Dr Nurse - I see both sides

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MisfitOutlaw said:
There is a huge difference in competition between the med students who took those classes and the curves versus any other field. What school was this where midlevels like pa and MD and all the fields take the same classes together?
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We did it for classes like ethics and nutrition in year one. Not the real classes
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Hoya11 said:
ASA at an all time low.

No advocacy.
Increased frequency of recertification.
Non evidence based guidelines

Probably worst physician group that exists
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To be fair, we are certified by the ABA, not the ASA.
 
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nimbus said:
To be fair, we are certified by the ABA, not the ASA.
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But ASA makes big bucks on CME material sales. That revenue would likely be quite a bit diminished absent onerous MOCA requirements.
 
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At my school the classes were separate. Dental had their own classes, not mixed at all with medicine. Only some post baccalaureate people in some of the med school classes.
 
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Hoya11 said:
ASA at an all time low.

No advocacy.
Increased frequency of recertification.
Non evidence based guidelines

Probably worst physician group that exists
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Change that to "definitely" and your post is spot on.
 
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coffeebythelake said:
Those are extremely committed individuals. Definitely not about the money. Considering CRNA pay vs MD pay
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I think for many CRNAs the original plan was to become an MD. Then when the coursework got really tough they switch to nursing major and become CRNA. So the idea of going back to become an MD is not an option because they have already tried and know that it’s too much for them. All they can do at that point is tear down the actual MDs and try to invalidate their worth and their education in order to rationalize their own shortcomings
 
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Hoya11 said:
I think for many CRNAs the original plan was to become an MD. Then when the coursework got really tough they switch to nursing major and become CRNA. So the idea of going back to become an MD is not an option because they have already tried and know that it’s too much for them. All they can do at that point is tear down the actual MDs and try to invalidate their worth and their education in order to rationalize their own shortcomings
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Interesting take on this. But they don't necessarily need to do anesthesiology residency after getting MD.
 
Hoya11 said:
I think for many CRNAs the original plan was to become an MD. Then when the coursework got really tough they switch to nursing major and become CRNA. So the idea of going back to become an MD is not an option because they have already tried and know that it’s too much for them. All they can do at that point is tear down the actual MDs and try to invalidate their worth and their education in order to rationalize their own shortcomings.
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Hmmmm, I don't think that at all. Most nurses start college knowing if they're pursuing a nursing major, since there are typically some pre-reqs along the way for nursing school. The exception might be those who graduated with another BS degree and take an accelerated nursing program, and a lot of those are the ones thinking about nurse anesthesia school or NP.
 
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I think most nurses that become a CRNA wanted to become a nurse. Then they saw colleagues skip away to school for 2 years, come back and make 3x their salary. Maybe 4x these days.

Interviewed a candidate a couple weeks ago. Turned down our offer because it's less than 300k.

Think about that for a minute.
 
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jwk said:
Hmmmm, I don't think that at all. Most nurses start college knowing if they're pursuing a nursing major, since there are typically some pre-reqs along the way for nursing school. The exception might be those who graduated with another BS degree and take an accelerated nursing program, and a lot of those are the ones thinking about nurse anesthesia school or NP.
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many wont tell you they switched majors when their colorful poster projects were not enough to get by as they had been to that point

sure its not the case for all, but a lot i suspect - just a theory of mine.

many who work for my group have prestigious undergrad institutions, villanova, lehigh, duke - why go there if the goal is RN which you can attain anywhere? and this is why they want to be doctors soo badly they will do anything to blur the line.
 
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Bertelman said:
I think most nurses that become a CRNA wanted to become a nurse. Then they saw colleagues skip away to school for 2 years, come back and make 3x their salary. Maybe 4x these days.

Interviewed a candidate a couple weeks ago. Turned down our offer because it's less than 300k.

Think about that for a minute.
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I can see this for some people. I have a bunch of friends from a former hospital that all started doing DNP school. They were all great nurses (preop/PACU), and when one decided to leave for an NP degree 3 others did shortly after.

Some of the crnas I've met say they went to nursing school just to become a crna, and they did their minimum ICU hours and applied to school. An anesthesia tech I know is starting nursing school to do that now.
 
Bertelman said:
I think most nurses that become a CRNA wanted to become a nurse. Then they saw colleagues skip away to school for 2 years, come back and make 3x their salary. Maybe 4x these days.

Interviewed a candidate a couple weeks ago. Turned down our offer because it's less than 300k.

