN, MSN, DNP, RN, CRNA]

Are CRNAs ashamed of being a nurse?

I'm not!

[medsurgnurse, RN]

I have the greatest respect for the experienced nurse who goes on to become a CRNA. But I have seen a few things that disturbed me. A new grad nurse whose reponse to learning new nursing skills was " I don't need to know this because I'm going to be a CRNA." Yes, you do need to know assessment, critical thinking, prioritization, and nursing skills like take care of chest tubes etc. Another time I went to a nursing conference, the local university had their students there; some first year students were talking about how they were going "straight to CRNA school" after graduation and not "waste time" nursing. I thought gee they don't even know if they'll make it through nursing school yet. It seems like there a whole generation of nurses coming up who really have no intention of ever doing bedside nursing. Again, I don't have a problem with nurses furthering their career by entering a different arena; but it scares me that the inexperienced nurses are the ones going into CRNA.