jfratian

jfratian DNP, RN, CRNA

Adult Critical Care

Major, U.S. Air Force Reserve - Staff Nurse Anesthetist

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All Content by jfratian

  1. CRNAs Should Not be Allowed to Practice Independently - One Anesthesiologist’s Opinion

    jfratian replied to tnbutterfly - Mary's topic in Certified Registered Nurse Anesthetist, CRNA

    Again encourage you to contact programs you're interested in and see what they say. It's a grey area. This is why the COA requires 'critcal care' and not 'ICU' experience. Some ERs give great...

  2. CRNAs Should Not be Allowed to Practice Independently - One Anesthesiologist’s Opinion

    jfratian replied to tnbutterfly - Mary's topic in Certified Registered Nurse Anesthetist, CRNA

    The available literature, though flawed, shows indie practice for CRNAs is broadly safe; what's out there is far more compelling than any one person's experience. Legislatures and hospital...

  3. CRNAs Should Not be Allowed to Practice Independently - One Anesthesiologist’s Opinion

    jfratian replied to tnbutterfly - Mary's topic in Certified Registered Nurse Anesthetist, CRNA

    You're not an AANA member...I'm shocked. No contempt or sneering...just varying levels of evidence. The individual experiences of any one person aren't enough to make system level policy...

  4. CRNAs Should Not be Allowed to Practice Independently - One Anesthesiologist’s Opinion

    jfratian replied to tnbutterfly - Mary's topic in Certified Registered Nurse Anesthetist, CRNA

    The accreditation standards read "minmum 1 year of critical care experience." Some programs will take ER experience on a case by case basis if they consider it critical care. In my graduating class...

  5. CRNAs Should Not be Allowed to Practice Independently - One Anesthesiologist’s Opinion

    jfratian replied to tnbutterfly - Mary's topic in Certified Registered Nurse Anesthetist, CRNA

    We can straw man all day. Would you like a new physician or an experienced CRNA? The probable lack of ability for AAs comes from a lack of training in independent models. And yes we can't study...

  6. CRNAs Should Not be Allowed to Practice Independently - One Anesthesiologist’s Opinion

    jfratian replied to tnbutterfly - Mary's topic in Certified Registered Nurse Anesthetist, CRNA

    Your personal experience isn't worth anything. You 10k cases in 30 yrs doesn't hold a candle to millions of safe anesthetics done by crnas without physician

  7. CRNAs Should Not be Allowed to Practice Independently - One Anesthesiologist’s Opinion

    jfratian replied to tnbutterfly - Mary's topic in Certified Registered Nurse Anesthetist, CRNA

    Is "based on my 30 yrs" going to be your answer to everything? From your comments, your baseline opinion of the nurse anesthesia residents seems pretty low. I suspect you're unlikely to get their...

  8. CRNAs Should Not be Allowed to Practice Independently - One Anesthesiologist’s Opinion

    jfratian replied to tnbutterfly - Mary's topic in Certified Registered Nurse Anesthetist, CRNA

    Hundreds of independent practice CRNA groups hire new grads every day. They do just fine. Decades of data across millions of anesthetics support that. The number of independent practice is growing...

  9. CRNAs Should Not be Allowed to Practice Independently - One Anesthesiologist’s Opinion

    jfratian replied to tnbutterfly - Mary's topic in Certified Registered Nurse Anesthetist, CRNA

    Advocating for improvements in the profession is always welcome. I have no doubt that minimum numbers will be raised soon given the averages I've seen from those graduating. There's always been a...

  10. CRNAs Should Not be Allowed to Practice Independently - One Anesthesiologist’s Opinion

    jfratian replied to tnbutterfly - Mary's topic in Certified Registered Nurse Anesthetist, CRNA

    Youre twisting my words. People choose to work in ACTs for all sorts of reasons. It could be money. It could be location, schedule, or some other personal reason. Some people that want to do...

  11. CRNAs Should Not be Allowed to Practice Independently - One Anesthesiologist’s Opinion

    jfratian replied to tnbutterfly - Mary's topic in Certified Registered Nurse Anesthetist, CRNA

    Independent obviously means providing the entire scope of anesthesia care without any supervision or direction from anyone else. When I go to work every day it's just me and the surgeon in the...

  12. Military nursing 2024

    jfratian replied to EmergencyRN08's topic in Government, Military

    Id say the navy has the best base locations minus portsmouth. In terms of overseas, most jobs are stateside so numerically it's less likely but not impossible. Military nursing is 80%...

