stanman1968

same thing happned to me except my son was born 2 weeks before school as well, i went fortune favors the bold.

anesthesia does not cancel cases, they just cancel the anesthetic, if the patient has a comorbidity that will make the anesthetic unsafe or endanger the patient then anesthesia does not have to do the case. It is no diffirent then is a surgeon does not feel a patient is good enough for surgery, not like anesthesia can make them do it.

I trust any poditrists, phamacists, audiologists PT will fall under this same restriction?

I am a crna so I am biased, but I would think about moving if needed, the fact is that you are considering a career, a profession. To pursue this living in Florida only is just not a realistic option. Advice get ADN work the unit while you get a BSN then go to anesthesia school. Or with your background go to medical school. I think the AA route is one you may regret for all of the reasons above.

A swan is not that important, but it appears tha the acuity level of your patients may be a bit low and that could be a problem.

your point is that if an anesthesiologist is there then they are supervising and are in charge, that is not the case as pointed out in many practice environments. The multiple misunderstandings and misstatements defiantly call your "expertise" into question. Perhaps if you were limit your statements to fact instead of opinion it would improve your credibility.

CRNA's are experts in their field, therefore by your logic I can call myself Doctor after completing my doctorate. It has nothing to do with the practice of medicine, dentists, podiatrists, optometrists, audiologists and pharmacists do not practice medicine, and neither do I anesthesia delivered by a nurse was ruled the practice of nursing in 1926. These are FACTS not opinion. This movement is one that is completely motivated by both parties one attempting to advance their profession and one trying desperately to impose their will on the other. Why do I say physicians are the ones dictating the use of this term, well their is no PUBLIC movement over this issue but certainly one by physicians, check out the AMA resolution 303.

I am sorry did you say that I pay too much attention to the LAWS and REGULATIONS governing my practice? That hospital policy somehow trumps them? Nice try that defense in court buddy it will be short at least. It is refreshing to see however that you admit that your experience is limited to your one whole academic practice, gosh such a deep well of experience, you will have to forgive me but as you say "where the rubber meets the road" AKA the real world what you do there does not mean squat. I hope that you are not so caviler in understanding your obligations and responsibilities legally speaking, I suggest you arm yourself with FACTS nor ASA propaganda or opinion, one will save you the other sink you guess which is which.

Now let me get this strait, when the title doctor is used the patient thinks they are speaking to physician, dentist, podiatrist, or optometrist. You realize three of these are non physicans and have limits on their practice right? It is the educational degree that they are addressing which is by the way the point we have been making, thanks for acknowldging it. As for appropriate it is not for physicans to decide who can use this academic term, matter of fact it is totally innappropriate but somehow this escapes you.

No an anesthesiologist is not "responsible" for me, he does his case I do mine period. You have got to be a med student or some new resident, it is quite clear that you are not at all familiar with any practice arrangment outside of an acedemic center. I strongly advise you aquaint yourelf with the nurse practice acts and the application of them, you would not be nearly as ignorant if you woulod educate yourself before you speak.

yes someone who has a doctorate can walk into a hospital and call themselves doctor, what they cannot do is practice medicine, big difference.

I have never practiced "under" an anesthesiologist. He did his cases I did mine, no "supervision". You really do not have a clue do you super whatever.

Look how hard can it be? Chiros, and podiatrists introduce themselves as doctors, BECAUSE THEY ARE DOCTOR IS NOT A JOB IT IS AN EDUCATIONAL DEGREE! Physicians do not own the name period. If I enroll and finisnh a DNP program then I will be a doctor, if I choose to use it as my title it will be my choice and if you super six decide not to recognize it rest assured I wouild not feel obliged to recognize yours. For the last time you do not own the title, period. Now go preach to chiros or pharmacists or audiologists or any of the others that have taken "your" title.

It is so specialized that the work is not applicable to the greater population.

There are pharD, and DPT, are they practicing medicine? To make this clear so clear that it can not (I hope to god) be misunderstood. The term doctor refers to an educational degree period, got it? Physician is the job title, sheesh.

AA classes are not far more complex, they are not better trained one can make an excellent argument that there training is inferior, they are taught to be dependent and many are taught little to no regional, that kind of limits what one can do, better only if inability or under training is "better".

Frequently it is, sort of.

right I just want to put the public in danger, of course. Let me see which side has the evidence? I can tell you which one it is not, and that is the reason they put up the mantle of patient safety to further their financial goals cloaked in "pt safety". Really if you have evidence present it you are just repetitive.

I will at this time that you really are a doctor, if you can offer any evidence to support your position other than silber bring it on, I however can bring up a great deal of evidence supporting mine, one is fact and one is opinion, guess which one yours is?

No we do not know that, the research does not support that, history does not support that.

You are pretty funny to, you assume you have any knowledge of my field, I did not realize that there was any degree of osmosis when writing a check, tell me what is the effect of milrinone on preload afterload and contractility along with it's mechanism of action? Please describe the mallampati scoring system? Could you please describe the structure of the lumbar plexus and the dermatomes covered by a lumbar plexus block, the risks and benefits and which surgery and conditions it would be appropriate for and what comorbidites would make it a poor choice? These are all very basic questions in the field of anesthesia as you are such an expert these should be an easy answer, if not you clearly do not know the first thing about anesthesia, writing a check does not give you any insight whatsoever.

paying for it does not include an understanding, proximity does not lend expertise...this I hope you DO understand.

I have noticed whenever the research does not agree with opinion it becomes "nursing" as if nursing were a bad word. What an awesome cogent rational defense!

If you do not by that crna operating without supervision in rural America you are clearly massively ignorant in the role CRNA's role in rural health care. You really should make some effort to educate yourself BEFORE you say something really not so smart.

all depends in my surgical center gig it is just endoscopy, push propofol and maintain airway. In my rural gig a bit more. I will do TKR and colon resection TKR go over labs vitals hx etc. see pt and perform a an interview if al is well (have had to cancel in past for uncontrolled angina etc.) discuss anesthesia and post op pain control, usually perform FNB and SNB preop take back induce monitor wake up to PACU manage any problems in PACU (pain, N/V, htn etc. etc) see them that night to check on pain control and see them the next day for post op. Overnight handle any calls for post op pain etc. etc. For colon resection see above for pre-op except thoracic epidural for post op pain control. Back to the OR start 2nd iv (18 G at least) hook up fluid warmer, all after induction and then all the same as TKR except I keep the epidural in place for 2-3 days post op, may dose with duramorph before catheter removal. In my rural gig I may get called for line placement or emergency intubation or any number of emergency cases but little trauma. there you go the 2 ends of the spectrum.