Law Suit Filed Against Collier Anesthesia and Wolford College Nurse Anesthesia Program

By interns do they mean SRNAs? And if so, then this could have a HUGE ripple effect. I know of several hospitals that couldn't keep their ORs open if it weren't for students running their own rooms.

Eileen

Seems pretty spot on, just needs to add a little blurb to catch the COA's attention about students forging case numbers under duress and the cookie would crumble. It'll probably come out at trial though. I think their business model has come back to bite them. You can only put other groups out of business for so long by offering bottom dollar pricing then using the students to make up the difference.

Originally Posted by eileen2010

By interns do they mean SRNAs? And if so, then this could have a HUGE ripple effect. I know of several hospitals that couldn't keep their ORs open if it weren't for students running their own rooms.

Eileen

I went to a program in TN that was just like that. It was obvious.

for many years prior to 2004 students that attended my program wrote the aana/coa to complain about similar issues, specifically the free labor the dept of anesthesia was receiving by the srna's, the dependency of the operating room schedule on the srna's, the overworking of the srna's, and the often hostile environment that existed. as to the best of my knowledge, there was no response. then, in the late summer / early fall of 2004 (my senior year) the was a death (overdose/suicide) of a junior srna a during an overnight call shift. within 2-3 days 2 representatives from the coa showed up at my school. using an act of congress to get every junior/senior srna out of the operating room late that afternoon, the put us all in a classroom with these two coa representatives. we were asked to tell the truth, to attempt not to embellish, that everything was confidential, and there was no faculty present. the juniors were reluctant to say anything, considering they still had well-over a year left. the seniors, however, with a few months left, told them everything about the program for well over an hour; although i'm sure it wasn't anything different than what had been written to them over the years. i don't know specifically what happened over the next year or two at the school, but i think they were placed on probation and the pd eventually stepped down (long over-due, imo). a few years ago i received an "alumni newsletter" stating that the dept of anesthesia had only 1 crna on staff when i was there, but that they presently had 17 crna's to staff the or. so, if anything good came out of it, the program got a good pd and the dept of anesthesia actually hired some crna's to work and cover call. that being said, i can relate to the above and would love to receive some back pay.

Fascinating debate this will turn out to be.

"Students should be paid". Wow. Every student? Nursing students? Radiology students? RT students? AA students? PT students? Medical students? Where is the line drawn?

Originally Posted by jwk

Fascinating debate this will turn out to be.

"Students should be paid". Wow. Every student? Nursing students? Radiology students? RT students? AA students? PT students? Medical students? Where is the line drawn?

I hear ya. Maybe this has to do with an anesthesia service billing and students being used as staff? Don't know...I'm Army trained so was paid anyway. But I get your point, where is the line drawn.

Hey

I do not agree that students should be paid, which includes medical students/residents.

I am all for students being used as staff because i believe there is a degree of learning that happens at that time which cannot happen when someone is in the room.

I dont feel using a student as staff is wrong. This is how you learn and its the trade off for the education you are getting. When it gets to the point that the student is working for a group greater than 40 hours a week it might be a consideration to provide some financial benefit to that student and it should be a choice for that student.

Originally Posted by jwk

Fascinating debate this will turn out to be.

"Students should be paid". Wow. Every student? Nursing students? Radiology students? RT students? AA students? PT students? Medical students? Where is the line drawn?

Pretty interesting. I guess the question is are srnas more like med students or residents? When I was in training, for the final 9 months or so I worked staff. Certainly worked more than 40hrs too

Originally Posted by MmacFN

Hey

I do not agree that students should be paid, which includes medical students/residents.

I am all for students being used as staff because i believe there is a degree of learning that happens at that time which cannot happen when someone is in the room.

I dont feel using a student as staff is wrong. This is how you learn and its the trade off for the education you are getting. When it gets to the point that the student is working for a group greater than 40 hours a week it might be a consideration to provide some financial benefit to that student and it should be a choice for that student.

Just saw your post, you don't think residents should be paid? What about fellows?

I've heard some schools don't pay their seniors but give them a very good break on tuition if they earn reimbursement for the cases the senior does. That would seem like a fair trade off to me. I don't have a problem working like a true staff CRNA...that's sort of the end goal of going to anesthesia school. And there's always a CRNA and MDA working with or around the student in the room, so it's not like collier anesthesia is not using their own staff to provide anesthesia, it's just supplemented. Wolford has clinical hubs in Tampa amd Davenport, and about half the class chooses to leave and go to these sites, so collier anesthesia receives no reimbursement for the cases done at these sites. I'm surprised to see that the people who filed the law suit were stationed in Naples. Traditionally the other clinical hubs get worked a lot harder!

