Why Do Anesthesiologists Despise CRNA's?

dfk, RN, CRNA · Aug 12, 2007

Interesting. If being paid is your litmus test for determining whether it's called education or not, your argument just got weaker.
my education statement was directed to an academic institution. i did not say you don't learn while working, but during those 2 years of icu experience, most people are working, so they can't be counted as individual time.
Undergrad: whether the major is nursing or biology, most people worked during undergrad. So, if one worked getting a BSN or a BS in biology, this cannot be considered education according to your argument. I guess that cancels those out.
umm, doesn't matter the degree, still getting education at college/univ. so, yea, education years.
Medical school: they're all four years long. The volume of work during this time doesn't allow for students to work. This, then, according to your test, is called education: 4 years.
CRNA school: SRNA's do not work during CRNA school. Most programs average 2.5 years; some are more, some are less. Anyone who says they are working full time during any portion of CRNA school is feeding you a line of bull. The same number of people who work during CRNA school is probably the same proportion as those who work during med school We'll call it a draw and say that you don't work during CRNA school. This, then, is called education: 2.5 years.
sorry, but this is not a blanket statement. and you don't know who or what i know. and, yea, people do AND can work full time during didactic. perhaps you just had a little harder time than others.
Residency: Interns and residents are being paid during this time. 3 years of residency and a one year fellowship for MD's are all paid. I guess this isn't education either then, according to your test.
ICU experience: the average student in CRNA school has 4 years of ICU experience. However, this is paid, and according to your test does not count as education.
So, there's your argument in your own terms: MD's have 4 years of education, CRNA's have 2.5. And if education determines pay, and an MD is paid 300K on average for anesthesia, then CRNA's should get 187K on average. Looks like according to your terms, CRNA's are underpaid.

so, where's the first four yrs of those that went to med school? that would be four more. where's the first four yrs of CRNA school? uh, that would be four too. so that brings us to a tally of 8 for meds, 6 +/- months for CRNA. so, i guess we are both wrong. again, not saying working/clinical is not education, but not the traditional education i spoke of.

dfk, RN, CRNA · Aug 12, 2007

We could go back and forth on this and that but I was wondering what your point was..... Maybe that we are over paid and under qualified? If thats what you are driving at lets just agree to disagree. This is starting to get ugly and no one here needs your negativity. People have worked very hard to become competent CRNAs and if you have a problem with the profession, its YOUR problem
i have no problem with the profession or anyone in general. all the point i was trying to make was that college/university time education is what is usually counted with regards to years of education. on the job education is also important, and i guess looking at it closer, RNs do not get their working yrs counted as education like the residents claim to. and i never said CRNAs are overpaid and underqualified either, so please don't put words into my mouth.

dfk, RN, CRNA · Aug 12, 2007

ummm, let me get this right
I learned what I know about taking care of cabg/valve from nursing school. Not hardly. The first two (and possibly more) years in the ICU was nothing but learning. But the residents get to claim it when they are the ones coming to me because they don't know why the epicardial wires aren't coming out the way they are supposed to. SO when residents aske me questions its educational, but when I'm going to classes for eight hours a week to learn critical care that's "just my job" that makes sense.
And I would really like to know who the two supermen/superwomen were that worked FULL TIME during their CRNA program. That may be stretching the truth just a wee bit. Besides there are no residents moonlighting?
Lastly what kind of medical professional are you that you come on a nursing web site and speak in such an inflammatory manner????
Oh and thanks for listening...:trout:
well, i guess this will go on forever. i don't disagree that on the job learning is education. my point was that when the "clarification" from docs say that their years of education is so many years, they do count the residency as yrs of education. when nurses are compared, they just have so much less in comparison. icu yrs are not counted, yet, yes, learning and education is always going on.
as for the working SRNAs, believe what you will, however, i chose to not step one foot in the hospital as an RN working. i'm glad to be out.
as for the residents moonlighting? i have no doubts.
by the way, i've been on this site for a long time, and express myself within the "limits" of this site. sorry if it came off as imflammatory, but it bothers me when people insist they are correct and don't take into consideration, sometimes, the actual truth.
thanks for LETTING me listen ~

dfk, RN, CRNA · Aug 12, 2007

Don't believe it.

i guess if you didn't just cut and paste what you wanted to show, then people would see that you left out probably the most critical portion of the statement. as i said before, usually during the didactic portions do i find people working the most. and yea, i DO believe it. i KNOW it. it comes easier to some than others.

heartrn35 · Aug 12, 2007

well, i guess this will go on forever. i don't disagree that on the job learning is education. my point was that when the "clarification" from docs say that their years of education is so many years, they do count the residency as yrs of education. when nurses are compared, they just have so much less in comparison. icu yrs are not counted, yet, yes, learning and education is always going on.
as for the working SRNAs, believe what you will, however, i chose to not step one foot in the hospital as an RN working. i'm glad to be out.
as for the residents moonlighting? i have no doubts.
by the way, i've been on this site for a long time, and express myself within the "limits" of this site. sorry if it came off as imflammatory, but it bothers me when people insist they are correct and don't take into consideration, sometimes, the actual truth.
thanks for LETTING me listen ~
Did you ever notice that when people say things like "sorry if it came off as inflammatory" they rarely mean it. I'm not sure what your problem is with this particular thread and I don't know you that well (but I will keep reading to find out) but you appear to be a WANABE. You want to be someone important, so you see if you can piss people off and get something going. How sad.
Oh and by the way since you are the knower of "the actual truth" I'll let God know he can take some time off since you are here to set us straight.

