Why don't CRNA's like AA's

deepz · Jun 5, 2004

Not snotty - just a different approach. And please, not again with the clinical comparisons. ........You personally do not know us. You've never met one of us, much less worked with one of us. You've only heard about us from your association or this board. ........I interview anesthetists for my group (70+, even split AA/CRNA). ........If you can do the job and work within our particular practice parameters, I'll not only respect you, I'll hire you!:) Call me and we'll chat.

Yes, snotty, my dear jwk, GeorgiaAA, or whatever pseudonym you hide behind this week. I seriously doubt that I am the only person on this CRNA/SRNA board growing tired of your repititious self-serving rants and boasts. Surely somewhere you could find an AA board where someone might actually care what you have to say? I'd invite you to go there.

Second, how on earth could you venture to claim to know the minds of others: who it might be that all of us might know, who we've met in our various lives, or where we might gather our information? Presumptuous, I guess. Snotty, for sure. Perhaps you learned that arrogance, and learned it well, from your A$A masters. They've also never understood the primary importance of the bedside nursing skills we CRNAs bring to anesthesia, and obviously you don't either. So be it.

As to your last offer, does the phrase 'where the sun don't shine' ring a bell?

deepz

u-r-sleeepy · Jun 5, 2004

You wrote:

"What's changed in 30 years of AA's... (I know, lots of you don't like the concept [ACT setting] - we fully supported it even before the ASA started liking us..."

Ahhhhhh yeah, so the establishment of AAs just "happened" um... HOW? Without the A$A's imput or help? Is that really true? ;-) You guys must be GOOD! You just up and decided on your own one day that you're going to create another anesthesia provider and hoped someone (A$A) might like you and bring you in and offer you a job?!? That's an AMAZING story!!!

"We're highly educated (just like you)..."

Ahhhh, no. You're NOT educated "just like me". Reality can be difficult for some personalities to grasp, but I encourage you to "get over it" and accept it. You're education and overall training is considerably different from ours.

Allow me to list a few areas of difference that I see:

1 - Because of the way some MDAs practice in "your neck of the woods"... some AAs practice outside their scope of practice at times, and yet the docs let it continue. Do you have a through understanding of the TEFRA shackles? Are you following them completely? Or rather - are your MDA "supervisors"?? I know for a fact they are not in many instances. Word does get around and that is part of what concerns people like me. Do you realize both the MDA and YOU are technically committing "fraud" when you don't follow TEFRA to the letter? Just think about it....

What happens when an MDA is "supervising" 2 rooms and OB...? and something starts to "happen" in one of your rooms? 8-O

2 - Limited role. Do you really enjoy knowing that your umbilical cord can never be cut from the MDA "Masters"? That would get to me after a while. That and a more narrow scope of practice overall.

Still, I have an idea for you - if your numbers ever do grow significantly, I would like to encourage you to begin forming a committee - or even a union!! - to plot and plan how to break free from the MDA shackles and be able to provide anesthesia without MDA supervision!!! "YEAH BABY!!!!!!!" That will get the A$A's attention!!!!! Hahahahahaha!!! I'm serious about this - if your numbers ever grow large enough... just start talking about your desire to "help the under-served areas of healthcare" in America and your willingness to provide anesthesia there and see how the docs respond. If you have a more or less steller record for safety - have at it! :)

Then again - maybe the AANA should think about offering some kind of "bridge program" for AAs to become full-fledged CRNAs? Then they could have the choice of ACT setting or independent practitioner. That would make the A$A soil their britches in record time! ;-) hahahahaha!!! (no - I don't really think that would be possible, but still, just the thought of it...!)

3 - The $$$$. I don't believe you're aware of this, but you are NOT making what most CRNAs are earning. Sure, there are some who are in your income level who practice near (or right next to!) you, but for the most part, you're not making the $$$$ we are. Proof you want? How's this little snippet from a CRNA:

"I have a CRNA friend in Atlanta and she said as soon as the hospital where

she worked in Atlanta hired enough AAs, her salary was cut by $20/hour with

no explanation given. Like it or lump it. I think that is where we are

headed."

That's a little over $40k/yr cut not including any OT. Why? Because she practiced in the Atlanta area... where AAs are employed, but YOU know better because you know Atlanta, right?

Most of us don't talk about our incomes too much, but let me just say - you're not close to me. I am a recent graduate also. The reason CRNAs you work with are making what you're making... is because their pay has been "downsized" to what you were offered. That's the only reason it is "equal" where you are.

When I was nearing graduation the offers for me were amazing! It was very "encouraging" to see what I was "worth" to so many potential employers. One of the things I decided on before interviewing was that I absolutely REFUSED to work in a setting that employed AAs. I also made it a point before accepting an invitation to interview: "Do you employ AAs? Would you ever consider employing AAs?" Yes, I did this! :)

The top MDA at the Austin (HUGE!) group where I interviewed was a little bit "weak" on his response to that question. He knew where I was coming from and got the point. He wanted me to work with them very much as my training was steller having done a lot of my clinicals in one of the top training hospitals in the country. I passed on their offer for several reasons. Still, I was just letting him know my take on the subject.

WHY don't YOU want to do better for yourself? Do you have any idea what the docs you're "under" are making? Don't you realize you could be making a lot more as a CRNA or MDA/DOA? Well, it was a thought of mine. If you're really as bright as you ??? want me to believe, why don't you go on to be an MDA or CRNA?

I don't know where this struggle will end. To me - it is all about "power and money" and you - the lowly AA - are caught in the middle. I don't like to "come down hard on you" in part because I know what that feels like. Basically, I don't want to "do to you" what some MDAs want to "do to me"! You seem bright and you're obviously a competent practitioner already. I think it's a pity the A$A is as "dirty" as they are and wonder where this will lead.

Only time will tell....

Sleeepy

jwk · Jun 5, 2004

Yes, snotty, my dear jwk, GeorgiaAA, or whatever pseudonym you hide behind this week. I seriously doubt that I am the only person on this CRNA/SRNA board growing tired of your repititious self-serving rants and boasts.
Perhaps you learned that arrogance, and learned it well, from your A$A masters.
deepz

Actually, GeorgiaAA and I are two different people. And there's only two of us "ranting". We're only trying to get a little balance into the discussion and a little real knowledge about AA's, something that is sorely lacking.

I'm not the one being arrogant. I don't claim that I'm better than anyone else.

This little "A$A" thing several of you are fond of using - that says a lot.

deepz · Jun 5, 2004

This little "A$A" thing several of you are fond of using - that says a lot.

Snotty to the last.

As an old soldier I will refuse, under the terms of the Geneva Convention, to deal harshly in a battle of wits with an unarmed opponent.

deepz

Sheri257 · Jun 5, 2004

I seriously doubt that I am the only person on this CRNA/SRNA board growing tired of your repititious self-serving rants and boasts.

Actually deepz, even I'm starting to agree with you on this one. (Miracles do happen. )

At first I was really interested in what AA's have to say, and hearing from the other side. But now ... well ... I don't really know if there's any real point to this ... It seems to be going nowhere.

If there was actually something newsworthy, like another state decision or something like that, then I could understand it. But outside of that, it's starting to look like the battle of the trolls.