Anyway, I found this post on www.hospitalsoup.com in the colonoscopy medications section.
jessica says:
I’m an internist and often request that patients undergo colonoscopy exams. I always thought that the sedation was to keep patients comfortable and that a qualified anesthesiologist would attend my patients. I’m shocked to find that many colonoscopy patients (most) undergo a brutal, painful and traumatizing exam without anesthesia, but inadequate “conscious sedation versed/fentanyl) administered not by an anesthesiologist. but by a nurse/crna who is not qualified to keep my patients comfortable. Colonoscopy patients often tell me that the nurse anesthetist doesn’t make the exam tolerable; they are thrashing about complaing of pain while a CRNA keeps telling then that “you are doing great”; administering an amnesia drug (Versed) in the hope that the unfortunate patient will forget how badly they were treated during the colonoscopy……. nurses (CRNA) are not qualified to administer any form of anesthesia..I will NOT recommend colonoscopy of any procedure requiring sedation unless an anesthesiologist (MD/DO) actually does the anesthesia 100% him/herself. I have too many patients who have had such a bad, dangerous experience with CRNA that they will NOT consider future lifesaving procedures,,,,
I promise the above is not me. However, it exactly parallels my thinking, so all you crna's who have called me various names, insulted my intelligence etc. can see that a doctor holds you in the same regard as I. That is; lower than dirt. I will never consider ANY procedure which involves sedation or an anesthesia nurse. I will make sure that the 'doctor' who wants to do my anesthesia is actually an MD doctor before proceeding. (As opposed to a nurse who has earned a doctorate in something other than medicine, like nursing or basket weaving, [HUMOR] you have to watch out for that one!) I may even have them sign a consent for ONLY an MD doctor's care prior to the procedure. I also want to avoid an assistant or other unskilled person performing my procedure. I'll put that right there with the "no sedation or Versed in any amount for any reason, before, during or after my procedure." Sorry to increase your workload MDAs but an anesthesia nurse is unacceptable to me for any part of my future procedures. Just like the internist above says.
My wonderful stepfather is also an internist, and he refuses Versed as well. He has noticed what a nurse friend of mine says, that is "every time one of my patients gets Versed, a little bit less of them comes back." Versed is tantamount to legalized torture, with the added fillip that we have to pay enormous amounts of money for this dubious "sedation" from an overpaid anesthesia nurse. Thanks Jessica for this post. We are RIGHT about this "medication" and crna's. (At least MOST anesthesia nurses. The good ones are the exception to the rule.)
I’m an internist and often request that patients undergo colonoscopy exams. I always thought that the sedation was to keep patients comfortable and that a qualified anesthesiologist would attend my patients. I’m shocked to find that many colonoscopy patients (most) undergo a brutal, painful and traumatizing exam without anesthesia, but inadequate “conscious sedation versed/fentanyl) administered not by an anesthesiologist. but by a nurse/crna who is not qualified to keep my patients comfortable. Colonoscopy patients often tell me that the nurse anesthetist doesn’t make the exam tolerable; they are thrashing about complaing of pain while a CRNA keeps telling then that “you are doing great”; administering an amnesia drug (Versed) in the hope that the unfortunate patient will forget how badly they were treated during the colonoscopy……. nurses (CRNA) are not qualified to administer any form of anesthesia..I will NOT recommend colonoscopy of any procedure requiring sedation unless an anesthesiologist (MD/DO) actually does the anesthesia 100% him/herself. I have too many patients who have had such a bad, dangerous experience with CRNA that they will NOT consider future lifesaving procedures,,,,
I promise the above is not me. However, it exactly parallels my thinking, so all you crna's who have called me various names, insulted my intelligence etc. can see that a doctor holds you in the same regard as I. That is; lower than dirt. I will never consider ANY procedure which involves sedation or an anesthesia nurse. I will make sure that the 'doctor' who wants to do my anesthesia is actually an MD doctor before proceeding. (As opposed to a nurse who has earned a doctorate in something other than medicine, like nursing or basket weaving, [HUMOR] you have to watch out for that one!) I may even have them sign a consent for ONLY an MD doctor's care prior to the procedure. I also want to avoid an assistant or other unskilled person performing my procedure. I'll put that right there with the "no sedation or Versed in any amount for any reason, before, during or after my procedure." Sorry to increase your workload MDAs but an anesthesia nurse is unacceptable to me for any part of my future procedures. Just like the internist above says.
My wonderful stepfather is also an internist, and he refuses Versed as well. He has noticed what a nurse friend of mine says, that is "every time one of my patients gets Versed, a little bit less of them comes back." Versed is tantamount to legalized torture, with the added fillip that we have to pay enormous amounts of money for this dubious "sedation" from an overpaid anesthesia nurse. Thanks Jessica for this post. We are RIGHT about this "medication" and crna's. (At least MOST anesthesia nurses. The good ones are the exception to the rule.)