GregRN · Aug 12, 2007

so, where's the first four yrs of those that went to med school? that would be four more. where's the first four yrs of CRNA school? uh, that would be four too. so that brings us to a tally of 8 for meds, 6 +/- months for CRNA. so, i guess we are both wrong. again, not saying working/clinical is not education, but not the traditional education i spoke of.

Nope, just one of us is wrong. I've already covered this. The undergrad years were canceled out due to working during that time. But your 8 vs. 6 years is even more favorable to CRNA's than the previous 4 vs. 2.5 years. Keep digging your hole though.

GregRN · Aug 12, 2007

(i even know of two srna's that work f/t during their program, mostly during didactic portions).

My B.S. detector is pegged.

In another of your posts you say that you know SRNA's who work part time, now you say full time. And part time could be one 8 hour shift every month or so. I'll bet I could count the number of full-time employed SRNA's on less than one hand.

FlGasman · Aug 13, 2007

Nope, just one of us is wrong. I've already covered this. The undergrad years were canceled out due to working during that time. But your 8 vs. 6 years is even more favorable to CRNA's than the previous 4 vs. 2.5 years. Keep digging your hole though.

another way to look at it if we are going to start triviazlizing requirements like (the invaluable) ICU exp:

years that have little or nothing to do with paitent care:

the whole undergrad med degree vs the first two years of bsn (unless you got an adn then BSN, then you count four producitve years

so

RN- 2-4 depending on adn

plus 2 ICU

plus 2.5 grad= 6.5 to 8.5

MD-

0 for undergrad-

4- med

4 residency

total 8 so whose less now??

we can go back and forth trying to rewrite everything by discounting requirements but in my book

the requirements are 8.5 for CRNA and 11-12 for anesthesiologist.

however none of that matters, I am happy with status quo and if one side tries to restrict the other the back and forth hurts both sides....

Josh L.Ac. · Aug 13, 2007

1. My first bachelor's degree was in biology / chemistry with an emphasis on pre-med and on Saturday, I completed an accelerated BSN program. I've done both.

There is no comparison.

Although I had to study more for my nursing degree d/t the volume of work, the classes did not compare to organic chem, biochem, or advanced cellular biology. It is ridiculous to compare nursing school to medical school when it is not even as difficult as pre-medicine classes. Granted, the didactic portion of nursing school does not need to be as difficult since the focus is on the technical aspect of the job, which is probably why a graduate nurse does better in the hospital than a MSIII...at least at first.

We actually had a student in my accelerated BSN program that completed the first three years of medical school. His informed opinion is that if you could ace the accelerated BSN program, you would probably do well at medical school.

But are they comparable in terms of difficulty and depth? Of course not.

2. Outcomes Research

People on both sides of the aisle point to research showing that CRNA outcomes are either comparable or not, but rarely does anyone post the research to actually strengthen their point. If you want to quote a study, post it in its entirety so we can judge the validity of the study ourselves.

3. Nurses started anesthesia

Great point but it is largely irrelevant. This justification for nurse anesthesia is a logical fallacy called "Argumentum ad antiquitatem" or "the argument to antiquity or tradition". This fallacious argument is quite common in the acupuncture world, so I am very familiar with it. Basically the idea is that because some important group did something years ago, it is somehow relevant to today. Yes the Chinese accurately described the circulation of blood 1700 years before Harvey figured it out, but that does not validate using acupuncture to improve the odds of IVF working.

Along the same line of logic, just because nurses [and janitors] started the field of [modern] anesthesia does not justify the concept of independent practice. In reality, Hua Tuo used anesthetic herbs to perform surgery in China 2100 years ago...does that mean that Chinese herbalists also have the right to practice anesthesia indepedently because we started the whole thing?

I plan on becoming a CRNA and working under the ACT model. Working under an anesthesiologist will not devalue or demean what I do, and conversly, demanding the right to practice independently will not legitimize the field of nurse anesthesia.

GregRN · Aug 13, 2007

another way to look at it if we are going to start triviazlizing requirements like (the invaluable) ICU exp:
years that have little or nothing to do with paitent care:
the whole undergrad med degree vs the first two years of bsn (unless you got an adn then BSN, then you count four producitve years
so
RN- 2-4 depending on adn
plus 2 ICU
plus 2.5 grad= 6.5 to 8.5
MD-
0 for undergrad-
4- med
4 residency
total 8 so whose less now??
we can go back and forth trying to rewrite everything by discounting requirements but in my book
the requirements are 8.5 for CRNA and 11-12 for anesthesiologist.
however none of that matters, I am happy with status quo and if one side tries to restrict the other the back and forth hurts both sides....