Think about that for a minute.
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The life of a nurse can be pretty unpleasant and gross. I've known more than a few CRNAs who openly admitted they became CRNAs once they discovered just how miserably awful being a floor RN can be.

All of the advanced practice nurse pathways are, first and foremost, an escape plan from being a nurse.

I think this is why some APNs work so hard to blur the lines between doctors and nurses. They hate being nurses.
 
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ChiDO said:
I tell all my cousins kids who are nurses or going to nursing school, go work in the icu and then go back to crna school immediately.

$300k+, good hours, overtime, little to no call...its a no brainer
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You can make 200k as a circulator. Easy job, just count a few things and open packages once in a while
 
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Ashers said:
I can see this for some people. I have a bunch of friends from a former hospital that all started doing DNP school. They were all great nurses (preop/PACU), and when one decided to leave for an NP degree 3 others did shortly after.

Some of the crnas I've met say they went to nursing school just to become a crna, and they did their minimum ICU hours and applied to school. An anesthesia tech I know is starting nursing school to do that now.
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I’m old. Cat is out of the bag in regards to how sweet a gig CRNA is. Started working in an OR almost 30 yrs ago. Back then, CRNA was more of a niche path for the super-motivated nurse.

These days, I think most RN students know about it before they start their first class as an RN. More and more, I see them choosing it for lifestyle/monetary reasons.

Like ChiDO, if I knew anyone studying to be a nurse now, I would encourage them to pursue CRNA. We also had an Anes Trch leave for anesthetist school. It didn’t work very well. Didn’t last a semester.
 
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ChiDO said:
I tell all my cousins kids who are nurses or going to nursing school, go work in the icu and then go back to crna school immediately.

$300k+, good hours, overtime, little to no call...its a no brainer
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Our crnas don’t make anywhere near that and our circulators don’t make 200 either. Neither is a realistic goal for kids though they might be able to find it somewhere.
 
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triggermaster said:
Our crnas don’t make anywhere near that and our circulators don’t make 200 either. Neither is a realistic goal for kids though they might be able to find it somewhere.
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agree. that's not the typical or average salary
maybe busting butt, doing locums, or travel nursing work
 
coffeebythelake said:
agree. that's not the typical or average salary
maybe busting butt, doing locums, or travel nursing work
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Circulators at my training program who were picking up extra cardiac call (so, probably actually working around 60hrs/week) were making $200-300K. I know of one who made over 300, but he was working a lot and was officially under a travel nursing contract.
 
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GassYous said:
Our nurses get 70-100/h
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I live in a union state with a modest cost of living and the nurses here are making half that, even after several large market adjustments in the last year.

A few observational responses to the discussion

1. I agree that non-physicians working in a hospital who use the word doctor are being disingenuous. Further, the amount of nurses wearing white coats make me laugh. One of our house nursing supervisors wears one, and I'm like, why??

2. While in nursing school, at the beginning of each block we did those little introductions, 90% of the students were like "oh yeah my future plan is NP school"

3. Now that I'm out on in the ED, I rarely hear our nurses talk about wanting to go on. In fact we have 3 nurses that I can think of that have their NP but choose to work as nurses in the ED instead - they hate NP life.

Personally, I do want to go on.. I dreamed of medical school for many years, but life kept getting in the way. I'm now over 40 and even in a perfect world the earliest I could start medical school is 48 -- frankly I just don't have the energy anymore. Anesthesia was always what I wanted to do, so CRNA seems like the right path, although working as an NP in the ICU is appealing for different reasons. I have no intent on calling myself doctor (although laughably, I am called doctor at least once per shift, usually by one of our migrant patients), and I have no idea of pushing any anti-physician agenda. I'm just a dude who wants to do a job.
 
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FiremedicMike said:
I have no intent on calling myself doctor (although laughably, I am called doctor at least once per shift, usually by one of our migrant patients), and I have no idea of pushing any anti-physician agenda. I'm just a dude who wants to do a job.
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For now...
 
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abolt18 said:
For now...
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A great lesson for newer attendings is that a lot of SRNAs are quite humble and receptive during their training. A lot of new grad CRNAs are quite humble and receptive during their first 1-2 years out.

Then one day they wake up after having absorbed a bunch of your knowledge and skills, and all of sudden they think it's their case and their patient.
 
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listen friends, I’ve been in the healthcare game for 25 years now. I’m well passed the billy badass stage.
 
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vector2 said:
A great lesson for newer attendings is that a lot of SRNAs are quite humble and receptive during their training. A lot of new grad CRNAs are quite humble and receptive during their first 1-2 years out.