Actually a CRNA IS qualified to deliver anesthesia. In fact, CRNAs were administering anesthesia long before there was any such thing as an anesthesiologist. To become a CRNA, one must complete a bachelor's degree in nursing (with at least a 3.5 GPA for most CRNA schools), pass the NCLEX certification exam, complete at least 2 years of bedside nursing in the intensive care unit, get a high score on the Graduate Record Examination, apply, interview, and be accepted to a credentialed CRNA program, complete 2 years of rigorous coursework and clinicals, and pass a licensing exam. We are taught and are qualified to do everything an anesthesiologist (MDA) can do. No one with a doctorate in basket weaving is qualified to provide anesthesia, unless of course the basket weaving degree was earned in addition to their Master's of Nurse Anesthesia, Doctorate of Nurse Anesthesia, or Medical degree. Please get your facts straight before posting ignorant rants on topics which you know nothing about.
ReplyDeleteAfter receiving my 1st bachelors and starting grad school, I decided to go back for a 2nd undergrad in nursing. It was the first time I had ever made "Dean's List" in my life and I continued to do so. Does that tell you how difficult nursing school is? No, do not work in the field. i earn much more and have a much better schedule-18 days off a month. Ironically I married a physician whom I met whilst traveling and he said NEVER, EVER, EVER allow a CRNA if either of us were to ever need surgery. Too many serious, pitentially fatal things can happen. i can tell you in nursing school you lear nothing compared to med students who know A & P like the back of their hands. The US is the only country that allows nurses to practise in such a manner. Why? It is cheaper to pay a CRNA than a very highly trained anesthesioligist. You get what you pay for. I went to nursing school with some real doozies. Be afraid. Be very afraid!
DeleteBy the way, most everyone passes the NCLEX, even those who went to a community college because they couldn't get admitted anywhere else so that argument is out the proverbial window. It's multiple choice and you can do sample tests to prepare. It doesn't take much. The questions may as well be "Lucky Charms are magically (blank). that might have bern too tough for some of the students. Lots go into nursing as they can't handle radiography, nuclear medicine, respiratory or physical therapy. I went in hoping to be one of the good ones, to make a difference. Other nurses don't allow that. There is no team effort, just gossip and lots of insecurities. Also, you can do online at your leisure. if you have the money and time anyone can do it.
DeleteAnonymous, I think you will make a difference. I admire your clear thinking and your ambition. I would love to have you as my nurse!
DeleteI hope you didn't think that I would allow your little gem to languish here in obscurity! Please display your arrogance and ignorance some more. I like it when anesthesia nurses themselves prove my point.
ReplyDeleteNope. Not qualified at all! I guess that's the reason our anesthesiologists allow our cadre of over 30 CRNAs to anesthetize and sedate pediatric patients 24/7/365..Hmmmmm.....
ReplyDeleteYour anesthesiologists do that to make more money. Nothing to do with "qualified." John, have your read what my crna Aaron did to me? Would you be happy with that? Was he "qualified" to do my anesthesia? Not when he mucked it up that badly.
ReplyDeleteIF my crna were "qualified" to perform my anesthesia, I would have had my surgery with a nerve block, pain meds and nausea meds ONLY! Just like I gave permission for. If he were "qualified" then he would have revealed that he was a nurse, not a doctor, as required by law, giving me the opportunity to fire him. After all, he was my temporary EMPLOYEE. I have the absolute right to hire or fire anybody *I* choose. I'm really surprised that you aren't grasping the situation.
Given a choice between a NURSE and a doctor performing my anesthesia, I choose a doctor whose education far exceeds the narrow parameters of anesthesia nurses. Do you understand this concept?
Just because Aaron didn't KILL me, doesn't mean that his ministrations were safe, effective, legal or competent. Surely that is plain enough for you!
Aaron was an incompetent screwup. I'm angry about it. Having you guys rallying around an incompetent screwup doesn't say much about you or your profession.
THEN we have the Versed issues...
As someone who did a second bachelor's degree program in nursing I find it a joke that a "3.5 GPA" is a valid argument. The only time in my life I ever made "Dean's List" was in nursing school, if that tells you anything. My husband is a physician (M.D.) as was my father. They refuse to ever let anyone other than another PHYSICIAN WHO SPECIALIZES in anesthesia even look at them. Both said they themselves would never touch anesthesia as too many things can-and do-go wrong. Just as they were not qualified, neither is a CRNA who has no where near the education or experience of a board certified ANESTHESIOLOGIST who completed a much more difficult undergrad than nursing and most likely with higher than a "3.5." Afterwards 4 MORE YEARS of medical school and THEN YEARS of residency /fellowship which consisted of NO LESS THAN 120 HOURS PER WEEK! (I remember him being gone for days at a time, despite living in resident housing right behind the Emergency Department of the hospital. A CRNA's training can not even come anywhere close to that. My father used to say, If nurses want to 'play doctor' then they should have gone to medical school. Nurses have their place, as do internists, pediatrician a, etc. but anesthesia is most definitely NOT one of them.
ReplyDeleteAmen Anonymous. Thanks for your insight.
ReplyDeleteYou could certainly see your enthusiasm in the work
ReplyDeleteyou write. The world hopes for even more passionate
writers such as you who are not afraid to mention how they believe.
At all times go after your heart.
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