CRNAs practicing in Plastics clinics?

jenniek · Apr 30, 2006

Do you not watch Nip/Tuck on FX? LOL.

Actually, they are used. I think Yoga may work with a plastic surgeon if I'm not mistaken. I do not think it would be very challenging. And plastic surgery is pretty ugly....face lifts, liposuction. It always gave me the chills when I worked in the OR with the plastic surgeon. But maybe that was just his shoddy work.....For increasing beauty, it's horrendous stuff.

If a plastic surgeon hires his own anesthesia provider, do you think they'd want to pay a CRNA or a anesthesiologist? I'm thinking they would go with a CRNA.

And, just so you know, sarcasm is intended. I need to use it in order to breath.....

Hey All
Someone asked me a question as to if i knew about CRNAs working in plastic surgeons offices. Hell, i dont have a clue.
Is this a common practice? Also, is this a challenging practice or something more for winding down the career?
What are the experienced ppls take on it?

MmacFN · Apr 30, 2006

LOL!

I thought that lady on nip tuck was an MD? How cool would it be to have from public CRNA exposure on a tv show!

I wonder if working plastics might be a challenge simply because of the lack of resources one might have in the hospital?

I dont know if i could do it, i get nauseated when i hear that crack of the nose when they pound it with a hammer and chisel! Ugh!

Do you not watch Nip/Tuck on FX? LOL.
Actually, they are used. I think Yoga may work with a plastic surgeon if I'm not mistaken. I do not think it would be very challenging. And plastic surgery is pretty ugly....face lifts, liposuction. It always gave me the chills when I worked in the OR with the plastic surgeon. But maybe that was just his shoddy work.....For increasing beauty, it's horrendous stuff.
If a plastic surgeon hires his own anesthesia provider, do you think they'd want to pay a CRNA or a anesthesiologist? I'm thinking they would go with a CRNA.
And, just so you know, sarcasm is intended. I need to use it in order to breath.....

jenniek · Apr 30, 2006

My bad. She is an MD. Not sure why I thought she was a CRNA. Guess I'm guilty of the male/female job role assumption. Bad me.......bad, bad, me.

Back to studying.....

rayman · Apr 30, 2006

My wife used to work for a private plastic surgeon..........only used crna's.

SigmaSRNA · Apr 30, 2006

Some of those plastic cases are long as all get out. Don't know if I would like to be working on one person for that long.

MmacFN · Apr 30, 2006

hey sigma!

Is it true that in anesthesia the length of time signifigantly increases risks in general to the patient? I havent read that anywhere, but ive often seen anestesiologists set time limits for surgeons. Is that common?

rn29306 · Apr 30, 2006

I think Yoga may work with a plastic surgeon if I'm not mistaken. I do not think it would be very challenging. And plastic surgery is pretty ugly....face lifts, liposuction.

She might have something to say about your second sentence when she sees this. You have to realize that plastic surgery is more of a business probably morso than any other anesthetic population. The plastic surgery population is unique in the fact that, for the most part, these operations are entirely elective with fairly well-paying customers. These patients want and expect their money's worth. Focus is certainly given on effecient pain control with minimal swelling (despite the surgeon's best attempts :). So to say that it is not very challenging is a misnomer. I agree that hopefully you are not running a Level 1 and giving hespan, FFP, crio, but these elective cases present their own unique problems and challenges.

We'll see what she says..

jenniek · Apr 30, 2006

Very true. I have worked as a OR nurse and the cases I've seen were minor. I guess stating I would prefer a different sort of challenge would be a better statement.

Great point about the plastic surgery clients.

She might have something to say about your second sentence when she sees this. You have to realize that plastic surgery is more of a business probably morso than any other anesthetic population. The plastic surgery population is unique in the fact that, for the most part, these operations are entirely elective with fairly well-paying customers. These patients want and expect their money's worth. Focus is certainly given on effecient pain control with minimal swelling (despite the surgeon's best attempts :). So to say that it is not very challenging is a misnomer. I agree that hopefully you are not running a Level 1 and giving hespan, FFP, crio, but these elective cases present their own unique problems and challenges.
We'll see what she says..

yoga crna · May 1, 2006

Yep, my primary practice setting is in cosmetic plastic surgery in an office surgery setting. I also have a separate corporation that runs the surgery center, so I wear two hats.

