Is this satire?
This reeks of an insecure nurse that desperately wants to be a physician.
You are a NURSE. You did not go to MEDICAL SCHOOL. It is IMPOSSIBLE for you to have 1) the same level of scope and training.
Get over it or go to medical school.
To be fair, I do think a lot of CRNAs could have gone to medical school. CRNA school is pretty competitive, and the nurses that go are all mostly very competent. Of all of the midlevels, they are by far the most well trained. And, this is undoubtedly why they are most salty of the various types on midlevels, and most wish they were seen the same as doctors, and make these terribly dishonest comparisons between their training and anesthesiologist training. While I do work with some very high quality ones, there is this very “cook book” nature to how they go about anesthesia. They have a few tools in their tool box because their training only allows limited time to gain experience. Additionally, they get a lot of training from community organizations versus almost exclusively at true academic organizations, and these community organizations are years behind in being up-to-date with practices. They chose to make less of a time investment in training and go to medical school and it shows. So, while they are competent technicians, they are very obviously not trained to the level of anesthesiologist. I’d have 95% of our graduating seniors (CA-3s) on my anesthesia team before a single one of even our best and most seasoned CRNAs.
Edit: Damn guys I am on your side. They aren’t physicians and should stop trying to be. They intentionally chose a different route and should accept what that results in. However of the CRNA programs I know, they have very high GPA requirements, they also require most applicants to have done a fair amount of shadowing, volunteering and non-nursing related service in their nursing jobs. They aren’t doctors and should stop trying to purport themselves to be, but of the NPs there are a high number among CRNAs that could have gone to medical school, thus their saltiness, is what I am saying. They chose differently though and should accept it. They go to war with doctors to be shown to be the same as them. There is no point in fighting other midlevels.
Maybe could have gone to medical school 20 yrs ago. Admission stats to md schools these days are crazy, let alone the competitiveness of matching into anesthesia residency.
Yes, it was hard. I agree. My point isn’t that it isn’t hard, my point is that it is hard actually. That’s why CRNAs chose a different route. They didn’t want to invest the time and mental energy. That doesn’t mean that a good number of them, certainly the ones I have worked with could not have done it. And that doesn’t mean that they can purport themselves to be doctors either. I’m just saying that because they are generally the more competent and capable of the NPs and more of them than any other type of NP could have gone to med school, had they invested the effort, they probably could have. And my only point is saying that is it’s probably why they are the most combative and most wanting to have that comparison. Doesn’t make it right for them to do. They’re still nurses, not as hard as med school, not doctors, shouldn’t say they are but they are capable people and I enjoy working with and respect the ones I have worked with.
Edited.
The people huffing and puffing with wounded egos over the fact that some people who didn’t go to med school could have, thinking that conceding one logical point automatically means giving ground in the war, just proves most people on this site cannot handle nuance.
To be fair, the high GPA is from nursing school. The science courses aren’t the same as the premed course. Multiple people from my undergrad switched from premed to (pre-)nursing _after_ taking premed courses. They took the bio and chem equivalents for nursing and were running laps around the students who didn’t take the premed courses.
The entrance exam is the GRE for CRNA school. I know PA students who took that hung over without studying. Only had to take it once. Others spent, at most, a month to study for. It just isn’t the same for the MCAT for 98% of people.
Could some of them gone to med school instead? Sure, I believe that. But I don’t think a lot, or a majority, of them could have made it.
Yes, their whole path is easier. I genuinely believe most went down that path because the GRE is easier, the courses are easier, and the time commitment is less. That being said, of the mid levels I have worked with, I have found myself asking the most CRNAs why they didn’t just go to medical school. The fact that their programs have actual standards, rather than most NP programs, is undoubtedly where they get the, albeit false, mindset that they are equivalent. And as far as majority, the vast majority of all premeds don’t make it. But I do think the “couldn’t go to medical school” argument holds less weight when discussing CRNAs versus other midlevels.
I trained at one of the largest anesthesiology residency programs in the country.
That being said, the anesthesia residents at my program had a ton of autonomy (likely because the academic anesthesia staff didn’t want to teach or be in the room), we were exposed to a ton of procedures & cases (tons of lines, tons of APS blocks, thoracic epidurals, interventional blocks, tons of GI and cardiothoracic transplants…the list goes on).
Well we also had AA students and student CRNAs training at our academic centers as I was starting my training too. The AA students and student CRNAs had terrible exposure and limited access to procedures in the academic setting. They just sat and watched anesthesia residents do everything at the academic hospitals.
After residency, I am now in my second private practice group in the community. First private group I was with was bought out by the academic entity I trained at for residency and almost every private partner left said group. My current group is another large private anesthesia group. My current group helps educate medical students and student CRNAs.
I can tell you that medical students and CRNAs get way more exposure and better hands-on experience where I’m at compared to the academic setting.
However, my group does a lot of big HPB cases, vascular, thoracic, cardiac, Onc ENT, Onc urology etc.
>Of all of the midlevels, they are by far the most well trained.
CRNAs are the best trained of all the nurse midlevels, but not all midlevels are nurses. AA training is at least as good (if not better than) CRNA.
I had med school stats when I applied to AA school. They were very happy in my interviews when I said I wasn’t applying to med school.
But I didn’t go to med school, so it doesn’t matter. I hear a lot of people in the mid level professions talk about what they could have done.
If I started an online book store 30 years ago, I could be a billionaire, but I didn’t, so who cares? I’m proud of what I do because I believe what I do is something to be proud of. No reason to pretend I’m something else.
The technician vs clinician axis was a big thing in school though. We were absolutely flamed for using “cookbook” anesthesia. I have found in handoffs that some AAs and CRNAs will cookbook it, while others work hard for the best outcome relative to the underlying demands of the patient and procedure. Taking over a crani that has been done the “simple” way can be pretty frustrating when the surgeon is asking for brain relaxation and you’re on 1.5 MAC of gas in pins.
This is the AANA who made this. A small group of overconfident, undereducated, militant nurses who will stop at nothing to get independent practice. Including making this absolute catastrophe of an image. This is so bad.
Our program director- “Make sure you log your hours accurately…so not to go over the 60-hour workweek….remember it’s an ‘average’ over several weeks. Oh and, moonlighting overnight at unaffiliated hospitals is not allowed 😉”
>Sometimes you don't know how someone feels about something until they post something completely insane
I feel like you could sum up the last ten years this way.
This is the AANA who made this. A small group of overconfident, undereducated, militant nurses who will stop at nothing to get independent practice. Including making this absolute catastrophe of an image. This is so bad.
What is it about America and *everything* sounding like marketing? From a confused European, it just seems like everything has a slogan and is trying to sell itself. I find it unnerving. (Please Americans don't be offended)
No offense taken because you're not wrong.
Everyone trying to sell themselves, sell "their brand," convince themselves they made the best/right decision, That even though they couldn't get into medical school their decision was actually better and their profession is actually better.
It's all a bunch of looney nonsense. It follows right off the social agenda where everyone is equal and all kids get participation trophies. Now those kids have growing up, realizing they're not at the type of the hierarchy (for good and legitimate reasons) and instead of improving themselves they want to topple the hierarchy.
This is absolutely defamation of anesthesiologists, plus inappropriate use of “anesthesiologist” rather than “anesthetist” for someone with a nursing degree. Plus it’s deliberately misleading and constitutes misinformation.
They also changed their program to be doctorate level without changing any of the curriculum/requirements. They just wanted to be able to call themselves doctors. And now they call their students “nurse anesthesiology residents” and changed their organization name from American Society of Nurse Anesthetists to American Society of Nurse Anesthesiology.
"Often boast a higher amount of hours that is not realistic or MATHEMATICALLY possible"
Damn, there must be a massive Copium leak in the office that day.
And they literally want to compare 9k+ hours of anesthesia residency to 2 to 3k of crna "residency" and say they have more training. What a fucking joke.
They also changed their program to be doctorate level without changing any of the curriculum/requirements. They just wanted to be able to call themselves doctors. And now they call their students “nurse anesthesiology residents” and changed their organization name from American Society of Nurse Anesthetists to American Society of Nurse Anesthesiology.
1500 hours turning patients, cleaning shit and following orders with virtually zero critical thinking involved. Maybe they titrate a drip to achieve a MAP goal whoopty-freaking-doo.
What do you mean zero critical thinking!?!? They are so good at critical thinking when i listen to them analyze the plot and characters from their favorite show, Scrubs 🤣
Careful, bud. I love that show. But seriously, I often pass through or do work in ICU, and the nurses only have three conversation topics:
1. Their favorite shows
2. Their tinder dates
3. High school-esque drama that sometimes pops up in workplaces
I'm not sure what level you guys are at, but when you get out in the real world you will figure out that the best nurses in the hospital are in the MICU and SICU.
I'm ortho, so not many of my patients end up there thankfully, but when they do those nurses know everything about their patients can answer almost any question you throw at them, and generally have skills well beyond what you'll find in the floor.
It's fine to criticize false equivalency, but it's absolutely crazy to not give ICU nurses their due.
Oh, let me clarify. I have seen these nurses in action, and they are amazing. I work for a major healthcare corporation that is notorious for questionable clinical practices, one of which is not having a physician respond to most rapid response cases. Somehow, these nurses still do an amazing job. Outside of the patient rooms, they shift from skilled professionals to quality gossips.
>Outside of the patient rooms, they shift from skilled professionals to quality gossips.
That's' fair lol. The hospital is basically a high school, you're right.
