Clinical Doctorate in Anesthsia

rn29306 · May 9, 2005

This statement is inaccurate. DrNPs in New York are permitted to use the title "dr" in the clinical area and it is not at all misleading because, strange as it may sound, they are clinical doctors---just of a different sort.

Everyone has their opinion and NY can do what it wants to. I think it is ethically wrong to call yourself a "dr" unless you are a physician. Consider this:

Patients cannot even keep anesthesia personnel separated in their minds, even after explaining to them numerous times the separation of CRNA vs MDA, not to mention circulating rns and PACU rns. Imagine going in for surgery and at minimum 5 people interviewing you, all in scrubs (PACU or holding RN, circulating RN, CRNA, MDA, and surgeon). Add being old to this equation and the confusion multiplies. Now 3 of them are calling themselves "dr". Do you honestly have time or want to explain for each patient just why you are a doctor and a nurse at the same time to EACH patient? And don't think other staff will refer to you as a "dr" either.

I don't have a problem calling PharmD's "dr", because in my experience, it is never in front of the patient. They always are looking at charts and labs at the desk in the units and thus it is not a question of misleading. Nurses are supposed to be patient advocates in all areas.

I don't see how running around introducing yourself as a "dr" when you aren't a physician holds up to this standard. It simply leads to confusion and misunderstanding. I am all for patient education but pre-op holding is not the time to grandstand for 15 minutes FOR EACH PATIENT trying to clarify why you are a "dr" and CRNA. It's about the patient and not someone's education or ego.

I'm all for the clinical doctorate if one thinks further education is needed in a subspecialty area. That's a big IF. It is not like the master's level of education is lacking or new grads are dangerous, so what is the big deal? I think the source of the problem lies within the realm of Nurse Practitioner and the lofty goals of the nursing organization that wants NPs to be independent Primary Care Providers with equal billing rights. Thus throw in the "dr" component to make it even more confusing. The CRNA program is along for the ride on the wings of the hopes of the NP programs.

I will never call myself a "dr" in the clinical arena to patients. If someone has achieved this level of education, they can call themselves "dr" anywhere they want to (academic world), except around my patients. My ego was checked when I got accepted into CRNA school and have done fine ever since. Others can do what they want and I feel sorry for those patients. Somehow patient advocacy / education and ego maintenance got crossed.

Lambert5883 · May 9, 2005

....I will never call myself a "dr" in the clinical arena to patients. If someone has achieved this level of education, they can call themselves "dr" anywhere they want to (academic world), except around my patients. My ego was checked when I got accepted into CRNA school and have done fine ever since. Others can do what they want and I feel sorry for those patients. Somehow patient advocacy / education and ego maintenance got crossed.

Present topic aside, If one has attained clincal doctorate status, I think it would be more than appropriate to introduce oneself to a patient in a clinical setting as Mr./Ms. John/Jane Doe, DrNP, DNP, DNSc (stated in acronym form). I would not agree with the usage of "doctor" preceding their name.

In academic settings I think it more than appropriate for a person with a clincal doctorate to refer to hinself/herself as Dr. John/Jane Doe. As for any other setting, use at your own discretion.

Tony35NYC · May 9, 2005

I think we've gone off topic here. Everyone is certainly entitled to their opinions, but a big part of why we're even having this discussion is that some of us insist on continuing to berate ourselves, each other, and the nursing profession by comparing ourselves to physicians and becoming so hung up on names and titles that we've lost focus on why these clinical doctorate degrees in nursing were created in the first place. As I've said before, a DrNP is not a degree to be compared to a medical school degree because they are two different things. Dentists do not compare themselves with clinical physicians but both professions are still clinical doctors, and no one has any problems with that distinction. At one point there was even a HUGE debate within academia and among the physicians themselves about the differences between allopathic physicians and osteopathic physicians. Now noone cares.

The states looked into these clinical doctorate nursing degrees as a means of getting more APNs into independent primary care. Why? Because there just isn't a lot of money to be made in family medicine anymore and most new grad physicians are continuing on to specialty areas in medicine. Notwithstanding, I suggest that nurses who pursue these advanced degrees are more interested in becoming more highly skilled clinicians who can competently and safely deliver primary care services to their patients than they are in comparing themselves to physicians. The nurse vs. doctor argument is redundant. It never gets anywhere because its no different than comparing apples and oranges. Instead of putting down DrNPs and saying things like 'other staff won't call you doctor' and 'Don't call yourself "dr" around my pts', how about a show of support for our colleagues instead?

rn29306 · May 9, 2005

I am all for the program IF it is a genuine clinical focus in an area that is needed (peds, cardiothoracic, hearts, trauma, neuro). No theory, no other BS. Nursing leadership wants to call it a clinical doctorate, then leave the BS that nursing academia is so famous for at the door. We will see if that pans out in the real world. Until then I sincerely have my doubts, but support those who choose to take that path. The whole "dr" thing is overrated but I disagree with those persons who parade around calling themselves "dr" in the clinical setting that are not physicians. Maybe I am old-fashioned, but patients will be mislead.

Everyone is certainly entitled to their opinions. I think it is a hoax of the NP community and nursing leadership for entitlement that has spilled over into the anesthesia field, but I guess we'll see.

jwk · May 9, 2005

The states looked into these clinical doctorate nursing degrees as a means of getting more APNs into independent primary care.

