Not trying to stir up bad ideas, but......

[Brian_SRNA]

Trying to stay away from the SDN is like the forbidden fruit. And I know i am stupid for even caring....but i do. My program starts is 2 months...I have worked for years to get to this point and for some reason it is getting under my nerves. I know that this battle has been going on for years, and that it will continue, but the arrogance of many of the MDA (attendings mind you) is scary. I almost laugh at some of the crap they say. But I guess I just needed reassurance (I know it sounds stupid), but I have sacrificed and taken out loans for the program...I have always, and will always continue to love this profession, as I grow with it. But I am really curious where everyone (Practicing CRNA's specifically) see this going as it relates to CRNA's ability to freely practice.

Brian

[traumaRUs, MSN, APRN]

North Cacalacky - What would you classify CRNA's as then, if not mid-level providers?

[North Cacalacky]

North Cacalacky - What would you classify CRNA's as then, if not mid-level providers?

I'm really not sure trauma, I can't offer a really good alternative. I think all nurses with degrees beyond BSN's should just be called advanced practice nurses. Perhaps mid-level provider is an appropriate title, but it may have a negative commotaion(Mid-Level as in inferior care) to the public. Advance practice nurse sounds better to me. Just an opinion. What do others think?

[deepz]

Yah, sorta like the term 'non-physician provider' -- the put-down is implicit.

I'm really not sure trauma, I can't offer a really good alternative. I think all nurses with degrees beyond BSN's should just be called advanced practice nurses. Perhaps mid-level provider is an appropriate title, but it may have a negative commotaion(Mid-Level as in inferior care) to the public. Advance practice nurse sounds better to me. Just an opinion. What do others think?

[jwk]

I'm really not sure trauma, I can't offer a really good alternative. I think all nurses with degrees beyond BSN's should just be called advanced practice nurses. Perhaps mid-level provider is an appropriate title, but it may have a negative commotaion(Mid-Level as in inferior care) to the public. Advance practice nurse sounds better to me. Just an opinion. What do others think?

You don't find the expression "mid-level" used much when dealing with the public. It's more in professional situations/discussions. You wouldn't introduce yourself as John Smith, Mid-Level Nurse Anesthetist or Jane Doe, Mid-Level Midwife. It's just a catch-all phrase to include everyone in-between entry level positions (RN, PT, OT, RT, RRT, etc.) and physicians.

[Brian_SRNA]

I'm really not sure trauma, I can't offer a really good alternative. I think all nurses with degrees beyond BSN's should just be called advanced practice nurses. Perhaps mid-level provider is an appropriate title, but it may have a negative commotaion(Mid-Level as in inferior care) to the public. Advance practice nurse sounds better to me. Just an opinion. What do others think?

I totally agree, although some might beleive that the actuall role is mid-level, APN's serve as "direct providers", providing direct, usually untethered care...again...it must be noted that no practitioner of healthcare...be it a doctor, chiropractor, dentist, surgeon, anesthetist or FNP is perfect...the whole BALANCE of healthcare depends on COLLABORATION...anyone that thinks he is above that (with the exception of Dr. Gregory House) is a danger to their profession, and my health. "Independent" practice is kind of a misrepresentation, I like "unobstructed" better. And I think that APN which every nurse( or almost every MSN nurse is, based on state law), is what we are first.....we are all Advanced Practice Nurses first, then we are CRNA's, FNP, CNS, Midwives etc. Just think of a football team. Ask a player what he does he says "I play football" usually, not I am a running back. They realize very well(most of them) that it takes collaboration (teamwork) to achieve there common goal.

SO my rambling is now done.

GO TEAM

Brian

[traumaRUs, MSN, APRN]

Thanks Brian and North - I do agree. I do not use mid-level providers except when at the office when talking about our PA's, NPs and me (CNS). Like you both stated, I certainly do use advanced practice when dealing with the public.

[paindoc]

CRNAs in our state are by law NOT advanced practice nurses. They cannot write narcotic or other prescriptions and can only administer drugs. The state legislature has determined they do not have enough training to be considered advanced practice nurses and just because they can pass gas, that doesn't make them competent to engage in diagnosis and treatment outside the operating room and L&D suites. I know this varies state by state, and largely hinges on whether they will engage in collaborative agreements. When the issue came up in my state, CRNAs did not want to be required to have collaborative agreements with any physician, therefore, they cannot by law be APNs.

[KannRN]

CRNAs in our state are by law NOT advanced practice nurses. They cannot write narcotic or other prescriptions and can only administer drugs. The state legislature has determined they do not have enough training to be considered advanced practice nurses and just because they can pass gas, that doesn't make them competent to engage in diagnosis and treatment outside the operating room and L&D suites. I know this varies state by state, and largely hinges on whether they will engage in collaborative agreements. When the issue came up in my state, CRNAs did not want to be required to have collaborative agreements with any physician, therefore, they cannot by law be APNs.

Wow! only administer drugs? not enough training because they only pass gas? and this leads to inadequate competence therefore they are not classified as APN's? PLEASE share with me what state this is! Thanks!!

[traumaRUs, MSN, APRN]

Wow - I'm curious too - which state paindoc?

[Brian_SRNA]

I am very curious what state this is too.....hmmm, with a name paindoc I guess what profession he might be in. Please let us know what state and where we can find the "legislature that says CRNA's dont have enough training to..."

Brian

[nursetim, NP]

I'm asking from ignorance here, what can mda's do that crna's can not? As to paindoc assertion, I will be an apn, but that in no way makes me able to pass gas. If crna's can not prescribe how can they practice independently?

[paindoc]

Indiana. And I did not say there was legislation...but that the legislature made that determination in their deliberations regarding CRNAs vs APNs.

We have specific requirements in IN for APN that are in excess of what CRNAs bring to the table. Of course CRNAs have the option of going to NP school for 2 years if they really want to be treated as APNs.