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  • ASA Attacking CRNAs Yet Own Resident Getting Poor Training



    Today on the "Student Doctor Network" in THIS thread you can read about a soon to be CA3 (that is the final year of the 3 year anesthesia residency) talking about his inadequate training. What is especially interesting is that other Physician Anesthesiologists on the same thread are mostly telling this resident it is "ok" and you can get the skills later.

    While it is admirable that this resident is concerned and looking for help it is hypocritical of the Physician Anesthesiologists to support this individual stating "you can get that after graduation" and yet at the same time disparage Certified Registered Nurse Anesthetists (CRNAs) if they were to do the same thing. In fact on that forum it has been done MANY times.

    The ASA and the Physician Anesthesiologists on this website are notoriously negative about Certified Registered Nurse Anesthesia (CRNA) training though they have been shown to have equivalent outcomes as physicians. Many of their critiques center on their inaccurate perception of hours and how they count them in comparison to CRNAs education (see that explanation HERE ). Their contention is that they get more hours of training based on their fuzzy math and that they get higher quality training which is their basis for suggesting that all CRNAs should be supervised by one of them.

    Most recently they have attacked CRNA training in an attempt to stop Veterans Affairs from utilizing all advanced practice nurses (including CRNAs) to their full scope of practice (you can comment in favor of this change and increasing high quality access to care for our veteran's here

    https://www.veteransaccesstocare.com

    However as can be seen in this Physician Anesthesia Resident's post there is clearly a quality issue in their own training programs to the degree that he/she is not sure he will be able to practice without someone supervising hm/her.

    I am a soon to be CA-3 and so far I have either little or no experience in the following areas:

    CVC (non IJ)
    A-lines (non radial)
    Regional Blocks (had a rotation, but did very few blocks)
    FOI
    Massive Transfusion (no transplant, rare trauma)
    Probably lacking in some other stuff I cant think of off the top of my head...

    I dont see it being likely that Im all of a sudden going to be able to accomplish these things during my CA-3 year. I dont really feel like the training I am getting will prepare me to practice independently. Is possible to transfer to another residency at this point, or am I destined to be a hack?


    The saying "you should not throw stones when you live in a glass house" comes to mind.

    However, i am sure that the aggressively political individuals on that website will not acknowledge the hypocrisy in this. After all, it is hard to convince someone of something when their salary depends on them NOT being convinced of it.


    ***UPDATE***

    Since this story was published there have been further attacks on CRNA training with silly statements by Physician Anesthesiologists on that forum such as:

    "
    A lion doesn't concern itself with the opinion of sheep"

    Making the clear suggestion of superiority in spite of every study, lower liability insurance costs and independent CRNAs all over the country doing it as good or better than this individual who likely does not even perform anesthesia.

    "$1000 says this guys "inadequate" partial training is better than any of theirs already."

    "
    The Navy SRNAs used to double up on their cases for numbers. I always thought that was shady. Sims as cases is ridiculous."

    A bold face lie. It is a violation of the accrediting agency for CRNA education (COA) for Student CRNAs to 'share' cases or to count 'simulations'.

    "
    They don't know what they don't know. The OP does. Just with that, he should run circles around most of them, as fresh grad."

    Of course the corollary is absolutely true. THEY do not know what THEY do not know, the difference is only this resident is smart enough to admit it. As evidenced by the further insult to CRNA training (which they know nothing about), this individual assumes a weakly trained CA2 could 'run circles' around a CRNA. Laughable at best.

    "
    The main issue is that they equate procedural competency with medical knowledge and decision making A nurse may be able to technically perform an ISB after a weekend workshop, but I would wager he is also more likely to order a CT and activate a stroke code because he's unaware of the incidence of Horner's (or for that matter what Horner's even is)."

    Except yet again, this comes from an individual who is clueless (does not know what he does not know) about CRNA training. A 1st year STUDENT CRNA would know what horner's is. Sad again that their ego's get in the way of reality.


    Comments 4 Comments
    1. AnesRes2014's Avatar
      AnesRes2014 -
      This forum has gone downhill fast. Where once it was mostly populated by reasonable individuals and one could have a reasonable and challenging discussion, it's now just full of slander, half-truths, and outright lies.