The states??? You mean national and state nursing organizations. "The state", for the most part, could care less.

Maxs · May 9, 2005

Doctors. You know when I went to the dentist, this is how he introduced himself. "Hi I am Dr. John Doe Endodontist. Psychologist, dentist, podiaterist, M.D, and etc call theirselves docs, but they all differ.

This CRNA (ethernaut) doctorate is probably going to be two more years of intensive or hardcore science and clinical practicum which is a good thing. Now here is where the twist comes in from. The reason that Ethernauts (CRNA's) are preferred is because they can work in rural areas, charge 2-3 times less than an Anesthesiologist and CRNA's can practice indepently unlike the AA whom must practice under the Anesthesiologist. The AA and MDA are like polyatomics you cannot break them down into simpler products, though they do exist seperately theoritically, but in nature the AA occurs only in conjunction with the MDA even though only the MDA can exist seperately.

What's going to change is the cost of Anesthesia by CRNA's. How will this help the shortage, rural areas, and over 1500 hospitals that solely depend on CRNA's for anesthesia, and 33% of Anesthesia done by CRNA's w/o collaboration or any kind of supervision. These numbers were from a research I can't remember the name of, but it was a a professional one and it was conducted in 1988 and those numbers can be even higher or less today. And the only reason for this will be the cost of education will go up. In a lot of way it's a good way and not so good in other ways, as long as it does not change $$$ for patients it's a good idea.

Maxs

fence · May 10, 2005

OK...If a chiropractor can call himself Doctor why not CRNA with a Doctoral Degree?

rn29306 · May 10, 2005

OK...If a chiropractor can call himself Doctor why not CRNA with a Doctoral Degree?

When a person makes an appointment with Dr. Bone Cracker, the chiro and pulls up in Mr. Cracker's office with a sign by the road and on the door that plainly states Dr. B. Cracker, Chiro a person is pretty sure that guy that walks into the room and examines his or her back is indeed Dr. Bone Cracker.

Same for dentists. A patient knows he or she is going to see a dentist and the middle-aged male or female who sits above them with all those nice shiny tools with fingers inserted all in your oral cavity is indeed Dr. Said Dentist. Logic states the person being very quiet and handing tools back and forth is obviously the assistant.

The same is not true for a patient entering into the hospital. Everyone, including the janitoral staff, sorry - sanitation implementation personnel, are wearing white lab coats, and now you have several individuals introducing themselves as a "dr".

Maxs · May 10, 2005

When a person makes an appointment with Dr. Bone Cracker, the chiro and pulls up in Mr. Cracker's office with a sign by the road and on the door that plainly states Dr. B. Cracker, Chiro a person is pretty sure that guy that walks into the room and examines his or her back is indeed Dr. Bone Cracker.
Same for dentists. A patient knows he or she is going to see a dentist and the middle-aged male or female who sits above them with all those nice shiny tools with fingers inserted all in your oral cavity is indeed Dr. Said Dentist. Logic states the person being very quiet and handing tools back and forth is obviously the assistant.
The same is not true for a patient entering into the hospital. Everyone, including the janitoral staff, sorry - sanitation implementation personnel, are wearing white lab coats, and now you have several individuals introducing themselves as a "dr".

Let me get this straight, you are saying if a podiatrist walked into my hospital room and said Hi my name is Dr. Jane Doe would it be wrong for him to call himself doctor even though he's not an MD, but he is a Doctor of Podiatry. He/she still has to tell that they're a podiatrist and that's just the pride that comes after the first title. I can see your philasophy, however, you are contradicting yourself. By that way, I have seen podiatrist who introduced theirselves as Dr's in hospitals and nursing homes to patients and how do you explain that. All I am saying is you are contradicting yourself.

Note: not a personal attack, just judging you by your statements.

Maxs

apaisRN, RN, CRNA · May 10, 2005

Maxs, I agree. We have doctors of medicine, veterinary medicine, dentistry, chiropractice and podiatry. Why shouldn't we have a doctor of nursing, in clinical settings? People understand that you don't ask your dentist about your back pain or your vet about your own health. They can figure it out about nurses, too. Patients are never going to get educated if we don't start doing it.

rn29306 · May 10, 2005

Do what you want. This thread is tiring as is this subject. We all have said what our respective opinions are and there's no changing that. Some of you want to go around calling yourselves Drs then go ahead. I'm retiring from the forums. Take care.

**RosesrReder, BSN, MSN, RN** · May 10, 2005

There is another BIG consideration to the practice doctorate for APRN's that no one has brought to mind - namely, where are the professors going to come from to teach all of these advanced practice nursing doctorate students? My school of nursing is clamoring to attract qualified faculty, as they are losing 5 instructors this year alone (several of these are full professors with doctorates). There are simply not enough nurse educators in the "pipes" to replace all of the aging nursing faculty. Presently, Masters level faculty are being used quite extensively to teach these advanced practice students. IF the practice doctorate becomes the standard, then only faculty with doctorates will be able to teach these students. There are simply not enough nursing faculty with doctorates to do this. And, this situation is only going to get worse (not better!) with time.

:rolleyes: I agree. There is trouble tryong to find qualified instructors for ADN+ programs much less this. :)