For clarification, I do NOT work for the surgeons, but am an independent contractor to the patients. I get paid directly from the patients, so there is no employment arrangement with the surgeons. However, my fees are very competitive with anesthesiologists and other independent CRNAs, which is important in keeping the business.

Regarding the anesthesia, my most challenging times in this field have been in the plastic surgery office setting. To begin with, you are practicing alone, no other anesthesia professional to help you, surgeons who are fairly useless when it comes to anesthesia problems and lack of support and back-up. I do work with a great group of RNs, who are a big help to me.

Some of my challenges have been: malignant hyperthermia at the end of a rhinoplasty case, unable to ventilate/intubate on a very well known person,

pulmonary embolus one day post-op on one of our nurses, patient who denied anabolic steroid use, but who emerged from anesthesia like a wild animal (later admitted to heavy duty steroid use), a patient having a lower body lift, that we were unable to keep an IV running (craziest thing I ever saw--probably had something to do with skin tone after having lost 200 lbs), the time I had a major fall in the middle of an anesthetic and wasn't sure I could finish the case (I did), the time the surgeon had urinary retention from BPH and had to be catheterized in the middle of the surgery, power failure and the back-up power system also failed and I could go on and on.

Office anesthesia is for the very experienced anesthetist. You must be able to work on your own, be able to handle the egos of the surgeons, the demanding and frequently dishonest (about their medical history) patients and a whole host of political and business issues. The anesthesia is the easy part. It can be boring, but it also can be very interesting and I have a chance to spend a lot of time with the patients pre and post-op.

I hope that answered some of your questions.

MmacFN · May 1, 2006

Wow

Amazing stuff yoga. I particularily liked the cath of the surgeon one. That must have been horrible for him.

Is it common for CRNAs to practice independantly in this manner? Or is this usually an MDA type job where CRNAs have made some inroads?

SigmaSRNA · May 2, 2006

Yep, my primary practice setting is in cosmetic plastic surgery in an office surgery setting. I also have a separate corporation that runs the surgery center, so I wear two hats.
For clarification, I do NOT work for the surgeons, but am an independent contractor to the patients. I get paid directly from the patients, so there is no employment arrangement with the surgeons. However, my fees are very competitive with anesthesiologists and other independent CRNAs, which is important in keeping the business.
Regarding the anesthesia, my most challenging times in this field have been in the plastic surgery office setting. To begin with, you are practicing alone, no other anesthesia professional to help you, surgeons who are fairly useless when it comes to anesthesia problems and lack of support and back-up. I do work with a great group of RNs, who are a big help to me.
Some of my challenges have been: malignant hyperthermia at the end of a rhinoplasty case, unable to ventilate/intubate on a very well known person,
pulmonary embolus one day post-op on one of our nurses, patient who denied anabolic steroid use, but who emerged from anesthesia like a wild animal (later admitted to heavy duty steroid use), a patient having a lower body lift, that we were unable to keep an IV running (craziest thing I ever saw--probably had something to do with skin tone after having lost 200 lbs), the time I had a major fall in the middle of an anesthetic and wasn't sure I could finish the case (I did), the time the surgeon had urinary retention from BPH and had to be catheterized in the middle of the surgery, power failure and the back-up power system also failed and I could go on and on.
Office anesthesia is for the very experienced anesthetist. You must be able to work on your own, be able to handle the egos of the surgeons, the demanding and frequently dishonest (about their medical history) patients and a whole host of political and business issues. The anesthesia is the easy part. It can be boring, but it also can be very interesting and I have a chance to spend a lot of time with the patients pre and post-op.
I hope that answered some of your questions.

Yoga, don't you feel like allowing a young, eager RRNA to shadow you one day? Pretty please??????