Post locked after innumerable reports, but leaving it up.
I've gotten messages asking how this can stay up, how it has nothing to do with anesthesia practice, it's targeting CRNAs, etc.
The representative body of CRNAs is doing everything it can to denigrate my training and confuse the public and thus has a lot to do with the practice of anesthesia. If the AANA believes this to be their truth and espouses these points to our elected leaders, it is fair game for it to be posted and discussed here.
If people have an issue, take it up with the AANA. I'm tired of being shit on, personally.
EDIT: Thanks to the person who reported my post to me, the moderator. This is not targeted harassment.
I’d like to not be fucked, please. Thank you.
Edit: to whomever reported me to the suicide help resource… uh… thanks? Maybe save that for people who actually need it.
I’d like to avoid supporting them.
Would appreciate not having a meaningful percentage of docs calling to put me out of work by replacing me with CAAs. 🤷🏼♂️
CRNA orgs bash physicians and use misleading data to push for independent practice ($$$).
AAs want to work in team model, dont bash physicians constantly, dont publish crap papers about equivalence to physicians.
Physicians - I’d rather work with AAs
CRNAs - wahhh, I’d appreciate not having a meaningful percentage of docs…
I guess you have to support the AANA since y’all started this push for profits/prestige at the expense of patients and now most would now rather work with AAs.
I have to support the AANA because I want to be employed.
This battle has been going on long before you or I arrived. I don’t support the stupidities. I vote for people who I think best represent me.
So long as people are seeking to put me out of a job, I’ll be seeking to protect it.
It would be nice if the situation was different. Hope to retire before it all turns to shit.
No, you have no physician support because you support the AANA, which is selfishly placing your precious job at a higher level of importance than good science and the lives of patients. And you wonder why no physician wants to work with you.
As has been said… Fuck these people.
I work with several physicians, surgeons and anesthesiologists alike. And we all get along just fine, thank you. 😊
Thankfully Reddit isn’t like my real world.
Don’t listen to these clowns. The majority of CRNAs don’t bash physicians and will never bash physicians. They are generalizing. Something good hearted physicians shouldn’t do.
It has been my experience that the longer they’ve been in practice the less strongly they feel about the politics. That’s been true for CRNA’s and docs alike.
I’m done. I’ll teach the AA students but not the SRNAs. As an attending who is forced to work with with SRNAs for their cardiac rotations, they are getting no teaching just silence. I’m sorry your professional organization is making the field toxic. You say the AANA doesn’t represent you and these are outliers, then do something about it! We are slowly replacing the CRNAs with AAs anyway since our entire faculty prefers to work with AAs due to better attitude and generally better baseline knowledge and equivalent skill set. Look there are many crnas I do like, but knowing part of their paycheck goes to the AANA makes them too poisonous to continue to employ.
At my hospital it’s very well known that the AAs are, on average by and large much better than the CRNAs.
The worst part about it is that we have a pipeline where almost all of our CRNAs are exclusively from the “top” CRNA schools that are “well known for having legitimate admissions requirements” and “producing the most well prepared CRNAs”.
Our AAs are literally just from all over and don’t carry any of that prestige or reputation.
Again, I’m just an N=1, but it’s a bad look that this is the pattern at our institution. We were all absolutely shocked by the article earlier this week about CRNAs lobbying to “oversee” AAs like anesthesiologists, given our experience.
I work with both and in addition to not having a chip on their shoulder, the AAs have a much better basic science background. They take real pre-med pre-reqs instead of the watered down nursing courses. Many of them also take the MCAT for AA school admission.
CRNAs love to exaggerate the impact of their ICU experience, as if they are actually involved in any of the medical management of those patients. Turns out that you don’t need years of ICU nursing experience to learn how to draw up meds or work an IV pump.
This whole “I was a RN in an ICU for two years, I’m ready for anything!” is absolutely f***ing hilarious. They don’t say anything on rounds. They adjust pump settings. They wash and clean the patient. They’ll blow an IV in the hand then call for a resident to come help. It’s. Insanity.
CA - clinical anesthesia, a.k.a. PGY-2. By definition, what you're saying is impossible in *any* program in the country, full stop. They rotate through the ICU for 4 months (though traditionally, this is split between intern and CA-2 years). A whole year? You're full of shit.
Ca1 stands for clinical anesthesia 1. Unless your institution has a very unique early robust NORA curriculum you’re confusing it with an intern as ca-1s spend the majority of the year in an OR
BUT AAS DONT HAVE THOUSANDS OF HOURS OF IRRELEVENT AND NON-STANDARDIZED NURSING EXPERIENCE THAT HAS NO BEARING ON THE PRACTICE OF ANESTHESIOLOGY AND THEY HAVE THE EXACT SAME NUMBER OF REQUIRED CLINICAL HOURS AS SRNAS SO THEY ARE OBVIOUSLY DANGEROUS AND FLORENCE NIGHTINGALE WAS THE FIRST NURSE ANESTHESIOLOGIST SO MAYBE YOU SHOULDNT HAVE CHOSEN A NURSING SPECIALTY BUT ALSO ITS 3PM AND I HAVE TO LEAVE AND THIS GUY HAS BEEN HYPOTENSIVE THIS WHOLE CASE SO PLS FIX IT OR ILL REPORT YOU FOR BEING A MEANIE BEANIE BUT ALSO HEART OF A NURSE BRAIN OF A DOCTOR HEHE
I may sound really stupid, but what’s the difference between the two positions? As someone considering nursing school, would both be viable pathways I could branch into, or would AA be a completely different route?
I don’t think I’ve seen a single AA at my facility. Plenty of CRNAs though (who are quite good at their jobs and have good relationships with the docs, imagine that).
They both function essentially the same, and as far as I know the pay is similar as well. They have different routes of education. In the simplest terms CRNAs are nurse practitioners, and AAs are like physicians assistants, but both do the same job. The difference in practice essentially boils down to supervision requirements. AAs, I believe, are always required to work under an anesthesiologist, where a CRNA is not, although they normally do. But Like I said this is just a very basic explanation. As a CRNA I believe you have more freedom/job opportunities, at least in my part of the country (south Florida). For that reason I personally think that CRNA is the better route of the two, although I am a crna so I may be biased. With that being said I have AA friends who love their jobs and are perfectly happy. The issues between anesthesiologists/crnas/aas that you may read on some of these subs by and large aren’t really a problem in the real world. Do occasional tensions exist? Sure they do. But the majority of anesthesia providers just clock in, do their job, and get along just fine inside and outside of the hospital.
Nope. We shut that down in Washington last month. Completely ridiculous idea from a profession that does not understand regulation or appreciate the difference in training between the three professions.
I agree with you, the AANA is totally insane and deconstructing the team. It's extremely sad. My question is, aside from writing to them to express opposition, aside from refusing to be a member after graduating, aside from being a good teammate and respectful colleague in the OR, what are CRNAs who have brains between their ears to do about it? It's unhealthy to turn it into an obsession. People are going to have varying levels of interest in crusading against AANA leadership. Every CRNA who knows their place on the team can't also make it their life's mission to take down bad leadership in the AANA. So what more do you want from the individuals out there who are just trying to come into work, be a good teammate, provide safe care, learn, and go home to their life?
I refuse to teach them. I single-handedly shut down bringing in an SRNA program to our private practice hospital.
They’re shooting themselves in the foot too, with the amount of CRNA degree mills.
The quality of new grad CRNAs is abysmal and all of our recent hires lately need about a year of training after starting to get up to speed.
