Why would a CRNA not be allowed to do hearts,OB, Cardio?

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I was looking throgh some CRNA ads and one caught my attention

"Special Conditions: 1 MD for every 2 rooms. CRNA is not allowed to do OB, Hearts or Cardio....no exceptions! May lose those skills if working there a long time."

This was from a large hosptial that does many types of surgeries. Why wouldn't they allow CRNAs to perform on the above mentioned cases?

Thanks

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job protection for anesthesiologists? costs for hospital?

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Surgeon preference.

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Specializes in medical, telemetry, IMC.

in the hospital where i just did my ob/l&d rotation, they have a crna who spezializes only in l&d, he did all the epidurals, spinals, ..... during the 6 days i did my clinicals there. i've never even seen an anesthesiologist there on the floor.

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Specializes in Urgent Care.
job protection for anesthesiologists? liability insurance costs for hospital?

My guess too would be liability issues. Myabe the hosp admins feel that there is less risk if the CRNA is totally focused just on that. Just my quess.

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Specializes in Oncology/Haemetology/HIV.

In some areas, due to cost of liability to the facilities, various practitioners find that they have limitations on their work.

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One should raise the obvious question of whether or not the hospital houses a large anesthesiology residency program. I suspect that any institution that runs 2:1 is, in fact, an academic and not private practice, otherwise this is a really poor model for making any real money for the group.

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I agree with all the above and will add there MAY have been complications that occurred in those noted cases. Not to ruffle any feathers, but I could if I wanted to, press a case against a horrible CRNA myself.

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politics, 99% of the time it's politics

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One should raise the obvious question of whether or not the hospital houses a large anesthesiology residency program. I suspect that any institution that runs 2:1 is, in fact, an academic and not private practice, otherwise this is a really poor model for making any real money for the group.

I think you nailed it here. It would be a financial disincentive for an attending to go 2:1 except for the teaching rules--that fortunately did not change this year.

But, yes there are politics too. When I was in San Antonio, there were NO CRNAs except in government (military & VA) hospitals.

I don't think there has ever been a difference in liability...'cept an MDA telling the surgeon "ya know if you don't have an ologist on the case, the bad stuff will fall on you. You really need me in the room to protect you."

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In some areas, due to cost of liability to the facilities, various practitioners find that they have limitations on their work.

"The principles governing the liability of a surgeon or obstetrician when working with a CRNA are the same as those governing the liability of a surgeon or obstetrician when working with an anesthesiologist. Whether or not a surgeon or obstetrician will be held liable for the negligence of the anesthetist depends on the facts of the case, not on the nature of the license of the anesthesia provider." Legal Issues in Nurse Anesthesia Practice, http://www.aana.com/crna/prof/legal.asp

I agree with charles-thor that a likely explanation is a residency program. And while one could make the argument that a 2:1 ratio is not the most cost effective, I think that assumes that both providers are employed by the group. If the CRNAs are hospital employed, revenue generation and billing becomes more complicated.

The issues surrounding the OP's observation are many and complex. It is not easily explained by one pat answer.

BTW, steelcityRN, I am sorry you had a horrible experience with a CRNA. Unfortunately, health care is complicated at all levels, and things happen. Sometimes a provider is personally responsible, and sometimes not. If you suffered because of professional negligence, it should be pursued. But for every CRNA incident, one could find an anesthesiologist incident. IMO, such logic quickly gets ugly, and really doesn't serve either provider, or the patient.

loisane crna

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Great question! I just spent two days in the OR observing, and I only met one anesthesiologist, and 5 CRNA. My goal is to become a CRNA and I would like to do hearts, OB etc.

Good Luck to everyone out there.

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