Your care with an anesthetist might actually be better

Dear Researcher

I have worked with many anesthesiologist and anesthetists.  The anesthesiologist is a physician who has completed a residency in anesthesiology.  

A Certified Nurse Anesthetist is a nurse with a four year degree (BSN) and a minimum of 1 year of critical care nursing. However, I believe that the average is about 5 years. This experience is often minimized by anesthesiologists who feel they are financially competing with the CRNA. However, critical care nurse operate under very broad treatment protocols and essentially run life saving emergency codes on highly unstable patients in critical care units. Then, the nurse completes a 3 year training program to become an anesthetist. So these are highly skilled individuals with a great deal of critical care experience and judgement.  

I currently operate at the UCLA surgery center, an 8 operating room surgery center. Anesthetists run anesthesia cases with the immediate availability of a supervising anesthesiologist. I generally feel that it is much safer doing my longer cases in this setting rather than an office operating room because, should there be a rare emergency, there is a vast array of highly capable and experienced medical staff available to assist and the resources to handle virtually any emergency.  

Emergencies are very rare but if you have one in your surgeon's office operating room, will your surgeon and his/her anesthetist or anesthesiologist have the resources to handle the issue?

Also, I find that nurse anesthetists tend to be a little more patient than anesthesiologists. For sure, this is a very broad generalization that does not apply to every individual. However, it is usually the anesthesiologist who are busy responding to emails, reading the wall street journal, or doing other nonsense during the case. I am sure they are great multitaskers and when someone is under general anesthesia the anesthesia does automate a number of critical care functions making it possible for the anesthesiologist to safely be distracted for a moment or two.  

However, I do a number of cases under IV sedation and this is one type of anesthesia where the "anesthesia provider" has to be present moment by moment. To be fair, there are anesthesiologist who are great at this, but as a rule of thumb, I find the capable nurse anesthetists are more willing to be present in the moment to provide this time of care.  

Hope this gives you a little better insight. 

An anesthesiologist is an MD; an anesthetist is an RN. With proper training both are qualified to administer anesthesia in a surgeon's accredited office operating room. Over the past  30 years I have used both.

Make sure the operating rooms are accredited or certified. Here in California we have made this a legal requirement. 

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