  13. Cleveland Clinic / UH hospital / Metro CRNA average salary

    jfratian replied to dlee50's topic in Certified Registered Nurse Anesthetist, CRNA

    A good way to figure out the market wage in your area for crnas is to go to gaswork.com and look at the posted jobs in your area of interest. Generally, rural and full scope practices are going to...

  14. CRNAs Should Not be Allowed to Practice Independently - One Anesthesiologist’s Opinion

    jfratian replied to tnbutterfly - Mary's topic in Certified Registered Nurse Anesthetist, CRNA

    I certainly never bought into the ACT concept and certainly won't change any minds already working in the field (which are generally already made up). My purpose in participating in this exchange of...

  15. CRNAs Should Not be Allowed to Practice Independently - One Anesthesiologist’s Opinion

    jfratian replied to tnbutterfly - Mary's topic in Certified Registered Nurse Anesthetist, CRNA

    I think the percieved quality of anonomized online discussion forums are pretty weak evidence of anything. We shouldn't be making healthcare decisions on that level of

  16. CRNAs Should Not be Allowed to Practice Independently - One Anesthesiologist’s Opinion

    jfratian replied to tnbutterfly - Mary's topic in Certified Registered Nurse Anesthetist, CRNA

    Not sure how one would objectively evaluate the quality of a discussion forum. I doubt any unbiased stakeholder would find that arguement compelling. Although, to that end I would consider several of...

  17. CRNAs Should Not be Allowed to Practice Independently - One Anesthesiologist’s Opinion

    jfratian replied to tnbutterfly - Mary's topic in Certified Registered Nurse Anesthetist, CRNA

    Agree to disagree. We have crnas and MDAs who truly cannot do anything but bread and butter. We have crnas and MDAs who do RFAs/pain procedures, exotic blocks, and hearts without any...

  18. CRNAs Should Not be Allowed to Practice Independently - One Anesthesiologist’s Opinion

    jfratian replied to tnbutterfly - Mary's topic in Certified Registered Nurse Anesthetist, CRNA

    While that sounds nice, 7 figures isn't much when you probably need 4 or 5 FTEs worth of physician anesthesiologists each making 600k/yr to cover one person in one ICU 24/7; imagine multiple ICUs with...

  19. CRNAs Should Not be Allowed to Practice Independently - One Anesthesiologist’s Opinion

    jfratian replied to tnbutterfly - Mary's topic in Certified Registered Nurse Anesthetist, CRNA

    Not sure who should manage ICU, but in practice it seems to be pulmonology, the acute care surgeon, the CT surgeon, or neurosurgeon depending on the case. I rarely see anesthesia managing ICU apart...

  20. CRNAs Should Not be Allowed to Practice Independently - One Anesthesiologist’s Opinion

    jfratian replied to tnbutterfly - Mary's topic in Certified Registered Nurse Anesthetist, CRNA

    Definitely not implying physician anesthesiologists can be replaced by us. Theres plenty of work to go around. However, I would point out that most generalist physician anesthesiologists can't do...

  21. CRNAs Should Not be Allowed to Practice Independently - One Anesthesiologist’s Opinion

    jfratian replied to tnbutterfly - Mary's topic in Certified Registered Nurse Anesthetist, CRNA

    I suspect major university teaching hospitals will always be physician dominant, so we'll probably never know the answer to that question. At an anecdotal level, I practice in an a part of the...

  22. CRNAs Should Not be Allowed to Practice Independently - One Anesthesiologist’s Opinion

    jfratian replied to tnbutterfly - Mary's topic in Certified Registered Nurse Anesthetist, CRNA

    Probably the most telling stats in this argument come from actuaries. No bias all math. CRNAs practicing in restrictive care team models with heavy physician supervision pay the exact same...

  23. Post doctoral CRNA certification programs?

    jfratian replied to NurseYyw's topic in Certified Registered Nurse Anesthetist, CRNA

    There is certainly a robust discussion to be had about whether the transition from 27-month/7semester MSN to 36 month/9semester DNP in nurse anesthesia was value added. However, I don't think that's...

  24. Commissioning, Rank, and Board

    jfratian replied to SP101BNZ's topic in Government, Military

    Pending degrees don't count. Either way, I think your 10 years of experience and MSN will equate to an O-3. You only get the O-3E with the equivalent of 4 years plus 1 day of active duty time....

  25. CRNAs working at VA hospital

    jfratian replied to ArmyTwin's topic in Certified Registered Nurse Anesthetist, CRNA

    As the saying goes, if you've been to one VA then you've been to one VA. They are all very different in terms of practice, case types, and supervision models. It's impossible to paint all VAs with a...