Why do practicing CRNAs not like OB?

fergus51 · Mar 21, 2004

Guess that's why you all make the big bucks Kevin:) I would hate to be on call:)

Personally, I am not a huge fan of epidurals thanks to the spiral of interventions they often start (continuous EFM, pit, IUPC, c-section... which is why I don't get nurses who think they make less work!), but when they work well they are a God send for the woman. I did find a big difference in attitude with the anesthesiologists who CHOSE to be on call for OB and those who were forced to. The ones that were forced to just didn't seem to want to bother with anything "unecessary" on their shifts. They seemed more interested in "real" operations and such.

SmilingBluEyes · Mar 22, 2004

For those among us who are overweight:
"You cannot dodge responsibility for how and why your life is the way it is. If you don't like your job, you are accountable. If you are overweight, you are accountable. If you are not happy, you are accountable." --Dr Phil McGraw

so, make rude and pointed jokes about "those who are overweight among us", right? I am sure Dr. Phil would praise your ill-placed remarks against professionals among your ranks. Not. How about this: Take responsiblity for YOUR actions, while you are at it, and let the overweight alone here.

I agree, fergus, epidurals make MUCH more work oftentimes, esp if done too early-on. And agree, the outcomes really improve with GOOD anesthesia care (as well as nursing care). It really does open up things for cascade of interventions I would rather avoid, as we can in natural labor. But where I work, epidurals are requested at least 80% of the time, with patients knowing they want them "now" even at 1 cm and contracting every 8 minutes. UGH........what can we do???? I feel like I am losing my skills as a true labor nurse here.......I miss those days.

fergus51 · Mar 22, 2004

I know what you mean Deb. I hate having someone come in and say "I had A contraction, I need the epidural!" Most places I have been at would not place one until the patient was at least 3 cm, but even then half of them wind up on pit. Or they get a patchy block. Or they get a high block. Or they can't push effectively. Or they get a nice fetal brady and mom and dad almost have simultaneous heart attacks... And on and on and on.... I MUCH prefer a labour without it, but it isn't my choice. I actually did a clinical rotation in a hospital that didn't offer epidurals to women in labor (because they only had one anesthesiologist and we don't have CRNAs in Canada) and the c-section rates were so much lower!!! I think birth has become so medicalized many women have forgotten it was possible long before anesthesiologists and CRNAs. Nice to have the option available, but I do wish people were more aware of the down sides of an epidural.

Qwiigley, BSN, MSN, DNP, RN, CRNA · Mar 22, 2004

Ok, not to be rude or anything.... but my question was directed towards CRNAs not L&D nurses. Please lets get back to the question. And those who wish to keep the topic this turned into can do so on a different question, please. Thank you so much.

loisane · Mar 23, 2004

Qwiigley,

I honestly don't have an answer to your question. I have noticed how some jobs make much of the fact that there is no OB. Like that is a selling point. So they must think that makes their position attractive.

I wonder if it could be the liability issue. Just like OBs are open to more liability-because they can be sued up to 18 years after a delivery with a bad outcome. The same is probably true for the anesthesia provider associated with a bad outcome delivery.

loisane crna

air · Mar 23, 2004

Qwiigley,
I honestly don't have an answer to your question. I have noticed how some jobs make much of the fact that there is no OB. Like that is a selling point. So they must think that makes their position attractive.
I wonder if it could be the liability issue. Just like OBs are open to more liability-because they can be sued up to 18 years after a delivery with a bad outcome. The same is probably true for the anesthesia provider associated with a bad outcome delivery.
loisane crna

Wow, Loisane, Now I see the light. I shadowed CRNA's prior to my interviews to get into school, I noticed many of the senior(age intended) did a lot of overtime in the OB, they outright encouraged me to master epidural techniques. I think I now know why, they will be retiring soon, at least so they told me, so their exposure to liability will not be too wide post active service.

Qwiigley, BSN, MSN, DNP, RN, CRNA · Mar 24, 2004

I actually love to place epidurals. I use a air/loss of resistance technique and have been rather pleased with the results. I plan to work on a saline technique, master that, then make a choice.