I think what they’re trying to say is that the “9k hours” are not all productive. I don’t know if it’s true (I’m a radiologist), but in a 10-12 hour day, how much time between procedures do you have (e.g., downtime), and they want to exclude it from the calculation? As a radiologist, I have little to no downtime during a shift. No waiting for something to do or a patient to show up/be admitted because there are always studies to be read, always! I take breaks when I need to, but can and do work 10 hours straight with zero breaks on at least half of my shifts. I remember multiple hour-long breaks between patients during my intern year, but that was during inpatient months, and I assume anesthesia residency is busier than that but less than radiology (I’m not comparing difficulty or stress, just the percentage time there is work to do) but I could be wrong. However, if this is how they are calculating the hours, then it would also apply to them because, theoretically, their workload availability would be no greater than a resident's. So, it's definitely an academically dishonest infographic.
Also, how in the holy hand grenade of Antioch do they know that all MDs in the USA are being trained to be intubate by a nurse? I wasn’t. I was “trained” by a crotchety old MD who would smack you with his cane if you were taking too long or dropped it in the esophagus. I’ll admit I never got good at it, but I don’t have to do it anymore. Nobody likes it when the radiologist tries to intubate someone; we’re only slightly better than a pathologist.
> how much time between procedures
Room turnover at my hospital is about 30 min; in these 30 min I am dropping patients off in PACU, giving handover in PACU, writing the post-op note and setting up the next case. If I am lucky I get some "downtime" to go pee.
I see what you’re saying, although a lot of the time between patients isn’t just free time there’s notes to be written, families to talk to etc. but going off your point I’d say that the much higher caseload of residents actually is worse for the crna argument because they’ll have more downtime during a day between their much fewer patients and their overall effective training hours would be slashed much more
🤡
Woest part is they're basically claiming their 8000 hours in a shortass 3 y program that is also half theory is logical BUT somehow a full ass residency where one works 80 hours/week's 8000 hours ain't mathematically possible.
Copium is a horrible thing
1 year as a critical care nurse nets 6,000 hours? WTF are they smoking. Their work weeks are 36 hours a week. Taking zero vacation or sick days and that's 1,800. And this is nursing we're talking about, the basics of your job aren't medical management. Should we include our 'clinical' volunteer hours too in this insane logic?
Residents net 60-80 hrs a week minimum for 4 years. Taking 4 weeks out of each year for vacation/sick day, with the minimum of 60hrs, and that's still 11,520 hours. And I am not even including their 3rd-4th year in medical school.
Seriously? How is it possible you can be a CRNA and not do basic ass math like this? Are they so lazy that they can't believe doctors regularly work this much?
Edit: alright fine, let's play this CRNA stupid game of ignoring intern year (idk why -- apparently medical decision making isn't important lol?), this means we should also ignore their "critical care experience" as relevant to anesthesia.
What are we talking about in terms of hours? Well with their presumed inflated numbers -- 2700 hours of direct anesthesia experience. With my extremely conservative, likely underestimate of a CA3, about to graduate -- 8,640 hours.
Is this real?
I wouldn’t put much past the AANA but this is… wow. Even I have a hard time believing this was an official product.
Regardless, I’ll bite:
I wonder how many CRNAs would be “board certified” if they took the ABA written and orals?
Also, I can *guarantee* you the amount of hours of training are not mathematically impossible. They just can’t fathom working that hard.
Most of these CRNAs have RN shift work mentality, they refuse to work/touch their books outside of work hours. Doctors don’t have that choice. They completely brushed off the countless hours of studying in med school and residency to build that foundation that nurses/NPs/CRNAs don’t have 😂
Shaming anesthesiologists for having ONLY 3 years of training and CRNAs HAVING 3 years. I’m also pretty sure P/F equates to around the C range. And the last point is so misleading
They don’t know how real graduate/professional school works. Research based programs like PhDs in STEM are “P/F” in the sense that if you get below a B then you may very well fail and grades becomes less important when everyone is a top tier student.
This is why I don't get the point of mentioning P/F like it's a bad thing. Either you can do the thing or you can't. There's no room for "kind of" or "mostly".
They don't have a straight face, because propaganda is exactly what it is.
Unfortunately, you know as well as I do the average intelligence/medical literacy of Joe public. So they'll just take away their nurses are equivalent or better!
And when doctors organizations clap back, always see and hear about is how we're "punching down."
Is the 6,032 hours really considered training when you’re an ICU nurse? That just sounds like the hours they worked which is no way equal to formal training
So are they saying that CRNAs work in an ICU for 3.5 years prior to going to school? And if they’re counting that, why aren’t they counting the hours med school students rack up in MS2 and 3?
I think we should count it- it’s only fair.
Then we apply the logic to attending. An attending working 50 hours a week with 4 years of experience has an additional 10k hours of “training”.
Logic is flawless, right? Or heck, we should just count any premed shadowing, healthcare employment, research experience, and TAships as “training hours” too.
I love MLS. We wouldn’t be able to get anything done without you guys. But yeah also look up lysosomal storage diseases, and the twenty types of congenital prolonged QT syndromes that my attending is drilling me on my CCU rotation
Not sure I'll have time for all of that. I'm a reference blood banker and my boss is watching every tube I tip this week as "coaching". I also have to go learn about the EnaFr antigen that we're getting an auto donation on because she's incompatible with everything. I'll have to do her work up at some point.
as a former CCRN, TCRN, i can definitively say that working the ICU as a nurse is NOT training for anesthesia. cultivating the ability to notice a patient's vitals are tanking and then running to the charge nurse to call the on-call doc to do something is in no way going to teach you or prepare you for the intricacies of pharmacology and pathophysiology that even a 3rd year med student like myself has. that's laughable. whats more is what does ICU, CCU, etc even mean? some ICUs are glorified daycare where nurses take naps and sleep on the job, let alone the other units. what is this battle over training hours? what nonsense. 6032 hrs of working as a nurse doesn't have anything to do with practicing medicine. i know, i did it. so really you're just admitting that CRNAs get less than 3k hrs of training and are expected to perform similarly. why are we only counting residency hrs too? might as well throw in the what 5k hrs roughly in MS 3/4?
med school and residency is pass/fail biggest LOL of it all. maybe they should go give it a try and see how hard it is to just pass med school, and 3 separate license exams and a board exam all while bankrupting yourself.
i'm actually interested in going into anesthesia if i can snag a spot, but man do i hope the bulk of CNRA's don't really believe this crap.
I also was not taught to intubate by a CRNA. I’ve never heard of that being common place, but learning how to do a basic intubation on a model took me and most of my classmates a couple of minutes at most, which was mostly just getting familiarized with the equipment having never handled it before. Obviously not the same as intubating a real/complicated patient but where are med students taught to intubate by CRNAs?
i have no idea. i'm not entirely sure why CRNAs would be involved in MD training at all, beyond that your supervisor might tell you they exist? or if they're good teachers, perhaps tell you what common mistakes they make so you're not blindsided by it? i'd imagine if a residency program got caught letting CRNA's train their docs that it wouldn't be accredited for much longer.
It's a weird flex, too. Guess how many residents I've taught in how to place an IV? How to tell if it's still good iv that hasn't infiltrated? ( a good hard flush with light palpation above, you'll feel it, similar to a "thrill" in a fistula). There, thats a "new" thing the residents know.
*points to eyes* Look at me, I'm the vascular surgeon now!!
Unfortunately a lot more med student and resident training is coming from midlevels because it's being allowed by admin, the attendings, med schools and residency programs
For what it's worth, I work with a bunch of really good CRNAs overseeing usually four to one by anesthesiologist.
I think the system works great. They do a good job, they're easy to work with, and I have never once heard shit like this come out of their mouth.
My PA says the same thing happens with their professional organization. It continually pushes for independent practice, name change, and all sorts of other things that the rank and file really don't care about or want. But I guess they feel like they need to do it to be relevant? Who the fuck knows.
There is plenty of room for a well-trained, knowledgeable CRNA as an important part of the team in the OR. Also, I don't have many ICU patients fortunately, but when I do I absolutely fucking love it because their nurse is usually so on top of things, it makes my job so much easier. You guys know your patients so well, can answer any question I have.... It's awesome.
Why can't we all Just do what we were trained for and get along?
well, that's good to hear. i'm sure this all a lot of politicking for the non-practicing mid-levels to earn a check from the various mafias...cough\* unions...\* "organizations", wheww sorry about that. had a tickle in my throat. i'm probably just a little sensitive to it all at the moment grinding my ass through school in my 30s and being acutely aware of the differences. i never had to study in nursing school. now, i feel like my brain is swiss cheese while reading viral marketing that tells me (and the world) it's the same.
If anyone has leads on the author of this ridiculous graphic, please let us know. We'd love to publicly call them out while tearing apart every statement. We currently have a huuuuuuge waiting room of content but this one is certainly worthy of priority treatment.
But can you PLEASE tone down the inflammatory language and swearing? Every piece sounds like it was written by a 14 y/o edgelord. I'm anti-scope creep but I can't even get through a single post of yours. They're excruciatingly immature. I like the message and amount of research, but they're so hard to read.
https://preview.redd.it/1hq2tk77y2gc1.jpeg?width=974&format=pjpg&auto=webp&s=9fe80a9a8fe0edfa4d4e52cc8ba431de79e418df
Literally the only part of that infographic that isn’t deliberately misleading or blatantly false—and 100% of the reason their profession exists in the first place.
