Experienced CRNA...ask me anything - page 12

Okay...If you've read my posts you know that I will be retiring soon. Now is your chance to ask a practicing CRNA anything. 12 years of experience from solo rural independent to... Read More

  1. by   ICUman
    Quote from loveanesthesia
    Additionally CRNA demand is increasing due to a shift from MDA heavy practices to utilization of more CRNAs.
    Would you mind expanding on why this trend is occurring?
  2. by   wtbcrna
    Quote from ICUman
    Would you mind expanding on why this trend is occurring?
    Money..CRNAs are more cost effective
  3. by   loveanesthesia
    CRNAs are cost effective-meaning high quality at lower cost.
  4. by   ICUman
    Quote from wtbcrna
    Money..CRNAs are more cost effective
    Quote from loveanesthesia
    CRNAs are cost effective-meaning high quality at lower cost.
    I'm curious if MDA's have pushback and high resistance to this happening, as it seems it may make their (MDA's) job prospects more difficult to obtain/retain. Of course I am in favor of CRNA's 100% and am happy about this trend, but I imagine there is some difficulty involved incorporating/replacing those jobs with nurse anesthesia providers.

    Seems like nothing but great prospects ahead for CRNA's.
  5. by   loveanesthesia
    Yes there is a lot of pushback from the ASA. It's why they are aggressively supporting AAs. Quality with AAs is not good and they know it, so they will not be replaced with AAs.
  6. by   ICUman
    Quote from loveanesthesia
    Yes there is a lot of pushback from the ASA. It's why they are aggressively supporting AAs. Quality with AAs is not good and they know it, so they will not be replaced with AAs.
    So they promote AA's in effort to have them take CRNA job opportunities? I've honestly never worked with an AA. It must be a regional thing.
  7. by   loveanesthesia
    AAs have to be medically directed so any OR with an AA also has to have an anesthesiologist. Some CRNAs work medically directed but medical direction by an anesthesiologist is not required for CRNAs. So CRNAs can work independently which is happening more and more.
  8. by   MHARNP
    Quote from 06crna
    I left a medically-directed ACT practice with a stifling, hierarchical culture and returned to independent PRN/locums coverage. I'm traveling and having a great time.
    Just entering school this coming May. The thought of traveling down the road (way, way down the road) sounds interesting. My husband works from home, so he would be able to travel with me. Could you elaborate a little more about what you're enjoying about the change? Any suggestions on what to look for or what to avoid?
  9. by   JEStewart
    How CRNA are managed in the hospital - I meant, how does the management company contracted CRNA now work within the hospital on the logistic side of it? Do these companies now dictate where CRNA go on a daily basis? Or is it more like a request made by the CRNA for a location preference then "see what you get" type of thing?

    Does this contracted out from a company affect the relationship with anesthesiologists in the hospitals where you work now? If you're rotating frequently, it be difficult to establish more of a consistent professional relationship. I don't know if that lack of would impact the CRNA role in hospitals where you might be required to work alongside. Assuming that happens....

    The last part that I didn't ask well - I was trying to ask if the management companies would alter how CRNAs are managed compared to on a hospital-to-hospital case? Micromanaged or local rules/policies or even in the way benefits are distributed - things like that?

    Thank you for taking the time to make this post and answer everyones' questions. I know I greatly appreciate it.
  10. by   offlabel
    Quote from JEStewart
    How CRNA are managed in the hospital - I meant, how does the management company contracted CRNA now work within the hospital on the logistic side of it? Do these companies now dictate where CRNA go on a daily basis? Or is it more like a request made by the CRNA for a location preference then "see what you get" type of thing?

    Does this contracted out from a company affect the relationship with anesthesiologists in the hospitals where you work now? If you're rotating frequently, it be difficult to establish more of a consistent professional relationship. I don't know if that lack of would impact the CRNA role in hospitals where you might be required to work alongside. Assuming that happens....

    The last part that I didn't ask well - I was trying to ask if the management companies would alter how CRNAs are managed compared to on a hospital-to-hospital case? Micromanaged or local rules/policies or even in the way benefits are distributed - things like that?

    Thank you for taking the time to make this post and answer everyones' questions. I know I greatly appreciate it.
    You're asking a very complex question that, ultimately, is concerned with the job satisfaction of the CRNA. Job satisfaction comes from a lot of different directions and is different for different people.

    If you simply value procedures and paychecks, locums travelling may be for you. You are the anonymous hired gun technician that shows up and does the work, gets paid and leaves. No one knows you, knows what you are actually capable of or knows if you are dependable when things go sideways. Surgeons could not care less about anything other than the last case you did for them. That's OK.

    Staying at one place for a long time is a goldmine too...Surgeons know you, the staff respect you, they know how old your kids are and where they go to school, if they go to school. When you've been off for a week everyone asks where you've been and if it was cool...If you do something a little inelegant in an anesthetic, they give you the benefit of the doubt and it's forgotten the next day...they trust you as much or more as the "new" anesthesiologist that's been there for 10 years. You know the cafeteria ladies and the gardeners and the housekeepers by their first names. You've put labor epidurals in the wives of surgeons and the nurses you work with. Put a price on that? Knock yourself out.

    You don't have to move your kids around every 5 or 6 years looking for that dream job and your 401K is comfortably into the 7 figures well before you retire.



    Staying at on place for a long time in the long run can be as lucrative as running around chasing the brass ring. Some folks got a lot better gig than me...not many though...
  11. by   RATMLPN
    I'm just beginning my studies pretty much, I'm an LPN now on the way to my RN. Is there any advice that you would give a nurse at the beginning of her career to keep in my mind during my studies? Useful electives, courses to really focus on, etc? I've been interested in this since I became an LPN.

    Thank you!
  12. by   JEStewart
    @ offlabel:

    I suppose that is a big factor in what my questions revolved around. I'm sensing a lot of friction between MDAs and CRNAs from the tone of this thread. Wondering if that's luck of the draw in regards to where you work and who might be on that day with you, regional, or skewed by the negative comments being made without any positive ones being mentioned. How real is this perceived friction, and how severe, as an industry?

    I'd vastly prefer a consistent work location or rotation of a few places compared to always being the new person no one knows how far to trust.

    I'm definitely interested in anesthesia for the science of it, the autonomy, responsibilities, and what I imagine to be an air of respect they seem to be given (but my experience is limited and not "real life"). I eagerly await a chance to shadow a CRNA real experience and one-on-one conversation.

    I monitored anesthesia for surgeries in the veterinary world for the last 10 years. Every year I learned more, and it was fascinating. CRNAs are the extreme opposite end of that. Veterinary medicine is more closely related triage MASH by comparison.
    Last edit by JEStewart on Aug 13

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