Comments on: CRNA salaries

By: a real anestheia provider

a real anestheia provider — Thu, 22 Oct 2009 15:05:20 +0000

The “bufoon” comment by IrishCRNA sums up the arrogance of many CRNA’s who are credentialed as nurses but “act” as physicians. I have been a MDA for 30 years, I started out as an RN then went to med school. Along the way, I have met many good MD’s, nurses and support personnel (such as CRNA’s). I want a MDA doing my anesthesia, but I don’t have to insult CRNA’s to express that opinion. Irishcrna-take a deep breath; nobody is trying to take your job as a nurse away; but don’t become apoplexic thinking that as a CRNA you are an anesthesiologist. You are not. Patient’s deserve an anesthesiologist, not a CRNA if they so choose.

By: crna1972

crna1972 — Sat, 10 Oct 2009 14:09:50 +0000

I am a CRNA and work with 10 MDAs and 9 other CRNAs. I have given anesthesia to 3 of the mdas for thier surgical procedures, at their request. ( over their partners) My point is this; its not the letters behind the name…MD v CRNA…its the individual providers competence. I have encountered many incompetent providers regardless of their qualifications. So, choose your provider on reputation, not by the letters that follow their name.

By: Also a SRNA

Also a SRNA — Tue, 06 Oct 2009 23:06:55 +0000

I am also a SRNA, and frankly I am sick and tired of all the hate-mongering that goes between MDs and CRNAs. I understand that some (and I do truly mean just some, not all) MDs think that we are ‘taking a piece of their pie.’ But as it stands, there are not enough anesthesiologists to perform the anesthesia in this country (especially in rural towns.) I believe that CRNAs are perfectly capable of providing great anesthesia care to a variety of patients.

I also believe that when you get down to it, the people that are angry with CRNAs are not truly angry at them because of the work that they are certified to do; they are angry at them collectively because of the pay that they receive. I feel no shame in saying that I believe we should be paid what we do; it is an incredible amount of work that we had to put in, not to mention those of us that worked night shift in ICUs while trying to raise a family (those that have ever worked the 7pm-7am know what I mean).

Healthcare should boil down to one thing–patient care. With the sparse amount of anesthesiologists out there, it truly benefits the patient to receive anesthesia from not only competent providers, but providers that do NOT show animosity towards one another. We should be fostering teamwork and not creating this gigantic rift between our professions.

Sorry if this was long-winded, but I needed to vent.

By: SRNA

SRNA — Mon, 05 Oct 2009 12:56:09 +0000

Anesthesia was a nursing specialty long before it was a physician specialty. The notion expressed here that nurses perform anesthesia because we don’t have enough physicians is absurd.

Good anesthesia depends on the person administering it. Nurse Anesthesia education is every bit as detailed in anesthesiology as an anesthesia residency. You may have an inadequate provider, but that will be due to the weakness of the individual, not nursing versus medical training.

Remember that CRNAs spent time (some for many, many years) providing watchful, vigilant care in an ICU, watching for hemodynamic issues and other critical complications. They serve as the eyes and ears for the intensivist MDs who cover the unit. That experience lends an assessment capability that serves them well at the head of the OR table. Most ICU nurses could not even tell you how many times they had to advocate for medical intervention when a physician refused to see that something was wrong with a patient. As a nurse, I was obligated on more than one occasion to correct anesthesia residents on their pharmacology. I was obligated by my duty to the patient, not by personal pride.

I’m not saying that makes doctors bad, but I am saying that nursing training and experience is not something to scoff at.
I could have gone to medical school. I chose not to. I will never make as much as an MDA, but that doesn’t bother me in the least. It does bother me when people who are clearly misinformed about the requirements and scope of practice for CRNAs make assumptions about the quality of care they provide.

By: IRISHCRNA

IRISHCRNA — Sat, 03 Oct 2009 05:10:32 +0000

Wow! Still amazes me how ignorant the public is concerning anesthesia providers. I have experienced the full circle of providing care. I have been supervised by “ologists”, some who never even show up to the room, some who are incredible to work with, some who resent we only have 7 years of school compared to their 12, some who value the work we do. Let’s talk about the work we do GARY, HOSPITALIST— this CRNA takes 75 call days a years where I am on. When you arrive into the ED, bloodied and gasping for air, fighting to save alive, I am there, securing your airway, stabilizing you hemodynamically, dropping lines and ordering drugs, blood, labs. All to save your life. I work in close alligence to any and all physicians also involved in your care. You are not a paycheck to me, you are not job security to me, I don’t read stocks, chat on the phone, leave the room as you sleep, or play on my blackberry, I watch every beat of your heart, every breathe you take. You are someone’s dad, someone’s brother, someone’s son. I speak for you when you can not speak for yourself. -
Hospialist-ha-you are just an arrogant buffon. And when a patient wants a real doctor with a specialty, don’t ask for a glorfied hopitialist, it a cheaper form of care, ask for an internal med doc. Cause I’m sick of explaining that you are an end all catch all for cheaper care..
I bust my irish arse, and I do EVERYTHING a “ologists”does and then some. So Gary, your surgeon is an idiot and you should consider getting a new one. He has the Doc God syndrome and has misinformed you.
Oh, and thank God, I do what an “ologist” does because now I am providing anesthesia services to a small rural community where “ologists” don’t want to come to. Not a big money maker for them.

