Have Docs kept you out of an OR room b/c your a CRNA?

jwk · Apr 30, 2006

Your position is that CRNAs can do Chronic Pain and the interventional aspects of it - since you guys contend it falls under the practice of nursing - and since you have some superficial exposure to pain intra-operatively and post-operatively.
Why don't CRNAs do Nephrology and Dialysis, or Pulmonology and Bronchoscopic Biopsies, or Intensive Care, or Pediatrics and vaccinations, or Cardiology and Interventional Caths w/ stent placement? You could argue that superficially you are exposed to renal management, bronchoscopies, vasopressor management, pediatric cases, intra-op MIs during your cases - so therefore those fields should become the practice of nursing...
that argument is weak - I implant spinal cord stimulators on a regular basis, but it doesn't mean that I will start doing Motor Cortex Stimulation. The acquisition of knowledge is necessary and so is the appropriate training.
A CRNA who is trained to do a physical exam is geared towards pre-op eval (ie: airway, cardiac, pulmonary, and checking if the pupils are dilated) - the finer findings of a non-crossing patellar reflex and positive ipsilateral babinski in a patient with loss of proprioception wouldn't mean much to you unless you had the fundamental knowledge of the proper functioning of the lateral corticospinal tracts with interruption of the lateral spinothalamic tracts - so that you could diagnose Brown-Sequard syndrome.
Somebody who treats chronic pain really should be a physician, and have both the background anatomical/physiological/neurological understanding of how to diagnose, and how to treat based on mentored experience (ie: residency or fellowship). Can you teach somebody to do a fluoroguided injection? Sure, I can teach my mother how to do that - is it appropriate (other than she will make good money)? no...
chronic pain is soo much more than understanding narcotics and sticking needles into somebody's spine based on MRI findings.

Well said.

WntrMute2 · Apr 30, 2006

Your position is that CRNAs can do Chronic Pain and the interventional aspects of it - since you guys contend it falls under the practice of nursing - and since you have some superficial exposure to pain intra-operatively and post-operatively.
Why don't CRNAs do Nephrology and Dialysis, or Pulmonology and Bronchoscopic Biopsies, or Intensive Care, or Pediatrics and vaccinations, or Cardiology and Interventional Caths w/ stent placement? You could argue that superficially you are exposed to renal management, bronchoscopies, vasopressor management, pediatric cases, intra-op MIs during your cases - so therefore those fields should become the practice of nursing...
that argument is weak - I implant spinal cord stimulators on a regular basis, but it doesn't mean that I will start doing Motor Cortex Stimulation. The acquisition of knowledge is necessary and so is the appropriate training.
A CRNA who is trained to do a physical exam is geared towards pre-op eval (ie: airway, cardiac, pulmonary, and checking if the pupils are dilated) - the finer findings of a non-crossing patellar reflex and positive ipsilateral babinski in a patient with loss of proprioception wouldn't mean much to you unless you had the fundamental knowledge of the proper functioning of the lateral corticospinal tracts with interruption of the lateral spinothalamic tracts - so that you could diagnose Brown-Sequard syndrome.
Somebody who treats chronic pain really should be a physician, and have both the background anatomical/physiological/neurological understanding of how to diagnose, and how to treat based on mentored experience (ie: residency or fellowship). Can you teach somebody to do a fluoroguided injection? Sure, I can teach my mother how to do that - is it appropriate (other than she will make good money)? no...
chronic pain is soo much more than understanding narcotics and sticking needles into somebody's spine based on MRI findings.

I have to agree w/ the Doc here (despite my usual position). Pain management seems clearly diagnosis and treatment, which makes it a Medical issue clearly. That doesn't mean we couldn't learn to deal with chronic pain, it just might mean we do it in a collaborate model.

MmacFN · Apr 30, 2006

well said Ten and Wntr

have to agree. I am not a CRNA but looking from the outside it does seem the case of practicing medicine

pass the propofol · May 9, 2006

It is so funny how jwk wants to be someones b****. I cannot imagine what it must be like to go through life always wanting to be something else, and putting everyone around you down on a discussion board that you are clearly not welcome. Tenesma, why do you and jwk (your AA) waste your time on this site. CRNA's are certainly beneath you and your henchman. Just thought I would stir up trouble, as you often do. It's too bad jwk, you'll never make CRNA dollars :crying2: . Tenesma, wouldn't it be better, as CRNA's are so far beneath you that you stick to some other board. I think you are a pompus jerk who doesn't have any manners. You must have alot of time to make bull**** posts and responses while other people are off making you money. How about it? :chuckle

TheLemur · May 9, 2006

It is so funny how jwk wants to be someones b****. I cannot imagine what it must be like to go through life always wanting to be something else, and putting everyone around you down on a discussion board that you are clearly not welcome. Tenesma, why do you and jwk (your AA) waste your time on this site. CRNA's are certainly beneath you and your henchman. Just thought I would stir up trouble, as you often do. It's too bad jwk, you'll never make CRNA dollars . Tenesma, wouldn't it be better, as CRNA's are so far beneath you that you stick to some other board. I think you are a pompus jerk who doesn't have any manners. You must have alot of time to make bull**** posts and responses while other people are off making you money. How about it? :chuckle

Where did that come from? jwk is a consistent and positive contributor. Other types of anesthesia providers posting makes this place less insular. By the way, you didn't refute what Tenesma said. Or was "jerk" your best response.

SmilingBluEyes · May 9, 2006

Sorry, but thread closed for temporary cooling-off and moderator discussion.

I would remind each participant to keep the focus on the TOPIC and NOT on others and keep attacks out of your posts here. If you are at all unclear, feel free to review the Terms of Service, particularly pertaining to personal attacks on this website.

Thank you.