The public says no to low-level anesthesia providers

Specialties CRNA

Published

Here's an article that is on the AANA site today.

Public Says No to low-level providers

Originally posted by SharonMH31

This is so typical of the hypocrisy that physicians exhibit in regards to non-physician providers of care, screaming to the public that it's about safety when it is really all about money and control.

Not to start a flame, but don't you think that's what AAs are saying about CRNAs? no one wants to lose their bread and butter

Craig,

I agree with your statement about critical thinking and know how important it is in all phases of anesthesia practice. While I have been a critic of the AANA's lack of an effective public relations campaign in the past, I see improvements in the last few years. My point to this discussion is rather simple, have a clear message that each one of us can expound like a mantra, do it whenever it is appropriate and continue to fight for our right to practice.

I will give you some of the examples I use in my practice. By the way, I am an independent practitioner in a practice with VERY high profile patients. Yesterday I gave an anesthetic to an attorney whose name is in the newspaper every day. There is no supervision of any kind in my practice.

These are are few of the phrases I use:

1. Both nurses and doctors give anesthesia. The anesthesia portion of our education is the same, I bring a nursing approach which is to give my total attention to you during your anesthetic and to make sure your anesthesia experience is safe and comfortable.

2. I have administered anesthesia for many years and believe me the surgeons wouldn't utilize my services if I wasn't good.

3. The surgeon likes having a nurse anesthetist -- there is only room for one doctor ego in the operating room.

4. We have been administering anesthesia for over 100 years and would not be still around if our care wasn't excellent. (this is overused, but it works)

5. Nurse anesthesiology is considered one of the best professions in the country; only the best can get in the programs, the standards are high and the opportunities abound.

6. If it were not for the advances in anesthesia, modern surgery would not have advanced as it has. Nurse anesthetists have had a significant role in these advances.

I spend a lot of time talking with my patients, both pre and post-op. I know that many of you cannot do that, but take every opportunity you have to promote our profession. It is the least you can do.

YogaCRNA

Nilepoc wrote:"I would really like to see the ASA stance on defining supervision as it relates to AA practice."

I believe this is the crux of the matter. It is easily found in the ASA literature. The ASA definition of the ACT (anesthesia care team) is fundamentally different from that of nurse anesthesia.

Go to the ASA website, and look for ACT and you can read all about their vision.

The ASA view is that anesthesia, by definition, is the practice of medicine. Nurse anesthetists only authority to perform anesthesia derives from the medical delegation to do so, the MDA is always the final authority.

The March issue of the ASA newsletter featured AAs. Here are some quotes:

"we realize that physicians must remain in charge of all aspects of medicine, including the delivery of anesthesia care"

"In re-examining the physician extender component of the anesthesia care team, AAs come to the forefront."

ASA NEWSLETTER , March 2003, Volume 67, Number 3

read it on line at: http://www.asahq.org/Newsletters/2003/03_03/mackey.html

loisane crna

Thank you Loisane,

I will look at that article a little later. Right now, its Miller time. (Ronald D. Miller that is)

Craig

Specializes in OR,ER,med/surg,SCU.

I am from Colorado. I used to work in rual Colorado where are anesthesia was provided by CRNAs'. I was amazed at how few people in the community, was even aware that the CRNA's were not doctors(anesthesiologist). I think it would do the profession of CRNAs a justice if they introduced themselves as such. I feel they need to make it know they have been providing anesthesia for eons of years. I feel alot of the public is unaware of this. I have too often heard the introduction of " I am your anesthesia provider". The public needs educated on CRNA's. Just my oppionion.

cwazycwissyRN,

Unfortunately, I believe your observation to be all too true.

This has been an ongoing issue among anesthetists. We try to keep educating our people to clearly identify themselves. But, for some reason, this simple thing seems difficult for some people.

(Sigh)We just have to keep trying, one person at a time. Thanks for bringing this to the attention of this board. I hope people will develop good habits, and stick with them.

loisane crna

I have to agree too. First, we need to get rid of the negativity towards nursing in general. If CRNAs were proud to be nurses and of the nursing profession, it would be a lot easier to acknowledge that he/she is a "nurse" anesthetist. The publics perception of nursing needs to change. They need to know that nurses are not simply maids and butt cleaners, but highly educated health care professionals that are an important part of the healthcare team. It's all about educating the public. Johnson and Johnson is making an attempt. Nurses need to stand up and be vocal and stick together to make nursing a strong and respected profession. Just my 2 cents.

