How do CRNAs/SRNAs benefit anesthesiology residents?

pnurseuwm · Jun 10, 2004

Well, everyone KNOWS that CRNAs don't exercise, they don't NEED to be with their families, and for goodness sake, CRNAs don't need sleep, they can work 24/7...... they really should bring their sleeping blankets and toothbrushes to work..... because as we all know CRNAs don't like to go home at reasonable hours.... heck, they are so self-sacrificing they don't even need homes, right! :rotfl: :rotfl:

Give me a break!

TejasDoc · Jun 10, 2004

I got the feeling that people are taking offense to the way that Wake Forest portrays their utilization of CRNAs and the effect that student nurses have on the training of their residents.

It's important more and more often for residency programs to explain how CRNAs and student nurses fit into their training programs. Having student nurses, in my opinion, having just finished interview for residency positions, does not help a program recruit applicants, and actually probably makes it more difficult to compete against programs which do not have a nurse anesthesia training program.

CRNA's, on the other hand, if used to relieve the residents at the end of a day, provide residents with breaks during the middle of the day, allow the residents to attend lectures and conferences, or to make sure that residents can have an interesting case and not another lap chole, can actually help to sell the residency. Finally, having CRNA's in a program gives the residents an opportunity to work with a field of health care professionals that they will have to work with, like it or not, everyday for the rest of their careers and in many cases learn to manage an anesthesia care team.

u-r-sleeepy · Jun 10, 2004

From the article:

"The anesthesia care team, which involves an attending anesthesiologist supervising a nurse..." aaaack aaack aaack - patoo-ey! "...supervising a nurse..." Talk about demeaning!

Let's see here - how about this:

The US finally realizes there is indeed a "crisis" in healthcare and some aggressive democraps (sorry folks... I guess my political bias is slipping out a litte here) push through some form of "socialized medicine". When you do the math and see what it costs to educate and then compensate the average MDA/DOA - who do YOU think is going to be on the "down$izing" list for healthcare dollar$??? When the politicians see how MDAs are compensated compared with CRNAs and realize that most (all?) "supervision" and "medical direction" is to insure the MDA/DOA's significant income... what do YOU think will happen with the way anesthesia is practiced? Just something to think about.

A good question to ask the surgery patient post op - "Did the person giving you anesthesia have donuts on his/her breath?" ;-)

Sleeepy

PS I know there are brilliant and wonderful MDAs practicing. I believe Tenesma is one of them. I do NOT intend to be making a blanket statement about all MDAs/DOAs. Still, so much of what is classified as "Medical Direction" or "Supervision" is UN-necce$$ary bunk! ...in my humble opinion. And of course - the public pays for that "waste-age" in the medical system!

user69 · Jun 10, 2004

Is there any procedure that you would want a MDA over a CRNA to be putting you under?

u-r-sleeepy · Jun 11, 2004

Is there any procedure that you would want a MDA over a CRNA to be putting you under?

If you're asking me?

If BOTH are well trained and experienced practioners? Nope. I cannot come up with a single situation. Perhaps others will and please do so. I like it when people make me "think" and stretch beyond my current understanding.

Sleeepy

catcolalex · Jun 11, 2004

first of all, a "nurse" is different than a nurse anesthetist student.

second, that response sounded as if the nurse anesthesia program existed solely to make the resident's lives easier.

i would take offense to that comment if i were a SRNA at wake forest. maybe the SRNA's could provide the resident's with a massage halfway into the case and then follow that with rolling out the red carpet as they leave. i would also take offense to tejasdoc's comment, " if used to relieve the residents at the end of a day, provide residents with breaks during the middle of the day, allow the residents to attend lectures and conferences, or to make sure that residents can have an interesting case and not another lap chole, can actually help to sell the residency". i'm glad he percieves the SRNA's role as one to promote or sell his residency program. what is this guy smoking? the CRNA program is not there to kiss the resident's feet. nor is it there to make his life easier. nor is it there to take the "boring" cases so that the resident's can take the "interesting" cases. this illustrates exactly why i would never go to a program that also has a anesthesia residency program along with it. why deal with this crap? at least somewhere else i can at least be graduated before being treated as totally incompetant and inferior. I would hope that the SRNA's in that program do not allow themselves to be treated as inferior providers as the previous posts suggest that they might be.

TejasDoc · Jun 11, 2004

First, I have to say that I joined this discussion group to add a differing opinion on certain issues, so that maybe some interesting discussions could start. What's the point in discussing an issue when everyone agrees?

