Common practice in the USA

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Hi! I'm new at allnurses.com forums and I have one question. I'm from Slovenia, working in anesthesia. I work as an assistant to anesthesiologist, MD. Here in Slovenia it is common practice that anesthesia is provided by a doctor and a nurse, who work together as a team. I do not have the knowledge or skills of the CRNA. My question is, what is the common practice in the USA? Do also exist doctor-nurse assistant teams or is anesthesia provided by one person only(MD or CRNA)?

I too apologize for the unfortunate reception. We frequently get people here who are hostile to the CRNA cause, so the regulars have gotten a little trigger-happy.

Please feel welcome to join us in discussions of anesthetic topics.

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Specializes in Anesthesia.
....Please feel welcome to join us in discussions of anesthetic topics.

Esp about AAs.

We'll pay the freight to ship you a few hundred. Two especially!

.

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The most common practice of anesthesia in this country is the anesthesia care team where a CRNA and an anesthesiologist work together to provide an anesthetic. In this model the CRNA has variable responsibility, in some places the MD may not be around very much, in others the MD is in the room frequently. The MD is usually associated with 2-4 operating rooms staffed by CRNAs. MD-only anesthesia is also found in many hospitals in the country where anesthesiologists alone practice anesthesia. CRNAs practice alone also in some hospitals in this country although this is less common than the first two models I mentioned. Yoga's post on her practice situation may be a little misleading because this is not how most anesthesia is delivered in this country. She seems to be a very experienced and competent anesthetist capable of solo practice, but not representative of most practice in this country. Alternatively AAs are used in a few locations with MDs in an anesthesia care team model instead of CRNAs. I am not trying to stir up any controversy on the pros/cons of the different models, just stating the facts of anesthesia practice.

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how could you possibly be working as an assistant and not know the answers to this question?

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how could you possibly be working as an assistant and not know the answers to this question?

Because the guy lives half way around the world from you, fool

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Specializes in Anesthesia.
Because the guy lives half way around the world from you, fool

Try the DeCaf, brother......

.

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Try the DeCaf, brother......

.

even better! :beer:

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Okay, does anyone else feel like they need to apologize for me? Anyone? Okay then.

I wasn't laughing directly at the poster so if the poster feels that I have offended her/him I really am sorry. I've just seen to many times on this board that we hear a story that sounds left of center and it ends up being someone not friendly to the CRNA cause, so forgive me for being skeptical. But I reiterate, if I offended the poster or anyone else from Slovenia, I am sorry.

I'm not apologizing for you;) - This board does get some wackos and everyone is entitled to a bad/cranky/cynical day. Hey, let's combine the two concepts... maybe some of the wide eyed "I'll be starting nursing school next year, how soon can I become a CRNA" posters would be startled to know that CRNAs aren't so wealthy that they never have a bad day :mad:

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The most common practice of anesthesia in this country is t CRNAs practice alone also in some hospitals in this country although this is less common than the first two models I mentioned. Yoga's post on her practice situation may be a little misleading because this is not how most anesthesia is delivered in this country. She seems to be a very experienced and competent anesthetist capable of solo practice, but not representative of most practice in this country.

I am not sure where you get your information, but according to the AANA from their annual membership survery, over 25% of CRNA administered anesthesia in this country is in private practice, office settings, military, etc. where there is no supervison/medical direction by anesthesiologists. Their data also states that over 70% of the anesthesia administrated in rural hospitals is by solo nurse anesthetists. This information is about two years old, so I requested the most current information from the membership department and will post it when I get it.

Please share your source of information, so we are sure we are both talking about the same data.

One of the things I love about being a nurse anesthetist is the wide variety of practice settings. I have worked in most of them and clearly like private, independent practice the best. However, it is not for everyone, nor should it be. If you need or want to be medically directed, there are many practice settings out there for you.

Thanks for the nice words. As you know, I have been doing this a long time, but not long enough to not question things. I had a long, loud discussion this afternoon in Starbucks with two other CRNAs (one with a PhD and an excellent teacher) about whether or not it is acceptable to give intramuscular diazepam. i said no, the other two said yes. I came home and checked the literature and found that it can be given, but has unreliable uptake from the muscle. Life-long learning and a good healthy discussion are some of the things I love about this field. In case you were wondering, we were discussing the advantages of diazepam for post-op muscle relaxation after submuscular breast augmentation surgery.

I'm off to do some yoga after a tough day witn a grouchy surgeon who caused two experienced nurses and 2 secretaries to cry.

Yoga CRNA

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I am not sure where you get your information, but according to the AANA from their annual membership survery, over 25% of CRNA administered anesthesia in this country is in private practice, office settings, military, etc. where there is no supervison/medical direction by anesthesiologists. Their data also states that over 70% of the anesthesia administrated in rural hospitals is by solo nurse anesthetists. This information is about two years old, so I requested the most current information from the membership department and will post it when I get it.

Please share your source of information, so we are sure we are both talking about the same data.

FROM THE ASA WEBSITE

"An estimated 40 million anesthetics are administered each year in this country. Anesthesiologists provide or participate in more than 90 percent of these anesthetics. "

This statement would lead me to believe that solo CRNA anesthesia is close to 10% of total anesthesia nationwide. Your stats are that 25% of CRNA anesthesia is CRNA only, which would probably go along with these numbers if you add MD-only anesthesia to the total denominator.

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Originally Posted by rayman

Because the guy lives half way around the world from you, fool

Heeeey, I'm a girl!:nurse:

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this is not the place to argue. please stick to the original post.

not all countries in the world practice anesthesia as we do in this country. please be aware that the us is not the only country in the world. the poster was asking about differences in practice here and in her country. and not all countries use crnas.

lets try to be courteaous to others. if you cannot do so,

please keep it to yourself.

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