Relationship with MDAs?

[TraumaNurse]

Hi everyone,

I was interested to hear from the CRNAs or SRNAs out there, how they are treated by the MDAs? There are many hospitals here in NH where CRNAs practice independantly and are very well respected in the community, however in some of the larger hospitals, there are a few MDs that are pushing to get rid of CRNAs altogether. Their position is that they do not feel CRNAs are adequately trained or educated to provide safe anesthesia (We know differently and the literature supports how safe CRNA practice really is!)

Does the obvious tension that sometimes exists between CRNAs and MDAs create an uncomfortable work environment? Do CRNAs get treated poorly or with disrespect by MDAs or surgeons? I would love to get your input. Thanks.

Paul

[loisane]

Boy oh boy, this question should generate some lively debate!

Well, from what I hear, CRNAs are treated with great respect in most places. Many, many people say that the MDAs they work side by side with do not align themselves with the inflammatory rhetoric that comes from the ASA (American Society of Anesthesiologists). Many times I have heard the opinion that if both our professional associations would just let it go, that we could work along side each other in peace.

Sadly, this rosy picture is not universal. There are many places that utilize the services of CRNAs, but do not believe in their right to autonomous practice. So I am sure you will get a mixture of responses to this question.

My personal experience has included only restricted practice workplaces. The MDAs I have personally worked with do not allow CRNAs full scope of practice, and are very much "micromanagers".

Despite working in such an arrangement, I am a huge advocate for independent practice. I believe it is important to preserve that role for nurse anesthetists. Of course, so does our national association.

The ASAs position is that anesthesia is the practice of medicine. Therefore any nurses engaged in anesthesia are being delegated the authority by a physician, who maintains ultimate control.

AANAs position is that anesthesia is the practice of medicine when done by physicians, and the practice of nursing when done by nurses. Therefore CRNAs are licensed professionals responsible for their own actions, capable of autonomous practice, or free to work collaboratively with other professionals.

As you can imagine, there just isn't any room for compromise on either side, given these positions. Does that same tension exist in the OR? Some places, you wouldn't even know there is any professional disagreement. In other places, the tension is a constant backdrop for every workplace encounter

loisane crna

[Tenesma]

i have had nothing but good experiences with CRNAs, and i think we work well together... I especially enjoy working with the older CRNAs because they often are a wealth of information!

So at my hospital we have a good relationship, the CRNAs and the surgeons often also have friendly relationships outside of the hospital!

I think this type of question about respect and treatment however leads to another question... Why worry about respect when this is the field you are interested in? if you are good at what you do and get along with people you will always get respect no matter what profession...

Tenesma MDA

[loisane]

>Tenesma: "if you are good at what you do and get along with >people you will always get respect no matter what profession..."

Well, not "always". Maybe "you SHOULD always get respect".

Tenesma, you have an obvious commitment to fairness and I can tell by your posts you are motivated by wanting the absolute best for your patients. Not only is this attitude commendable, it gives me great encouragement and hope.

Not everyone's motivation is excellent patient care. Our profession has attracted way too many people that are motivated by greed. Examples of these type of people can be found among physicians AND nurse anesthetists.

Some days it is a struggle to remind myself that the greedy ones are not in the majority.

loisane crna

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

As a SRNA in the Kaiser sytsem in So. California, I can say that the CRNAs and the SRNAs are treated very well and with respect. The scope of practice differs in each of the hospitals, but CRNAs in Cal are licensed to have a full practice w/o MDAs. Generally, in most of the Kaisers, CRNAs are treated well. (One exception that I heard of 2nd hand).