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Bluebolt

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  1. Bluebolt

    Go Fund Me

    I understand your perspective, Offlabel. I've heard so many convincing viewpoints on both sides of the debate about this hot topic. I'll leave my personal opinion out of it until after my upcoming graduation.
  2. Bluebolt

    Go Fund Me

    Wow, Offlabel, you surprise me. I would have never taken you for the type to support this new movement. Big changes seem to be on the immediate horizon.
  3. Bluebolt

    LPN's Certified in Anesthesiology..

    I'm very confused by what the OP is trying to say. The flight of ideas and perhaps word salad have me concerned. Maybe go seek out your nearest emergency dept, ASAP.
  4. Bluebolt

    Was CRNA worth it all?

    I wouldn't have been anything else. The hardest thing I've ever done but also the most rewarding.
  5. Bluebolt

    Overtime?

    The same thing happened at the main hospital in my town this year. CRNA only now. From what I heard the CRNAs worked very autonomously and provided all the anesthetics while the MDAs provided a half done preop and mediocre blocks. The administrators and business team of the hospital realized that the CRNAs were doing all the work and never had issues they couldn't handle and when they needed a second set of hands just called the board runner (chief CRNA). They realized how much money they would save by just hiring in more CRNAs and letting all the MDAs go. A big ACT in a local city to here also decided to fire a couple MDAs, make the board runner a CRNA, and open up regional blocks to the CRNAs. This is probably one of the largest anesthesia management companies in the nation so if it works well financially for them here it will surely spread to other locations. "The times, they are a changin" - Bob Dylan
  6. Bluebolt

    Partnership Track in a Practice

    Ah, it's approaching that moment in time I've been working a decade for, graduation. The excitement, exhaustion, burnout, and anticipation is palpable in the air of the classroom. As some of you may have noticed this is a (very) great market for CRNAs salaries, benefits, and autonomy. It provides new graduates with a unique issue of having so many options it's hard to decide what to do. There are a few great practices I've narrowed it down to but wanted to get some informed advice from those of you in practice currently. There is an opportunity to be on a partnership track in a practice after a couple of years invested. Have any of you done this? What are the pros and cons of becoming a partner in a group?
  7. Bluebolt

    1099 vs w2

    So those of you with more real-world experience with this would you say that with a job offer of $250,000 1099 would be equivalent to a W-2 offer of $220,000? As a single male I would just have to cover myself for basic health insurance, malpractice, pay the employers half of taxes, cover my own CME, and while I would get 6 weeks vacation it wouldn't be paid. It's been so long since I've worked and earned a paycheck is it usually about 30% of your salary that you can write off towards FICA/Medicare/state tax as a W-2? So then would I expect closer to 50% of my income to go somewhere else if I'm 1099? Although, I hear there are tax advantages (how so?) so that perhaps when I file taxes I get a portion of my paycheck back? Can you tell it's job interview season and I'm crunching numbers...
  8. Bluebolt

    Employer paying off Student Loans?

    Yeah, what Brandon said. As the OP who 3 years later is looking at graduating with my CRNA DNP this Summer I'm still waiting on that option that will pay off the $150,000-$200,000 (Yeah, turns out it was more expensive then I originally calculated). Crickets... No, nothing then? (except military...) I did know one upperclassman that moved to a rural area and they offered to pay maybe $10K per year for 4 years as long as she stayed. So that is maybe $40k with a 4 year committment and she said it got taxed pretty heavy. Currently the best bet I've found is moving to a rural area that's offering a high salary and working 50-60 hrs a week. Hope this helps Brandon!
  9. Bluebolt

    CRNAs vs. AAs

    This is a misnomer. Saying we have a similar scope of practice would be like saying AAs have a similar scope of practice to whom they are assisting, their physician anesthesiologist. They are technically allowed to perform all aspects of anesthesia as long as an anesthesiologist tells them and directs them while they do it. A CRNA is licensed to perform all aspects of anesthesia, without being directed or supervised to do so. As I said in a recent post people get confused with CMS billing regulations asking in about 33 states for a physician (any physician/dentist/podiatrist) to sign the chart in order to get paid. This is not them directing the CRNA or even supervising their practice, and again this isn't tied to their license to practice, just getting paid by CMS. This is not true for AAs who's actual license in the 17 states that allow them to practice require specifically a physician anesthesiologist to direct and supervise their practice at all times. Where some people get confused is when a CRNA chooses to work in an anesthesia practice with AA's that requires strict medical direction. This was their choice, people have different reasons for why this was necessary for them at this point in their life. While they work there they will have to conform to a practice designed to cover AAs scope of practice, essentially reducing the CRNA to half capacity. At any point, they could simply leave and go open up their own CRNA only practice if they felt inclined to do so. That is the real difference between them. If you get into CRNA school you'll begin to understand the vast difference in training, mentality, and scope of practice and independence between an AA and a CRNA.
  10. Bluebolt