Realistically, until you are allowed to practice anesthesia it's all considered training, whether you're paid or not. MD: 4 years undergrad, 4 years med school, 3 years residency=11 years. CRNA: 4 years undergrad, whatever ICU time you spend (average is 4), 2.5 years CRNA school. But all of this really does not matter. Again, any increased training is irrelevant unless it leads to better outcomes.

Biotechnology · Aug 13, 2007

1. My first bachelor's degree was in biology / chemistry with an emphasis on pre-med and on Saturday, I completed an accelerated BSN program. I've done both.
There is no comparison.
Although I had to study more for my nursing degree d/t the volume of work, the classes did not compare to organic chem, biochem, or advanced cellular biology. It is ridiculous to compare nursing school to medical school when it is not even as difficult as pre-medicine classes. Granted, the didactic portion of nursing school does not need to be as difficult since the focus is on the technical aspect of the job, which is probably why a graduate nurse does better in the hospital than a MSIII...at least at first.
We actually had a student in my accelerated BSN program that completed the first three years of medical school. His informed opinion is that if you could ace the accelerated BSN program, you would probably do well at medical school.
But are they comparable in terms of difficulty and depth? Of course not.
2. Outcomes Research
People on both sides of the aisle point to research showing that CRNA outcomes are either comparable or not, but rarely does anyone post the research to actually strengthen their point. If you want to quote a study, post it in its entirety so we can judge the validity of the study ourselves.
3. Nurses started anesthesia
Great point but it is largely irrelevant. This justification for nurse anesthesia is a logical fallacy called "Argumentum ad antiquitatem" or "the argument to antiquity or tradition". This fallacious argument is quite common in the acupuncture world, so I am very familiar with it. Basically the idea is that because some important group did something years ago, it is somehow relevant to today. Yes the Chinese accurately described the circulation of blood 1700 years before Harvey figured it out, but that does not validate using acupuncture to improve the odds of IVF working.
Along the same line of logic, just because nurses [and janitors] started the field of [modern] anesthesia does not justify the concept of independent practice. In reality, Hua Tuo used anesthetic herbs to perform surgery in China 2100 years ago...does that mean that Chinese herbalists also have the right to practice anesthesia indepedently because we started the whole thing?
I plan on becoming a CRNA and working under the ACT model. Working under an anesthesiologist will not devalue or demean what I do, and conversly, demanding the right to practice independently will not legitimize the field of nurse anesthesia.

Well said........

in2b8ix2b8 · Dec 24, 2010

Interesting. If being paid is your litmus test for determining whether it's called education or not, your argument just got weaker.
Undergrad: whether the major is nursing or biology, most people worked during undergrad. So, if one worked getting a BSN or a BS in biology, this cannot be considered education according to your argument. I guess that cancels those out.
Medical school: they're all four years long. The volume of work during this time doesn't allow for students to work. This, then, according to your test, is called education: 4 years.
CRNA school: SRNA's do not work during CRNA school. Most programs average 2.5 years; some are more, some are less. Anyone who says they are working full time during any portion of CRNA school is feeding you a line of bull. The same number of people who work during CRNA school is probably the same proportion as those who work during med school We'll call it a draw and say that you don't work during CRNA school. This, then, is called education: 2.5 years.
Residency: Interns and residents are being paid during this time. 3 years of residency and a one year fellowship for MD's are all paid. I guess this isn't education either then, according to your test.
ICU experience: the average student in CRNA school has 4 years of ICU experience. However, this is paid, and according to your test does not count as education.
So, there's your argument in your own terms: MD's have 4 years of education, CRNA's have 2.5. And if education determines pay, and an MD is paid 300K on average for anesthesia, then CRNA's should get 187K on average. Looks like according to your terms, CRNA's are underpaid.

BRAVO GregRN! You elucidated the foolishness of the previous argument of what does and doesn't constitute 'education' based on if one is drawing a salary or not. I am a CRNA and shared my cardiac rotation with an anesthesia resident (a 'doctor'); he had no clue how to handle the hemodynamics/drugs and even an episode of VT immediately post-op. My ICU experience made my cardiac rotation seem like cake; the resident, on the other hand, was a deer in headlights much of the time! Attending grand rounds as residents presented their cases (the binds they got themselves into), was amusing...giving Dilantin IV slam and then you have no BP which is refractory to any pharmacological intervention...and the list goes on! Of all the years of education that an MDA has, really only 3 or 4 of that is anesthesia training. I used the same text books as residents, worked side by side with them...no magical powers came from their M.D. status that made them a better anesthesia provider. Vigilance, ethics, continuing education, skill and ability do not depend on the degree one possesses; it stems from the motivation of the individual.