Then one day they wake up after having absorbed a bunch of your knowledge and skills, and all of sudden they think it's their case and their patient.
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Yup. At one practice, I worked with two CRNAs as students and junior CRNAs. After about a decade in and after attaining leadership roles within the department, they advocated to administration for a medical supervision as opposed to a medical direction model to administration. I.e, raising supervision ratios and lowering the amount doc FTEs as a way of saving money.
 
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vector2 said:
A great lesson for newer attendings is that a lot of SRNAs are quite humble and receptive during their training. A lot of new grad CRNAs are quite humble and receptive during their first 1-2 years out.

Then one day they wake up after having absorbed a bunch of your knowledge and skills, and all of sudden they think it's their case and their patient.
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Saw this all the freaking time in the Army. Many, however, turned during their last year of clinical training, and were adversarial from that point on.
 
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Dr. Rude said:
I definitely would try to **** them.
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Definitely. Nurse is a red flag along with bartender, artist, & therapist, but no reason not to smash if they’re down… but be careful.
 
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epidural man said:
Why? They ARE doctors. They are doctors of Nursing. They are bad for saying this?
NO responable PERSON is arguing that - despite the myriad of posts above trying to scream out that fact.
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I'm Catholic.. and we call our priest "Father" Bert.
I'm also a Dad/Father of a 10 yr. old girl
anywhere else, it's ok to call me Father, but if we're inside the Church and I wear all black (think of nurse wearing white lab coats ) and ask everyone to address me as "father" I am misleading them, even though, technically I earned it.

Had a patient with poorly controlled diabetes, HbA1c of 14.. only adjustment made in 2 years by her "Doctor" was change the metformin 500 BID to metformin 850 BID.. ( and recent eGFR was 3 years ago) No additional oral hypoglycemics, no talk about starting on insulin, no referral to Endo.., no referral to dietician , Ophthalmology to evaluate for DM retinopathy, no foot eval etc etc.
I Googled the practice.. and guess what, DNP introducing themselves doctors.

The person who lost here is the patient, who thought she's getting care by a physician.
she was better seeing a medical student.
 
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Lee Ik-jun MD said:
I'm Catholic.. and we call our priest "Father" Bert.
I'm also a Dad/Father of a 10 yr. old girl
anywhere else, it's ok to call me Father, but if we're inside the Church and I wear all black (think of nurse wearing white lab coats ) and ask everyone to address me as "father" I am misleading them, even though, technically I earned it.

Had a patient with poorly controlled diabetes, HbA1c of 14.. only adjustment made in 2 years by her "Doctor" was change the metformin 500 BID to metformin 850 BID.. ( and recent eGFR was 3 years ago) No additional oral hypoglycemics, no talk about starting on insulin, no referral to Endo.., no referral to dietician , Ophthalmology to evaluate for DM retinopathy, no foot eval etc etc.
I Googled the practice.. and guess what, DNP introducing themselves doctors.

The person who lost here is the patient, who thought she's getting care by a physician.
she was better seeing a medical student.
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I've seen consults staffed by oncology and ENT NPs, with no attending sign off!! How does an NP know the complexity of cancer care compared to a board certified fellowship trained oncologist. Or... the ENT NP giving surgical recommendations on complex care needs...

It's a race to the bottom and it's only shifting into higher gear quicker than ever.
 
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2Fast2Des said:
I've seen consults staffed by oncology and ENT NPs, with no attending sign off!! How does an NP know the complexity of cancer care compared to a board certified fellowship trained oncologist. Or... the ENT NP giving surgical recommendations on complex care needs...

It's a race to the bottom and it's only shifting into higher gear quicker than ever.
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Hospitals want this. The C suite run by business men want this. Pay an NP a little less than a doctor but they bill more because they order all these unnecessary tests and workup. A twofer!
 
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The only saving grace for us. And I told people this years ago even before the salaries went up after 2019 is that if you extrapolate crna w2 salary of 150-160k (back in 2017/8 ish). When you adjust it for hours docs work plus weekends and overtime. Their equivalent salary back than would have been around 280k. Compared to Average doc salary around 360k back in 2017/8.

It’s not that much of a savings especially crnas dictate their work hours using hourly method.

Fast forward to 2023. Crna salary is 200k base and with overtime easily 260-280k and not working much more days than docs. Docs average is around 475k now

Again extrapolated weekends and call hour responsibilities to crnas to same as docs. That same crna salary would be close to 400k. Not much income difference.
 
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