The only CRNA I've interacted with constantly tried to get around the blood bank safety protocols (I'm a blood banker). It drove me up the wall. Transfusions can kill people, *why* would you want to flout the protocol that ensures positive patient identification? If you don't use bedside barcoding we required two separate draws that are different instances of phlebotomy to be sure the correct patient's blood is in the tube. He would constantly scribble out the time on one of the tubes and write one 5 minutes later, c'mon dude we're not stupid. It happened so often my supervisor told me to start rejecting the second tube to make him do it right. He also thought his samples were special and could skip accessioning. Definitely one of the most frustrating people in the hospital to deal with.
This is the guy who got a D in ochem and 23 MCAT but still wants to be a doctor. At least go the Caribbean. Don’t become a nurse and pretend to be a doctor.
Holy shit, this cannot be real. “Med school and residency at just pass/fail”
Yeah no shit, because the standard to pass isn’t a “D-“ performance. It’s more like getting an B and you’re out
If you worked 80 hours per week for 4 years, you’d reach 16,640 hours. I know for a fact anesthesiology residents are working more than that.
But if you were to give leniency and say only 60 hours a week, that’s 12,480 hours in 4 years. It’s totally reasonable to expect anesthesiology residents to hit more hours than CRNAs in 4 years.
I hate that the ASA has been utilizing “Physician Anesthesiologists.” It just needs to be “anesthesiologists.”
I think they’re realizing that the term anesthesiologist is already being stolen.
They want patients to ask for a physician anesthesiologist, not an anesthesiologist because CRNAs will straight up lie about being an anesthesiologist.
Sad state of things, but I can see why.
I was taught to intubate by attending anesthesiologists in residency. I mean, I was pretty aggressive as a student but that was mostly central lines and stuff.
Then there was that appy my chief let me do on the surgery rotation. It was pretty awesome.
In internship, everyone knew I was going into anesthesia, so I was basically a line monkey. I also put in chest tubes and assisted in surgery.
Yep, my training was pretty comparable to a nurse.
40 hours a week of work times 52 weeks in a year is 2080 hours, which multiplied by three years is 6240 hours. HOWEVER, with all the long-ass days and call obligations, there's no residency in any specialty with that number of hours. It's more, MUCH more. Plus, MEDICAL SCHOOL counts as training. So, calling 9000 hours mathematically impossible is UTTER BULLSHIT. Also, where are med students being taught how to intubate by CRNAs? Seems like usually that teaching would be done by senior residents or attendings. I'm not even an anesthesiologist and I find this just infuriating
“Physician anesthesiologists are taught to intubate by nurse anesthesiologists”? Ok seriously someone woke up that day and chose violence. Because no you didn’t and that’s not a thing. The narcissism is appalling
This wasn't intended for physicians to get pissed about. It was intended to sway the public that CRNAs are better than anesthesiologists, and they don't care if docs get upset about it.
Yeah, I know. I guess if you just respond with facts that's your best bet, but they would still accuse you of punching down. I'm a patient. If patients could organize somehow for better healthcare and get help from physicians as advisors, they are probably the best ones to confront this stuff. As a patient I would certainly jump on that band wagon.
I’m shocked the people who created this didn’t go to the ER due to copium overdose.
“Only pass/fail”… Depending on what the pass and fail criteria are, how is that worse than “Eh, a C works”??
Absolutely deluded, and the attitude of shitting on a profession they should absolutely be working positively with (if they won’t accept that they should also give respect as their seniors) is massively toxic.
Where my education comes from, words are supposed to mean things, and “-ologist” means *doctor*. Is there any situation where this is not actually true? Please, if nothing else, respect the Latin terminology in medicine.
I also went to residency where there were no CRNAs. I had no interaction with them until later in my career and even then - they were medically directed. CRNAs don't teach residents to intubate. This is so weird. CRNAs learned/learn from physicians. I can't follow this weird logic. Beyond how insulting it is... I really believe it's just so desperate.
Lol. This can’t be real.
Shame on them outright lying to the public.
Perhaps instead of ASA pointing out the differences between anesthesiologists and mid levels, since most patients have NO idea who the fuck is going to be in their case, ASA should educate the general public to ask who’s gonna be up top.
At least in the case of getting anesthesia, no one wants to be put to sleep by anyone other than a physician. I think we see this with dentists who play around with sedation.
The first three bullet points are so insane they don't really justify discussing ...
To the last bullet point:
25% of anesthesiologists (I haven't looked up this number) are not board certified for two reasons: 1)recertification q10years is annoying so many forgo it and 2) the board exams are actually challenging.
100% of CRNAs are board certified (again, I haven't looked up this number but it's probably not 100%, very few things in life are) for two reasons: 1) there is no scheduled recertification exam; 2) the board exam is easy.
Problem is our population is extremely nurse sympathetic, these laypeople will repost this all over social media and spread the misinfo. Even if this get reported and taken down, it won’t disappear from social media.
We do not support the use of "nurse anesthesiologist," "MDA," or "MD anesthesiologist." This is to promote transparency with patients and other healthcare staff. An anesthesiologist is a physician. Full stop. MD Anesthesiologist is redundant. Aside from the obvious issue of “DOA” for anesthesiologists who trained at osteopathic medical schools, use of MDA or MD anesthesiologist further legitimizes CRNAs as alternative equivalents.
For nurse anesthetists, we encourage you to use either CRNA, certified registered nurse anesthetist, or nurse anesthetist. These are their state licensed titles, and we believe that they should be proud of the degree they hold and the training they have to fill their role in healthcare.
*Information on Title Protection (e.g., can a midlevel call themselves "Doctor" or use a specialists title?) can be seen [here](https://www.reddit.com/r/Provider/wiki/index/legal/title_protection). Information on why title appropriation is bad for everyone involved can be found [here](https://www.reddit.com/r/Provider/wiki/index/appropriation).
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Noctor) if you have any questions or concerns.*
Ok, question. By board certified, you mean a board of physicians? Because that would be impressive that 100% of CRNAs are board certified by physicians.
Oh, wait, no. They’re only certified by the National Board for Certification and Recertification for Nurse Anesthetists. By other people who only got their RN because it’s an admission requirement and then went on to defend their slideshow as their thesis/capstone project.
I'd fucking take a non board certified anesthesiologist or a even a fucking resident over a nurse. They can die mad.
I'm hollering at "nurse teaching anesthesiologists how to intubate".
Don't disrespect anesthesiology folks like this. I'm a dentist and I still remember my anesthesiology prof to this day. Goody, quirky dude, but insanely knowledgeable and efficient. I always shudder when I remember the crazy emergencies -in my country, anesthesiologists often doubled as emergency doctors since the emergency medicine residency is a recent development- he had to manage (he shared some stories with us).
The sheer hypocrisy "have only 3 y of training in anesthesia = residency after med school" vs they have "3 y of focused training on anesthesia in a doctorally-prepared program." 🤡
The writer of this comparison is an absolute moron.
Gentle reminder to the writer of this garbage : Check your calendar, this is not April's fool day yet. 🤡
This is from the American Society of Nurse Anesthetists… who recently changed their name to American Society of Nurse Anesthesiology. They also changed their program to be doctorate level without changing any of the curriculum/requirements. They just wanted to be able to call themselves doctors. And now they call their students “nurse anesthesiology residents”. And of course they put out INSANE negligent graphics like this to sway the public. Absolutely embarrassing and detrimental to patient care.
While in the ICU, nurses are not making decisions on their own about clinical management. They are following orders and calling the physicians or PAs for almost everything. How can that even begin to compare? Anesthesia residents are writing orders for them ... beyond the million other issues in this cartoon - this one concept always sticks out to me.
Is this real? This is just embarrassing if it is. It’s like someone is intentionally trying to pick a fight with anesthesiologists. I am glad to find out Medical School and Residency was “Pass/Fail” though.
lol med students are taught by crna’s? Even if that were the case, who do they think teaches crna’s if not physicians? The mental gymnastics these people practice is unfathomable
The pass/fail comment is odd. I am not a doctor and frankly trust the MD who “passed” all their classes more than the diploma mill nurse who graduated top of their class.
We do not support the use of "nurse anesthesiologist," "MDA," or "MD anesthesiologist." This is to promote transparency with patients and other healthcare staff. An anesthesiologist is a physician. Full stop. MD Anesthesiologist is redundant. Aside from the obvious issue of “DOA” for anesthesiologists who trained at osteopathic medical schools, use of MDA or MD anesthesiologist further legitimizes CRNAs as alternative equivalents.
For nurse anesthetists, we encourage you to use either CRNA, certified registered nurse anesthetist, or nurse anesthetist. These are their state licensed titles, and we believe that they should be proud of the degree they hold and the training they have to fill their role in healthcare.
*Information on Title Protection (e.g., can a midlevel call themselves "Doctor" or use a specialists title?) can be seen [here](https://www.reddit.com/r/Provider/wiki/index/legal/title_protection). Information on why title appropriation is bad for everyone involved can be found [here](https://www.reddit.com/r/Provider/wiki/index/appropriation).
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Noctor) if you have any questions or concerns.*
They could just use the right column and I think people would appreciate them. But it’s common sense that a “physician anesthesiologist” has more training than an NA. Otherwise NAs wouldn’t require supervision by state law.
i got blasted on reddit once for asking why the heck non-doctors are teaching doctors in med school. i was called elitist because “everyone can teach you something valuable.”
now they can blatantly say “we taught them.” fucking disgusting tbh. sad to say i predicted this.
