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Does it bother CRNA's that MDA's get so much more...?

CRNA   (52,620 Views 148 Comments)
by ICU, RN, BSN, B.S. ICU, RN, BSN, B.S. (Member)

ICU, RN, BSN, B.S. specializes in Medical/Telemetry. Now ICU.

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I agree....the greedy lazy docs should go. But with CRNAs telling the surgeons, patients, and hospitals that they are at least as good as (if not better than) anesthesiologists, there will be some push back. As reimbursement by Medicare and linked insurers falls, there will be more pressure on the anesthesiologists to engage in self preservation. It will definitely be a war.

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A war? With affordability on the side of the CRNAs, the only ones who would even have the time to show up to the battlefield would be the MDAs. The CRNAs would be too busy in the OR, asking about 1/2 to 1/3 less to be compensated for doing what they're doing.

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nomadcrna has 30 years experience as a CRNA, NP and specializes in Anesthesia, Pain, Emergency Medicine.

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We have been at war for some time now.

BTW, we ARE just as good.

Evidenced based medicine. Look at the peer reviewed studies.

BTW, what is your background. It says nurse on your profile.

I agree....the greedy lazy docs should go. But with CRNAs telling the surgeons, patients, and hospitals that they are at least as good as (if not better than) anesthesiologists, there will be some push back. As reimbursement by Medicare and linked insurers falls, there will be more pressure on the anesthesiologists to engage in self preservation. It will definitely be a war.

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NurseSnarky specializes in OR; Telemetry; PACU.

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I'm not a CRNA...I'll get that out there now. I've wanted to pursue a degree in the field for some time, so I do know about the politics involved. I've also went toe to toe with a MD over what a CRNA can do, has done (i.e. history), and their huge importance (was told that CRNA's are nothing without an Anesthesiologist).

My desire to become a CRNA is not the money. I've never sat down and thought it was unfair that an MD gets paid more. MDs get their feathers ruffled that there are so many CRNAs in the profession with many more on the way...it's the old boys club. But CRNAs have been around forever...surgeons wanted nurses to give anesthesia as they would give their undivided attention to the patient during the procedure whereas a resident wanted to pay more attention to the case and doc (1800s).

As many of us know, a doc does not have to be present or even in the building or even on staff (small rural hospitals) in order for CRNAs to provide anesthesia care. If something goes wrong, it's the surgeon or another doc that gives orders for any problems. It would be the same if something went wrong if a doc was giving anesthesia...the surgeon then ICU doc would take over care. It's hooey plain and simple that an Anesthesiologist is required in some places...and I'll leave it at that.

In the United States, there have been three challenges brought against nurse anesthetists for illegally practicing medicine: Frank v. South in 1917, Hodgins and Crile in 1919, and Chalmers-Francis v. Nelson in 1936.[19][20] All occurred before 1940 and all were found in favor of the nursing profession, relying on the premise that the surgeon in charge of the operating room was the person practicing medicine. Prior to World War II, the delivery of anesthesia was mainly a nursing function. In 1942, there were 17 nurse anesthetists for every one anesthesiologist.[21] The numbers of physicians in this specialty did not greatly expand until the late 1960s. Therefore, it was legally established that when a nurse delivers anesthesia, it is the practice of nursing. When a physician delivers anesthesia, it is the practice of medicine. When a dentist delivers anesthesia, it is the practice of dentistry. There are great overlaps of tasks and knowledge in the health care professions. Administration of anesthesia and its related tasks by one provider does not necessarily contravene the practice of other health care providers.[22][23] For example, endotracheal intubation (placing a breathing tube into the windpipe) is performed by physicians, physician assistants, nurse anesthetists, anesthesiologist assistants, respiratory therapists, paramedics, EMT-Intermediates, and dental (maxillofacial) surgeons. In the United States, nurse anesthetists practice under the state's nursing practice act (not medical practice acts), which outlines the scope of practice for anesthesia nursing.

http://en.wikipedia.org/wiki/Nurse_anesthetist

The history of the CRNA is fascinating to me as I used to believe it was always a physician's job to deliver anesthesia until I delved into the history of it.

The History of Nurse Anesthetists

Nurses were the first professional group to provide anesthesia services in the United States. Established in the late 1800s, nurse anesthesia has since become recognized as the first clinical nursing specialty. The discipline of nurse anesthesia developed in response to requests of surgeons seeking a solution to the high morbidity and mortality attributed to anesthesia at that time. Surgeons saw nurses as a cadre of professionals who could give their undivided attention to patient care during surgical procedures. Serving as pioneers in anesthesia, nurse anesthetists became involved in the full range of specialty surgical procedures, as well as in the refinement of anesthesia techniques and equipment.

http://www.anesthesiapatientsafety.com/na_glance/history.asp

Good info here:

http://www.aana.com/brieflookhistory.aspx

And finally a review on a must read book:

This review is from: Watchful Care: A History of Americas Nurse Anesthetists (Hardcover)

One of the most effective ways to devalue a profession, or any group for that matter, is to ignore their history. Anesthesia texts written for primarily a physician audience have for decades systematically avoided mention of the considerable contributions made to the specialty of anesthesia by Nurse Anesthetists. This book tackles, and successfully masters the task of tracing the development of anesthesia as a nursing specialty from the 19th century to the 1980's. The author also chronicles the multiple, albeit unsuccessful, attempts of organized medicine to stifle the development CRNA's, the profession that has been providing the majority of anesthesia care to Americans for over a century. The book is a "must read" for anyone, nurse, physician or patient, who has an interest in the subject of anesthesia. It is worth the search to find the "out of print" work. Hopefullly, it will be reprinted!

http://www.amazon.com/Watchful-Care-History-Americas-Anesthetists/dp/082640510X/ref=sr_1_sc_1?ie=UTF8&qid=1323012985&sr=8-1-spell

The book is available at the AANA website.

