re: Wisconsin Hospital Replaces All Anesthesiologists with CRNAs

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I agree. CRNA training shouldn’t be included in the same category as NPs. I am a CRNA and when I graduated I had over 1000 anesthetics under my belt. The same graduating class of NPs only had 500hrs of clinicals. CRNA school was basically a full time job. Clinicals mainly from 6-3pm M-Th and class on fridays. This was for 2 years continuously after 9 months of intense didactic work to begin the program. No summer break, no Christmas break, no spring or fall break. Long story short, CRNA training is much more intense and thorough than NP training. No offense to NPs.

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I do agree with this too. cRNAs working within their a scope are probably more trustworthy and better trained than a large segment of working NPs. I just think its dangerous and misleading for cRNAs to misrepresent themselves as a physician.

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But you drove yourself out of those areas on purpose. Now crnas and nps serve these areas and the pts couldn’t be happier or know the difference.

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Boom

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But you drove yourself out of those areas on purpose. Now crnas and nps serve these areas and the pts couldn’t be happier or know the difference.


Boom

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thats not a boom. despite nurse lobbying, data shows that midlevels do not flock to rural areas to underserved areas which was the main argument for their gaining independence. this is propaganda, not boom.

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Patients lose in an environment when expertise is not valued and the only thing that matters is the hospital’s bottom line.

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This is an elitist attitude. You think just because a physician anesthesiologist isn’t present, people get substandard care. That’s what is insulting. Why is it ok for the CRNA to stay after 3 to work when the anesthesiologist goes home? Is the care only excellent from 7-3? We are not saying they are not valued. We are saying we are all valued. You lose the argument when you try to equate poor outcomes and inferior care when one isn’t present.

Hospitals not only see the monetary value but they see the clinical value. If that is the argument the anesthesiologist continue to try to sell, they will continue to lose contracts and positions in places like this.

I do work in a few different settings and in one specific setting, they got rid of 2 physician anesthesiologist for an all CRNA practice. After working there for a while, I would hear horror stories about the anesthesiologist and how they would be called for an epidural, only to arrive 1 hour later. We have been complemented for our care and how much more professional the practice has become.

Whether you are a CRNA or an anesthesiologist, we both have poor providers within our profession and we both have excellent ones. When you try to drag one profession down by peddling scare tactics to the public, then you’re being disingenuous. Not every provider is created equal and I am sure this hospital has 100% confidence in their anesthesia group to do the job while providing excellent, safe care.

Lol and you are degrading CRNAs as a whole because of a few

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Not the point. Would you rather have a midwife serving your poor area or nothing?

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thats exactly the point. its not a rural midwife or nothing... they just are midwives in cities, working wherever they wanted to in the first place. they didnt start flocking to those rural areas like the propaganda bought into suggests, they just started doing it where they already were.

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Boom

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That’s a boom?

Mid levels don’t want to be in rural areas any more than physicians. Here is an example:

FPA was implemented in Arizona in 2002. Within the first five years of passing the law, the number of NPs in the state increased by over 50 percent (1). Over the ensuing years, however, FPA has not improved Primary Care access in underserved/rural areas. By 2010, fewer than 10% of NPs worked in rural areas (2). Currently, Arizona has a shortage of Primary Care providers in all counties – worse in rural areas. The state currently ranks 44th in the nation for primary caregivers, at 77.9 per 100,000 population (3). This is much lower than Pennsylvania’s current rate of 208.7 per 100,000 population (4). Pennsylvania does not have FPA (5).

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Nurse Anesthesiologist

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I know the AANA approved this but I refuse to identify myself this way. When I introduce myself I say my name and that I’m a nurse anesthetist and part of the anesthesia team. I work with a very cool and good group of anesthesia docs and don’t feel the need to piss off my friends and colleagues. They trust me to run the cases how I feel is safest and also trust me to call if I need an extra set of hands. I have no ego as far as that goes and patient safety can only suffer from it.

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You get lumped in with the NPs because every time state legislation is brought up to allow midlevels to practice independently it includes NPs and CRNAs.

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Legislation, specifically in Louisiana, is different for NP’s vs CRNA. NP’s are required to have a collaborative practice agreement and CRNA’s don’t. The current bill proposed by the NP’s doesn’t include CRNA’s. It does mention APN practice but we are not included in the language. We are required to be supervised by a physician, based on CMS guidelines. That supervision isn’t termed a collaborative practice agreement. We all know surgeons know nothing about anesthesia but hospitals without physician anesthesiologist have a hard time recruiting new physicians because they somehow feel liable for CRNA malpractice. Truth is, a surgeon is no more liable if he is with a CRNA or a physician anesthesiologist. There is plenty of case law that proves that and, to my knowledge, surgeons don’t pay any increased premiums when working with only CRNA’s.