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wtbcrna MSN, DNP, CRNA

Anesthesia
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wtbcrna is a MSN, DNP, CRNA and specializes in Anesthesia.

USAF nurse

wtbcrna's Latest Activity

  1. wtbcrna

    Flu shot, get sick

    That’s inaccurate. The flu vaccine is 40-60% average effectiveness. https://www.CDC.gov/flu/vaccines-work/vaccineeffect.htm The flu vaccine has shown to reduce hospitalizations in the elderly by 40%. In children 74% of PICU admissions for flu did not receive the flu vaccine. In adults the vaccine reduce ICU admissions with the flu by 82%. The rate of serious reactions from the flu vaccine, which is usually allergy related, is approximately 1:1,000,000. The most common VICP claim is shoulder pain after vaccinations. The primary cause of those longterm shoulder pain is injections into the shoulder joint instead of the deltoid muscle. People often state GBS is a serious side effect caused by flu vaccine. The fact is some studies show an increased incidence of GBS 1-2 cases per million flu vaccinations while other studies show no increased incidence. The fact is that those who don’t get the flu vaccine often have a higher chance of GBS than those who get the flu vaccine. The 1976 swine flu vaccine being the exception to that. https://www.CDC.gov/flu/prevent/general.htm https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6985921/ https://pubmed.ncbi.nlm.nih.gov/31771864/
  2. The better question is why were 60 obese OB patients scheduled for general anesthesia.
  3. wtbcrna

    CRNAs: We are the Answer

    Making 350-450k is not usual and you can see the AANA annual compensation and benefits summary to verify that for yourself. The CRNAs that usually make that much are usually partners/owners and also specialize in pain. You can also look on gaswork.com to verify the salaries being offered also. All of your information is secondhand hearsay. Have you verified the salaries from any independent sources yourself? Her being limited has nothing to do with AANA or CRNAs, if she wants a specific type of job she will have to compromise.
  4. wtbcrna

    CRNAs: We are the Answer

    I’m finding it hard to believe that your friend is looking that hard when I can do a 30 second search and find rural anesthesiologists jobs. https://www.gaswork.com/search/Anesthesiologist/Job
  5. wtbcrna

    CRNAs: We are the Answer

    2 CRNAS working during scheduled cases. 1 week of call at a time. There is general surgery/GI, ortho, and OMFS. There was normally 2-4 cases M-Th. You don’t work in CAH because you want excitement. The majority of us go there for quality of life job.
  6. wtbcrna

    CRNAs: We are the Answer

    It’s easier to tell her that than argue why they do it and that they won’t pay her anymore than the CRNAS. By the way all your information is secondhand hearsay.
  7. wtbcrna

    CRNAs: We are the Answer

    I just came from what would be considered a CAH. I had a gsw to the neck, a 19mo pediatric death in the ER that I had to lifeflight with, hangings, someone got drunk and fell out of 4 story window, workers falling off of three story scaffolding , GI bleed with only 2 units of blood in the hospital, MVAs, and lots of people coming to the OR with unknown etiologies that end up being pain to deal with it in the OR. That was all in less than years time. It isn’t about the volume but the amount resources you have to deal with it. In a CAH you’re it and you do it all often as the only anesthesia provider.
  8. wtbcrna

    CRNA, Anesthesiologist Relationships

    You have worked in an independent CRNA practice?
  9. wtbcrna

    CRNAs: We are the Answer

    We are talking two different things. You have to be critical access hospital to even get the pass through money, which is for hospitals with less than 25 beds. your friend hasn’t been effected at all if she is only been looking at hospitals over 25 beds. She is being effected solely by market economics. https://www.ruralhealthinfo.org/topics/critical-access-hospitals https://ecfsapi.fcc.gov/file/7021904954.pdf
  10. wtbcrna

    CRNAs: We are the Answer

    1. If you are interested see closed claim cases and “let the record show” book by the AANA if you can find a copy that will explain the topic. You can also do searches on the AANA. 2. Calling for help or not calling for help doesn’t determine liability
  11. wtbcrna

    CRNAs: We are the Answer

  12. wtbcrna

    CRNA, Anesthesiologist Relationships

    In the work area CRNAs and MDAs do usually get along just fine. That doesn’t mean that there isn’t constant underlying issues or that politics of anesthesia aren’t still there. Your experience with anesthesia providers is very limited and only encompasses one type of anesthesia practice. Read “Watchful Care” if you’re interested. https://www.aana.com/store/AANA-books
  13. wtbcrna

    CRNAs: We are the Answer

    This isn’t true. You are trying to take an extremely complicated topic and simplify it. 1. When and if a CRNA or MDA did not follow facility guidelines (this what usually happens in ACT practices where they are found liable d/t not calling)or was determined to not have met standard of care they can be held liable. The MDA in an act is almost always initially going to be named in the lawsuit but that doesn’t determine if they are going to be held liable for example if the MDA and CRNA agreed on one type of anesthetic plan but the CRNA did something totally different without consulting the MDA and something bad happened d/t that plan it’s not as likely the MDA will be held liable.
  14. wtbcrna

    CRNAs: We are the Answer

    1. That is per the ASA studies on ACTs and meeting billing requirements. 2. Salaries are lower in ACT practices generally because CRNAs are employees while the MDAs control and own the practices. It also goes back to the market where almost everyone wants to live/work in the city but almost no one wants to work in rural areas. You can also pay CRNAs more when you eliminate redundant anesthesia providers, which is what ACT practices promote. 3. My understanding is the rural pass through money goes to the hospitals not directly to CRNAs. 4. Your friend is billing the insurance directly also. Does it matter? Rural practices don’t have the same volume and you are often getting paid for being on call up to 50% of the year not because of the insurance/CMS reimbursements. 5. There are 1-2 states that require MDA involvement. Opt out and non-opt out states are only about billing CMS and is easily worked around in most states by the surgeon signing a prefilled order sheet requesting anesthesia. When you don’t take care of Medicare patients then it’s a non-issue at all and except for those 1-2 states you don’t even have to worry about having the order/sign off for anesthesia. https://www.aana.com/advocacy/state-government-affairs/federal-supervision-rule-opt-out-information/fact-sheet-concerning-state-opt-outs 6. Hospitals can and have gone to all CRNA or all MDA practices, but no matter the rhetoric there isn’t enough CRNAs or MDAs by themselves to do all the anesthetics in the USA.
  15. wtbcrna

    CRNAs: We are the Answer

    1. We all have professional anesthesia liability insurance. It’s dictated by the state the amount we have to have, which is the same for all anesthesia providers whether MDA or CRNA. The pockets are the same size, but the more pockets they can get into the more the possible payout. Also insurance even if you aren’t clearly in the wrong will often pay out a settlement to eliminate long and costly litigation. 2. Notifying the surgeon doesn’t cover you. It can help but it doesn’t eliminate liability. What it does eliminate is the surgeon saying they didn’t know and throwing you or someone else under the bus. CRNAs even in an ACT practice are still overall considered independent providers. We are no longer just nurses and held to totally different standards.
  16. wtbcrna

    CRNAs: We are the Answer