MDA/CRNA infighting

[jrsquire1]

I've been throwing the idea around for a little while now of possibly pursuing anesthesia as a CRNA. I think my biggest fear is working in a hostile environment where nursing and medical practices do not get along. I understand this changes from place to place, individual to individual, but is there much infighting at your institution that you practice at? Or do the services generally get along?

[wtbcrna, MSN, DNP, CRNA]

I've been throwing the idea around for a little while now of possibly pursuing anesthesia as a CRNA. I think my biggest fear is working in a hostile environment where nursing and medical practices do not get along. I understand this changes from place to place, individual to individual, but is there much infighting at your institution that you practice at? Or do the services generally get along?

My best advice, be wary of any job that has a high turnover rate. That is usually one of the best indicators that there is something fundamentally wrong with the work environment.

In general though most anesthesia providers get along at work.

[Scooby-Dooby-Doo]

Something I was told today from a CRNA: Anesthesiologists don't like being called "MDA."

[wtbcrna, MSN, DNP, CRNA]

Something I was told today from a CRNA: Anesthesiologists don't like being called "MDA."

MDA isn't a derogatory term and I have MDAs that use that term to refer to themselves.

[Scooby-Dooby-Doo]

Thanks for the clarification wtbcrna. I used it too and was heavily criticized on using it from the CRNA, telling me to never use it.

I'm currently in a unique situation where I'm shadowing a CRNA at my facility. I couldn't at other nearby facilities after I called them, so this is my only shot that I don't want to lose. This CRNA is the only CRNA in the teaching hospital since the hospital uses anesthesia residents from a strong partnership with a local school. He told me he was a recent graduate who second-thought about his career choice after finishing, didn't enjoy crna school and being hazed in school, and wouldn't recommend going to his school, just employed this year, and has never had any RNs/RN students like me shadow him, so I am trying to make a good first impression.

I'm telling this because the CRNA that I'm shadowing "eats his young," (I graduate next month BSN) after a shadow day with him, which was something that I didn't think would happen after my last amazing shadow experience from the previous hospital. At times he isn't profesional as he would swear in front of me. Don't get me wrong, I'm glad that I learned so much from what he tells me and am very honored to have this rare opportunity too but unsure how much longer I can take all the other things he says with a grain of salt, such as the MDA label and the bias research work that CRNAs have contributed to the profession.

Anyway, you can see my dilemma if I should stay for more hours/exp or stop with my current hours/exp.

[jwk]

My best advice, be wary of any job that has a high turnover rate. That is usually one of the best indicators that there is something fundamentally wrong with the work environment.

In general though most anesthesia providers get along at work.

Ah, a rare source of agreement. Most groups really do get along just fine. Politics are generally left at the door. I know of one relatively recent AANA president who worked in a heavily medically directed ACT practice and got along just fine with the docs they worked with.

Most people would or should know ahead of time what type of work environment they're going into - whether medically directed, supervised, collaborative or independent. If you're the type that is going to want to be independent in your practice, then clearly a heavy ACT environment would probably not be your first choice and you would be looking for something more in line with the way you want to practice, although depending on the area, that may not always be possible. For example - in metro Atlanta, ACT practices are just about the only thing available, yet within 30 miles of downtown, there are a number of CRNA-only practices.

Turnover is hard to judge - it would be nice to be able to talk with people in the group, and not necessarily the ones actually doing the hiring and see how they view things. Even better, if you're still in school, would be to arrange a clinical rotation so you can actually see the group dynamic. Groups using recruiters should be a red flag - there are reasons groups and hospitals use recruiters and it's rarely because the practice is stellar.

[wtbcrna, MSN, DNP, CRNA]

Ah, a rare source of agreement. Most groups really do get along just fine. Politics are generally left at the door. I know of one relatively recent AANA president who worked in a heavily medically directed ACT practice and got along just fine with the docs they worked with.

Most people would or should know ahead of time what type of work environment they're going into - whether medically directed, supervised, collaborative or independent. If you're the type that is going to want to be independent in your practice, then clearly a heavy ACT environment would probably not be your first choice and you would be looking for something more in line with the way you want to practice, although depending on the area, that may not always be possible. For example - in metro Atlanta, ACT practices are just about the only thing available, yet within 30 miles of downtown, there are a number of CRNA-only practices.

Turnover is hard to judge - it would be nice to be able to talk with people in the group, and not necessarily the ones actually doing the hiring and see how they view things. Even better, if you're still in school, would be to arrange a clinical rotation so you can actually see the group dynamic. Groups using recruiters should be a red flag - there are reasons groups and hospitals use recruiters and it's rarely because the practice is stellar.

I agree with JWK on this. Professionals may argue like crazy out of the work setting, but true professionals leave the politics at the door and take care of their patients while at work.

[macanes, BSN, MSN, DNP, CRNA]

I agree with the other comments here. I have worked primarily in military settings -- as active duty, then contractor, and now GS. I generally enjoy working in the military environment, if only for independence. However, I'm at a small MEDDAC, and things might be different at the large medical centers.

Also, I'm a fan of the Army program in anesthesia nursing (bias alert -- still one of the best, with Navy ). Don't shy away from the military without checking that route. I can put you in touch with an active duty guy who went to school on his civilian dime. Or, more like 1.5 million dimes. The military is a GREAT way to go to graduate school for that reason. If you can get accepted directly into the anesthesia program from your civilian nursing practice (that is, get some critical care experience in the civilian world), you are golden.

[loveanesthesia]

I would avoid using MDA until you know the lay of the land. Some anesthesiologists will take offense and if you're new I'd just avoid it.