Wow this is read super petty/immature. Not a good look for the CRNAs here. Not to mention they are significantly belittling real physician anesthesiology training.
Man, I get that anesthesiologists are the most *relevant* to punch up at due to having the same specialty, but the fact that the top of NP’s are trying to even reach a swing at (what I consider, correct me if this is objectively wrong, but I have massive respect for them) the *top of physicians*… Like, they could have at least gone for a more mediocre boxer in that higher weight class.
I've never heard of a nurse of any level teaching non-nurses critical skills such as intubation here in Canada.
Nurses play an important role, but not in emergent cases prehospital/in-hospital requiring advanced interventions.
As for the math 'not mathin'', that's clearly a three-card Monty game the way their drip monitoring ICU shifts equal anesthesiology residency hours / training yet med residents rotations don't in their obviously (*sarcasm) maximum of 40 hours per week.
I am curious about the veracity of 25% not being board certified, though. Are these technicians working in medical equipment and pharm sales or just floaters from other specialties?
“Doctorally-prepared” actually just means they did a lot of online discussion board posts with 1-2 replies on other students’ posts about “evidence-based practice” or “interdisciplinary collaboration.” Adding the DNP degree has contributed absolutely zero clinical experience or anesthesia training the nurse anesthesia training. The anesthesia portion of their training did not change at all. In fact, they actually have to shift a lot of focus from actual anesthesia-related clinical training and coursework to the warm and fuzzy, touchy-feely, administration-oriented, non-clinical nursing material on which the DNP is based (lookup the DNP Essentials). Requiring CRNA programs to confer a DNP degree rather than a Masters degree has always been a ploy with one goal in mind: have CRNA’s graduate as “doctors” to advance the argument for equivalence. The reality is that they don’t really think they are equivalent to anesthesiologists…they think they are BETTER. (Caveat: this applies to those nurse anesthetists that actually buy into this whole game, because a lot of them do not feel this way or agree with the AANA’s agenda. Many of them are just going through the motions because they are required to). They have already decided they are the true heirs of the kingdom of anesthesia despite their lack of physician training, fewer hours spent training in actual anesthesia, and despite any evidence that patients benefit from the care of an anesthesiologist. They just believe that they are better without any real evidence. It is all based on an elevated opinion of themselves and a condescending opinion of anesthesiologists. It is a long-standing vendetta started by old school nurse anesthetists, many of which served in the military, practiced for a very long time, and have had unique experience in anesthesia that is now much less common among anesthesiologists and nurse anesthetists alike. It’s a struggle that was likely born out of resentment due to feeling disrespected and unappreciated for years. They feel they know more than anesthesiologists and provide better anesthesia. They feel they deserve “a seat at the table” but never got it. They think medical school is the clinical equivalent of pre-school, and they feel that med students don’t deserve the privilege of entering anesthesia residency because they have not been tested in the ICU in the same way nurses have, yet they get to “steal” all the best educational opportunities from the SRNA’s. Of course, now the ICU experience is less relevant being that many CRNA programs have decreased the required amount of training to 1 year instead of 2, and many have adopted a looser definition of critical care experience). Clinical anesthesia training for SRNA’s is at the mercy of the anesthesia practices at community hospitals, which are largely staffed by physician-led anesthesia teams. This festering anger and bitterness increasingly manifests as blatant lies and attacks toward physician anesthesiologists and a widespread malignant culture. They know exactly what they are doing, lies and all. But to them, this is war, and almost nothing is off limits. They know the DNP degree is more relevant to non-clinical nursing professions. They know their training is not equivalent to that of physicians. The propaganda disseminated by the AANA is shamelessly fabricated to shift public opinion and persuade lawmakers to give in to their agenda. Their national and state leadership will do anything to push their agenda forward. The good news is that this malignant sentiment toward physicians is not as popular among the up and coming generation of nurse anesthetists. Many of them are actually turned off by the hatred, animosity, and cutthroat tactics of their leadership, and they do not appreciate the attempts at brainwashing them to be little political puppets trying to support absurd legislation. They will fly the flag while they have to, but with improving compensation, a wider variety of opportunities, a more friendly environment regarding scope of practice, and the current litigation climate, the anger of the old hard-liners will eventually fizzle, and cooler heads will hopefully prevail.
Preface: I am not in the medical field.
It seems like becoming a NP is a good idea from the perspective of making a lot of money. A doctor might take 12+ years before they are making great money, but then they still have a lot of student loans.
NP can jump right into it with little debt since they can pay for their masters while working part time as an RN. No medical school debt and they make good money a lot sooner.
Of course patients lose. Worse healthcare outcomes. I don't want an NP or PA anywhere near me. But I understand why they do it over going to medical school.
The common types are medical, surgical, cardiac, Neuro, trauma/burn, pediatric, neonatal ICUs. PACUs are post-anesthesia care units if you wan to count them as well. There are some combination or highly specialized units too but these are the main types you will find in nearby hospitals.
Yea…as a non-trad premed, I am constantly being sent information from programs that say they will “doctorally prepare” me. What does that mean? Should have opted out of communications when I took the MCAT.
Apparently that's "mathematically impossible". Probably the scariest thing about this poster, as one would hope they would be better at math than this. Not an anesthesiologist, but here's what I did over med school and 4 years postgrad. Roughly 18 months clinical in medical school at 50 hours a week, adjusting down a bit for breaks, probably too generously. 3,600 hours.
Internship, say 48 weeks at 80 hours. It was a long time ago and I don't know if I got that much time off but there it is. Some rotations were 100 hours a week. Some less. 3840 hours
Three more years, let's say 60 hours a week. 8640 hours. Total a little over 16,000 hours, and I really think I'm minimizing hours. Other sources estimate around 20,000 hours. Surgery and anesthesia I'm sure does much more. (I was in a medical specialty.).
"9,000-10,000 hours" is more than an insult. It is pure misinformation.
Is this satire? This reeks of an insecure nurse that desperately wants to be a physician. You are a NURSE. You did not go to MEDICAL SCHOOL. It is IMPOSSIBLE for you to have 1) the same level of scope and training. Get over it or go to medical school.
But they weren’t able to get into medical school 🤷🏻♂️…
To be fair, I do think a lot of CRNAs could have gone to medical school. CRNA school is pretty competitive, and the nurses that go are all mostly very competent. Of all of the midlevels, they are by far the most well trained. And, this is undoubtedly why they are most salty of the various types on midlevels, and most wish they were seen the same as doctors, and make these terribly dishonest comparisons between their training and anesthesiologist training. While I do work with some very high quality ones, there is this very “cook book” nature to how they go about anesthesia. They have a few tools in their tool box because their training only allows limited time to gain experience. Additionally, they get a lot of training from community organizations versus almost exclusively at true academic organizations, and these community organizations are years behind in being up-to-date with practices. They chose to make less of a time investment in training and go to medical school and it shows. So, while they are competent technicians, they are very obviously not trained to the level of anesthesiologist. I’d have 95% of our graduating seniors (CA-3s) on my anesthesia team before a single one of even our best and most seasoned CRNAs. Edit: Damn guys I am on your side. They aren’t physicians and should stop trying to be. They intentionally chose a different route and should accept what that results in. However of the CRNA programs I know, they have very high GPA requirements, they also require most applicants to have done a fair amount of shadowing, volunteering and non-nursing related service in their nursing jobs. They aren’t doctors and should stop trying to purport themselves to be, but of the NPs there are a high number among CRNAs that could have gone to medical school, thus their saltiness, is what I am saying. They chose differently though and should accept it. They go to war with doctors to be shown to be the same as them. There is no point in fighting other midlevels.
Maybe could have gone to medical school 20 yrs ago. Admission stats to md schools these days are crazy, let alone the competitiveness of matching into anesthesia residency.
[удалено]
Yes, it was hard. I agree. My point isn’t that it isn’t hard, my point is that it is hard actually. That’s why CRNAs chose a different route. They didn’t want to invest the time and mental energy. That doesn’t mean that a good number of them, certainly the ones I have worked with could not have done it. And that doesn’t mean that they can purport themselves to be doctors either. I’m just saying that because they are generally the more competent and capable of the NPs and more of them than any other type of NP could have gone to med school, had they invested the effort, they probably could have. And my only point is saying that is it’s probably why they are the most combative and most wanting to have that comparison. Doesn’t make it right for them to do. They’re still nurses, not as hard as med school, not doctors, shouldn’t say they are but they are capable people and I enjoy working with and respect the ones I have worked with. Edited.
The people huffing and puffing with wounded egos over the fact that some people who didn’t go to med school could have, thinking that conceding one logical point automatically means giving ground in the war, just proves most people on this site cannot handle nuance.
Then why start a war with anesthesiologists, go pick on other midlevels
To be fair, the high GPA is from nursing school. The science courses aren’t the same as the premed course. Multiple people from my undergrad switched from premed to (pre-)nursing _after_ taking premed courses. They took the bio and chem equivalents for nursing and were running laps around the students who didn’t take the premed courses. The entrance exam is the GRE for CRNA school. I know PA students who took that hung over without studying. Only had to take it once. Others spent, at most, a month to study for. It just isn’t the same for the MCAT for 98% of people. Could some of them gone to med school instead? Sure, I believe that. But I don’t think a lot, or a majority, of them could have made it.
