an interesting and somewhat ignorant article title

**canoehead, BSN, RN** · Oct 27, 2006

I think the author of the article doesn't realize how much more critical patients have become. Giving Versed and having someone stop breathing is rare, but a competent RN knows how to bag and yell for help. A CRNA is even more prepared, and it wouldn't even raise their pulse rate.

If docs choose to delegate tasks to nurses so they can have a life outside the hospital they should not be surprised when we actually USE those skills. It follows that if we are performing the task, then we should be the ones getting paid for it.

jwk · Oct 27, 2006

...but a competent RN knows how to bag ...

100% disagree - VERY FEW RN's, regardless of competency, can adequately bag a patient.

catcolalex · Oct 27, 2006

I'd like to add that very few respiratory therapists know how to adequately bag a pt.

platon20 · Oct 27, 2006

I dont understand what you are angry about. Did you read it? It has almost nothing to do with CRNAs. In fact I dont remember CRNAs being mentioned at all in that article.

Its mostly about how surgery has started to move outside of the hospital. Its more about location than about the practioner giving the anesthesia. If anything, the article title is misleading more than ignorant.

skipaway · Oct 28, 2006

I dont understand what you are angry about. Did you read it? It has almost nothing to do with CRNAs. In fact I dont remember CRNAs being mentioned at all in that article.

That's the point platon20. CRNAs aren't mentioned. This is an article written by an Anesthesiologist known to be unfriendly to CRNAs practicing office based or independent anesthesia in the US.

These quotes from the article...1. "But just imagine, says Miller (anesthesiologist), what might have happened if that (man who stopped breathing after a small dose of Midazolam and resuscitated by Miller)had taken place outside a hospital without a trained anesthesiologist present."

2. "Their is simply no way trained anesthesiologists can meet the demand-especially since the increase in surgeries has been accompanied by a simultaneous increase in what anesthesiologists are asked to do."

3. "That helps explain why, at a rough guess, some doctors estimate 45% of all sedation today is handled by people other than anesthesiologists."

Basically he's fearmongering. He's telling readers that they are in danger b/c they may not have a "doctor" giving their anesthesia. What he fails to mention is there are >23000 CRNAs in this country who are giving anesthesia on a daily basis in all manners of practice and that we are just as well trained and competent to do these procedures as the almighty Dr. Miller.

That's what all the anger is about. It's a common theme from the ASA (American Association of Anesthesiologists) that people will die or get seriously injured if an Anesthesiologist isn't involved in their care. I'm tired of it too. Time Magazine is read by alot of Americans and they should be more balanced. IMHO

DebbieSue · Oct 28, 2006

I totally agree. I read the article, and found the silence re: CRNAs to be absolutely deafening. Didn't say anything bad about them, mind you, just completely and totally ignored their existence. Very subtle, very potent.

zrmorgan · Nov 2, 2006

I dont understand what you are angry about. Did you read it? It has almost nothing to do with CRNAs. In fact I dont remember CRNAs being mentioned at all in that article.
Its mostly about how surgery has started to move outside of the hospital. Its more about location than about the practioner giving the anesthesia. If anything, the article title is misleading more than ignorant.

Planton let me put 2 and 2 together for you...the following are direct quotes.

"A big chunk of surgery is now handled without an anesthesiologist, raising risks for patients" - TIME magazine

"CRNAs are advanced practice nurses who are the hands-on providers of approximately 65% of all anesthesia given in the United States each year" -AANA Website

What you must appreciate is the power that publications such as TIME have on our lawmakers, and the public who do not vote based on outcome studies posted in scientific publications. The general public probably spends 5 minutes a year even thinking about anesthesia. When a media for the masses powerhouse spews out drivel such as the quote above, it is a lasting impression on vast numbers of readers. How far past the headlines do most of the readers get?

Call it misleading, call it ignorant, I don't care. I am not angry, just want our readers to keep their attention on a publication that reaches millions of households around the country. I take back the "fired up", I suppose I meant I was motivated to inform.

I have a suggestion for TIME...

"A big chunk of surgery is now handled without a trained anesthetist, raising risks for patients"

paindoc · Nov 2, 2006

One of the most important aspects of outpatient office anesthesia or hospital anesthesia (eg GI lab) is that the anesthetics are NOT being administered by qualified physicians or CRNAs. It is highly doubtful that CRNAs administer 65% of all anesthetics while anesthesiologists give the other 35%. What is much more likely is that 10-15% of anesthetics are administered by non CRNAs/non-MDs and there is where a large part of the problem lies. I used to be called frequently to the GI lab, to the MRI scanner, to the ED when oversedation was being used by non anesthesia trained people....it gives me chills to think of what is going on in physicians offices and surgery centers, and how close to disaster patients may be every day when well meaning but untrained physicians, frequently preoccupied at the other end of the patient, push the limits of anesthesia to moderate sedation or beyond.

catcolalex · Nov 2, 2006

well said paindoc, now that is how a the same point can be said in a respectable way that is both honest and fair.

tridil2000, MSN, RN · Nov 2, 2006

I think the author of the article doesn't realize how much more critical patients have become. Giving Versed and having someone stop breathing is rare, but a competent RN knows how to bag and yell for help. A CRNA is even more prepared, and it wouldn't even raise their pulse rate.
If docs choose to delegate tasks to nurses so they can have a life outside the hospital they should not be surprised when we actually USE those skills. It follows that if we are performing the task, then we should be the ones getting paid for it.

any rn who is in an environment where vesed is being administered also knows romazicon should always be available.

deepz · Nov 3, 2006

........It is highly doubtful that CRNAs administer 65% of all anesthetics while anesthesiologists give the other 35%.......

Not so quick there -- and not so categorically black-and-white either, if you please. The quote you are responding to:

"CRNAs are advanced practice nurses who are the hands-on providers of approximately 65% of all anesthesia given in the United States each year" -AANA Website"

does not assert that American anesthesia is an either/or equation. It says CRNAs are the *hands-on providers* in 65%.

The AANA makes no claims as to whose hands are on the donuts in the OR lounge.

!