Md's Against Crna's?

Specialties CRNA

Published

I work in a large academic medial center in the SICU. I am also interviewing next week for anesthesia school!!! (this is a whole other discussion!!:imbar ) Today while at work one of the anesthesia residents came to preop one of my patients for tracheostomy surgery in the morning. As I was chit chatting with him about anesthesia school the resident for my patient's primary team came over and joined our conversation. The surgical resident has made comments to me about calling anesthetists "NINJAS". I asked him about this one day and he said because they are "silent asassins". As we were joking today I told the anesthesia resident about this "nick" and the surgery resident said that only applied to CRNA's not MDA's. The anesthesia resident in turn made several ugly remarks about CRNA's and their incompetence. This infuriated me! I (very nicely) pointed out to them that there is incompetence in every field, MD's included! I have been reading in these forums about the struggle for power between these two groups of professionals, but have yet to witness any of it untill today. I just don't understand why MD's have such a problem with the practice of CRNA's!

Any one have any "reasonable" ideas?

Thank you for proving my point about prejudice without knowing the facts. I got my QMA to help pay for my nursing school and I have several years of pre-pharmacy under my belt. It seems the nurses on here think that you just walk in to a room and sign up for you certification without any training. In my state you take a full pharmacology course that you have to pass with a B or above. Then you spend 150 hours in training with a RN. After that you take a state certification test that must be passed with a 90%. 150 hours spent in training is more than most of the LPN's I work with recieved in clinicals. I am in no way saying a QMA is qualified to carry out all of a RN's duties, but I am saying that putting down QMA abilities is the exact same as a MD putting down a CRNA. They don't understand what that person went through to get to the point, and neither do you.

And don't you think the arguments you just posted are exactly the same as the arguments that MD's have against CRNA's. CRNA have not had as much training as they have. CRNA's are not doctors and QMA's are not nurses. But that doesn't mean that CRNA's can't do their job just as well as an MD. And that doesn't mean a QMA can't pass meds just a well as a nurse.

P.S. Just so you can get your facts straight, Med error rates are 30% higher for RN's and LPN's than they are for QMA's in the State of Indiana in a study conducted by the Indiana State Board of Nursing. Mabye you should keep quiet until you know what you are talking about.

Crystle-clear, you are wrong in some of your assumptions and I continue to disagree with you, but this thread is moving toward getting locked so I'll let it go. Good luck in your nursing endeavors.

First of all COOM BY YA!!!

Second of all. Texas doesn't have QMAs so I can't speak on what they do but I can see how they can be an extremely valuable asset. EXTREMELY.

However, apaisRN is right. CRNAs (in relation to anesthesia) can do ALL of the things an MDA can do (based on training).

A QMA cannot do ALL the things an RN can do. She's not putting QMAs down. She is just saying that your ANALOGY is misspoken. RN/LPN or LVN would probably be a better analogy because our training is similar just like an MDA vs CRNA. AGAIN, no QMA bashing here. You all are GREAT in my book.

Third I gotta say that if I was an MDA and there was a profession that can do my job just as well as me for half to one third the money, I'd be fighting too. That's why you just have to shake the animosity off, because it will come. Just be the safest, best practitioner you can be and they can't say anything to you. And for the record, I'm all for working with MDAs as long as there is mutually respect.

This is a very arrogant and uncalled for statement. You may very well be more intelligent than many physicans, but to belittle their education and years of hardwork by crediting it to their parents/upbringing is ridiculous. Most MD's graduate medical school with hundreds of thousands of dollars in debt and work very hard during school and residency - most are in early thirties with huge debt before they start making a real salary. Maybe you could have gone to medical school if you wanted to, but you didn't. It has nothing to do with silver spoons or BMWs, many docs have come from poor backgrounds. Any intelligent person can earn an MD if they work hard enough.

In spite of what you believe most physicians respect crna's, other advanced practice nurses, rn's, etc. Some MD's are arrogant egomaniacs but that is the exception rather than the rule. You should also show respect to practitioners with other backgrounds.

