Why havent CRNAs pushed MDAs out yet?

PANurseRN1 · Jun 5, 2006

Nursing as a whole might be a 'subpar' profession but Nurse Anesthesia is anything but.

Wow, I'll bet you're a real treat to work with. Thank goodness for you you're moving on and won't have to slum with the rest of us groundlings.

:rolleyes:

athomas91 · Jun 5, 2006

My point was that MDA isn't a recognized title except by nurses on this board. The majority of people on this board ran yoga off with their ignorance, so good luck with that. Nursing as a whole might be a 'subpar' profession but Nurse Anesthesia is anything but. I do realize that doctors are doctors and nurses are nurses. If i minded being a part of an ACT then I would go to medical school and never have to see another anesthesia provider in a private office setting. But rather I look forward to the day I can goto school for 27 months and triple or quadruple my current salary passing gas as part of an ACT. I guess I'm just not as militant as the rest of this board, and would consider myself lucky to make the bank I would, and doing the job of a doctor with only a masters. I also acknowledge the docotor-nurse food chain and can't get mad that a doctor is trading stocks and drinking coffee while I'm 'working'. Afterall, he did goto medical school. Education always affects where you are on the food chain. I have 0 qualms playing indian and having a social life in my 20s and 30s while someone who sacrficed much more than that plays chief.
But please continue on your quest to rid the world of evil, incompetent anesthesiologists. Afterall you might change the world, and increase my future salary, though I remain doubtful.

1. MDA isn't a recognized term except on this board ey??

2. the majority of people didn't run yoga off...it was a select few numbskulls who like yourself comment on issues they know - i will be generous - 10% about

3. noone said an ACT program isn't good - but your comments were no where near pro-CRNA - as a matter of fact as a Nurse Anesthetist I found them rather anti-CRNA

4. no one here is militant - but some (like myself) take offense when those who aren't practicing but sitting on the sidelines commenting decide to tell me and even worse those with ump-teen years of experience that a Dr. is superior just because they have Dr. in front of their name... you will find with time and experience that practitioners vary in aptitude not based on their title but rather on experience, personal fortitude, thirst for knowledge and a little common sense.

5. I personally am not "mad" there is a food chain - i myself am working in an ACT setting as I feel it is beneficial to establishing a successful career and practice... however - your comments were " I for one, like the idea of having someone in a supervisory role to help you out or do the cases requiring their finesse." ... which is highly derogatory - you flat out say that if you want "finesse" you need MD as a title... and earlier call others "ignorant..."

6. NOONE has advocated the abolition of -ologosts... but this is a CRNA posting site - so you might want to consider that we tend to be pro- CRNA ... we don't fight to be the only practitioners... but we do fight to maintain our rights and practice and advance it...

I mean - you are aware of who started the practice of anesthesia -- are you not?

as far as MD's "sacrificing" more... that is again debatable...i worked for 6yrs in ER's and trauma bays - and have seen just about every thing you can possibly see in medicine..i went to school for 4 yrs to do that...then i went unpaid for 30 months to learn anesthesia... at least residents get paid... and i cannot argue that they don't have more "school" time - i will however argue that our nursing time shouldn't be forgotten as it is training for what we do - and that a good CRNA will equal if not outshine any -ologist... and honest MD's will admit that...

so.... just for the record - yoga i miss ya.

soliant12 · Jun 5, 2006

I am tired of people who are not CRNAs or SRNAs coming into these threads and offering their poorly thought out "opinions" on something they nothing about. The real people who sacrificed are the CRNAs who came before me and did such an excellent job that we enjoy the comforts of high pay and near total autonomy unheard of in any other nursing profession. These previous CRNAs were sometimes brought up on criminal charges for practicing medicine without licenses or daring to challenge the field of medicine in the search for autonomy and a broader scope of practice.