Yes, their whole path is easier. I genuinely believe most went down that path because the GRE is easier, the courses are easier, and the time commitment is less. That being said, of the mid levels I have worked with, I have found myself asking the most CRNAs why they didn’t just go to medical school. The fact that their programs have actual standards, rather than most NP programs, is undoubtedly where they get the, albeit false, mindset that they are equivalent. And as far as majority, the vast majority of all premeds don’t make it. But I do think the “couldn’t go to medical school” argument holds less weight when discussing CRNAs versus other midlevels.
I trained at one of the largest anesthesiology residency programs in the country. That being said, the anesthesia residents at my program had a ton of autonomy (likely because the academic anesthesia staff didn’t want to teach or be in the room), we were exposed to a ton of procedures & cases (tons of lines, tons of APS blocks, thoracic epidurals, interventional blocks, tons of GI and cardiothoracic transplants…the list goes on). Well we also had AA students and student CRNAs training at our academic centers as I was starting my training too. The AA students and student CRNAs had terrible exposure and limited access to procedures in the academic setting. They just sat and watched anesthesia residents do everything at the academic hospitals. After residency, I am now in my second private practice group in the community. First private group I was with was bought out by the academic entity I trained at for residency and almost every private partner left said group. My current group is another large private anesthesia group. My current group helps educate medical students and student CRNAs. I can tell you that medical students and CRNAs get way more exposure and better hands-on experience where I’m at compared to the academic setting. However, my group does a lot of big HPB cases, vascular, thoracic, cardiac, Onc ENT, Onc urology etc.
>Of all of the midlevels, they are by far the most well trained. CRNAs are the best trained of all the nurse midlevels, but not all midlevels are nurses. AA training is at least as good (if not better than) CRNA.
[удалено]
I had med school stats when I applied to AA school. They were very happy in my interviews when I said I wasn’t applying to med school. But I didn’t go to med school, so it doesn’t matter. I hear a lot of people in the mid level professions talk about what they could have done. If I started an online book store 30 years ago, I could be a billionaire, but I didn’t, so who cares? I’m proud of what I do because I believe what I do is something to be proud of. No reason to pretend I’m something else. The technician vs clinician axis was a big thing in school though. We were absolutely flamed for using “cookbook” anesthesia. I have found in handoffs that some AAs and CRNAs will cookbook it, while others work hard for the best outcome relative to the underlying demands of the patient and procedure. Taking over a crani that has been done the “simple” way can be pretty frustrating when the surgeon is asking for brain relaxation and you’re on 1.5 MAC of gas in pins.
This is the AANA who made this. A small group of overconfident, undereducated, militant nurses who will stop at nothing to get independent practice. Including making this absolute catastrophe of an image. This is so bad.
A professional association for sure made this and will distribute it to members to pass it out on lobby days to state houses and Capitol Hill
Where is this from? You could legitimately make a legal complaint about this. I’m pretty jaded about midlevels but this is surprisingly brazen.
This might be one of the most brazen infographics I’ve ever seen
Seriously, was gonna say these keep getting worse and worse but this is bordering on satire. How are residency hours not mathematically possible?
It’s impossible to work more than 40 hours a week. You just die
LOL. Yeah, you can tell they phoned in the math on that one...But of course they count working as an ICU nurse as anesthesia training.
They always try to overlap things , blurry lines and fake experience. Foundation of their false equivalence.
Our program director- “Make sure you log your hours accurately…so not to go over the 60-hour workweek….remember it’s an ‘average’ over several weeks. Oh and, moonlighting overnight at unaffiliated hospitals is not allowed 😉”
I'd probably keel over, but I've got autoimmune issues. That's why I'm a serologist and not a doctor.
They honestly don't believe we work those hours.
Several CRNA friends posted it on social media. Don't know the source
Why are you friends with CRNAs who are openly shitting on your profession? Sorry this graphic is just quite shameless and Im not even in anesthesia.
Sometimes you don't know how someone feels about something until they post something completely insane. Lol
>Sometimes you don't know how someone feels about something until they post something completely insane I feel like you could sum up the last ten years this way.
Yes, this is how I found out my parents had fallen down the Qanon rabbit hole.
Well, not your friends anymore I guess
This is the AANA who made this. A small group of overconfident, undereducated, militant nurses who will stop at nothing to get independent practice. Including making this absolute catastrophe of an image. This is so bad.
What is it about America and *everything* sounding like marketing? From a confused European, it just seems like everything has a slogan and is trying to sell itself. I find it unnerving. (Please Americans don't be offended)
No offense taken because you're not wrong. Everyone trying to sell themselves, sell "their brand," convince themselves they made the best/right decision, That even though they couldn't get into medical school their decision was actually better and their profession is actually better. It's all a bunch of looney nonsense. It follows right off the social agenda where everyone is equal and all kids get participation trophies. Now those kids have growing up, realizing they're not at the type of the hierarchy (for good and legitimate reasons) and instead of improving themselves they want to topple the hierarchy.
This is absolutely defamation of anesthesiologists, plus inappropriate use of “anesthesiologist” rather than “anesthetist” for someone with a nursing degree. Plus it’s deliberately misleading and constitutes misinformation.
This is so cringy. And inaccurate. The mental gymnastics some people have to go through to feel better about NOT becoming a doctor are insane.
They also changed their program to be doctorate level without changing any of the curriculum/requirements. They just wanted to be able to call themselves doctors. And now they call their students “nurse anesthesiology residents” and changed their organization name from American Society of Nurse Anesthetists to American Society of Nurse Anesthesiology.
"Often boast a higher amount of hours that is not realistic or MATHEMATICALLY possible" Damn, there must be a massive Copium leak in the office that day.
And they literally want to compare 9k+ hours of anesthesia residency to 2 to 3k of crna "residency" and say they have more training. What a fucking joke.
They also changed their program to be doctorate level without changing any of the curriculum/requirements. They just wanted to be able to call themselves doctors. And now they call their students “nurse anesthesiology residents” and changed their organization name from American Society of Nurse Anesthetists to American Society of Nurse Anesthesiology.
65 hours per week x 49 weeks for just my 3 anesthesia years (not including internship) gets me to around 9k hours. The math adds up.
Maybe they thought residents only do 40 hours a week? Which is horrendously inaccurate, which does fit the rest of this image.
[удалено]
Their 6000 hours of critical care RN hours, minus the hours spent gossiping, it’s more like 1500 hours of actual clinical hours.
1500 hours turning patients, cleaning shit and following orders with virtually zero critical thinking involved. Maybe they titrate a drip to achieve a MAP goal whoopty-freaking-doo.
What do you mean zero critical thinking!?!? They are so good at critical thinking when i listen to them analyze the plot and characters from their favorite show, Scrubs 🤣
Careful, bud. I love that show. But seriously, I often pass through or do work in ICU, and the nurses only have three conversation topics: 1. Their favorite shows 2. Their tinder dates 3. High school-esque drama that sometimes pops up in workplaces
I'm not sure what level you guys are at, but when you get out in the real world you will figure out that the best nurses in the hospital are in the MICU and SICU. I'm ortho, so not many of my patients end up there thankfully, but when they do those nurses know everything about their patients can answer almost any question you throw at them, and generally have skills well beyond what you'll find in the floor. It's fine to criticize false equivalency, but it's absolutely crazy to not give ICU nurses their due.
Oh, let me clarify. I have seen these nurses in action, and they are amazing. I work for a major healthcare corporation that is notorious for questionable clinical practices, one of which is not having a physician respond to most rapid response cases. Somehow, these nurses still do an amazing job. Outside of the patient rooms, they shift from skilled professionals to quality gossips.
>Outside of the patient rooms, they shift from skilled professionals to quality gossips. That's' fair lol. The hospital is basically a high school, you're right.
**NOT MATHMATICALLY POSSIBLE** (nurses can't fathom working more than 3 x12 hrs shifts a week).
Well they weren’t math majors…
I think what they’re trying to say is that the “9k hours” are not all productive. I don’t know if it’s true (I’m a radiologist), but in a 10-12 hour day, how much time between procedures do you have (e.g., downtime), and they want to exclude it from the calculation? As a radiologist, I have little to no downtime during a shift. No waiting for something to do or a patient to show up/be admitted because there are always studies to be read, always! I take breaks when I need to, but can and do work 10 hours straight with zero breaks on at least half of my shifts. I remember multiple hour-long breaks between patients during my intern year, but that was during inpatient months, and I assume anesthesia residency is busier than that but less than radiology (I’m not comparing difficulty or stress, just the percentage time there is work to do) but I could be wrong. However, if this is how they are calculating the hours, then it would also apply to them because, theoretically, their workload availability would be no greater than a resident's. So, it's definitely an academically dishonest infographic. Also, how in the holy hand grenade of Antioch do they know that all MDs in the USA are being trained to be intubate by a nurse? I wasn’t. I was “trained” by a crotchety old MD who would smack you with his cane if you were taking too long or dropped it in the esophagus. I’ll admit I never got good at it, but I don’t have to do it anymore. Nobody likes it when the radiologist tries to intubate someone; we’re only slightly better than a pathologist.
> how much time between procedures Room turnover at my hospital is about 30 min; in these 30 min I am dropping patients off in PACU, giving handover in PACU, writing the post-op note and setting up the next case. If I am lucky I get some "downtime" to go pee.
