Doctor Frustrations

Specialties CRNA

Published

I was recently accepted into CRNA school, and I am quite excited! I was browsing the internet, and found a website (similar to this one) where student MDs can have discussions about practice, etc. I was appauled at what discussions were brought up about Anesthesiologists versus CRNAs. The discussions made CRNAs sound like villians....derogatory terms like "how have we let RNs attain such bloated salaries, with only 2 years of college and a paper certificate...?" "CRNAs are JUST nurses, who think they can safely administer anesthetics....really all they think is they are putting someone to sleep and then waking them up....they don't even hold a candle to the excellent anesthesia in which an MD can administer...." :angryfire

I was just wondering if anyone had some thoughts on this. To me it just validates the fact that physicians (well, these ones) have NO CLUE what RNs do. I guess the gap between MDs and RNs is not near closing....and why? Because of the MDs in my opinion. Most seem so affixiated on this "superiority" complex. Okay! Yay! Good for you! YOU are the "BOSS!" Here's your medal....or should I say your sign...? I suppose if I spent that much time in school I would want recognition for it, but there is no need to sound like ignorant jerks! CRNAs are still nurses, YES! But that in my opinion is what will make us BETTER at administering an anesthetic and really caring for a patient. We know how to talk to the patient! Our model for care is far more holistic than the medical model, which Anesthesia should encorporate, since its also about ensuring patient comfort. AND we are definitely smart enough to safely administer anesthetic to different pt populations with complex disease etiologies.

I work in a large, large teaching institution, where I am constantly feeling as though I am "babysitting" these new residents, who, for example are fresh out of medical school and haven't the slightest idea of what the hell they are doing when placed in the ICU setting. I hate to break it to the self proclaimed "superior/INFALLIBLE" MDs, but we're all human, we all make mistakes.

I just don't get the deal. On many of my CRNA shadowing experiences I was sort of given the impression that there wasn't much tension between the MD anesthesiologists and the CRNAs.

What can I expect here?

Doctors are just trying to protect their profession, and are perpetuating stereotypes and twisting the facts to reinforce their position.

Your post does the same to some extent, portraying the nurse as the one who gives holistic, loving care as opposed to the other kind of care that doctors give (?). I've met plenty of docs, anesthesiologists and others, who have an excellent bedside manner and can give a nurse a run for her money...

At the psych unit, for example, there was a psychiatrist who always bought in some small present/luxury (chocolates, etc.) for the homeless patients. I watched a pediatrician take 15 minutes to really talk to a boy therapeutically about WHY he was biting his fingernails and strategies to stop. I saw an anesthesiology give a massive amount of hand-holding and labor support to a c-section mom who's husband was away on business and couldn't make it to the birth...

Excellent point!!! Thank you for noting that doctors can be excellent with their people skills. I've known my fair share of physicians who are some of the most caring, understanding, and sensitive people I know. And I know some nurses who are pure fire-breathing dragons that don't know the first thing about compassion. There are good and bad people everywhere.

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"I often say the world of anesthesia is The Curdle Zone, where the cream of nursing rises to meet the dregs of medicine. That coagulation is not apppetizing."

I decided to look around various websites to see if there was a site similiar to the SDN for CRNAs. I was curious about a CRNA's take on the supposed rift between the CRNAs and M.D.s.

I am not at all suprised by the quote from one of the posters on this thread. However, let's review a few common misconceptions about medical doctors.

Most of the folks are correct. Medical school is 4 years. Anesthesiology residency consists of a one year internship and three years of clinical anesthesia training as set forth by the ACGME.

To get into medical school is no small feat as i'm sure some of you have tried and were not successful. It takes a lot of well-qualified folks two applications cycles to get accepted. And on average, for every one that gets in, 8-10 do not.

Anesthesiology has quickly become one of the most popular specialties to join in recent years. This trend will also show that the average USMLE board score has gone up as well as the GPA of the average applicant who matched into an anesthesia residency.

While i'm quite sure you felt your CRNA training was difficult. Look at the average training required of an M.D.. You take one board exam to be an RN and one board exam to be a CRNA. M.D.s take USMLE step 1 (350 question. 8 hours) step II (same) step II-CS (6-8 hours) and USMLE step 3 (350 questions + case scenarios/ 14 hours). This is done before they EVER pass any anesthesia. Then there is the matter of the anesthesia boards. One full day examination followed by an oral board examination. While I understand that the ICU experience you get is valuable don't forget who you call when a serious problem arises. While it is very easy to take an order. It is often difficult to formulate a differential diagnoses, workup and treatment plan in a time-sensitive and often pressured environment.