By: Stephen

Stephen — Wed, 16 Sep 2009 12:06:06 +0000

With respect to the comments of the last three posters, I think that it should be made clear that there are NOT enough physician anesthesia providers to allow 1:1 anesthesia coverage for every patient requiring anesthesia in this country. The anesthesia care team, consisting of an anesthesiologist, a CRNA or more recently an AA, has been providing safe, quality care for years and years and will continue to do so. To equate the nonphysician providers with flight attendants flying planes is clearly over the top and only serves to continue the sort of hysterical fear-mongering that appears in the last three posts. As a board-certified pediatric anesthesiologist, I chose CRNA colleagues to care for both of my children when they required surgery.

By: Gary

Gary — Tue, 08 Sep 2009 22:25:12 +0000

Dr Pho’s article raises interesting questions. I had surgery scheduled this week and called to inquire about the anesthesia practitioners; specifically I asked to speak to the anesthesiologist who would be performing the anesthesia for my case…..this is a reasonable request and I don’t want to ask questions on the day of surgery, but they told me that nobody would call me back except for a CRNA. The CRNA told me that she would be doing the case, that she’s licenced to practice without supervision and that CRNA’s can do any anesthesia function that an anesthesiologist can do. If this is true, why do we have anesthesiologists? Aren’t they supposed to supervise CRNA’s? Evidently not. My surgeon said that he will request an anesthesiologist for my case (that’s what he would demand for his own surgery), but he could not be sure that one would be available. The surgery was to be this morning and there was no anesthesiologist available, despite my waiting for 2 hours. What a waste of time, IV’s, preop drugs etc. I needed to have the surgery done so I almost agreed to have the CRNA do the case until she repeated the line about being equal to an anesthesiologist; my surgeon interjected politely: “no, you are not”. Then the surgical nurses tried to convince me how good the CRNA’s were, but since my surgeon didn’t have confidence in them, I cancelled the procedure. The surgeon told me that he would make sure that an anesthesiologist was available when we reschedule. I wonder how many patients are put at unecessary risk by getting anesthesia from an unsupervised nurse? I won’t be one of them.

By: hospitalist

hospitalist — Sun, 06 Sep 2009 17:34:24 +0000

I have heard this argument for many years; crna vs physician..which is better? if you are saying that a crna salary even comes close to that of a physician, then it’s clear: anesthesia should be performed by a physician. If patients agree to a reduced price with increased risk, then let them decide to get their anesthesia from a nurse. But be honest with them; I’m sick of patients being told in a preop interview just prior to surgery that a nurse will be doing their anesthesia! When they question how an anesthesiologist can “supervise” simultaneous procedures (many crna’s, one physician), I tell them: depending on the schedule, you might not even have MD supervision at all! I would never receive any type of anesthesia from anyone except for a board-certified anesthesiologist 1:1; an dI document this on the consent: “I agree to anesthesia provided 1:1 by Dr X; I am not consenting to anesthesia services provided by any other person(s). This works well.

By: gareth

gareth — Sun, 23 Aug 2009 01:20:45 +0000

I recently had anesthesia andhad the misfortune to have a CRNA administer (or try to administer) anesthesia. It was a disaster from start to finish. The anesthesiologist was nowhere to be found; when he finally arrived, the damage was done. His contribution to the procedure was swearing at the CRNA for being an unquallified nurse who should stick to backrubs and bedpans. She was a arrogant person and now I’m scared to have any type of surgery. When did doctors become so few and far between that we have to have urses do this job? Maybe the flight attendants should fly the airliners?

By: Anonymous

Anonymous — Mon, 27 Jul 2009 01:51:02 +0000

I have seen this arguement over and over again. It took my husband almost 10 years to become a CRNA. Legally, he can do everything that an Anesthesiologist can. As far as billing goes, CRNA’s get reimbursed excactly the same as an MD. If an MD is supervising, the reimbursment is split 50/50. Then the MD pockets the money and pays the CRNA a minimal salary. The MD’s where my husband works, their idea of “supervising” consists of sitting in the break room eating, watching tv and playing on the computer, then come out to sign the chart when the case is done. What a joke! They all freak out if they actually have to deliver anesthesia. I would take a CRNA any day over an MD. They have more hands on experience, not just book smart. My husband is excellent at his job and is the most requested anesthesia provider here. The problem is that MD’s are money hungry. In my opinion, CRNA’s are underpaid for what they do. Also, none of the MD’s will go to L&D and half of them can’t even put in an epidural without 4 or 5 sticks. L&D is not a cakewalk with easy patients. It can definately turn nasty fast. My husband ends up working an average of 60 hours per week. I never know when he will be home. While he works his butt off for a minimal average CRNA pay and the MD’s sit on their butt raking in the dough.