Posted by Dave J on January 14, 2008, 12:48 pm, in reply to "Re: Apples to apples"
MY point is that until a DOCTOR tells you a patient needs an anesthetic, you have nothing to do. It is the SURGEON who determines the patient needs a surgery and an anesthetic to go along with it.
Yes, he leaves the details FOR THE MOST PART to you. But I bet you know certain surgeons who do not want a spinal for their inguinal hernia repairs, who want really deep sedation for their EGDs and who want all of their breast biopsies done under general. YOU get to decide how to do the anesthetic as long as it does not conflict with what they want. Yes, sometimes you can get them to go along with you if the patient really does need it, but for the most part, you give an anesthetic based upon patient condition AND what the surgeon wants.
And yes, you can cancel cases if you feel the patient is too big of an anesthetic risk. After all, you are ONLY a NURSE anesthetist, not a MDA. Just as I am. There are some cases I believe are best left to a MDA in a major medical center and not done by a CRNA is a small rural hospital.