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wtbcrna is a MSN, DNP, CRNA and specializes in Anesthesia.

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I'm not a CRNA...I'll get that out there now. I've wanted to pursue a degree in the field for some time, so I do know about the politics involved. I've also went toe to toe with a MD over what a CRNA can do, has done (i.e. history), and their huge importance (was told that CRNA's are nothing without an Anesthesiologist).

My desire to become a CRNA is not the money. I've never sat down and thought it was unfair that an MD gets paid more. MDs get their feathers ruffled that there are so many CRNAs in the profession with many more on the way...it's the old boys club. But CRNAs have been around forever...surgeons wanted nurses to give anesthesia as they would give their undivided attention to the patient during the procedure whereas a resident wanted to pay more attention to the case and doc (1800s).

As many of us know, a doc does not have to be present or even in the building or even on staff (small rural hospitals) in order for CRNAs to provide anesthesia care. If something goes wrong, it's the surgeon or another doc that gives orders for any problems. It would be the same if something went wrong if a doc was giving anesthesia...the surgeon then ICU doc would take over care. It's hooey plain and simple that an Anesthesiologist is required in some places...and I'll leave it at that.

http://en.wikipedia.org/wiki/Nurse_anesthetist

The history of the CRNA is fascinating to me as I used to believe it was always a physician's job to deliver anesthesia until I delved into the history of it.

http://www.anesthesiapatientsafety.com/na_glance/history.asp

Good info here:

http://www.aana.com/brieflookhistory.aspx

And finally a review on a must read book:

http://www.amazon.com/Watchful-Care-History-Americas-Anesthetists/dp/082640510X/ref=sr_1_sc_1?ie=UTF8&qid=1323012985&sr=8-1-spell

The book is available at the AANA website.

I totally agree with you on most accounts, but in small rural hospitals it is often going to be the CRNA who takes care of the patient in ICU when it is there patient and something goes wrong. We will write the orders/give meds/adjust the vent settings etc. until the patient is stabilized or can be transported.

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I know this post is old. I just want you to understand one thing. Just because someone is an MD does not entitle him to great knowledge. A title is exactly what it is just a title. If you truly want know more about medicine or anesthesia you need to understand that going to medical is not the only way to do so. CRNA's are not just giving more responsibilities how everyone here says. CRNA's are an essential part of a surgical team. Just like the OR nurses. We become just titles when we become scared to give our input on things just because it is out of our scope of practice.

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168 Posts; 2,021 Profile Views

I spoke to an anesthesiologist and she said unless you have your heart set on medical school go for the crna, she said its less school and not a huge difference in compensation in her opinion.

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Bluebolt has 6 years experience.

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I'm interviewing for the Mayo Clinics CRNA-DNP program in 2 weeks. If I get in, the program will be full time for 3.5 years, very rigorous academic and clinical undertaking. My BSN program was 4.5 years full time including summers and has more credit hour requirements than any other bachelors program I'm aware of. I have been working in an ICU for over 3 years honing my clinical skills and knowledge about drips, titrating meds, assisting in intubation, central lines, hemodynamic interpretation of PA catheters, etc. If you consider my time in the ICU part of my pre-training for CRNA function I will finish my degree as Dr. Bolt independently practicing anesthesia with 11 years of education and training.

Before any other nurse who is pre-programed to be appalled at a nurse being addressed as a (oh my!) Doctor, I never said I'd be addressed as an MD. I'd be Dr. Bolt CRNA-DNP just like a Dentist is called a "Doctor" and a pharmacist is a "Doctor" and your Dean of your nursing program was called "Doctor".

The times, they are a-changin.

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171 Posts; 2,024 Profile Views

I'm interviewing for the Mayo Clinics CRNA-DNP program in 2 weeks. If I get in, the program will be full time for 3.5 years, very rigorous academic and clinical undertaking. My BSN program was 4.5 years full time including summers and has more credit hour requirements than any other bachelors program I'm aware of. I have been working in an ICU for over 3 years honing my clinical skills and knowledge about drips, titrating meds, assisting in intubation, central lines, hemodynamic interpretation of PA catheters, etc. If you consider my time in the ICU part of my pre-training for CRNA function I will finish my degree as Dr. Bolt independently practicing anesthesia with 11 years of education and training.

Before any other nurse who is pre-programed to be appalled at a nurse being addressed as a (oh my!) Doctor, I never said I'd be addressed as an MD. I'd be Dr. Bolt CRNA-DNP just like a Dentist is called a "Doctor" and a pharmacist is a "Doctor" and your Dean of your nursing program was called "Doctor".

The times, they are a-changin.

I have never heard a pharmacist introduces him/herself as Dr. [insert] in clinical setting... I don't know where to come down on this, but from what I have noticed in my 5+ years as a RN, whenever someone introduces him/herself as Dr. where I work, almost all patients and even staff assume that individual is a physician...

Edited by AndersRN

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171 Posts; 2,024 Profile Views

Paging doctor nurse, doctor nurse, paging doctor nurse doctor nurse.

lol lame

To be honest, I don't get why some DNP insist to be called doctor in healthcare settings. I don't see that 'conduct' coming from other health professionals (PT, PharmD etc..) that hold doctorate degree.

I know it's not even the proper term for physicians, but everyone knows that doctor in these settings is synonymous with physician...

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wtbcrna is a MSN, DNP, CRNA and specializes in Anesthesia.

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Then if the title Doctor is synonymous with physician what do you call dentists, podiatrists, optometrists, and doctoral prepared psychologists..?

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