My point was that MDA isn't a recognized title except by nurses on this board. The majority of people on this board ran yoga off with their ignorance, so good luck with that. Nursing as a whole might be a 'subpar' profession but Nurse Anesthesia is anything but. I do realize that doctors are doctors and nurses are nurses. If i minded being a part of an ACT then I would go to medical school and never have to see another anesthesia provider in a private office setting. But rather I look forward to the day I can goto school for 27 months and triple or quadruple my current salary passing gas as part of an ACT. I guess I'm just not as militant as the rest of this board, and would consider myself lucky to make the bank I would, and doing the job of a doctor with only a masters. I also acknowledge the docotor-nurse food chain and can't get mad that a doctor is trading stocks and drinking coffee while I'm 'working'. Afterall, he did goto medical school. Education always affects where you are on the food chain. I have 0 qualms playing indian and having a social life in my 20s and 30s while someone who sacrficed much more than that plays chief.
But please continue on your quest to rid the world of evil, incompetent anesthesiologists. Afterall you might change the world, and increase my future salary, though I remain doubtful.

MmacFN · Jun 5, 2006

Oh my

Ok i just realised. Topher is a student not even an RN yet.

Topher, you need to learn more about the current profession your in before you start commenting on the advanced practice roles. You clearly have no idea what it means to be a Nurse let alone a CRNA. Nor do you have the knowledge of the politics in these professions to base such comments.

Stick to the STUDENT nurse forums as opposed to preaching and challenging people who have been doing this for years.

rayman · Jun 5, 2006

I am tired of people who are not CRNAs or SRNAs coming into these threads and offering their poorly thought out "opinions" on something they nothing about. The real people who sacrificed are the CRNAs who came before me and did such an excellent job that we enjoy the comforts of high pay and near total autonomy unheard of in any other nursing profession. These previous CRNAs were sometimes brought up on criminal charges for practicing medicine without licenses or daring to challenge the field of medicine in the search for autonomy and a broader scope of practice.

Yep, like deepz said earlier: "we stand on broad shoulders".

rn29306 · Jun 5, 2006

where the heck is yoga....loisanne....
i am sick to death of people who have no idea what a CRNA is, what they do, what it takes to be one, how we compare to other anesthesia providers, our scope of practice and generally anything else anesthesia related feeling they have a valid/correct/stabile opinion to offer about the profession. ... until you walk a mile...maybe you shouldn't comment.

:w00t: Nicely said.

Bring back yoga.

deepz · Jun 5, 2006

Yep, like deepz said earlier: "we stand on broad shoulders".

On giants' shoulders.

"A dwarf sees farther than the giant when he has the giant's shoulders to mount on."--Samuel Taylor Coleridge: The Friend, sect. i. essay viii.

And yeah, where is yoga????

Nitecap · Jun 5, 2006

you guys have just taken this poor excuse for a thread and ran with it. Enough is enough now people.

MDA yadda yadda yadda. Fact is now that I am consciously aware the majority of Anesthesiologists i know dont support term I dont not use it any longer. I think you guys should practice this as well, especially if you know certain MD's that dont not like the term. Believe me there are way more impt issues to fight about than the term MDA. Its all over job ads,employment agency websites and gaswork.com so who gives a fucq. Just drop it now.

yoga crna · Jun 5, 2006

I haven't had the time to study the discussion on this thread, but I do have a few comments.

While I do not like the term MDA, it has been used by the appellate court in at least one of the CRNA anti-trust cases. I think it was the Bhan case. That alone does not give it credence, but it is at least an acknowledgement of it in the legal arena.

This thread was started by an apparently militant nurse practitioner and RNFA. If you read her/his previous posts, you will see that she states that she does 95% of the surgery and the surgeon does 5%. I find that hard to believe. And talk about legal issues!!!. I have nothing against militancy--CRNAs can write the book on it, but it must be done purposefully, with careful planning and a lot of support. In the unwritten history of the AANA, it is well known that when we went for Medicare direct reimbursement, we got no help from organized nursing. They said that reimbursement was not an appropriate nursing issue and didn't help us with our lobbying efforts. After we were sucessful, organized nursing came to us and asked us to help them get what we got. I have seen similar scenarios played out every day in the operating room and hospital settings. Nurses do not know how to get power and want others to fight their battles for them. Could that be what we have here?

More to come.

I think I need to do some yoga to calm down.

yoga crna

MmacFN · Jun 5, 2006

glad your back.

TopherSRN · Jun 5, 2006

Oh my
Ok i just realised. Topher is a student not even an RN yet.