    CRNAs being supervised by drs who are not anesthesiologists

    Those regulations are in order to bill for Medicare and Medicaid (CMS). It has nothing to do with your license to practice anesthesia. CMS requests that in 33 of the 50 states you need a physician/dentist/podiatrist to have a signature on the chart. It does not make them responsible for your anesthetic but CMS wants it in order to pay you for your services. It's an archaic request and has already been removed from 17 states and growing. Not to mention the very obvious point you make that none of these healthcare professionals are trained in anesthesia and are not "supervising" you in any way. They are also not responsible for your anesthetic because they are not trained or knowledgeable in anesthesia. You will be responsible for whatever anesthesia services you provide because you are the trained and licensed anesthesia provider, not them. Ultimately, it's an artificial barrier to practice encouraged by a group of competing anesthesia providers who want more of the market share for themselves. Walmart can't eliminate Target but they can try to block the entryways with a bunch of shopping carts. I believe New Jersey is the only state that does require a physician anesthesiologist to sign the chart. In all the other 33 states that do want signatures, CRNA only practices are alive and well and simply have the surgeon/podiatrist/dentist put their name on the chart so everybody gets paid.
  11. Bluebolt

    Do you use the title "Dr."?

    Just move to a state with independent practice for APRNs. Open your own practice, use your title how you see fit while also positively representing your field as a Nurse Practitioner. Make sure your patients have high-quality care and make sure the whole world knows it was from an exceptional doctorate prepared CRNP. Forget trying to play ego/political games of batman and robin, go be Superman somewhere else.
  12. Bluebolt

    Med school drop out, now a CRNA. ask me anything...

    I agree it's not wise to make blanket statements that nurses don't do cadaver lab. At my university, it was a very competitive BSN program so many of us did extra sciences to make ourselves stand out to the admissions dept. I did take an elective dissection class with cadavers in undergrad. Of course, in CRNA school I did another more intensive cadaver lab.
  13. Bluebolt

    Do you use the title "Dr."?

    "Good morning, I'm Dr. Smith your CRNA providing your anesthesia today." That should take you less than 10 minutes. It encompasses all the information required to inform your patient about who you are, your education, and what you will be doing for them. Progress is never made with complacency or apathy.
  14. Bluebolt

    Do you use the title "Dr."?

    Thank the Lord for you, Wtbcrna. Sometimes I read some comments from people claiming to be APRNs on here and I almost hope they are internet trolls rather than real life APRNs. If you have a Florence Nightingale complex please stay at the bedside and continue pressing your white skirt and wearing that white hat. The rest of us are in 2018 with doctorates performing research and advancing the field. Acknowledging and respecting the past is one thing, living in the past is stagnant death. A competitor provider will not encourage their competition to advance their practice, recognition, education, or title. If you're standing around waiting for them to encourage it, you'll be standing for a long time. Know your state laws, understand that you must not impersonate a physician, always include your credentials if you use your title. Don't expect Florence to like it. She will be over there making sure she can bounce a coin off the bed another nurse made.
  15. Bluebolt

    Experienced CRNA...ask me anything

    I'm a third-year SRNA currently looking at jobs. I fall into the millennial generation. I have a very different perspective than the one you describe, as do many of my classmates. We had a recruiter today who brought us lunch and gave the pitch. My first question was not about vacation or call schedule but what type of peripheral nerve blocks do the CRNAs perform in their practice. Other students wanted to know what practice model it was and did they us QZ billing. Is it collaborative or "supervised/directed". Will we be expected to float between multiple facilities. Are the CRNAs employed by the hospital or group members. Are CVLs and epidurals done by the CRNAs or MDAs. The pay and benefits package can be negotiable, a practice culture and politics can not. I think you'll find this new generation of DNP graduates are more involved in future practice and autonomy and not just lifestyle. You will always have some who are interested in working somewhere with a light schedule and weekends free but that can be said for any career field. You mention working somewhere with AAs and CRNAs and I really can't speak to that type of practice environment or culture because AAs are not allowed in my state or anywhere in states close to me. I did meet an SRNA at Mid Year Assembly who said during her rotations in Atlanta (huge concentration of AAs) she felt the environment was toxic with disgruntled aggressive interactions between all anesthesia providers. It got to the point where an AA would try to relieve her CRNA from a case and she would have to excuse herself as well because her clinical hours aren't allowed to be counted if an AA is on the case. Apparently, there were unpleasant things said by the AAs to the SRNAs about this. Perhaps your perspective is from an environment that I'm just very unfamiliar with, along with SRNA training programs different than my own.
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