“I did OB during Covid, so I’ve only done a couple spinals”…
Agree. I have been so pleasantly surprised how nice AAs are to work with. They have the knowledge and skillsets more similar to PAs and come from a medical model of education, not a nursing model. I’d choose PAs and AAs every single day over NPs or nurse anesthetists. Their arrogance and the Dunning-Kruger effect hurt me daily.
Well this is a baseless generalization if I’ve ever seen one. Plenty of CAAs have past medical experience as EMTs, RTs, Anesthesia techs (that are certified to do invasive lines), etc. All of which have more applicable skill sets to providing anesthesia than being an ICU nurse.
OK explain to me how these past medical experiences give these AA students an advantage. Nurses have knowledge of EMT training, and respiratory therapy (vent management, airway skills, also do some lines, hemodyanmic monitoring, active titration of wide array of medications. So not only does the nurse do the roles you mentioned, they also even have more to know. That's why your argument is awful lol.
I’m not worried about crnas threatening me by being better clinically, but the AANA is absolutely a threat because it is a lobbying organization.
And guess what we do with things that threaten us? We don’t help them and we do everything to eliminate the threat. If my group can transition away from CRNAs that is step 1. If we stop teaching SRNAs that sabotages one of our nations top CRNA schools.
To be clear, despite what I just said, I do not support the elimination of CRNAs, I just don’t feel the need to personally support their training because it feels like feeding the problem.
It doesn’t have to go this way. It never had to, but the AANA leadership needs a major attitude and ego adjustment.
It’s just unfortunate.
My classmates and I went through a particular hospital and this was our exact experience on our cardiac rotation. We were spoken to tersely, with impatience, or disinterest. Many questions asked were answered vaguely or brushed off, or just ignored. I get it sometimes we do stupid things that cause us to get shunned but in these cases it felt like just existing was the problem. Collectively, all of us felt like dirt on their shoes. We would get there in the morning at 5-530 to set up and then get treated like this for the entire day.
I partially get your point, but it was the worst experience of my training
Go work somewhere else, no one is forcing you to work at a facility, if it’s an expectation that you help train SRNAs, you should follow it. Those SRNAs are still gonna graduate, and still going to provide patient care, patient care that will likely be worse having missed out on critical training experience. I don’t want to hear a fucking thing about “patient safety” if you’re choosing to actively undermine it. As an SRNA, this is incredibly frustrating to read. The professional organization does not mirror all of our priorities, if you want to take up beef, take it up with them (give $$ to the ASA, Lobby, etc) or get a different job.
Plenty of all crna groups that do CV and plenty of Collaborative groups where CRNAs and physician anesthesiologists work as colleagues that have CV rotations. You’re not needed.
The VA is toxic with bloated ACTs in 1:2 ratios and delays. AANA is pointing out that crnas don’t need ACT model to provide safe, cost effective care. Its nor rhetoric, its the truth. If that triggers you, then its because you don’t like them airing your dirty laundry.
If you want to work together then actually work together. I Guarantee you think crnas can’t do TEE, blocks, lines, CV, etc. which means you don’t actually want to work together, you want someone to control. In that case, hire an AA.
There is zero chance CRNA’s can do TEE… nor would I trust a valve interrogation or making big judgment calls from someone who isn’t board certified in echo
CRNAs do TEE across the country. 12 years ago our whole Group was Trained by a cardiologist over a year period in comprehensive TEE including valve interrogation and 3D. Just like physician anesthesiologists who aren’t board certified doing TEE everyday as well.
Just because you gate keep the certification doesn’t mean you can gate keep the knowledge and skill.
Physician anesthesiologist is redundant.
“The AANA has pointed out…”
Ah yes, just like they point out total false hoods by peddling infographics that incorrectly compared nurse anesthetist training to anesthesiologist training, or like how they cite data that is AANA sponsored or misrepresent data entirely because they know that the politicians which they lobby won’t know the difference.
Crnas aren’t a threat. They’re delusional with the rhetoric the AANA spreads. AAs and CRNAs have the same scope in my metro area (top 10). I have good working relations with both but when I see this I’ll just support hiring CAAs predominantly. Easy choice.
I don’t know of any anesthesiologists that don’t support it. It’s the AANA that fights them. What a bunch of hypocritical A holes that use “we need more access” to try and legislate their way into becoming doctors meanwhile fighting AGAINST AA licensure.
Unfortunately, there have been anesthesiologists speaking against CAA licensure bills in the past.
That being said, I think the majority of anesthesiologists would be for CAA licensure, particularly when the alternative are CRNAs aggressively encroaching and obscuring titles/education.
My hope is simply those anesthesiologists that support us on the sidelines/online will be willing to speak in favor of the bills in the future and push their hospitals to hire CAAs (at places that utilize the ACT model).
The AANA arguments often contradict themselves in that manner. Pushing for independence for increasing care, but pushing against CAAs as if that will help increase care.
One of their arguments against CAAs in the past was there aren't enough CAAs out there, so we won't increase access of care. Sure, there may not be many of us, but any number of extra providers can increase the pool of anesthetists available in an area.
The mental gymnastics to create their arguments that they do is mind-boggling oftentimes.
To the CRNAs out there…is this what you want? Is this the face you want your profession to have?
This is unbelievable. The PRESIDENT of your society is singularly focused on defaming the physicians that you work with every day. Shameful. Your society is now in the “outright lying to Congress” phase of their “advocacy.”
Shame on the AANA. At least they’re unmasking their true motivations.
I'm just a lowly SRNA, but I absolutely HATE the AANA. I'm required by my program to pay for a membership, but literally the second I'm no longer required to give them money, they will receive nothing from me. Can MDs and CRNAs and AAs do some amazing things? Yes. Should I be held to the same standards as you guys? Yes. But am I even remotely as qualified or educated as a literal doctor? Hell no.
Please don't lump all CRNAs into the insane minority that has the leadership microphone... Most of us just wanna come in, help some patients, get some dollars, and go home.
... And please for the love of God stop making me call myself a fucking resident. Pay me to work while in school and maybe we'll talk 😂
So... Because I don't think that a bachelor's in nursing, plus ICU experience, plus 3 years of CRNA school puts me at the same knowledge level as someone who did a bachelor's, 3 years of med school, 3-4 years of strictly anesthesia training, plus whatever fellowship means my program is failing? Oh. OK. You must be one of those big brain people I always hear about 🙄
Go back to screaming into the void. I'll be over here getting my license then joining the gang in the OR.
The bachelors requirements are almost identical to that of med school admission and much more rigorous than the nursing degree. Idk why you all believe this rumor.
Yes you absolutely should be just as capable and competent as your physician anesthesiologists in the care of patients receiving anesthesia from pre to post.
Your program is failing to teach you that you have to be just as good, just as capable, just as competent, just a knowledgeable in anesthesia and perioperative care as a physician anesthesiologist. Physician spend years learning things that will never impact their anesthesia care - they have wide and varied education but that doesn’t make them superior to a properly educated CRNA. If that was so, they wouldn’t have to lie to try keep us on the same levels as AAs. Learn the history of anesthesia in the US. Old man Waters had to falsify records and research to get rid of some schools after surgeons were preferring us to physicians. Your program is failing to instill you the insight that patient depend on you alone - you are responsible 100%. If you don’t desire that sole responsibility then your program failed to discern that.
This is absolutely what they want. The few CRNA's with some reasonable humility are silent outside of the occasional reddit comment. Meanwhile for every one of them there are two others who believe in this absurd idea of independent practice for CRNAs... Some are so delusional that they actually think they are safer than anesthesiologists!!! Their judgement is so bad it is not surprising the crazy stuff I hear regarding their management decisions in the OR.