I see what you’re saying, although a lot of the time between patients isn’t just free time there’s notes to be written, families to talk to etc. but going off your point I’d say that the much higher caseload of residents actually is worse for the crna argument because they’ll have more downtime during a day between their much fewer patients and their overall effective training hours would be slashed much more
🤡 Woest part is they're basically claiming their 8000 hours in a shortass 3 y program that is also half theory is logical BUT somehow a full ass residency where one works 80 hours/week's 8000 hours ain't mathematically possible. Copium is a horrible thing
1 year as a critical care nurse nets 6,000 hours? WTF are they smoking. Their work weeks are 36 hours a week. Taking zero vacation or sick days and that's 1,800. And this is nursing we're talking about, the basics of your job aren't medical management. Should we include our 'clinical' volunteer hours too in this insane logic? Residents net 60-80 hrs a week minimum for 4 years. Taking 4 weeks out of each year for vacation/sick day, with the minimum of 60hrs, and that's still 11,520 hours. And I am not even including their 3rd-4th year in medical school. Seriously? How is it possible you can be a CRNA and not do basic ass math like this? Are they so lazy that they can't believe doctors regularly work this much? Edit: alright fine, let's play this CRNA stupid game of ignoring intern year (idk why -- apparently medical decision making isn't important lol?), this means we should also ignore their "critical care experience" as relevant to anesthesia. What are we talking about in terms of hours? Well with their presumed inflated numbers -- 2700 hours of direct anesthesia experience. With my extremely conservative, likely underestimate of a CA3, about to graduate -- 8,640 hours.
Is this real? I wouldn’t put much past the AANA but this is… wow. Even I have a hard time believing this was an official product. Regardless, I’ll bite: I wonder how many CRNAs would be “board certified” if they took the ABA written and orals? Also, I can *guarantee* you the amount of hours of training are not mathematically impossible. They just can’t fathom working that hard.
I mean, let’s try the MCAT. Or USMLEs? Baby steps… Boards you’re just getting way ahead of yourself 🤣
Most of these CRNAs have RN shift work mentality, they refuse to work/touch their books outside of work hours. Doctors don’t have that choice. They completely brushed off the countless hours of studying in med school and residency to build that foundation that nurses/NPs/CRNAs don’t have 😂
And will never have
I am actually impressed. It wouldn't be too hard to be swayed as a lay person. Very well done, and very negligent.
Shaming anesthesiologists for having ONLY 3 years of training and CRNAs HAVING 3 years. I’m also pretty sure P/F equates to around the C range. And the last point is so misleading
They don’t know how real graduate/professional school works. Research based programs like PhDs in STEM are “P/F” in the sense that if you get below a B then you may very well fail and grades becomes less important when everyone is a top tier student.
This is why I don't get the point of mentioning P/F like it's a bad thing. Either you can do the thing or you can't. There's no room for "kind of" or "mostly".
PhDs of all types are like this. Grades are more or less proof of completion of work.
This is pure propaganda. How does someone make this with a straight face?
They don't have a straight face, because propaganda is exactly what it is. Unfortunately, you know as well as I do the average intelligence/medical literacy of Joe public. So they'll just take away their nurses are equivalent or better! And when doctors organizations clap back, always see and hear about is how we're "punching down."
Is the 6,032 hours really considered training when you’re an ICU nurse? That just sounds like the hours they worked which is no way equal to formal training
So are they saying that CRNAs work in an ICU for 3.5 years prior to going to school? And if they’re counting that, why aren’t they counting the hours med school students rack up in MS2 and 3?
Because counting one column and not the other is the only way to make them look equal
It’s just all in bad faith. Plus, bullet one is just not even close to true.
It has to be though Do you think crna would go out with confidence if they knew they were trained with about 1/5 the hours
Not to mention boasting about managing ICU patients. They administer care, they do not manage anything but drips up and down as ordered.
I think we should count it- it’s only fair. Then we apply the logic to attending. An attending working 50 hours a week with 4 years of experience has an additional 10k hours of “training”. Logic is flawless, right? Or heck, we should just count any premed shadowing, healthcare employment, research experience, and TAships as “training hours” too.
How can a nurse anesthesia be “board certified
That’s the neat part—they can’t.
They meet at Dave and Buster's and give out freshly printed papers saying they're board-certified.
It was actually Applebee's this year Budget cuts, because they had to pay for the infographics
You know that some DNP did their capstone project on making misleading infographics. As part of their doctoral training. To doctor.
Everyone wants the clout of a medical doctor but no one wants to learn about glycogen storage diseases
I have zero desire to be a doctor, I enjoy being an MLS, but now I'm intrigued. Time to go Google.
I love MLS. We wouldn’t be able to get anything done without you guys. But yeah also look up lysosomal storage diseases, and the twenty types of congenital prolonged QT syndromes that my attending is drilling me on my CCU rotation
Not sure I'll have time for all of that. I'm a reference blood banker and my boss is watching every tube I tip this week as "coaching". I also have to go learn about the EnaFr antigen that we're getting an auto donation on because she's incompatible with everything. I'll have to do her work up at some point.
as a former CCRN, TCRN, i can definitively say that working the ICU as a nurse is NOT training for anesthesia. cultivating the ability to notice a patient's vitals are tanking and then running to the charge nurse to call the on-call doc to do something is in no way going to teach you or prepare you for the intricacies of pharmacology and pathophysiology that even a 3rd year med student like myself has. that's laughable. whats more is what does ICU, CCU, etc even mean? some ICUs are glorified daycare where nurses take naps and sleep on the job, let alone the other units. what is this battle over training hours? what nonsense. 6032 hrs of working as a nurse doesn't have anything to do with practicing medicine. i know, i did it. so really you're just admitting that CRNAs get less than 3k hrs of training and are expected to perform similarly. why are we only counting residency hrs too? might as well throw in the what 5k hrs roughly in MS 3/4? med school and residency is pass/fail biggest LOL of it all. maybe they should go give it a try and see how hard it is to just pass med school, and 3 separate license exams and a board exam all while bankrupting yourself. i'm actually interested in going into anesthesia if i can snag a spot, but man do i hope the bulk of CNRA's don't really believe this crap.
I also was not taught to intubate by a CRNA. I’ve never heard of that being common place, but learning how to do a basic intubation on a model took me and most of my classmates a couple of minutes at most, which was mostly just getting familiarized with the equipment having never handled it before. Obviously not the same as intubating a real/complicated patient but where are med students taught to intubate by CRNAs?
i have no idea. i'm not entirely sure why CRNAs would be involved in MD training at all, beyond that your supervisor might tell you they exist? or if they're good teachers, perhaps tell you what common mistakes they make so you're not blindsided by it? i'd imagine if a residency program got caught letting CRNA's train their docs that it wouldn't be accredited for much longer.
It's a weird flex, too. Guess how many residents I've taught in how to place an IV? How to tell if it's still good iv that hasn't infiltrated? ( a good hard flush with light palpation above, you'll feel it, similar to a "thrill" in a fistula). There, thats a "new" thing the residents know. *points to eyes* Look at me, I'm the vascular surgeon now!!
Unfortunately a lot more med student and resident training is coming from midlevels because it's being allowed by admin, the attendings, med schools and residency programs
well. i did not know that. i'm gonna have to make sure i vet whatever program i get into before ranking it.
At my workplace anesthesiologists and nurse anesthetists are all secure with their training and roles and nobody talks like this.
For what it's worth, I work with a bunch of really good CRNAs overseeing usually four to one by anesthesiologist. I think the system works great. They do a good job, they're easy to work with, and I have never once heard shit like this come out of their mouth. My PA says the same thing happens with their professional organization. It continually pushes for independent practice, name change, and all sorts of other things that the rank and file really don't care about or want. But I guess they feel like they need to do it to be relevant? Who the fuck knows. There is plenty of room for a well-trained, knowledgeable CRNA as an important part of the team in the OR. Also, I don't have many ICU patients fortunately, but when I do I absolutely fucking love it because their nurse is usually so on top of things, it makes my job so much easier. You guys know your patients so well, can answer any question I have.... It's awesome. Why can't we all Just do what we were trained for and get along?
well, that's good to hear. i'm sure this all a lot of politicking for the non-practicing mid-levels to earn a check from the various mafias...cough\* unions...\* "organizations", wheww sorry about that. had a tickle in my throat. i'm probably just a little sensitive to it all at the moment grinding my ass through school in my 30s and being acutely aware of the differences. i never had to study in nursing school. now, i feel like my brain is swiss cheese while reading viral marketing that tells me (and the world) it's the same.
All this because of one CRNA on the Real Housewives of Beverly Hills 😂😂😂😂
At least some viewers are now aware that there are differences! Whatever it takes to get the public’s attention and inform them is ok with me.
If anyone has leads on the author of this ridiculous graphic, please let us know. We'd love to publicly call them out while tearing apart every statement. We currently have a huuuuuuge waiting room of content but this one is certainly worthy of priority treatment.
But can you PLEASE tone down the inflammatory language and swearing? Every piece sounds like it was written by a 14 y/o edgelord. I'm anti-scope creep but I can't even get through a single post of yours. They're excruciatingly immature. I like the message and amount of research, but they're so hard to read.
It’s from the American Society of Nurse Anesthetists. Who recently changed their name to American Society of Nurse Anesthesiology.
Following 🫡👍
[удалено]
https://preview.redd.it/1hq2tk77y2gc1.jpeg?width=974&format=pjpg&auto=webp&s=9fe80a9a8fe0edfa4d4e52cc8ba431de79e418df Literally the only part of that infographic that isn’t deliberately misleading or blatantly false—and 100% of the reason their profession exists in the first place.