Listen up:

I don't belittle the education or efforts of anyone! I both respect and appreciate how hard MDs have to work. That having been said, I expect to graduate from my BSN program about $100,000 in debt, after 5 years of very hard work! While I may not graduate with an MD behind my name, I still will have invested a great deal of time and money in my education. I think that most nurses have grown weary of their hardwork being belittled.

Everyone in healthcare works hard for their education, not just doctors.

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.
Thank you for proving my point about prejudice without knowing the facts. I got my QMA to help pay for my nursing school and I have several years of pre-pharmacy under my belt. It seems the nurses on here think that you just walk in to a room and sign up for you certification without any training. In my state you take a full pharmacology course that you have to pass with a B or above. Then you spend 150 hours in training with a RN. After that you take a state certification test that must be passed with a 90%. 150 hours spent in training is more than most of the LPN's I work with recieved in clinicals. I am in no way saying a QMA is qualified to carry out all of a RN's duties, but I am saying that putting down QMA abilities is the exact same as a MD putting down a CRNA. They don't understand what that person went through to get to the point, and neither do you.

And don't you think the arguments you just posted are exactly the same as the arguments that MD's have against CRNA's. CRNA have not had as much training as they have. CRNA's are not doctors and QMA's are not nurses. But that doesn't mean that CRNA's can't do their job just as well as an MD. And that doesn't mean a QMA can't pass meds just a well as a nurse.

P.S. Just so you can get your facts straight, Med error rates are 30% higher for RN's and LPN's than they are for QMA's in the State of Indiana in a study conducted by the Indiana State Board of Nursing. Mabye you should keep quiet until you know what you are talking about.

I'm going to apologize to the OP for the continued hijacking, but if there's one thing that annoys me, it's when negative remarks are made as a defense of someone's position or job title, and when they are made, the person that made them just wonders why there is animosity towards them in response.

When people state things like "150 hours spent in training is more than most of the LPN's I work with recieved in clinicals," "Just so you can get your facts straight," "Med error rates are 30% higher for RN's and LPN's than they are for QMA's in the State of Indiana in a study conducted by the Indiana State Board of Nursing. Mabye you should keep quiet until you know what you are talking about" and then state things "I'm just pointing out some of the hypocrisy I've read in these forums," it's pretty clear what the problem is.

Mutual respect is a pretty cool thing if everyone participates in it, but when someone comes to a nurses board and acts like nurses are the enemy, they really cannot be surprised by the response of some of the nurse here.

Want respected by others? Be respectful to others. Plain and simple

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.
I think that most nurses have grown weary of their hardwork being belittled

Thank you.

Specializes in Anesthesia.
.......Right now medicine greatly overshadows nursing. Physicians make more money and have the confidence of the public behind them. ........

Actually, the average CRNA salary exceeds the average FP or pediatrician, much to the doctors' consternation.

And opinion polls consistently are showing the public's confidence in nurses to above their confidence in physicians.

deepz

Specializes in ICU.

I've been lurking around for a while viewing the discussions on this forum. There is some great info on this board for CRNA's, SRNA's, RN's etc. Political and clinical. I think it is beneficial to have a place to vent about the CRNA/MDA debate. The discussion may get heated, but as long as everyone avoids the personal attacks, I say carry on.

I am a 1st year SRNA, but I've done some research on the CRNA/MDA debate and I have some opinions about it. I read the AANA and the ASA websites, and I read the threads over on SDN from time to time because they have some informative CRNA vs MDA discussions. Some of the residents and MDA's have GOD complexes and seem to despise CRNA's, but some of them are more realistic and know CRNA's will always be needed and utilized.

Like almost everything else, it's all about money and control. CRNA's will never completely get out from under the thumb of the MDA's, but MDA's will never completely control anesthesia or nurse anesthetist. The ASA and AANA must know this. They've tried to play nice, but they have competing interest.

MDA's will say that CRNA's are not qualified to administer anesthesia independently, but they do it all of the time without an increase in negative outcomes. When I read some of the posts on SDN, I don't think they have a clue about the amount of training and education we go through. My own family doesn't completely understand what I'm doing, or how much additional education it takes to be a CRNA. Physicians have more education and more training, but I do not need that level of education and training to provide safe anesthesia.