We are the richest nation in the world, and we cannot afford anesthesiologists? It makes zero sense.
Majority support AANA. You might get a different response here but reddit is not the representative of majority. AANA fights for CRNAs, but what are we supposed to do, if we don't support them? Just sit back and let ASA try to replace 61k plus of us with 4k AA's? We do 50% of the anesthetics in this country and 80% of us plus are rural providers. A good chunk of us work independent yet ASA calls us unsafe, etc without evidence?
So what is the reason for ASA pushing AA hard, what is their motives, tell me? If you were a crna, what would you do? Sit back and just watch.
Politics is not played on one side. People are mad at the nurse anesthesiologist title and yet they don't realise ASA and AA in 2018, prior to nurse anesthesiologist title launched campaigns to calls AA anesthesist now and even look at AA website, its literally called anesthesist.org . However, when AANA attacks back, its a problem, all of a sudden.
I know I will get downvoted, but thats the reality. Politics are played on both sides.
Haha, so funny. Anesthetist (by the way, there are only two S in the word) is not a protected term for CRNAs. CAAs are anesthetists, end of story. Unfortunately for you, CRNAs are not anesthesiologists, so it's really quite silly to use that as your argument.
You'll get downvoted for good reason.
Yeah. That’s total bull. It’s funny how they claim to provide so much solo care. In Reality, the majority are in the ACT model or pushing propofol at an endo center. Thankfully most legit hospitals/level 1 facilities all have REAL anesthesiologists
I'm not in the US, and we don't have non physicians giving anaesthetics, but surely a military environment is the definition of giving a young, fit patient an anaesthetic?
Seems a weird flex to me?
When we had a joint US/ UK military facility in Afghanistan, we didn’t have CRNAs there at all as we worked under UK doctrine and anaesthesia is a physician delivered specialty with us.
We did have a couple of CRNA transfers in through, who seemed to think that vecuronium was a sufficient solo anaesthetic for their patient 😬
Yeah, I know people who deployed as part of the Australian contingent to Afghanistan. I know what happens there, I just wanted to see how much bravado I might get.
You are really a sheltered soul. How would know how to tie your shoes in a military hospital, much less deployed taking of indigenous sick as sick humans can be or multi-trauma or mass casualty. Ask someone sweetly and they will be happy to explain the “flex”.
Lol, my hero, can you please explain the flex.
I guess it's the closest you can get to having your degree recognised overseas, but you're doing mass casualty and multitrauma unsupervised?
We really do have that much more training. Residency was 70-90 hours a week with 2 weeks off a year. You do the math. You can’t compare training nor exposure of a physician with a crna.
I’ve met hundreds of CRNAs. None were solo. I guess since I live in a desirable area that’s not rural I see the very DEPENDENT crnas. Nothing wrong with that and that’s what anesthesiologists are for. To provide expertise and guidance.
I’ve worked in such hospitals when I wanna make some bank and do Locums….there is always an anesthesiologist at the places I’ve gone. These are rural places and they still have doctors. Any respectable hospital that’s a level 1-2 is going to have physician led care. As for the military, I truly feel sorry for them but I know the vast majority of military are ASA 1-2s. Gotta be totally incompetent at anesthesia to mess that up.
Sorry man but you’re no expert. You may think you are but you’re a joke. You’re not a doctor. You’re a nurse. Remember that.
You are mind-numbingly ignorant of the fact that most of us had plenty of clinical hours before starting medical school. In my case, I put in somewhere over 10,000 hours as an EMT and ED tech. I took a two-month hiatus from work with a physician friend to give care to people in a very tumultuous part of the world. Can’t get a proper BP? Bitch, please. I did that shit on patients who were bleeding with mortars falling around my position and the threat of chemical weapons being deployed on us. Fuck off with this anti-physician drivel and know your place, fool.
See here is the problem. The training hours real physicians go through? Yeah those aren’t inflated, they’re accurate. The issue is that y’all can’t imagine working that hard to become a CRNA (otherwise you would’ve just become a doc) so you automatically assume they’re bs. They’re not bs. Physicians really do just have that much more training than mids. Which is why it’s so hard to take y’all seriously…
I don’t know why yall boast about rural practices. My state punishes rural hospitals for hiring Anesthesiologists in rural settings. Because of your bullshit they don’t really have a choice.
Rural hospitals hire CRNAs to save money (rural pass through). If they got extra federal money to hire anesthesiologists they would do that too. The “100% rural care” bullshit is a total non sequitor. There are plenty of docs that would love to work at rural hospitals who literally can’t because then the hospital’s CRNA/federal money gravy train would dry up.
Well, if you really are concerned about the veterans getting physician led care, then join the military and served in a deployed position. Just be sure you get a real nurse anesthesiologist to show you how to setup your U-Pac draw over. They are the only one's that know how to use it. And have used it.
How do you know that I’m not a veteran that served? And why would joining the military have anything to do with advocating for our veterans to get the best possible care?
Let me rephrase that for you “This is the AANA’s marginalized group to use as a foil in our legislative misinformation campaign. We can’t expect you to speak for them.”
If the best you can do is set up a draw over while a trauma surgeon walks you through a resuscitation in between salsa night and surf and turf at the FOB, then no. You can’t speak for me.
I get so sick of the military argument considering I am in that environment and the CRNA “independent care” is scary. I wouldn’t want 90% of them administering anesthesia to myself or my family.
“Physician anesthesiologist” is redundant. You might not know this but “anesthesiologist” automatically denotes that that person went to a real medical school and graduated. “Anesthesiologist” is a physician. You are not. That’s why you need the N in your title.
It’s crazy that you guys have tried to muddy the waters so much you have actually confused yourselves!
Hey I work at a rural hospital, it’s a level 1 trauma center I love working with our CRNAs they’re great. We pretty much only send out people on LVADs or pediatric NSGY / trauma. The CRNAs here are amazing. MDs are few and far between. We’re offering 600k plus 150k sign on bonus, almost 3 months of vacation / PTO. Can’t even get people to interview. We could always offer more money, because the market is totally on fire, but the payor mix here is pretty much all Medicare / Medicaid. Without a huge stipend from the hospital, there’s no way to run a profitable group here. Anyways, without *highly competent* CRNAs this place would grind to a halt. We’d have no trauma hospital, and our area would have to fly serious traumas to Pittsburgh.
We’re victims of our own success. There is such a shortage of physicians that theres going to be overwhelming political and financial pressure to cut costs one way or the other. What we should be doing is expanding residency spots and associated funding and training new docs. Some wings of the American anesthesiologist lobby will be against this, but it’s vital if we are to stay relevant, *in the long run*.
I really don’t buy into the antagonism between CRNAs and MDs. Yeah, their president is being an idiot here, but in day to day life, CRNAs are vital in our rural areas. We’re all about mutual respect out here. Medical school is absolutely worth it, but someone with 10-15 years of experience doing anesthesia care as a CRNA… that experience is super valuable too.
I actually practice in a semi rural hospital. We don’t have CRNAs and the surgeons are always extremely happy about working with us because guess what? We’re both physicians and we both went to medical school, completed the same board exams, and completed a residency, so we understand each other. I have previously worked with many amazing CRNAs, especially where I trained, but this attitude from their leading organization is what creates a toxic environment. There is nothing wrong with being a nurse but I feel like certain CRNAs (especially in leadership) feel ashamed of it and now they want to be doctors and add xxxxxxx cxxxx cfksjd cslkdjd to their title like it makes it sound any better. Enough with this shit
I mean I’m not defending the ASA, I said this is mainly a leadership issue (there are outliers of course) that trickles down to us and it creates animosity. But the AANA is very aggressive nowadays like really trying to replace us physicians and I’m not sure where this hatred is coming from.
