Question regarding CRNA practicein Community hospital vs Teaching hospital

Scope of practice can vary widely depending on the culture of the institution you are at. This is definitely something to consider when you are applying for jobs. I work at a teaching hospital (however we do not have anesthesia residents) so the CRNAs do a large number of cases involving very sick patients. We do cardiac (if desired) and neuro. However, our scope of practice states that we are not allowed to perform peripheral blocks or epidurals, while we do perform spinals and arterial and central line placements. Some hospitals are definitely more "CRNA friendly" then others.

Scope of practice can vary widely depending on the culture of the institution you are at. This is definitely something to consider when you are applying for jobs. I work at a teaching hospital (however we do not have anesthesia residents) so the CRNAs do a large number of cases involving very sick patients. We do cardiac (if desired) and neuro. However, our scope of practice states that we are not allowed to perform peripheral blocks or epidurals, while we do perform spinals and arterial and central line placements. Some hospitals are definitely more "CRNA friendly" then others.

It's a shame that you can't perform peripheral blocks or epidurals. I guess that many of the epidurals are done for OB cases. I know that in many hospitals CRNAs are not allowed to perform any type of anesthesia for OB cases to due to the high rate of malpractice. Don't know if this is the reason why you can't perform epidurals in your case though.

I have been a CRNA for over 25 years in middle and east Tennessee. I was trained at Erlanger Medical Center in Chattanooga, Tennessee. There we were taught and permitted to be autonomous. There was no MDA residency program there. In our senior year we were doing all but hearts essentially on our own and the day after graduation you were on your own again save for hearts. Since then I have been in more rural practices where there are only CRNAs who administer all forms of anesthesia including doing arterial lines, central lines, pain management, epidurals, spinals, and all forms of regional anesthesia. It is a little to moderately more stressful but the rewards are greater.

I think many CRNAs are doing OB except in some teaching hospitals (and a few other situations) where the anesthesia residents need the cases for their numbers.