Las Vegas Sun

Yada Yada...more CRNA self promotion when all of us should be directing our attention to patients injured by our sloppy practices and to elevating the standard of care to ensure the safe delivery of medical care...

FACT: Sedation for the overwhelming majority of endoscopic procedures performed by gastroenterologists can be safely delivered by trained RNs (not CRNAs) working under the gastroenterologist's direction at NO ADDITIONAL COST to the patient. The extra $500-1,000 in anesthesia charges resulting from having a CRNA give the drugs does not provide a safer procedure and only serves to inflate the costs of care by employing high priced professionals to do tasks that do not require their expertise. Morphus' concern over anesthesiologists in the lounge is laughable. What about a nurse charging $500 to give 100 mg of propofol for a 15 minute colonoscopy? Not a bad way to drink a latte.

Gastroenterologists and RNs who choose to become proficient in airway management can manage deep sedation with propofol (the same drug used incorrectly by CRNAs and at least one anesthesiologist in LV) safely and at no charge to the patient. Over 450,000 such sedations have been reported and will be presented at the annual gastroenterology meetings in May.

FACT: CRNAs earn $150,000-$200,000 annual medial incomes in the U.S., depending on the environment of care. That income exceeds what a hard working and highly trained family physician or internist can command. It is out of line with the training and expertise required. But if I had it I would shout out and defend it as assertively as Morpheus is doing.

Nice defense of the CRNA industry! Sounds like CRNAs are quite culpable on their own in this story however, as all reported cases of hepatitis C transmission in this outbreak have been linked to CRNAs failing to adhere to safe injection practices. Crying "the doctor made me do it" is certainly not exculpatory, but is rather an indictment of poor professional autonomy, judgement, and ability to put the patient's safety first. We need a new standard of care. The old one failed our patients, and failed us.