The simple fact of the matter is that the quality and caliber of M.D.s coming out of medical school has improved drastically over the years.

A statement such as the one above is incorrect, jaded and offensive. CRNAs are qualified to do the bread-and-butter cases under the supervision of a physician. That is how it is and with the proper lobbying that is how it will stay.

Congratulations on being accepted into CRNA school. That is a tremendous feat and I wish you all the best. But the simple fact is, if anesthesia is provided by a CRNA there is a higher morbidity and mortality. (Look it up.) I know several M.D.'s who used to be CRNAs and they will be the first ones to tell you that you have no idea what you don't know. And you never will unless you go to med school. It is the comments like those above that create a problem. We are not equals when it comes to patient care. That is a simple fact. But, i respect your job and I see a need for it.

Best of luck in school.

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bionicokie76, thank you for your take on the situation.

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"I often say the world of anesthesia is The Curdle Zone, where the cream of nursing rises to meet the dregs of medicine. That coagulation is not apppetizing."

I decided to look around various websites to see if there was a site similiar to the SDN for CRNAs. I was curious about a CRNA's take on the supposed rift between the CRNAs and M.D.s.

I am not at all suprised by the quote from one of the posters on this thread. However, let's review a few common misconceptions about medical doctors.

Most of the folks are correct. Medical school is 4 years. Anesthesiology residency consists of a one year internship and three years of clinical anesthesia training as set forth by the ACGME.

To get into medical school is no small feat as i'm sure some of you have tried and were not successful. It takes a lot of well-qualified folks two applications cycles to get accepted. And on average, for every one that gets in, 8-10 do not.

Anesthesiology has quickly become one of the most popular specialties to join in recent years. This trend will also show that the average USMLE board score has gone up as well as the GPA of the average applicant who matched into an anesthesia residency.

While i'm quite sure you felt your CRNA training was difficult. Look at the average training required of an M.D.. You take one board exam to be an RN and one board exam to be a CRNA. M.D.s take USMLE step 1 (350 question. 8 hours) step II (same) step II-CS (6-8 hours) and USMLE step 3 (350 questions + case scenarios/ 14 hours). This is done before they EVER pass any anesthesia. Then there is the matter of the anesthesia boards. One full day examination followed by an oral board examination. While I understand that the ICU experience you get is valuable don't forget who you call when a serious problem arises. While it is very easy to take an order. It is often difficult to formulate a differential diagnoses, workup and treatment plan in a time-sensitive and often pressured environment.

The simple fact of the matter is that the quality and caliber of M.D.s coming out of medical school has improved drastically over the years.

A statement such as the one above is incorrect, jaded and offensive. CRNAs are qualified to do the bread-and-butter cases under the supervision of a physician. That is how it is and with the proper lobbying that is how it will stay.

Congratulations on being accepted into CRNA school. That is a tremendous feat and I wish you all the best. But the simple fact is, if anesthesia is provided by a CRNA there is a higher morbidity and mortality. (Look it up.) I know several M.D.'s who used to be CRNAs and they will be the first ones to tell you that you have no idea what you don't know. And you never will unless you go to med school. It is the comments like those above that create a problem. We are not equals when it comes to patient care. That is a simple fact. But, i respect your job and I see a need for it.

Best of luck in school.

You say M&M is higher when CRNAs provide anesthesia, yet you also say you respect our job and see a need for it. You respect poor patient outcomes? You are contradicting yourself. Please provide the reference for your above statement about outcome differences between providers. For every one you provide, I can counter it with one that says outcomes are no different.

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Specializes in ICU/Flight.

Would you like to expand on the higher M&M associated with CRNA provided anesthesia? Aside from one study, that when published included serious criticism regarding its questionable methodology, you'll be hard pressed to find that evidence. If you look at the most recent study, the Pine study, you'll see that there is no established difference.

CRNA's have established themselves as highly qualified anesthesia care providers. Are they educated as physicians? No, but has physician education ever been demonstrated to be necessary for anesthesia care? No...