Let me clarify. I dont think that GME money should exist. That is public money called graduate education money which comes from our taxes. Noone else gets that why should they? If money is paid it should come from the group itself. Afterall they benefit from the residents / fellows work by getting low cost labor.

Originally Posted by J-Dubya

Just saw your post, you don't think residents should be paid? What about fellows?

I'm glad to finally see that this issue is being debated. Florida Anesthesia groups need to stop subsidizing their labor/staffing with students. There is a surplus of CRNAs in the state that could staff these ORs, but employers won't hire more CRNAs as long as they have an unlimited source of free labor they can utilize.

I don't see the upside to srna staffing. being left alone is important and can be easily done by a staff crna leaving the room. the uspide to having a crna assigned to that room with you is obvious: someone's immediately available for consultation and to break you out of the room for pre/post-op blocks, PACU management experiences, codes, emergency cases, etc.

I was never treated as staff but had plenty of alone time.

I didn't experience it, but seems to me if you're a "staff srna" you're likely getting the worst of the ACT training restrictions.

At the places where I ran my own room, it was just that. I ran my own room. Yes, I did discuss my plan of care with an MDA or a CRNA but then I was left to preop the pt, implement the plan (yes, including regional), deal with any issues that arose during the case and finally bring them to PACU. If anything, it showed me how I might be able to work independently after graduation. A doc was available for consultation, but 99% of the time didn't interfere if all was going well.

The places where I was always assigned with a CRNA could either be great (CRNA willing and able to teach, instruct, enlighten, expand my knowledge base) or suck royally (my way or the highway type CRNA).

The upside for the group is obvious to me. A CRNA costs money, especially after hours (they left at 3 or 5pm), on call, or on the weekends. SRNAs are free labor and they can bill for our services. Even at 50% reimbursement, it's cheaper than paying OT. And if you are talking about places that have students working 40-60 hours a week, that's a lot of CRNAs they don't have to hire.

Eileen

Originally Posted by jwk

Fascinating debate this will turn out to be.

"Students should be paid". Wow. Every student? Nursing students? Radiology students? RT students? AA students? PT students? Medical students? Where is the line drawn?

If the student's service can be billed for, they are being utilized in place of hiring staff and they are neccessary for the day to day functioning of the facility= YES ie:SRNAs; it is reasonable to ask for compensation.

Originally Posted by MmacFN

Hey

I do not agree that students should be paid, which includes medical students/residents.

I am all for students being used as staff because i believe there is a degree of learning that happens at that time which cannot happen when someone is in the room.

I dont feel using a student as staff is wrong. This is how you learn and its the trade off for the education you are getting. When it gets to the point that the student is working for a group greater than 40 hours a week it might be a consideration to provide some financial benefit to that student and it should be a choice for that student.

I think you have to take in to account that SRNAs and Residents are mature adults sometimes with families. It's a give take relationship with the facility. The compensation paid to residents is a very small fraction of what the facility is earning from their labor- not to mention the federal funding that is given to the facility for training residents!

Originally Posted by J-Dubya

Pretty interesting. I guess the question is are srnas more like med students or residents? When I was in training, for the final 9 months or so I worked staff. Certainly worked more than 40hrs too

Medical students are NEVER left unattended to administer anesthesia!

I was staff my last 1.5 years.

It made a huge difference. I learned how to use drugs that others wouldnt let you use. I got to learn in real time. The only time I saw an MDA was during induction, they didnt come for emergence.

Originally Posted by menneab

I don't see the upside to srna staffing. being left alone is important and can be easily done by a staff crna leaving the room. the uspide to having a crna assigned to that room with you is obvious: someone's immediately available for consultation and to break you out of the room for pre/post-op blocks, PACU management experiences, codes, emergency cases, etc.

I was never treated as staff but had plenty of alone time.

I didn't experience it, but seems to me if you're a "staff srna" you're likely getting the worst of the ACT training restrictions.

I agree.

Stop the federal funding, make them use student loan (like the rest of us) for their education or force the group that has the contract or the hospital that is using them for slave labor to pay.

As for the family thing. Frankly, its irrelevant. When one makes the decision to goto med school or CRNA school they do so with the understanding that they will be nearly an absentee family member for that period of time in comparison to before then. It is how it works and if someone cant understand that up front then they need reconsider applying.

There is no give and take when you are a student, there is only give.

Originally Posted by Kurls

I think you have to take in to account that SRNAs and Residents are mature adults sometimes with families. It's a give take relationship with the facility. The compensation paid to residents is a very small fraction of what the facility is earning from their labor- not to mention the federal funding that is given to the facility for training residents!

Medical students are more like RN students. Not CRNAs.


Residents for anesthesia are left alone within the first month at many residencies.

Originally Posted by Kurls

Medical students are NEVER left unattended to administer anesthesia!