How exactly does a surgeon "supervise" a CRNA?

[platon20]

I dont get it. A surgeon knows NOTHING about gas at all.

So I'm confused when I hear some CRNAs say that their "supervising physician" (in states that require a supervising physician) are the surgeons running the case.

Explain to me exactly how a surgeon can "supervise" or "collaborate" wtih a CRNA.

[dfk, RN, CRNA]

Sheesh. Obviously you don't know what you're talking about.

And you give surgeons far too little credit.

d

:yeahthat:

[zrmorgan]

Fine, then lets throw out the term "supervision" and use "collaboration" instead.

How does a surgeon "collaborate" with a CRNA when the surgeon doesnt know jack about anesthesia?

Is a rocket scientist capable fo "collaborating" with a civil engineer?

Is a garbage man capable of "collaborating" with a McDonalds employee?

Of course not, because they are two totally separate jobs that have nothing to do with each other.

So thats my question. How does a surgeon "collaborate" with a CRNA when surgeons dont know ANYTHING about anesthesia?

wow! "Anything about anesthesia?" I guess it is safe to say that you don't know "jack" about surgery? Or that you don't know "ANYTHING" about surgery.

if that is the case, maybe you should be supervised!

please tell me you were being a tad bit extreme.

as someone said on this post before....you were a bit apples and oranges as well.

also, the collaboration example I posted earlier...see above.

z

[CRNA2BKY]

Thats what I'm talking about though. If there are no MDAs on staff and its just hte CRNA and surgeon, how does this work? Does the CRNA go up to the surgeon and ask "will you collaborate with me or supervise me on this case?" Or does the law state that the surgeon AUTOMATICALLY is supervising/collaborating with the CRNA?

For the states that require some kind of collaboration/supervision, how could this possibly work with a surgeon?

BTW, surgeons dont know anything about gas. If you asked them what the method of action of propofol was, they wouldnt have a clue.

Thats why I dont understand how a surgeon could possibly "supervise" or "collaborate" with a CRNA. Its the same thing as asking a family practice doctor to "collaborate" with a neurosurgeon.

You are assuming that the CRNA needs supervision. Your assumption is wrong! CRNA's do not need supervision!

[foraneman]

here is an excerpt from the Montana Supreme Court defining supervision in a case decided this week.

MONTANA SOCIETY OF ANESTHESIOLOGISTS,

MICHAEL D. STERBIS, M.D.,

Plaintiffs and Appellants,

v.

MONTANA BOARD OF NURSING,

Defendant and Appellee,

MONTANA ASSOCIATION OF NURSE

ANESTHETISTS,

Intervenor and Appellee.

"In addition, the MMA argues in its amicus brief that the level of supervision anticipated does not involve the surgeon instructing the CRNA on just how anesthesia should be administered as the surgeon does not exercise control over the "means and method" used by CRNAs in administering anesthesia. Rather, according to the MMA, the supervision involves the responsibility of the physician to ensure that the proper decisions regarding patient care are made in the operating room; that the CRNA is competent, qualified and mentally alert; and that the CRNA keeps the surgeon informed of any changes the CRNA may detect in the patient's status. However, it could be argued that a surgeon would require the exact same things from an anesthesiologist."

This is an excellent definition of supervision. This case involved an attempt by the Montana Society of Anesthesiologists to prevent CRNA's from practicing without physician supervision and to reverse the "opt-out" in Montana. This despite every professional board having supported the opt-out, including physicians. The anesthesiologists lost on partial summary judgment, although they are still fighting what is an absurd battle on other issues.

Greg Stocks CRNA EJD:smiley_ab

[wolfordstudent]

The relationship between a CRNA and a surgeon is purely collaboration. A CRNA that takes orders from a surgeon will end up making a mistake eventually.

E.g., If the patient has a vagal response d/t to surgeon's maneuvering in the patient's abdomen, you as a CRNA will tell the surgeon to stop - and any smart surgeon WILL stop, until the patient is stable.

As for the legality of the issue, even if an MDA supervises a CRNA, if something goes wrong, in a court of law, a CRNA cannot use the excuse: " I did ... that because the MDA told me to". In a court of law you are all by yourself, because you are supposed to make independent decisions.

If you are a CRNA uncomfortable with the medical direction during a case, you can sign out. Period.

All this legal knowhow comes from three MDA's I work with who have been sued.