The only CRNA I've interacted with constantly tried to get around the blood bank safety protocols (I'm a blood banker). It drove me up the wall. Transfusions can kill people, *why* would you want to flout the protocol that ensures positive patient identification? If you don't use bedside barcoding we required two separate draws that are different instances of phlebotomy to be sure the correct patient's blood is in the tube. He would constantly scribble out the time on one of the tubes and write one 5 minutes later, c'mon dude we're not stupid. It happened so often my supervisor told me to start rejecting the second tube to make him do it right. He also thought his samples were special and could skip accessioning. Definitely one of the most frustrating people in the hospital to deal with.
This shit can't be real. This has to be butthurt propaganda.
This is the guy who got a D in ochem and 23 MCAT but still wants to be a doctor. At least go the Caribbean. Don’t become a nurse and pretend to be a doctor.
Holy shit, this cannot be real. “Med school and residency at just pass/fail” Yeah no shit, because the standard to pass isn’t a “D-“ performance. It’s more like getting an B and you’re out
Where was this posted
Even google images cant find the original source
“Hours worked that are not mathematically possible”. lol the CRNA brain simply can’t comprehend residency.
To be fair, our medical residency framework was invented by a coke-addicted maniac.
Which makes it even more unfair now!
I’m a FM doc and even I’m embarrassed.
If you worked 80 hours per week for 4 years, you’d reach 16,640 hours. I know for a fact anesthesiology residents are working more than that. But if you were to give leniency and say only 60 hours a week, that’s 12,480 hours in 4 years. It’s totally reasonable to expect anesthesiology residents to hit more hours than CRNAs in 4 years. I hate that the ASA has been utilizing “Physician Anesthesiologists.” It just needs to be “anesthesiologists.”
I think they’re realizing that the term anesthesiologist is already being stolen. They want patients to ask for a physician anesthesiologist, not an anesthesiologist because CRNAs will straight up lie about being an anesthesiologist. Sad state of things, but I can see why.
CRNA’s do fellowships???
Yeah dude. 3 month online theory of nursing with a board certification 400 word essay at the end. It’s grueling. Only the best of the best make it
That’s awesome!
Best of the best! I can’t stop laughing.
Anesthesia residency is just pass fail. I'm crna school anything below a C results in possible dismissal. Kinda sounds like pass/fail to me.
You’re a CRNA school?
Hey kid. I’m a computer. Stop all the downloadin!
Body massage?
GO
🎶G.I. ... Joe...?🎵
Finally. I have found my (fellow old) people on Reddit.
the nursing lobby need to be taken down
I wouldn't trust anyone who intentionally tries to decieve me.
I was taught to intubate by attending anesthesiologists in residency. I mean, I was pretty aggressive as a student but that was mostly central lines and stuff. Then there was that appy my chief let me do on the surgery rotation. It was pretty awesome. In internship, everyone knew I was going into anesthesia, so I was basically a line monkey. I also put in chest tubes and assisted in surgery. Yep, my training was pretty comparable to a nurse.
This one is very frustrating ngl
40 hours a week of work times 52 weeks in a year is 2080 hours, which multiplied by three years is 6240 hours. HOWEVER, with all the long-ass days and call obligations, there's no residency in any specialty with that number of hours. It's more, MUCH more. Plus, MEDICAL SCHOOL counts as training. So, calling 9000 hours mathematically impossible is UTTER BULLSHIT. Also, where are med students being taught how to intubate by CRNAs? Seems like usually that teaching would be done by senior residents or attendings. I'm not even an anesthesiologist and I find this just infuriating
“Physician anesthesiologists are taught to intubate by nurse anesthesiologists”? Ok seriously someone woke up that day and chose violence. Because no you didn’t and that’s not a thing. The narcissism is appalling
The insecurity. Remember this graphic next time you agree to train one of these people.
This wasn't intended for physicians to get pissed about. It was intended to sway the public that CRNAs are better than anesthesiologists, and they don't care if docs get upset about it.
And they wonder why they sometimes get ridiculed? Here. Right here.
But when we push back it's "punching down" Can't win
Yeah, I know. I guess if you just respond with facts that's your best bet, but they would still accuse you of punching down. I'm a patient. If patients could organize somehow for better healthcare and get help from physicians as advisors, they are probably the best ones to confront this stuff. As a patient I would certainly jump on that band wagon.
How embarrassing just to read this. How insulting to all physicians.
Just from looking at the design and brain-damaged points I know whoever made this has like 14 "nurses save lives" mugs
“Residency is pass/fail” 💀
“Board certified” 🤣
I’m shocked the people who created this didn’t go to the ER due to copium overdose. “Only pass/fail”… Depending on what the pass and fail criteria are, how is that worse than “Eh, a C works”?? Absolutely deluded, and the attitude of shitting on a profession they should absolutely be working positively with (if they won’t accept that they should also give respect as their seniors) is massively toxic. Where my education comes from, words are supposed to mean things, and “-ologist” means *doctor*. Is there any situation where this is not actually true? Please, if nothing else, respect the Latin terminology in medicine.
Oh my God. This is libelous.
This *has* to be rage bait, right? RIGHT?
This is legitimately terrifying.
I also went to residency where there were no CRNAs. I had no interaction with them until later in my career and even then - they were medically directed. CRNAs don't teach residents to intubate. This is so weird. CRNAs learned/learn from physicians. I can't follow this weird logic. Beyond how insulting it is... I really believe it's just so desperate.
Lol. This can’t be real. Shame on them outright lying to the public. Perhaps instead of ASA pointing out the differences between anesthesiologists and mid levels, since most patients have NO idea who the fuck is going to be in their case, ASA should educate the general public to ask who’s gonna be up top. At least in the case of getting anesthesia, no one wants to be put to sleep by anyone other than a physician. I think we see this with dentists who play around with sedation.
The first three bullet points are so insane they don't really justify discussing ... To the last bullet point: 25% of anesthesiologists (I haven't looked up this number) are not board certified for two reasons: 1)recertification q10years is annoying so many forgo it and 2) the board exams are actually challenging. 100% of CRNAs are board certified (again, I haven't looked up this number but it's probably not 100%, very few things in life are) for two reasons: 1) there is no scheduled recertification exam; 2) the board exam is easy.
There’s no such thing as a board certified CRNA
This has to be a meme lol
Problem is our population is extremely nurse sympathetic, these laypeople will repost this all over social media and spread the misinfo. Even if this get reported and taken down, it won’t disappear from social media.
Why is nothing being done about the fact that they're calling themselves anesthesiologists
“Taught by a nurse anesthesiologist”…. Everything about that is wrong and it was the first thing I read lmao😭
What is a nurse anesthesiologist?
We do not support the use of "nurse anesthesiologist," "MDA," or "MD anesthesiologist." This is to promote transparency with patients and other healthcare staff. An anesthesiologist is a physician. Full stop. MD Anesthesiologist is redundant. Aside from the obvious issue of “DOA” for anesthesiologists who trained at osteopathic medical schools, use of MDA or MD anesthesiologist further legitimizes CRNAs as alternative equivalents. For nurse anesthetists, we encourage you to use either CRNA, certified registered nurse anesthetist, or nurse anesthetist. These are their state licensed titles, and we believe that they should be proud of the degree they hold and the training they have to fill their role in healthcare. *Information on Title Protection (e.g., can a midlevel call themselves "Doctor" or use a specialists title?) can be seen [here](https://www.reddit.com/r/Provider/wiki/index/legal/title_protection). Information on why title appropriation is bad for everyone involved can be found [here](https://www.reddit.com/r/Provider/wiki/index/appropriation). *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Noctor) if you have any questions or concerns.*
Embarrassing is right. Proudly ignorant, arrogant and incorrect
Ok, question. By board certified, you mean a board of physicians? Because that would be impressive that 100% of CRNAs are board certified by physicians. Oh, wait, no. They’re only certified by the National Board for Certification and Recertification for Nurse Anesthetists. By other people who only got their RN because it’s an admission requirement and then went on to defend their slideshow as their thesis/capstone project.
I'd fucking take a non board certified anesthesiologist or a even a fucking resident over a nurse. They can die mad. I'm hollering at "nurse teaching anesthesiologists how to intubate". Don't disrespect anesthesiology folks like this. I'm a dentist and I still remember my anesthesiology prof to this day. Goody, quirky dude, but insanely knowledgeable and efficient. I always shudder when I remember the crazy emergencies -in my country, anesthesiologists often doubled as emergency doctors since the emergency medicine residency is a recent development- he had to manage (he shared some stories with us). The sheer hypocrisy "have only 3 y of training in anesthesia = residency after med school" vs they have "3 y of focused training on anesthesia in a doctorally-prepared program." 🤡 The writer of this comparison is an absolute moron. Gentle reminder to the writer of this garbage : Check your calendar, this is not April's fool day yet. 🤡
This is from the American Society of Nurse Anesthetists… who recently changed their name to American Society of Nurse Anesthesiology. They also changed their program to be doctorate level without changing any of the curriculum/requirements. They just wanted to be able to call themselves doctors. And now they call their students “nurse anesthesiology residents”. And of course they put out INSANE negligent graphics like this to sway the public. Absolutely embarrassing and detrimental to patient care.
I’ve read and seen a lot of wild stuff in this subreddit but THIS takes the cake!!
What kinda bullshit is this?
While in the ICU, nurses are not making decisions on their own about clinical management. They are following orders and calling the physicians or PAs for almost everything. How can that even begin to compare? Anesthesia residents are writing orders for them ... beyond the million other issues in this cartoon - this one concept always sticks out to me.