Second, I can't really say that I think u-r-sleeeepy's comments were constructive or really that relevant to the discussion topic. The statement "The anesthesia care team, which involves an attending anesthesiologist supervising a nurse, provides the majority of anesthesia health care in this country", as far as I know, is a statement of fact, or am I wrong? Now, if Wake Forest's anesthesia program has that fact wrong, then you should drop them a line and let them know what an anesthesia care team really is, or that said team does not provide the majority of anesthesia health care in this country. I think they'd like to know if they have that wrong.

The following comment "A good question to ask the surgery patient post op - "Did the person giving you anesthesia have donuts on his/her breath?" ;-)" Again, not constructive. It does a great job helping to rally the troops I guess, but when it comes to creating a better relationship between CRNAs and anesthesiologists, my thought is that it just makes matters worse.

As for the economics of health care, we can tackle that topic here I guess, or we can start another discussion, but I'd love to have a good talk about that too, I imagine it would be very interesting. :)

Catcolalex, I'm sorry you took offense to my comments, I think you misunderstood them. First, I never said anything about the CRNAs performing any duties which were outside their scope of practice, so I imagine that comments about "massage" and "red carpet" were just supposed to make people jump on the case of the MD.

And I think I was pretty clear that I don't think it is the job of the student nurse anesthetists to kiss the feet of the resident. One, I never said that I thought nursing students should be used to relieve the residents or let the residents get interesting cases, I said CRNAs. This doesn't come from a belief that the residents are better than the CRNAs, it comes from the fact that these CRNAs are employed by a training program, so it is their job (which they get paid a good living to do) to make sure that the trainees (which, in this case I was speaking of residents, since it was the topic of the Wake Forest page, but also applies to the student nurse anesthetists) receive the best training possible. If that means that they provide breaks, give up interesting cases or relieve the residents/nursing students so they have a chance to read, then that's what they do. Their nurse anesthesia training is complete.

Finally, I have to say I think a lot of this negativity stems from the fact that many anesthesiologists have not taken their RESPONSIBILITY to supervise and direct CRNAs seriously enough, whether that be out of laziness or greed. If they're getting paid to do that, that's what they should be doing, and if they're not, shame on them. Maybe I have this all wrong too, I readily admit that I don't really have any experience with this, except reading the comments of this and other webpages. But I know I would also be angry if I thought people I worked with were getting paid to do a job they weren't doing.

TD

loisane · Jun 11, 2004

The statement "The anesthesia care team, which involves an attending anesthesiologist supervising a nurse, provides the majority of anesthesia health care in this country", as far as I know, is a statement of fact, or am I wrong?
TD

Yes, it is an undisputed fact that the majority of anesthestics are provided by CRNAs and anesthesiologists working together.

But what is the nature of that team? This is where we have disagreement. TejasDoc, I ask you to examine your phrase "which involves an attending anesthesiologist supervising a nurse". That is YOUR definition of the team. It is NOT nurse anesthesia's definition. You assume that CRNAs need supervision, and we do not accept that assumption. Even when CRNAs work with anesthesiologists, the nature of that relationship does not need to include "supervision".

I believe I understand your major point. That there are benefits to residents if they choose an institution that employs CRNAs, and the original quote was a "marketing tool". I think it is a fair assessment of this picture.

So I have no issue with your major point. But some of the underlying philosophy/assumptions do strike a nerve with many of us. I do not know if you indeed hold these beliefs, or are simply repeating phrases you have heard. You say you are here for discussion, so I offer my insight in that spirit.

loisane crna

jwk · Jun 11, 2004

Is there any procedure that you would want a MDA over a CRNA to be putting you under?

In a practice where the ANESTHETISTS do all the cases (AA or CRNA) I'd much rather have the anesthetist be the one doing the case and staying in the room with me for MOST cases.

gaspassah · Jun 12, 2004

tejas, i think i just sounds belittling to the anesthetists, whether they are srnas or crnas that their job is to give breaks, let the resident leave early, or provide the resident with the time to do interesting cases while the srna or crna does the mundane ones. it has the tone of handmaideness (i made that

word up) to it.

why not state it as a cooperative environment where the srnas crnas and residents work together to ensure proper education and training for all,

d

deepz · Jun 12, 2004

why not state it as a cooperative environment where the srnas crnas and residents work together to ensure proper education and training for all,
d

Because some animals (anesthesia providers) are MORE equal than others.

http://www.gaspasser.com/animal%20farm.html

!