CRNAs: Teaching or Private hospital

[lifeLONGstudent]

CRNAs:

What is your preference and why: Teaching hospital or private hospital? What about private practice or specialty clinics, day surgery clinics?

[hpadua]

In day surgery facilities, patients tend to be healthier and anesthesia easier.

In teaching hospitals, the MD residents get to do the procedures such as central lines, blocks, etc., so CRNAs don't have to worry about these as much.

[lifeLONGstudent]

i was asking about practicing crna's preference, not so much what the differences are.

so, which is your preference and why?

anyone else out there with an opinion?

[hpadua]

of course, easy anesthesia is preferable, as it lowers your litigation risk. Of course, I'd rather have the anesthesia residents do all these procedures.

The answer to your question was already implied in my original answer.

[ready4crna?]

In day surgery facilities, patients tend to be healthier and anesthesia easier.

In teaching hospitals, the MD residents get to do the procedures such as central lines, blocks, etc., so CRNAs don't have to worry about these as much.

hpa-

And your statement would be based on...? Maybe in your particular facility, but I assure you this is not the case in a majority of sites-Usually your case= your lines etc.

And to drive a point home, there is no "easy" anesthesia. "Easy" is the type provided by competent providers who make it look so. For an analogy- Tiger Woods makes golf look easy, but go and try to duplicate his swing.

Life long-This is probably why your question has not been answered-

Many of the CRNA's that I interact with are involved in the type of practice they want to be involved in. In other words- the CRNA's in teaching facilities would tend to say they would not do anything else. Just as those in outpatient settings say they would not do anything else. The field is wide open for practice settings and opportunities for variety that if a CRNA is unhappy, they tend to go find someplace that makes them happy. (I realize a truly broad generalization, but you can count my statement as anecdotal evidence awaiting validation.)

[hpadua]

hpa-

And your statement would be based on...? Maybe in your particular facility, but I assure you this is not the case in a majority of sites-Usually your case= your lines etc.]

The creator of this thread asked for my preference or opinion. So my statement is based on my opinion.

And to drive a point home, there is no "easy" anesthesia.

And this statement is based on...? You're certainly entitled to your own opinion.

[ready4crna?]

Quote: And this statement is based on...? You're certainly entitled to your own opinion.

Informed, evidenced based opinion.

Here is a cursory overview of "easy" cases gone bad (read death or serious injury- take a close look at the numbers.).These are just the voluntary reporting of closed claims. There are more. I will grant that anesthesia is safer now then it ever has been, but EVERY anesthetic has an element of danger surrounding it (ASA 1 has a 0.06-0.08% chance of death). Vigilance is mandatory in any practice setting, and the skill of the provider is what makes it LOOK "easy". Now then- the first is a study of ASA 3/4 kids, but the rest are healthy chitluns' who did not make it or were seriously injured from anesthesia mishaps both here and in Canada.

http://www.anesthesia-analgesia.org/cgi/content/abstract/104/1/147

http://www.asahq.org/Newsletters/2005/06_05/jimenez06_05.html

http://www.cja-jca.org/cgi/content/full/47/2/105