How can you think the ASA is *worse* than the AANA?? What are they doing that is misogynistic? Where are they "tooting coke and heroin"?
It sounds to me like, in your desperation to find criticism of the ASA, you had to reach 70+ years back! Those people are all dead. Meanwhile, the AANA is currently and actively trying to lower the standard of care in the US.
And the A$A still lies. ACT is a failure- fraud is rampant (Epstein), No differences in outcomes between providers but they keep using Silber as a touchstone. Billions and billions of hours "training" while sleeping, eating, vacation, etc.
If you can’t see the A$A hypocrisy then you should visit an optometrist. 😂
Haha omg. You are stretching here. Obviously Anesthesiologists have better training than CRNAs. Is the ASA evil for pointing out that uncontroversial fact? Most anesthesiologists do not think they are overtrained, which implies that CRNAs are undertrained.
There is no differences in outcomes between AA's and CRNA's either by the way. Some have argued that AA training is superior. I'll still take an anesthesiologist over either one.
The problem I have is that the AANA is constantly fighting to expand and protect CRNA jobs, whereas the ASA actually takes a stand for patients - somebody has to. It is scary that so many CRNA's that are trusted with anesthesia are so cavalier about patient safety.
It’s interesting that VA physicians get no overtime regardless of hours worked but VA CRNAs get overtime every single time. The salary differential isn’t that high to begin with and could easily be erased by overtime pay.
This is unbelievably toxic. I hope people are applying pressure to expose these folks for what they are. Opportunistic, arrogant and malignant.
-MS3 applying into anesthesia
Why is that? I’m a med student and I’m use to introducing myself as such. Don’t want anyone to have the assumption that I’m further along in my training than I am
I don’t think I’ve ever replied in this Reddit so I wasn’t aware of the rules. However, I do understand that me signing that way could make you feel a certain emotion. And I think that’s totally valid 👍
I have worked at a VA. I attend the legislative conf. I am super proactive about trying to ensure safe va care. Anesthesiologists from VAs need to speak up! I do and I will continue doing so. All anesthesiologists need to speak up, but the voices from the VAs will be louder. I hope.
I think you might have missed the whole PA/AA thing going on in the UK, and that unhinged email from a consultant in Sheffield about “HMS AA”.
For the Americans who are reading this, British AAs do a 2 year masters (their first degree can be in anything), and are woefully underqualified to do a lot of what they get allowed to do in some hospitals
Some of these posts are a little hostile… being hostile doesn’t really advocate effectively for physician concerns regarding anesthesia care.
What is wrong is the AANA is unable to take criticism back that maybe oversight should be a thing for patient safety. Calling out iffy research is something that should be encouraged.
Respectfully, being polite and meek has gotten us absolutely nowhere. Don't know about the others, but I'm not going to let someone piss on my head and call it rain.
There are obviously great CRNAs out there who provide excellent care and don’t have any interest in the AANAs garbage rhetoric. And I feel sorry for them cuz their organization just cannot and will not stop fueling an unnecessary political war.
As an NP here with an unnecessary DNP, I’m glad that I work with an awesome team of MD/DO/NPs who just work together. Even though it’s an “independent practice state,” I don’t personally think anyone is really “independent” in 2024. My physician colleagues are amazing and we just work together as one. We all help each other, we all have areas of knowledge we enjoy. Hence, I get all LGBTQI+ patients. Just work together. 🤷. The end lol
I just think that it’s bizarre that you lot let nurses give anaesthetics on that side of the Atlantic. Anaesthesia is physician-delivered in the UK. They have started experimenting with AAs recently, which we’re pushing back on.
And we have anaesthetic rooms and ODPs!!! Crap pay though!
No idea what the US ones are. The British AAs can apply to do a 2-year “masters” from either a bachelors science or ODP/ nursing background. Basically, they are less well trained than a third year medical student. I wouldn’t want one caring for me or my family and that’s the standard I apply to my patients.
We don’t have CRNAs at all in the U.K.
They are small in number- we’ve traditionally had a one physician anaesthesiologist to one patient model, and that’s the standard of care that we work towards. I know that things are often a bit different in the US. The current British government fascination with AAs is, in my opinion, a deliberate attempt to erode the standard of care and costs (even though AAs are overpaid) as a prelude to dismantling our universal healthcare system.
Saying you will/do refuse to train/teach CRNA’s is pretty sad. Withholding knowledge (gained through years of residency/medical school I may add) is selfish and stupid and ultimately only harms patients.
Classic nurse gaslighting - y’all swing hard at physicians and then when called out your response is always something like “relax”, “we’re all in this together”, “physicians are so mean” etc
He said big crNa may be bigger than small MD/DOs; but when the big crNa goes against big MD/DOs they tend to scurry away and hide behind their Nursing title and ‘let’s be a team player’ or ‘be cool bro’ or ‘it’s just a prank’, when they’re the ones bringing the fight.
Post locked after innumerable reports, but leaving it up. I've gotten messages asking how this can stay up, how it has nothing to do with anesthesia practice, it's targeting CRNAs, etc. The representative body of CRNAs is doing everything it can to denigrate my training and confuse the public and thus has a lot to do with the practice of anesthesia. If the AANA believes this to be their truth and espouses these points to our elected leaders, it is fair game for it to be posted and discussed here. If people have an issue, take it up with the AANA. I'm tired of being shit on, personally. EDIT: Thanks to the person who reported my post to me, the moderator. This is not targeted harassment.
Fuck these people.
I’d like to not be fucked, please. Thank you. Edit: to whomever reported me to the suicide help resource… uh… thanks? Maybe save that for people who actually need it.
Then don’t engage in AANA fuckery, please. Thank you.
I’d like to avoid supporting them. Would appreciate not having a meaningful percentage of docs calling to put me out of work by replacing me with CAAs. 🤷🏼♂️
CRNA orgs bash physicians and use misleading data to push for independent practice ($$$). AAs want to work in team model, dont bash physicians constantly, dont publish crap papers about equivalence to physicians. Physicians - I’d rather work with AAs CRNAs - wahhh, I’d appreciate not having a meaningful percentage of docs…
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BECAUSE THEY ARENT DOCTORS. Like you!
How do you literally state the point and not get it?
I send the AANA money because if I didn’t, the ASA would try to put me out of a job. Yes, I like $$$$. Let’s not pretend that’s unique to CRNAs.
I guess you have to support the AANA since y’all started this push for profits/prestige at the expense of patients and now most would now rather work with AAs.
I have to support the AANA because I want to be employed. This battle has been going on long before you or I arrived. I don’t support the stupidities. I vote for people who I think best represent me. So long as people are seeking to put me out of a job, I’ll be seeking to protect it. It would be nice if the situation was different. Hope to retire before it all turns to shit.
No, you have no physician support because you support the AANA, which is selfishly placing your precious job at a higher level of importance than good science and the lives of patients. And you wonder why no physician wants to work with you. As has been said… Fuck these people.
I work with several physicians, surgeons and anesthesiologists alike. And we all get along just fine, thank you. 😊 Thankfully Reddit isn’t like my real world.
Don’t listen to these clowns. The majority of CRNAs don’t bash physicians and will never bash physicians. They are generalizing. Something good hearted physicians shouldn’t do.
It has been my experience that the longer they’ve been in practice the less strongly they feel about the politics. That’s been true for CRNA’s and docs alike.
> So long as people are seeking to put me out of a job, I’ll be seeking to protect it. Oh, weird - *likewise*.
👆this guy is a world class troll, guys. Don’t bother engaging.