      The post in question was edited by ADMIN to make it look worse than reality and to promote the agenda; it actually states non-IJ CVCs and non-radial a-lines. The other stuff was unedited.

      Ironic coming from a forum where y'all have actually debated whether simulation counts as the real thing, and whether or not you can count a procedure or case just by being in the room even if you don't participate.

      I'm out. Hopefully some of my threads and responses will be helpful to future generations, if any one actually bothers to come here.
    1. ADMIN's Avatar
      ADMIN -
      AnesRes.

      The issue is with WHAT the ASA is saying about CRNAs and what the people on SDN say. Regardless if you like the tactic here (which is MUCH more reasonable than SDN people), the fact is they constantly lie and complain and disparage CRNA education and then turn around and tell this resident (and others) 'don't worry about it you can pick it up post grad". Not to mention the outright lies about hours which they don't even try to prove (because they cannot).

      Pot Meet Kettle.

      Now, the issue of simulation was only about central lines.

      Additionally the concern about counting cases when one does not participate in them is actually a VIOLATION of the COA rules for case counting.

      It is unfortunate that you feel the need to walk away. However, you must do what you think is right and that is OK.

      Having said all of that, what is written above is not only accurate but it highlights the lies told by Jane Fitch and the ASA.
    1. yankeern's Avatar
      yankeern -
      Quote Originally Posted by AnesRes2014 View Post
      This forum has gone downhill fast. Where once it was mostly populated by reasonable individuals and one could have a reasonable and challenging discussion, it's now just full of slander, half-truths, and outright lies.

      The post in question was edited by ADMIN to make it look worse than reality and to promote the agenda; it actually states non-IJ CVCs and non-radial a-lines. The other stuff was unedited.

      Ironic coming from a forum where y'all have actually debated whether simulation counts as the real thing, and whether or not you can count a procedure or case just by being in the room even if you don't participate.

      I'm out. Hopefully some of my threads and responses will be helpful to future generations, if any one actually bothers to come here.
      Wow really. SDN is ten time worse then this in regards to lies regarding CRNAs. The ASA loves telling lies and false truths regarding CRNAs. I guess it is ok for the ASA and anesthesiologists to talk shit but when we do it you get all butt hurt.

      Sent from my SM-G935V using Tapatalk
    1. AnesRes2014's Avatar
      AnesRes2014 -
      Quote Originally Posted by ADMIN View Post
      AnesRes.

      The issue is with WHAT the ASA is saying about CRNAs and what the people on SDN say. Regardless if you like the tactic here (which is MUCH more reasonable than SDN people), the fact is they constantly lie and complain and disparage CRNA education and then turn around and tell this resident (and others) 'don't worry about it you can pick it up post grad". Not to mention the outright lies about hours which they don't even try to prove (because they cannot).

      Pot Meet Kettle.

      Now, the issue of simulation was only about central lines.

      Additionally the concern about counting cases when one does not participate in them is actually a VIOLATION of the COA rules for case counting.

      It is unfortunate that you feel the need to walk away. However, you must do what you think is right and that is OK.

      Having said all of that, what is written above is not only accurate but it highlights the lies told by Jane Fitch and the ASA.
      I get it when organizations lie and/or tell half-truths. The ASA is guilty of it just like the AANA is. It's politics, whatever. I guess I had always operated under the assumption that this website was operated by individuals who had higher standards than that. But recently it's been all about inciting internet lynch mobs against random anesthesia residents and making up quotes off of SDN to stoke the political fires.

      It's cool if this site is more about being a mouthpiece for the AANA. Every group needs their safe space where they can pat each other on the back and rally the troops. But that involves propaganda and spin and not being stymied by sometimes inconvenient truths, and my objective here was to spread some actual knowledge about the medical training side of things, so I think our paths are dovetailing.

      If I have any sort of lasting message for students who visit this site, it is to not believe everything you are told, and to seek out the truth on your own as best as you are able. That goes for the medical realm as much as it does for politics or any other issue. Don't trust people who claim "everyone has an agenda except for me."

      Best of luck to everyone.
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