While I applaud Johnson and Johnson for their attempt to help recruit people into nursing. I think the theme they used for their ad campaign did very little to promote our image. It actually stressed the old belief that all you have to do well to be a nurse is just care . I cringed when I saw their commercial and theme about how much nurses care, if that is all we have to emphasize when promoting nursing then we deserve the old stereotype of being caring hand maidens. I for one try to point out to people whenever possible that nursing school is hard and that many go through 4 year university programs to become one. Also, I try to inform people about the education requirements to become a CRNA, 6-7 years of college and at least one year of critical care experience. I also feel that when we as profession harp on the caring aspect that we are some how implying that the others health care workers don't care as much, because they don't constatntly mention it. I think it starts in nursing school with the heavy emphasis on being the supreme patient advocate and caring health care provider regardless of our work conditions or low pay. I think the the change needs to start in nursing school. The old sterotypes are going to be hard to change and will take years; just recently when I was on vaction I was talking to a retired military person and when I told him what I do he said that was great they really need men in the profession to help turn all those big patients. I wanted to ask if he thought I said nurses aid or RN and that did he realize that in the military RN's with BSN's are commissioned officers. As i said we have along way to go for respect as a profession.

Ill second that, comercial gave me gas

How many of you guys have encountered situations like this:

Walk into a pts. room and family members are at the bedside, family members are eagerly asking you questions about the condition their loved one, until they find out ............."Oh, you are JUST the nurse." And suddenly are not as eager to talk with you. When I used to work in the ED, I went into a pts. room to perform the initial assessment, he was talking on a cell phone. When I walked in the room he told the person on the line that he had to go b/c the doctor is here.......I told him I was the nurse and he said "oh" and continued to talk on the phone. Talk about no respect.

It is sad that we, as a society, cannot get past the idea of males being nurses (and are not always physicians). However, the point being the respect issue, you are absolutely correct. I am a female nurse and I have the same problem. Additionally, I am fairly young and I get mistaken frequently for the nurse technician (people just cannot believe that someone as young as I could be an RN). I remember another time recently when the nurse technician did not have time to insert a foley catheter. She asked if I could do it since she was so busy. I have done a ton of them. Anyway, I walked into the room of an approx. 75 year-old female and she said "Honey, have you ever done this before?" Surprised, I said "Yeah, I've done many of them." She said "No way...you don't look a day over 18." I told her I was 24. I got it in fine the first time and she said it was the best one she's had yet. Although nurses are still pretty respected, they are not respected like they used to be. Many patients treat nurses like waitresses and believe they are in a hotel where they should get "first class service." Although I believe patients should get excellent patient care service, I do not believe we should be made to feel like waitresses who wait on each patient hand and foot. I went through too much school for that. If I wanted to keep being a waitress I would have stayed in the restaraunt business. Sometimes I question each case wondering "Exactly how sick is this person after all?" If it were me, and I was feeling terrible enough to be in the hospital, I wouldn't be worried about some of the petty things these people seem to worry so much about. Just my thoughts.

Welcome to the world of bedside nursing, I think some of these examples of getting very little respect as a health care professional are very real. That is one of the main reasons I am seeking more education, so that hopefully, I will be treated more like a college educated professional than a glorified waiter or nursing assistant. Although, in the hospital I work at, a large inner city teaching hospital, the patients treat me pretty well, they usually think I am a doctor, even though I constantly tell them that I am their nurse. If I had A dollar for every time one of them has said you need to go back to school and become a doctor, I would be rich. I don't think many of us realize when we choose a career in health care that you basically need to get a masters degree ( PT, PHARM. D, NP, CRNA, ect.) to get in a position where you will have some autonomy and respect. THat is sad but seems to be true. I have expressed my opinion on this before and still believe that as long as you can become RN with a community college degree you will be treated as such. I started with a ASN from a university medical center, however, I quickly realized that in the world of medicine just like academia, a bachelors degree is the entry point and to get to the really good jobs you must get a masters, ph.d., or MD. Now I come from a blue collar background and am very down to earth and believe that GOD values all of us, regardless of our education. I am just stating the facts as I see them in regards to job opportunities in the world of health care. P.S. Now that I am getting ready to go to grad school, and have seen how some of the OR nurses treat the SRNA's, I can now see how many of the residents that I work with take offense when bedside nurses, many with associate degrees, belittle them and try to tell them how to practice medicine. WE should not take shit from anyone but we as nurses should also treat other health care workers with respect, especially if want to be respected.

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