Are MDA's overqualified? Is anesthesia the realm of nursing?

I believe providing anesthesia is a blend of nursing and medicine. MDA's titrate meds, manage airways, start IV's, administer blood products, monitor hemodynamics etc. CRNA's treat symptoms, make independent decisions, perform invasive procedures, run codes etc. These functions overlap. Some MDA's are spreading the notion that CRNA's are following a list of standard orders without knowing why they are doing something or giving something.

I will not graduate if I don't know why I am doing something or giving something, and I definitely will not pass boards.

CRNA's have had to fight for many years to be where they are today. I think one of the biggest problem with the profession, is the level of misunderstanding by the healthcare community, fellow nurses, and the public. I would recommend that anyone wanting to enter nurse anesthesia read the book "Watchful Care: A History of America's Nurse Anesthetist" by Marianne Bankert. It's required reading in my program.

I make sure I tell all of my patients that I am a nurse anesthesia student, and then I explain what that is. Many of the CRNA's I have worked with in clinicals do not explain who they are to the patient. They just say they are with the anesthesia department.

We've got a long way to go.

Well, I have met nice people and mean people. I am finishing my BSN and applying in May for CRNA school. I am very lucky in that I found an MDA that loves to teach....my clinicals have become an internship...so I guess it depends on the person you are talking with and their attitude.

Great post BEA! You make some good observations. It shows that you aren't treating you masters degree as a means to an end, which is smart. I want to repost some more insight from members on this board (don't know if you've read these posts or not).

Regarding the SDN:

https://allnurses.com/forums/f16/the-aana-asa-the-sdn-116727.html

There are some fair anesthesiologists who post on SDN, but some members (primarily med studnets) have no clue. Case-in-point, take this med student who got terribly offended when a CRNA asked him and his instructor to leave the room because they were talking too loud:

"I saw a senior CRNA actually told the director of anesthsiology and me, the rotator to get out of her room because the teaching was too loud...I'll respect you as a NURSE because you have the skill we need, not because the years of academic education you have. Know your limit, respect your superior, or you won't find a job...My exposure with CRNA is short. Any longer I'd be ashamed to be a MD in the department even as a rotator. It reflects the disaster it could be heading to if anethesiologists aren't doing something about it. Do u think if I stayed in the department I would see the magic change of aggressive behaviors among these CRNA? No. It won't negate what I have seen even in short period of two wks.... It should have never happen, not even for one day... Imagine, a scrub nurse telling a general surgeon to get our of HIS/HER room, it would be the end of his career...know your limit, and respect your superior...Only after their aggressive behavior are warned and checked, we can rest assured and be friends. After all, friendship means mutual respect."

This student took the request to leave the room very personally. I bet he doesn't have a clue on what precordials are, and the subtle changes that can be heard without loud talking in the background. I have to wonder if this is the case. When you mentioned "GOD complex", I wanted to show you the ridiculous post where the words "superior" and "respect" are overused.

Specializes in ICU.

I agree with you ether. It's mostly the residents and students on the SDN site that fan the flames. It's amazing how arrogant they can be. Although, I shouldn't be to surprised. I've worked with physicians for the last 8 years :chuckle. One day they will be out in private practice, and hopefully they will understand the importance of CRNA's in that practice.

They can choose to work with us or not, but the number of nurse anesthetists graduating from anesthesia schools are increasing:

I found an interesting piece of info in the CMS Medicare Part B Update Final Rule: Agency Language on Anesthesia Teaching Rules

"...there has been an increase in the number of nurse anesthesia programs from 83 programs in 2000 to 105 programs projected for 2006. The number of nurse anesthesia graduates has surged from 1075 nurse anesthetist in 2000 to 2035 projected for 2006."...

Strength in numbers:cheers:

See the newest feel-good-about-your-doctor commercial by the AMA. It has a mother and her young daughter thanking the MD who took care of the girl in the NICU years ago. No mention of the round the clock nursing care. I'm sure the MD did do a lot of good, but how about equal time?

Was it a resident in the commercial? They called back after the NICU nurse paged them??? Showbiz!

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