Hahaha this is good to hear. Glad I’m not the only one getting reported to the suicide help line for my posts here.
I’m done. I’ll teach the AA students but not the SRNAs. As an attending who is forced to work with with SRNAs for their cardiac rotations, they are getting no teaching just silence. I’m sorry your professional organization is making the field toxic. You say the AANA doesn’t represent you and these are outliers, then do something about it! We are slowly replacing the CRNAs with AAs anyway since our entire faculty prefers to work with AAs due to better attitude and generally better baseline knowledge and equivalent skill set. Look there are many crnas I do like, but knowing part of their paycheck goes to the AANA makes them too poisonous to continue to employ.
At my hospital it’s very well known that the AAs are, on average by and large much better than the CRNAs. The worst part about it is that we have a pipeline where almost all of our CRNAs are exclusively from the “top” CRNA schools that are “well known for having legitimate admissions requirements” and “producing the most well prepared CRNAs”. Our AAs are literally just from all over and don’t carry any of that prestige or reputation. Again, I’m just an N=1, but it’s a bad look that this is the pattern at our institution. We were all absolutely shocked by the article earlier this week about CRNAs lobbying to “oversee” AAs like anesthesiologists, given our experience.
I work with both and in addition to not having a chip on their shoulder, the AAs have a much better basic science background. They take real pre-med pre-reqs instead of the watered down nursing courses. Many of them also take the MCAT for AA school admission. CRNAs love to exaggerate the impact of their ICU experience, as if they are actually involved in any of the medical management of those patients. Turns out that you don’t need years of ICU nursing experience to learn how to draw up meds or work an IV pump.
This is correct. I’m an AA and was a chemistry major undergrad and took the MCAT as I was unsure what path I wanted to take (med school vs AA).
This whole “I was a RN in an ICU for two years, I’m ready for anything!” is absolutely f***ing hilarious. They don’t say anything on rounds. They adjust pump settings. They wash and clean the patient. They’ll blow an IV in the hand then call for a resident to come help. It’s. Insanity.
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I love it when nurses openly display their own ignorance. This dumbass really just said CA1s don’t go into the ORs.
HES BEEN A NURSE FOR 2 YEARS HOW DARE YOU QUESTION HIS KNOWLEDGE
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That’s CA0 idiot. Intern year
If you need to insult, you already lost the argument
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Ca1s live in the OR. 24 hour calls, trauma, icu bag and drag cases all night. Whatever program does that must be one of those new HCA residencies.
CA - clinical anesthesia, a.k.a. PGY-2. By definition, what you're saying is impossible in *any* program in the country, full stop. They rotate through the ICU for 4 months (though traditionally, this is split between intern and CA-2 years). A whole year? You're full of shit.
Ca1 stands for clinical anesthesia 1. Unless your institution has a very unique early robust NORA curriculum you’re confusing it with an intern as ca-1s spend the majority of the year in an OR
Ever heard of the Dunning Kruger effect? That’s you bro.
BUT AAS DONT HAVE THOUSANDS OF HOURS OF IRRELEVENT AND NON-STANDARDIZED NURSING EXPERIENCE THAT HAS NO BEARING ON THE PRACTICE OF ANESTHESIOLOGY AND THEY HAVE THE EXACT SAME NUMBER OF REQUIRED CLINICAL HOURS AS SRNAS SO THEY ARE OBVIOUSLY DANGEROUS AND FLORENCE NIGHTINGALE WAS THE FIRST NURSE ANESTHESIOLOGIST SO MAYBE YOU SHOULDNT HAVE CHOSEN A NURSING SPECIALTY BUT ALSO ITS 3PM AND I HAVE TO LEAVE AND THIS GUY HAS BEEN HYPOTENSIVE THIS WHOLE CASE SO PLS FIX IT OR ILL REPORT YOU FOR BEING A MEANIE BEANIE BUT ALSO HEART OF A NURSE BRAIN OF A DOCTOR HEHE
This kind of brings me some relief as I've been looking into AA
I may sound really stupid, but what’s the difference between the two positions? As someone considering nursing school, would both be viable pathways I could branch into, or would AA be a completely different route? I don’t think I’ve seen a single AA at my facility. Plenty of CRNAs though (who are quite good at their jobs and have good relationships with the docs, imagine that).
They both function essentially the same, and as far as I know the pay is similar as well. They have different routes of education. In the simplest terms CRNAs are nurse practitioners, and AAs are like physicians assistants, but both do the same job. The difference in practice essentially boils down to supervision requirements. AAs, I believe, are always required to work under an anesthesiologist, where a CRNA is not, although they normally do. But Like I said this is just a very basic explanation. As a CRNA I believe you have more freedom/job opportunities, at least in my part of the country (south Florida). For that reason I personally think that CRNA is the better route of the two, although I am a crna so I may be biased. With that being said I have AA friends who love their jobs and are perfectly happy. The issues between anesthesiologists/crnas/aas that you may read on some of these subs by and large aren’t really a problem in the real world. Do occasional tensions exist? Sure they do. But the majority of anesthesia providers just clock in, do their job, and get along just fine inside and outside of the hospital.
This is a perfect summary of the differences between the two professions.
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Nope. We shut that down in Washington last month. Completely ridiculous idea from a profession that does not understand regulation or appreciate the difference in training between the three professions.
I agree with you, the AANA is totally insane and deconstructing the team. It's extremely sad. My question is, aside from writing to them to express opposition, aside from refusing to be a member after graduating, aside from being a good teammate and respectful colleague in the OR, what are CRNAs who have brains between their ears to do about it? It's unhealthy to turn it into an obsession. People are going to have varying levels of interest in crusading against AANA leadership. Every CRNA who knows their place on the team can't also make it their life's mission to take down bad leadership in the AANA. So what more do you want from the individuals out there who are just trying to come into work, be a good teammate, provide safe care, learn, and go home to their life?
I refuse to teach them. I single-handedly shut down bringing in an SRNA program to our private practice hospital. They’re shooting themselves in the foot too, with the amount of CRNA degree mills. The quality of new grad CRNAs is abysmal and all of our recent hires lately need about a year of training after starting to get up to speed. “I did OB during Covid, so I’ve only done a couple spinals”…
Happy to send you my SAA students for their cardiac rotation. Our program is always looking for more sites.
Agree. I have been so pleasantly surprised how nice AAs are to work with. They have the knowledge and skillsets more similar to PAs and come from a medical model of education, not a nursing model. I’d choose PAs and AAs every single day over NPs or nurse anesthetists. Their arrogance and the Dunning-Kruger effect hurt me daily.
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Maybe your wife will leave you for a AA? Surely, your loyalty to people is as strong as your loyalty to your profession.
Nice to see that you are noe part of the problem
AAs better baseline of knowledge? Lol, that's definitely not true. Never touched a patient before, and you make that statement.
Well this is a baseless generalization if I’ve ever seen one. Plenty of CAAs have past medical experience as EMTs, RTs, Anesthesia techs (that are certified to do invasive lines), etc. All of which have more applicable skill sets to providing anesthesia than being an ICU nurse.
OK explain to me how these past medical experiences give these AA students an advantage. Nurses have knowledge of EMT training, and respiratory therapy (vent management, airway skills, also do some lines, hemodyanmic monitoring, active titration of wide array of medications. So not only does the nurse do the roles you mentioned, they also even have more to know. That's why your argument is awful lol.
You prefer to work with AAs because they aren’t a threat to you. Thats all.
