"Let me direct anyone interested to an article in "The Hill" posted on 9/2/2010 in the healthcare blog titled Study: (Doc supervision of nurse anesthetists is expensive,ineffective and "irrational" )I don't think it will change the ranter's minds but may just educate and put to ease the general populace about CRNA,s!! Just cut and paste what is the between (parenthesis) above"
First of all it is absolutely ABSURD to use a study such as this. It tries to compare apples and oranges. CRNA's may be just fine for routine things like sedation, although the FDA wants a machine for sedation because this job is so easy. CRNA's are not getting, nor are they adequately trained for the hard cases. Those cases are (mostly? always?) handled by DOCTORS. Since the DOCTORS are getting the tricky anesthesia cases where the mortality rate is understandably much HIGHER, it seems to me that this study proves the exact opposite of what "Dano" is trying to prove. It seems to prove that despite the much more dangerous anesthesia problems confronting real Doctors, they have the same success rate as CRNA's who get the easy sedation and ASA1 cases.
In this study (seems to me it was funded by CRNA's themselves, more research necessary) they try to use billing, medical BILLING and data to reach some sort of conclusion that they are just as good as Doctors. Nice try. We would need to know how many people DIED as a result of their anesthesia. Then we would need to know how many of these patients were ASA1, ASA2, ASA3 etc. and what their prognosis was prior to medical intervention. None of this is available. We need a real comparison of outcome based medicine, not some stupid research into billing and claims. I want to know how many CRNA's screw up their patients as opposed to how many Doctors screw up THEIR patients by comparing like patients, not billing statements. Since CRNA's in general do NOT work on the worst patients, this might be hard.
The main reason for this study is that CRNA's want to raise their rates and make just as much as Doctors for much less training. For proof of that look at the CRNA web site and read all the whining and moaning going on about this very thing. They want to be independent contractors
and they truly feel that normal people will choose a NURSE to handle their anesthesia even if the cost is the same as for an MDA. Are they out of their mind? If CRNA's are so cocksure that patients would trust a nurse as much as a Dr. why do the CRNA's CONCEAL THE FACT THAT THEY ARE JUST A NURSE? My CRNA NEVER ONCE TOLD ME HE WAS JUST A NURSE! This is illegal and it doesn't say much for the whole group of CRNA's. Dano if you are so proud of your profession, let me ask you this; Do you tell your patients that you are an anesthesia nurse? Do you tell your patients that they have an absolute RIGHT to have a Dr. perform their anesthesia, instead of a CRNA? Chances are you DON'T!
The outfit that "Dano" cites as empirical evidence that CRNA's are just as good as Doctors is RTI. What type of studies do they do? They research health RECORDS and other data which as we all know are replete with omissions, lies, falsehoods and other CYA insertions. That's it. They don't ask patients, don't identify which procedures are being studied, not at all. They are looking at medical CLAIMS against CRNA's. This is ANECDOTAL evidence at best. It's a big stretch to compare outcomes based on this kind of "evidence" and Dano you know it. There's a huge difference between having CRNA supplied colonoscopy anesthesia and having your Dr. supplied open heart surgery, with co-morbidity. You really can't compare outcomes by the kind of medical records this outfit used. This is very disingenuous of you Dano.
For more proof of a deliberately skewed "study" look who is behind it. Paul Santoro, (big surprise) the AANA president. The next on the list is the Journal of Nursing Economics (another surprise huh?) I have EMPIRICAL evidence to refute the so-called FACT that nurses cost less. Honeybabe I have the BILL!
I also had a bad outcome from my nurse supplied anesthesia. A nurse isn't an acceptable alternative to a Doctor for my anesthesia. I never would have believed that a NURSE would be doing my anesthesia in the first place. This would have been unacceptable to me ESPECIALLY in light of the fact that my CRNA was going to give me general anesthesia. Of course that little item was another FACT that wasn't revealed to me by the nursey poo.
I would NEVER EVER have allowed a nurse to give me a "dangerous" axillary block either. What the hell! I'm going to let a NURSE give me a shot right into the nerve and risk permanent nerve damage? Not on your life. Especially since he went on and on about how dangerous it was... Well, I guess it was a lot more dangerous than it needed to be because I DIDN'T HAVE A DOCTOR! No wonder the jerk simply shot me up with a poison like Versed. He NEVER wanted me to find out just how badly I was abused. He claimed that he had to give me g/a because my nerve block didn't work! Well, jeez, ya think? Never mind that I had stated emphatically NO to g/a or anything like Versed/Midazolam! A NURSE was playing Dr. of course it didn't work. He knew it wouldn't work ahead of time because he isn't a Dr. and doesn't have the training of a Dr. I had no problems with it, but HE HIMSELF claims that his work was substandard (by inference) and that's why the g/a. I remember exactly what happened, (no amnesia from the overdoses of Versed this non Dr. gave me) so his little subterfuge didn't work anyway, but it sure made me aware of the LIES that he and everybody told me.
Which brings me back to my statement that the examination of MEDICAL RECORDS doesn't prove a thing about how "safe" anesthesia nurses are! The study that Dano cites is nothing but a fluff piece without merit, slanted in favor of the very people who instigated the study. Kinda like the FDA really works for the drug manufacturers, it doesn't actually have anything to do with patient safety. You need to go to the website that Dano wants you to. Look at who is salivating over this little bit of lunacy! Look at the comments on the page, look at the rebuttal from the MDA's, keeping in mind that CRNA's hold themselves in very high regard and form your own opinion. After all, I am not a disgruntled patient, the victim of a medical assault, I AM SIMPLY A "RANTER" according to the poster "Dano."
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