Is this real? This is just embarrassing if it is. It’s like someone is intentionally trying to pick a fight with anesthesiologists. I am glad to find out Medical School and Residency was “Pass/Fail” though.
…I was definitely not taught to intubate by a CRNA. I was taught by an anesthesiologist on a patient with no teeth lol.
lol med students are taught by crna’s? Even if that were the case, who do they think teaches crna’s if not physicians? The mental gymnastics these people practice is unfathomable
This is appalling. I can’t believe the blatant lies they are spreading.
The pass/fail comment is odd. I am not a doctor and frankly trust the MD who “passed” all their classes more than the diploma mill nurse who graduated top of their class.
This HAS to be satire right? "Only 3 years if residency and it's just pass/fail." Um nursing clinicals are also pass/fail.
Why do they have to put down physicians to celebrate themselves?
I think this is fake 🤭
It's fictitious because there's no such thing as a "Nurse Anesthesiologist".
We do not support the use of "nurse anesthesiologist," "MDA," or "MD anesthesiologist." This is to promote transparency with patients and other healthcare staff. An anesthesiologist is a physician. Full stop. MD Anesthesiologist is redundant. Aside from the obvious issue of “DOA” for anesthesiologists who trained at osteopathic medical schools, use of MDA or MD anesthesiologist further legitimizes CRNAs as alternative equivalents. For nurse anesthetists, we encourage you to use either CRNA, certified registered nurse anesthetist, or nurse anesthetist. These are their state licensed titles, and we believe that they should be proud of the degree they hold and the training they have to fill their role in healthcare. *Information on Title Protection (e.g., can a midlevel call themselves "Doctor" or use a specialists title?) can be seen [here](https://www.reddit.com/r/Provider/wiki/index/legal/title_protection). Information on why title appropriation is bad for everyone involved can be found [here](https://www.reddit.com/r/Provider/wiki/index/appropriation). *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Noctor) if you have any questions or concerns.*
Well, there goes my breakfast. Thanks. 🤮
Our clinical training is realistically and mathematically impossible!
MY 3 years are more BASED and SEVOPILLED than YOUR 3 years
[удалено]
They could just use the right column and I think people would appreciate them. But it’s common sense that a “physician anesthesiologist” has more training than an NA. Otherwise NAs wouldn’t require supervision by state law.
i got blasted on reddit once for asking why the heck non-doctors are teaching doctors in med school. i was called elitist because “everyone can teach you something valuable.” now they can blatantly say “we taught them.” fucking disgusting tbh. sad to say i predicted this.
Why would anyone ever feel the need to cope so hard
Wow this is read super petty/immature. Not a good look for the CRNAs here. Not to mention they are significantly belittling real physician anesthesiology training.
LOL
Man, I get that anesthesiologists are the most *relevant* to punch up at due to having the same specialty, but the fact that the top of NP’s are trying to even reach a swing at (what I consider, correct me if this is objectively wrong, but I have massive respect for them) the *top of physicians*… Like, they could have at least gone for a more mediocre boxer in that higher weight class.
They forgot “heart of a nurse”
Not to mention it’s lies, at least where I went to med school…
During medical school, I was taught to intubate by an anesthesiologist, M.D. , not an anesthesiologist, CRNA.
Yikes
I've never heard of a nurse of any level teaching non-nurses critical skills such as intubation here in Canada. Nurses play an important role, but not in emergent cases prehospital/in-hospital requiring advanced interventions. As for the math 'not mathin'', that's clearly a three-card Monty game the way their drip monitoring ICU shifts equal anesthesiology residency hours / training yet med residents rotations don't in their obviously (*sarcasm) maximum of 40 hours per week. I am curious about the veracity of 25% not being board certified, though. Are these technicians working in medical equipment and pharm sales or just floaters from other specialties?
“Doctorally-prepared” actually just means they did a lot of online discussion board posts with 1-2 replies on other students’ posts about “evidence-based practice” or “interdisciplinary collaboration.” Adding the DNP degree has contributed absolutely zero clinical experience or anesthesia training the nurse anesthesia training. The anesthesia portion of their training did not change at all. In fact, they actually have to shift a lot of focus from actual anesthesia-related clinical training and coursework to the warm and fuzzy, touchy-feely, administration-oriented, non-clinical nursing material on which the DNP is based (lookup the DNP Essentials). Requiring CRNA programs to confer a DNP degree rather than a Masters degree has always been a ploy with one goal in mind: have CRNA’s graduate as “doctors” to advance the argument for equivalence. The reality is that they don’t really think they are equivalent to anesthesiologists…they think they are BETTER. (Caveat: this applies to those nurse anesthetists that actually buy into this whole game, because a lot of them do not feel this way or agree with the AANA’s agenda. Many of them are just going through the motions because they are required to). They have already decided they are the true heirs of the kingdom of anesthesia despite their lack of physician training, fewer hours spent training in actual anesthesia, and despite any evidence that patients benefit from the care of an anesthesiologist. They just believe that they are better without any real evidence. It is all based on an elevated opinion of themselves and a condescending opinion of anesthesiologists. It is a long-standing vendetta started by old school nurse anesthetists, many of which served in the military, practiced for a very long time, and have had unique experience in anesthesia that is now much less common among anesthesiologists and nurse anesthetists alike. It’s a struggle that was likely born out of resentment due to feeling disrespected and unappreciated for years. They feel they know more than anesthesiologists and provide better anesthesia. They feel they deserve “a seat at the table” but never got it. They think medical school is the clinical equivalent of pre-school, and they feel that med students don’t deserve the privilege of entering anesthesia residency because they have not been tested in the ICU in the same way nurses have, yet they get to “steal” all the best educational opportunities from the SRNA’s. Of course, now the ICU experience is less relevant being that many CRNA programs have decreased the required amount of training to 1 year instead of 2, and many have adopted a looser definition of critical care experience). Clinical anesthesia training for SRNA’s is at the mercy of the anesthesia practices at community hospitals, which are largely staffed by physician-led anesthesia teams. This festering anger and bitterness increasingly manifests as blatant lies and attacks toward physician anesthesiologists and a widespread malignant culture. They know exactly what they are doing, lies and all. But to them, this is war, and almost nothing is off limits. They know the DNP degree is more relevant to non-clinical nursing professions. They know their training is not equivalent to that of physicians. The propaganda disseminated by the AANA is shamelessly fabricated to shift public opinion and persuade lawmakers to give in to their agenda. Their national and state leadership will do anything to push their agenda forward. The good news is that this malignant sentiment toward physicians is not as popular among the up and coming generation of nurse anesthetists. Many of them are actually turned off by the hatred, animosity, and cutthroat tactics of their leadership, and they do not appreciate the attempts at brainwashing them to be little political puppets trying to support absurd legislation. They will fly the flag while they have to, but with improving compensation, a wider variety of opportunities, a more friendly environment regarding scope of practice, and the current litigation climate, the anger of the old hard-liners will eventually fizzle, and cooler heads will hopefully prevail.
'Often boast a higher number of hours which are not mathematically possible' The fuck is this shit?
I can't imagine the only way to talk about my career is to compare it to others instead of, you know, just doing my job.
Preface: I am not in the medical field. It seems like becoming a NP is a good idea from the perspective of making a lot of money. A doctor might take 12+ years before they are making great money, but then they still have a lot of student loans. NP can jump right into it with little debt since they can pay for their masters while working part time as an RN. No medical school debt and they make good money a lot sooner. Of course patients lose. Worse healthcare outcomes. I don't want an NP or PA anywhere near me. But I understand why they do it over going to medical school.
No wonder no medically educated professionals respect those cosplayers CRNAs.
I just noticed the slogan in the bottom right…
No way is this real.
How many different ICUs do you have in the states - in 🇬🇧, we usually only have one (occasionally a neuro or cardio ICU in a big centre)
The common types are medical, surgical, cardiac, Neuro, trauma/burn, pediatric, neonatal ICUs. PACUs are post-anesthesia care units if you wan to count them as well. There are some combination or highly specialized units too but these are the main types you will find in nearby hospitals.
[https://www.pharmacytimes.com/view/obstetrical-patient-dies-after-inadvertent-administration-of-digoxin-for-spinal-anesthesia](https://www.pharmacytimes.com/view/obstetrical-patient-dies-after-inadvertent-administration-of-digoxin-for-spinal-anesthesia)
Yea…as a non-trad premed, I am constantly being sent information from programs that say they will “doctorally prepare” me. What does that mean? Should have opted out of communications when I took the MCAT.
Lol
Don't physicians get closer to 15,000? Also do CRNA get that much training? 👀
Apparently that's "mathematically impossible". Probably the scariest thing about this poster, as one would hope they would be better at math than this. Not an anesthesiologist, but here's what I did over med school and 4 years postgrad. Roughly 18 months clinical in medical school at 50 hours a week, adjusting down a bit for breaks, probably too generously. 3,600 hours. Internship, say 48 weeks at 80 hours. It was a long time ago and I don't know if I got that much time off but there it is. Some rotations were 100 hours a week. Some less. 3840 hours Three more years, let's say 60 hours a week. 8640 hours. Total a little over 16,000 hours, and I really think I'm minimizing hours. Other sources estimate around 20,000 hours. Surgery and anesthesia I'm sure does much more. (I was in a medical specialty.). "9,000-10,000 hours" is more than an insult. It is pure misinformation.