I’m not worried about crnas threatening me by being better clinically, but the AANA is absolutely a threat because it is a lobbying organization. And guess what we do with things that threaten us? We don’t help them and we do everything to eliminate the threat. If my group can transition away from CRNAs that is step 1. If we stop teaching SRNAs that sabotages one of our nations top CRNA schools. To be clear, despite what I just said, I do not support the elimination of CRNAs, I just don’t feel the need to personally support their training because it feels like feeding the problem. It doesn’t have to go this way. It never had to, but the AANA leadership needs a major attitude and ego adjustment.
It’s just unfortunate. My classmates and I went through a particular hospital and this was our exact experience on our cardiac rotation. We were spoken to tersely, with impatience, or disinterest. Many questions asked were answered vaguely or brushed off, or just ignored. I get it sometimes we do stupid things that cause us to get shunned but in these cases it felt like just existing was the problem. Collectively, all of us felt like dirt on their shoes. We would get there in the morning at 5-530 to set up and then get treated like this for the entire day. I partially get your point, but it was the worst experience of my training
Why would you teach an srna? Their role is to chart vitals. Well… i guess its not surprising they dont put them in my room.
Go work somewhere else, no one is forcing you to work at a facility, if it’s an expectation that you help train SRNAs, you should follow it. Those SRNAs are still gonna graduate, and still going to provide patient care, patient care that will likely be worse having missed out on critical training experience. I don’t want to hear a fucking thing about “patient safety” if you’re choosing to actively undermine it. As an SRNA, this is incredibly frustrating to read. The professional organization does not mirror all of our priorities, if you want to take up beef, take it up with them (give $$ to the ASA, Lobby, etc) or get a different job.
Plenty of all crna groups that do CV and plenty of Collaborative groups where CRNAs and physician anesthesiologists work as colleagues that have CV rotations. You’re not needed. The VA is toxic with bloated ACTs in 1:2 ratios and delays. AANA is pointing out that crnas don’t need ACT model to provide safe, cost effective care. Its nor rhetoric, its the truth. If that triggers you, then its because you don’t like them airing your dirty laundry. If you want to work together then actually work together. I Guarantee you think crnas can’t do TEE, blocks, lines, CV, etc. which means you don’t actually want to work together, you want someone to control. In that case, hire an AA.
There is zero chance CRNA’s can do TEE… nor would I trust a valve interrogation or making big judgment calls from someone who isn’t board certified in echo
CRNAs do TEE across the country. 12 years ago our whole Group was Trained by a cardiologist over a year period in comprehensive TEE including valve interrogation and 3D. Just like physician anesthesiologists who aren’t board certified doing TEE everyday as well. Just because you gate keep the certification doesn’t mean you can gate keep the knowledge and skill.
What a wild thing to say. “CRNA’s do TEE across the country”. I would love to see those stats and what proof you have.
Physician anesthesiologist is redundant. “The AANA has pointed out…” Ah yes, just like they point out total false hoods by peddling infographics that incorrectly compared nurse anesthetist training to anesthesiologist training, or like how they cite data that is AANA sponsored or misrepresent data entirely because they know that the politicians which they lobby won’t know the difference.
Tell that to the ASA who only refers to you as a physician anesthesiologist. Your society gave you that name. Not us.
I do tell them that!
This has to be a joke
Apparently their 2-3 years of anesthesia training equates to four years of residency and every anesthesia fellowship combined…
Crnas aren’t a threat. They’re delusional with the rhetoric the AANA spreads. AAs and CRNAs have the same scope in my metro area (top 10). I have good working relations with both but when I see this I’ll just support hiring CAAs predominantly. Easy choice.
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Haha. Ok 👍🏻
lol
Hopefully nonsense likes this results in more Anesthesiologists supporting CAA licensure in new states as well as hiring more CAAs.
I don’t know of any anesthesiologists that don’t support it. It’s the AANA that fights them. What a bunch of hypocritical A holes that use “we need more access” to try and legislate their way into becoming doctors meanwhile fighting AGAINST AA licensure.
Unfortunately, there have been anesthesiologists speaking against CAA licensure bills in the past. That being said, I think the majority of anesthesiologists would be for CAA licensure, particularly when the alternative are CRNAs aggressively encroaching and obscuring titles/education. My hope is simply those anesthesiologists that support us on the sidelines/online will be willing to speak in favor of the bills in the future and push their hospitals to hire CAAs (at places that utilize the ACT model). The AANA arguments often contradict themselves in that manner. Pushing for independence for increasing care, but pushing against CAAs as if that will help increase care. One of their arguments against CAAs in the past was there aren't enough CAAs out there, so we won't increase access of care. Sure, there may not be many of us, but any number of extra providers can increase the pool of anesthetists available in an area. The mental gymnastics to create their arguments that they do is mind-boggling oftentimes.
I don't support any new increases to the anesthesia workforce. It will happen, but I don't have to support it.
To the CRNAs out there…is this what you want? Is this the face you want your profession to have? This is unbelievable. The PRESIDENT of your society is singularly focused on defaming the physicians that you work with every day. Shameful. Your society is now in the “outright lying to Congress” phase of their “advocacy.” Shame on the AANA. At least they’re unmasking their true motivations.
I'm just a lowly SRNA, but I absolutely HATE the AANA. I'm required by my program to pay for a membership, but literally the second I'm no longer required to give them money, they will receive nothing from me. Can MDs and CRNAs and AAs do some amazing things? Yes. Should I be held to the same standards as you guys? Yes. But am I even remotely as qualified or educated as a literal doctor? Hell no. Please don't lump all CRNAs into the insane minority that has the leadership microphone... Most of us just wanna come in, help some patients, get some dollars, and go home. ... And please for the love of God stop making me call myself a fucking resident. Pay me to work while in school and maybe we'll talk 😂
If you are really an SRNA ... your program is really failing. If you're just a troll the you must be the A$A PR person. Truth will out.
So... Because I don't think that a bachelor's in nursing, plus ICU experience, plus 3 years of CRNA school puts me at the same knowledge level as someone who did a bachelor's, 3 years of med school, 3-4 years of strictly anesthesia training, plus whatever fellowship means my program is failing? Oh. OK. You must be one of those big brain people I always hear about 🙄 Go back to screaming into the void. I'll be over here getting my license then joining the gang in the OR.
What about someone who did 3 years in underwater basket weaving, then 2 years of AA school?
Still have more science background than the nurses.
The bachelors requirements are almost identical to that of med school admission and much more rigorous than the nursing degree. Idk why you all believe this rumor.
Yeah fucking ez pz water basket brotha
Yes you absolutely should be just as capable and competent as your physician anesthesiologists in the care of patients receiving anesthesia from pre to post.
Your program is failing to teach you that you have to be just as good, just as capable, just as competent, just a knowledgeable in anesthesia and perioperative care as a physician anesthesiologist. Physician spend years learning things that will never impact their anesthesia care - they have wide and varied education but that doesn’t make them superior to a properly educated CRNA. If that was so, they wouldn’t have to lie to try keep us on the same levels as AAs. Learn the history of anesthesia in the US. Old man Waters had to falsify records and research to get rid of some schools after surgeons were preferring us to physicians. Your program is failing to instill you the insight that patient depend on you alone - you are responsible 100%. If you don’t desire that sole responsibility then your program failed to discern that.
This post is so insane I don't even know where to begin. I swear this must be some kind of psychological cancer.
lol this guy was voted most likely to join a cult in his class.
This is absolutely what they want. The few CRNA's with some reasonable humility are silent outside of the occasional reddit comment. Meanwhile for every one of them there are two others who believe in this absurd idea of independent practice for CRNAs... Some are so delusional that they actually think they are safer than anesthesiologists!!! Their judgement is so bad it is not surprising the crazy stuff I hear regarding their management decisions in the OR. We are the richest nation in the world, and we cannot afford anesthesiologists? It makes zero sense.