Nice assumption but wrong. You are not a CRNA so why dont you stick to Pre-CRNA forums? Way to be a hypocrite. I'll post anywhere I'd like, anytime I like until an admin says otherwise with a ban.

Also, I concede that my posts arn't as 'pro-crna' as others, but I wasn't aware I had to share the same view as everyone to post here. I guess I need to read the TOS again or something.

I don't automatically assume MDs are smarter or more capable than CRNAs. It it hard to discount 4 years of medical school and then a residency where they manage airways fulltime for 3-5 years (though most don't do fellowships). I can't discount a ICU nurse's experience either, they are managing sick individuals and often can anticipate orders before they are received. The medical school training, the clerkships, the internships all help the MD to understand things in a broader perspective, such as comorbidities etc. Then add the residency.

There are incompetent anesthesiologists, and there are horrible CRNAs. There are also brilliant individuals in both fields. But given everything is equal the education factor is still there. That was my point, nothing more.

After reading yoga's post I see the legwork was done on the OP's history. Had I have known that I would have never even given this thread as second glance as most of my comments were directed towards the OP. Yes, a CRNA can do most everything an anesthesiologist can, but MDs will always have a place in an ACT, imho.

gaspassah · Jun 5, 2006

first i would like to start off with the statement that i usually try to stay out of these arguments as they tend to go nowhere. however, this time i'll jump in and give my 2 cents.

i am a crna and work in an institution that trains both SRNA's and residents.

some of my training was also in this type of setting and i have seen how both are done.

to make the statement that physicians are better trained or have more experience because they are md's and go through residency programs that offer many different experieces is just not accurate. are they trained more in medicine, sure, in mediciine. nursing has it's own advantages when it comes to anesthesia that medicine does not have. i'll use the icu as an example as that is where my nursing experience comes from. while the resident sees the patient and writes orders on the care of the patient. i am the practicioner that delivers that care, i sit at the bedside for 12 hours titrating gtts, pushing med, manageing fluids etc. and documents and observes the effects on the patient and adjusting the plan within parameters. so delivery, observation and titration of all sorts of agents, i think, gives the nurse the advantage when assessing changes in the patients dynamics while under anesthesia as this is what we do at the bedside. this is what i'll call vigilence.

residents will get to manage, through the nurses for delivery, the care of pts with htn, pe's diabetes etc. but the management of these under anesthesia is different than trying to optimize the patient for daily living. any emergency in the OR can be treated equally well by any well trained anesthesia provider. the key is knowing what drugs to use when, in some cases, which is why we take pharmacology. other times it's just abc's and supportive actions at other times. neither of which require a residency rotation in ER, ICU, Internal medicine etc etc. airway management that was mentioned earlier is a skill that a monkey can be taught, thats why as CRNA's in training, youre paired with a CRNA to teach you these skills, i now residents and attendings that couldnt start an iv if their life was on the line. so that argument holds no water.

also it has been stated on the board more than once that anesth. residents have better training in anesthesia. that is just plain bogus. i have no randomized control trial study to back this up, its anectdotal at best, but i have witnessed 3 residency training programs, which for reasons known i can't state who they are, put first year, first week residents in a case, when the only anesthesthesia training they had was when they were given a copy of morgan and makhail a day earlier and were told to read the first 3 chapters, and were left alone with the patients, to manage the case. i have actually had residents, just a couple mind you, whom i was paired with as a senior student state they felt they had no idea what they were doing and that we were much more prepared to be in the OR initially. this was after several discussions on patient management during the case.

medical anesthesia and nurse anesthesia get to the same destination but often get there by different routes. i can tell, with about 95% certainty, after observing an anesthesia provider for about 15 minutes if they are a doc or a nurse. most seasoned providers will tell you the same thing.

i dont dislike residents, or attendings, and i think there is enough pie to go around also, however i dont like mda's trying to dictate NURSE anesthesia, and the parameters or levels at whick we can practice. nurses do not interfere with the practice or medicine, medicine should stay out of the state boards of nursing and nursing practice. we all have the best interests of the patients in mind. we both put out well trained providers, with a very few exceptions.

anesthesia politics revolves mostly around money, to believe otherwise is a mistake. the root of most political smoke, is the result of buring money.

there is alot more i could go on about, but i'll stop here for now.

d