Monday, July 5, 2010

Comment on Turf Wars

I reproduced this in the body of the blog as you see, instead of leaving it only in the comments. I said that I would use comments in this way if they were interesting to my readers and I think this one is. The perspective is one that I haven't seen so far. Thanks anonymous.

"My wife is a physician (not an anesthesiologist) and my daughter is a CRNA. Anyone who equates the med school training of an anesthesiologist to the nursing school training of a CRNA is making a silly comparison. Nursing school for a CRNA (albiet 2 more years of nursing school) doesn't compare to medical school. It's an apples and oranges comparison. If you want safe anesthesia, you need an anesthesiologist. But lets stop and smell the roses (horsesh*t): if you get anesthesia, you are probably going to get it from a CRNA simply because they are cheap. Multiple CRNA's "supervised" (maybe) by single anesthesiologist. Not safe. Never has been. Physicians get anesthesiologists when they have surgery, but you won't. CRNA's usually chime in that they prefer fellow CRNA's, but then they can cherry-pick a certian CRNA....Bad CRNA's are terrible. Even my daughter the CRNA can't believe how much CRNA's can get away with; they basically practice medicine unsupervised because nobody gives a damn. "

I have a couple of comments. First, I have read that the average wage for a crna is 168,500. I personally don't think that's cheap, but maybe the crna's are cheap for their employers as opposed to having doctors. I was charged $800 for a 70 minute operation for the anesthesia. I was charged another 800 bucks for taking the offending screws back OUT. I don't know how anesthesia distributes the money as crna's are required by law to be supervised.

At the risk of sounding really snotty, the alleged anesthesiologist supervisor, a Dr. B, was very nasty toward me in the PACU and subsequent phone call. I am thinking that I wouldn't have been happy with his services either. This Dr. claimed later that he had zero knowledge of me, my anesthesia or the crna, that he was in no way responsible for what happened to me. (Why was he in the PACU claiming that he knew all about what happened?) Nobody admitted that they were in charge of the nurse, not even my surgeon. The hospital claimed that the crna was an "independent contractor" and thus beyond their control or supervision. Everybody back pedaled when they realized that I was NOT going to "go home and forget about it!"

Disclaimer; I have this all documented! This is MY blog based on MY EXPERIENCES and I have back up with legal documents, citations from governing bodies etc. Sometimes MY perception of things is NOT what the caregivers perception is. Examples; Aaron L crna claims I had "anxiety." (not so I would notice) Aaron claims that I agreed to his desired course of action. (not even close) Dr. B claims that he "calmly" explained things to me in the PACU when I was "irate" about my treatment. He actually appeared to be seething with anger that *I* a moron truck driver would DARE question what had been done to me by the educated people within those hallowed walls. He obfuscated, ducked, dodged, and lied. I have his documented "interview" with me, replete with falsehoods. This is only the truth in my opinion, based on the documents and my own impressions. If anybody who was involved in my care wishes to have their side of the incident printed on this blog, please e-mail me at and I will be more than happy to put them up.

I was unable to ascertain who was "supervising" if anybody. The law states that each person contributing to my care must be listed by name and with their job, on the informed consent document. There was no valid informed consent document let alone one containing the name and the duty of each person involved in my care, so there you are. This poster says what I suspected, that crna's are without the supervision required by law. (The hospital was cited for the lack of names and duties by the Idaho Board of Health and Welfare, just one of many citations regarding my care.)

The law states that it is a right of the patient to have a doctor and not a nurse for anesthesia. By law, these nurses are required to inform the patient that they are merely a nurse and that patients can demand and get a real doctor. Not happenin' at least where I went. I had never heard of a nurse anesthetist. I know now! I found out when I called the anesthesia group after the debacle to get the last name of the DOCTOR who had assaulted me. I couldn't read his writing or signature, also against the law. The office girl cheerfully said "Oh you mean our *crna* Aaron!" Your what?

Those of us who are "outlier" patients who are difficult to anesthetize, have paradoxical reactions to the drugs and have "emergence delirium" don't want a crna. Not on your life. (pun intended) But, since I had NO IDEA that I was going to be forced to have sedation and g/a against my will, and that the anesthesia provider was a NURSE what was I supposed to do? Read their minds?
In anonymous' final statement he writes "Bad CRNA's are terrible. Even my daughter the CRNA can't believe how much CRNA's can get away with; they basically practice medicine unsupervised because nobody gives a damn." This should scare us all, regardless of the posturing by crna's who claim that they are the doctors' equal...

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