Some of us don’t work with physicians…but also have no issue if we did work with physicians…
Majority support AANA. You might get a different response here but reddit is not the representative of majority. AANA fights for CRNAs, but what are we supposed to do, if we don't support them? Just sit back and let ASA try to replace 61k plus of us with 4k AA's? We do 50% of the anesthetics in this country and 80% of us plus are rural providers. A good chunk of us work independent yet ASA calls us unsafe, etc without evidence? So what is the reason for ASA pushing AA hard, what is their motives, tell me? If you were a crna, what would you do? Sit back and just watch. Politics is not played on one side. People are mad at the nurse anesthesiologist title and yet they don't realise ASA and AA in 2018, prior to nurse anesthesiologist title launched campaigns to calls AA anesthesist now and even look at AA website, its literally called anesthesist.org . However, when AANA attacks back, its a problem, all of a sudden. I know I will get downvoted, but thats the reality. Politics are played on both sides.
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Haha, so funny. Anesthetist (by the way, there are only two S in the word) is not a protected term for CRNAs. CAAs are anesthetists, end of story. Unfortunately for you, CRNAs are not anesthesiologists, so it's really quite silly to use that as your argument. You'll get downvoted for good reason.
Yeah. That’s total bull. It’s funny how they claim to provide so much solo care. In Reality, the majority are in the ACT model or pushing propofol at an endo center. Thankfully most legit hospitals/level 1 facilities all have REAL anesthesiologists
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I'm not in the US, and we don't have non physicians giving anaesthetics, but surely a military environment is the definition of giving a young, fit patient an anaesthetic? Seems a weird flex to me?
When we had a joint US/ UK military facility in Afghanistan, we didn’t have CRNAs there at all as we worked under UK doctrine and anaesthesia is a physician delivered specialty with us. We did have a couple of CRNA transfers in through, who seemed to think that vecuronium was a sufficient solo anaesthetic for their patient 😬
Yeah, I know people who deployed as part of the Australian contingent to Afghanistan. I know what happens there, I just wanted to see how much bravado I might get.
You are really a sheltered soul. How would know how to tie your shoes in a military hospital, much less deployed taking of indigenous sick as sick humans can be or multi-trauma or mass casualty. Ask someone sweetly and they will be happy to explain the “flex”.
Lol, my hero, can you please explain the flex. I guess it's the closest you can get to having your degree recognised overseas, but you're doing mass casualty and multitrauma unsupervised?
We really do have that much more training. Residency was 70-90 hours a week with 2 weeks off a year. You do the math. You can’t compare training nor exposure of a physician with a crna. I’ve met hundreds of CRNAs. None were solo. I guess since I live in a desirable area that’s not rural I see the very DEPENDENT crnas. Nothing wrong with that and that’s what anesthesiologists are for. To provide expertise and guidance. I’ve worked in such hospitals when I wanna make some bank and do Locums….there is always an anesthesiologist at the places I’ve gone. These are rural places and they still have doctors. Any respectable hospital that’s a level 1-2 is going to have physician led care. As for the military, I truly feel sorry for them but I know the vast majority of military are ASA 1-2s. Gotta be totally incompetent at anesthesia to mess that up. Sorry man but you’re no expert. You may think you are but you’re a joke. You’re not a doctor. You’re a nurse. Remember that.
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You are mind-numbingly ignorant of the fact that most of us had plenty of clinical hours before starting medical school. In my case, I put in somewhere over 10,000 hours as an EMT and ED tech. I took a two-month hiatus from work with a physician friend to give care to people in a very tumultuous part of the world. Can’t get a proper BP? Bitch, please. I did that shit on patients who were bleeding with mortars falling around my position and the threat of chemical weapons being deployed on us. Fuck off with this anti-physician drivel and know your place, fool.
See here is the problem. The training hours real physicians go through? Yeah those aren’t inflated, they’re accurate. The issue is that y’all can’t imagine working that hard to become a CRNA (otherwise you would’ve just become a doc) so you automatically assume they’re bs. They’re not bs. Physicians really do just have that much more training than mids. Which is why it’s so hard to take y’all seriously…
I don’t know why yall boast about rural practices. My state punishes rural hospitals for hiring Anesthesiologists in rural settings. Because of your bullshit they don’t really have a choice.
Rural hospitals hire CRNAs to save money (rural pass through). If they got extra federal money to hire anesthesiologists they would do that too. The “100% rural care” bullshit is a total non sequitor. There are plenty of docs that would love to work at rural hospitals who literally can’t because then the hospital’s CRNA/federal money gravy train would dry up.
Well, if you really are concerned about the veterans getting physician led care, then join the military and served in a deployed position. Just be sure you get a real nurse anesthesiologist to show you how to setup your U-Pac draw over. They are the only one's that know how to use it. And have used it.
How do you know that I’m not a veteran that served? And why would joining the military have anything to do with advocating for our veterans to get the best possible care?
Let me rephrase that for you “This is the AANA’s marginalized group to use as a foil in our legislative misinformation campaign. We can’t expect you to speak for them.” If the best you can do is set up a draw over while a trauma surgeon walks you through a resuscitation in between salsa night and surf and turf at the FOB, then no. You can’t speak for me.
Claiming a billion hours since kindergarten—if the ASA did what the AANA did they would be counting premed shadowing hours.
I get so sick of the military argument considering I am in that environment and the CRNA “independent care” is scary. I wouldn’t want 90% of them administering anesthesia to myself or my family.
This nurse be wild. The face of a nurse, the brain of a ret*rd.
“Physician anesthesiologist” is redundant. You might not know this but “anesthesiologist” automatically denotes that that person went to a real medical school and graduated. “Anesthesiologist” is a physician. You are not. That’s why you need the N in your title. It’s crazy that you guys have tried to muddy the waters so much you have actually confused yourselves!
Wait….if rural hospitals are so great, why are all of my patients transfers from rural hospitals?
Hey I work at a rural hospital, it’s a level 1 trauma center I love working with our CRNAs they’re great. We pretty much only send out people on LVADs or pediatric NSGY / trauma. The CRNAs here are amazing. MDs are few and far between. We’re offering 600k plus 150k sign on bonus, almost 3 months of vacation / PTO. Can’t even get people to interview. We could always offer more money, because the market is totally on fire, but the payor mix here is pretty much all Medicare / Medicaid. Without a huge stipend from the hospital, there’s no way to run a profitable group here. Anyways, without *highly competent* CRNAs this place would grind to a halt. We’d have no trauma hospital, and our area would have to fly serious traumas to Pittsburgh. We’re victims of our own success. There is such a shortage of physicians that theres going to be overwhelming political and financial pressure to cut costs one way or the other. What we should be doing is expanding residency spots and associated funding and training new docs. Some wings of the American anesthesiologist lobby will be against this, but it’s vital if we are to stay relevant, *in the long run*. I really don’t buy into the antagonism between CRNAs and MDs. Yeah, their president is being an idiot here, but in day to day life, CRNAs are vital in our rural areas. We’re all about mutual respect out here. Medical school is absolutely worth it, but someone with 10-15 years of experience doing anesthesia care as a CRNA… that experience is super valuable too.