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It is for this very reason that I hate doctors. I respect them for their knowledge and expertise in medicine but when it comes to their bedside manners or the way they treat other medical PROFESSIONALS (yes, I said 'professionals,' not 'scum') since they aren't on the same social status as them, well, it leaves much to be desired. Like the original OP said, "Ok! Yes! You are the boss! You call the shots! But damn! We're all human. Just because you have more education than I doesn't mean that you're immortal or that your shtuff doesn't stink."

I was recently accepted into CRNA school, and I am quite excited! I was browsing the internet, and found a website (similar to this one) where student MDs can have discussions about practice, etc. I was appauled at what discussions were brought up about Anesthesiologists versus CRNAs. The discussions made CRNAs sound like villians....derogatory terms like "how have we let RNs attain such bloated salaries, with only 2 years of college and a paper certificate...?" "CRNAs are JUST nurses, who think they can safely administer anesthetics....really all they think is they are putting someone to sleep and then waking them up....they don't even hold a candle to the excellent anesthesia in which an MD can administer...." :angryfire

I was just wondering if anyone had some thoughts on this. To me it just validates the fact that physicians (well, these ones) have NO CLUE what RNs do. I guess the gap between MDs and RNs is not near closing....and why? Because of the MDs in my opinion. Most seem so affixiated on this "superiority" complex. Okay! Yay! Good for you! YOU are the "BOSS!" Here's your medal....or should I say your sign...? I suppose if I spent that much time in school I would want recognition for it, but there is no need to sound like ignorant jerks! CRNAs are still nurses, YES! But that in my opinion is what will make us BETTER at administering an anesthetic and really caring for a patient. We know how to talk to the patient! Our model for care is far more holistic than the medical model, which Anesthesia should encorporate, since its also about ensuring patient comfort. AND we are definitely smart enough to safely administer anesthetic to different pt populations with complex disease etiologies.

I work in a large, large teaching institution, where I am constantly feeling as though I am "babysitting" these new residents, who, for example are fresh out of medical school and haven't the slightest idea of what the hell they are doing when placed in the ICU setting. I hate to break it to the self proclaimed "superior/INFALLIBLE" MDs, but we're all human, we all make mistakes.

I just don't get the deal. On many of my CRNA shadowing experiences I was sort of given the impression that there wasn't much tension between the MD anesthesiologists and the CRNAs.

What can I expect here?

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when you say that they'll never get it and wishing they would get it just frustrates you even more - ain't that the truth! you're right. they never will get it. i had a friend who is in med school. he said "yeah, well, that's the old generation of doctors. this generation of doctors is much, much friendlier and much more down to earth." it'd be a cold day in hell before the majority of doctors climbed down off their so-called high horses to be with the rest of us common folk.

First if all, if you don't want to know, don't ask. If you don't want to see CRNAs trashed by the likes of jwk and the A$A rabid-types at SDN, don't go there. Their world is NOT the real world. When you say

you have struck the nut of the matter. They don't get it, they never will get it, and you only frustrate yourself by wishing they would get it.

I often say the world of anesthesia is The Curdle Zone, where the cream of nursing rises to meet the dregs of medicine. That coagulation is not apppetizing.

All IMHO, of course.

d

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It is for this very reason that I hate doctors."

And what a gleaming example of professionalism you are perpetuating.

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and what a gleaming example of professionalism they are perpetuating when they act like they're God and everyone else is not. don't get me wrong - we need doctors. i'm grateful that we have them. but it's the way that some of them act that many people (including myself) do not appreciate.

And what a gleaming example of professionalism you are perpetuating.
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i'm grateful that we have them. but it's the way that some of them act that many people (including myself) do not appreciate.

That's better!

Jeez, there is no other topic as incendiary as anesthesia, docs and CRNAs's!!!

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Specializes in Anesthesia.
"I often say the world of anesthesia is The Curdle Zone, where the cream of nursing rises to meet the dregs of medicine. That coagulation is not apppetizing."

.............The simple fact of the matter is that the quality and caliber of M.D.s coming out of medical school has improved drastically over the years..........

Drastically? Really?!

If only the doctor's grasp of English could match his reach.....

!

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...To get into medical school is no small feat as i'm sure some of you have tried and were not successful...

this excerpt from his post says it all about him, and docs like him...

elitism and arrogance, pure and simple...

He's saying, "I'm smarter than you, nyahh, nyahh, nyahh, nyahh, nyahhhh"

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