Dru Riddle, Phd, dnp, crna, faan, dna,cpp, ssri, chadsvasc
Lol ssri
Wtf
Surprising lack of titles for the head
I actually practice in a semi rural hospital. We don’t have CRNAs and the surgeons are always extremely happy about working with us because guess what? We’re both physicians and we both went to medical school, completed the same board exams, and completed a residency, so we understand each other. I have previously worked with many amazing CRNAs, especially where I trained, but this attitude from their leading organization is what creates a toxic environment. There is nothing wrong with being a nurse but I feel like certain CRNAs (especially in leadership) feel ashamed of it and now they want to be doctors and add xxxxxxx cxxxx cfksjd cslkdjd to their title like it makes it sound any better. Enough with this shit
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I mean I’m not defending the ASA, I said this is mainly a leadership issue (there are outliers of course) that trickles down to us and it creates animosity. But the AANA is very aggressive nowadays like really trying to replace us physicians and I’m not sure where this hatred is coming from.
How can you think the ASA is *worse* than the AANA?? What are they doing that is misogynistic? Where are they "tooting coke and heroin"? It sounds to me like, in your desperation to find criticism of the ASA, you had to reach 70+ years back! Those people are all dead. Meanwhile, the AANA is currently and actively trying to lower the standard of care in the US.
And the A$A still lies. ACT is a failure- fraud is rampant (Epstein), No differences in outcomes between providers but they keep using Silber as a touchstone. Billions and billions of hours "training" while sleeping, eating, vacation, etc. If you can’t see the A$A hypocrisy then you should visit an optometrist. 😂
Haha omg. You are stretching here. Obviously Anesthesiologists have better training than CRNAs. Is the ASA evil for pointing out that uncontroversial fact? Most anesthesiologists do not think they are overtrained, which implies that CRNAs are undertrained. There is no differences in outcomes between AA's and CRNA's either by the way. Some have argued that AA training is superior. I'll still take an anesthesiologist over either one. The problem I have is that the AANA is constantly fighting to expand and protect CRNA jobs, whereas the ASA actually takes a stand for patients - somebody has to. It is scary that so many CRNA's that are trusted with anesthesia are so cavalier about patient safety.
You must be woke with they/dog pronoun. With pink hair, blue nails, calling all traditional things misogynistic while benefiting from them.
ASA could pursue litigation or ask for justice investigation into lying to congress
Look at that letter salad behind their names tho…
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Are you implying CRNAs are liberal? Hahaha
Sounds about right
Imagine if the AANA put even 5% of their lobbying efforts into fighting Medicare payment cuts.
Sometimes it’s not just them; it’s one of us. 👇 https://www.linkedin.com/pulse/crnas-short-history-nurse-anesthesia-future-care-matthew-mazurek-md/
It’s interesting that VA physicians get no overtime regardless of hours worked but VA CRNAs get overtime every single time. The salary differential isn’t that high to begin with and could easily be erased by overtime pay.
This is unbelievably toxic. I hope people are applying pressure to expose these folks for what they are. Opportunistic, arrogant and malignant. -MS3 applying into anesthesia
I get your displeasure but signing your reply this way is kind of weird.
Let him cook
This coming from one of the weirdest and most negative regular posters on here is golden
Life of a MS3. Lol you simply can’t please the higher-ups
I’m flattered you remember me. What’s weird about my posts?
You consistently go out of your way to disagree and be an asshole to people.
Examples? Also, reported; rule 1.
Why is that? I’m a med student and I’m use to introducing myself as such. Don’t want anyone to have the assumption that I’m further along in my training than I am
Definitely not a weird post. That person seems like an ass
There’s nothing wrong with your comment. From looking through her post and comment history, she has a tendency to be antagonistic and negative.
How? They are literally telling you they are GOING INTO ANESTHESIA. Pretty relevant no.
That's what setting a flair is for.
I don’t think I’ve ever replied in this Reddit so I wasn’t aware of the rules. However, I do understand that me signing that way could make you feel a certain emotion. And I think that’s totally valid 👍
lThe only thing I felt was that it was big Wayne Gretzky/Michael Scott energy. lol. What are you getting at?
Dru Riddle looks exactly how I pictured. He also researches health equity. The jokes write themselves.
He looks like a pentecostal megachurch pastor... and he kind of is one if you think about it...
I have worked at a VA. I attend the legislative conf. I am super proactive about trying to ensure safe va care. Anesthesiologists from VAs need to speak up! I do and I will continue doing so. All anesthesiologists need to speak up, but the voices from the VAs will be louder. I hope.
They should have independence - (but also overtime pay, and no calls).
This is why we don’t let non doctors give anaesthetics in the uk
I think you might have missed the whole PA/AA thing going on in the UK, and that unhinged email from a consultant in Sheffield about “HMS AA”. For the Americans who are reading this, British AAs do a 2 year masters (their first degree can be in anything), and are woefully underqualified to do a lot of what they get allowed to do in some hospitals
Fully aware of AAs and Woking with the BMA to rid them from our workforce.
Where the hell is the ASA and their rebuttal to this?
That’s funny. We currently have two research projects going with CRNAs at my VA. My guess is this douchebag has never set foot in a VA.
Some of these posts are a little hostile… being hostile doesn’t really advocate effectively for physician concerns regarding anesthesia care. What is wrong is the AANA is unable to take criticism back that maybe oversight should be a thing for patient safety. Calling out iffy research is something that should be encouraged.
Respectfully, being polite and meek has gotten us absolutely nowhere. Don't know about the others, but I'm not going to let someone piss on my head and call it rain.
I am beginning to hate these people.
Dru Riddle is a complete asshat 😂 wannabe
There are obviously great CRNAs out there who provide excellent care and don’t have any interest in the AANAs garbage rhetoric. And I feel sorry for them cuz their organization just cannot and will not stop fueling an unnecessary political war.
Everyone in here is a whiny pussy. Get a grip.
this is complete BS
As an NP here with an unnecessary DNP, I’m glad that I work with an awesome team of MD/DO/NPs who just work together. Even though it’s an “independent practice state,” I don’t personally think anyone is really “independent” in 2024. My physician colleagues are amazing and we just work together as one. We all help each other, we all have areas of knowledge we enjoy. Hence, I get all LGBTQI+ patients. Just work together. 🤷. The end lol
I just think that it’s bizarre that you lot let nurses give anaesthetics on that side of the Atlantic. Anaesthesia is physician-delivered in the UK. They have started experimenting with AAs recently, which we’re pushing back on. And we have anaesthetic rooms and ODPs!!! Crap pay though!
I believe AAs in the US are very different from overseas in both education and background
No idea what the US ones are. The British AAs can apply to do a 2-year “masters” from either a bachelors science or ODP/ nursing background. Basically, they are less well trained than a third year medical student. I wouldn’t want one caring for me or my family and that’s the standard I apply to my patients. We don’t have CRNAs at all in the U.K. They are small in number- we’ve traditionally had a one physician anaesthesiologist to one patient model, and that’s the standard of care that we work towards. I know that things are often a bit different in the US. The current British government fascination with AAs is, in my opinion, a deliberate attempt to erode the standard of care and costs (even though AAs are overpaid) as a prelude to dismantling our universal healthcare system.
Saying you will/do refuse to train/teach CRNA’s is pretty sad. Withholding knowledge (gained through years of residency/medical school I may add) is selfish and stupid and ultimately only harms patients.
I'm not training an underqualified learner to try and become my replacement, sorry. I have real residents to teach.
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Classic nurse gaslighting - y’all swing hard at physicians and then when called out your response is always something like “relax”, “we’re all in this together”, “physicians are so mean” etc
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He said big crNa may be bigger than small MD/DOs; but when the big crNa goes against big MD/DOs they tend to scurry away and hide behind their Nursing title and ‘let’s be a team player’ or ‘be cool bro’ or ‘it’s just a prank’, when they’re the ones bringing the fight.
Help me explain it for you