Is the AA profession gaining ground?

And many AAs aren't nurses before beginning their anesthesia training and it doesn't seem to be affecting the level of care that THEY provide. So why are you right and I'm so wrong. OF COURSE, it's not the degree that makes the provider a great clinician. I actually agree with you on that point. Masters prepared or certificate, it's the persons intellect and work ethic that ultimately determines how they'll function in the stress filled and often fast paced environment of the OR.

Let me ask you this - where did you get your experience before you started taking care of patients in the ICU? I mean, surely you weren't pushing all of those dangerous drugs and titrating drips and taking care of those incredibly sick patients with no prior clinical experience were you? Maybe all ICU nurses should be nursing assistants first so that they will have clinical experience before entering the acute care environment of the ICU. Oh wait - you went to NURSING SCHOOL with didactic and clinical rotations BEFORE you entered the ICU as a bonafide licensed practitioner. AAs get 2 solid years of hands-on direct patient care proctored by practicing AAs and MDAs before they are ever left alone in the OR.

We've already proven that you don't have to have a nursing background to be an anesthetist. I think that it just galls you guys that there is a shorter path to the same goal. Just because you have to jump through all of those hoops that your nursing profession places in front of you, doesn't mean that I have to.

I maintain that each and every one of you great CRNAs would have been just fine had you entered CRNA school right out of nursing school. Maybe not right away, but ultimately - yes. I know it, and I think you know it too - you just can't say it.

However, its the 1% of cases that you train for. That is where the RN background will be invaluable when the patient crashes and the **** hits the fan. Ive literally coded thousands of patients, managed multiple drips and titrated them to a fine balance in a crisis. AAs will never have this experience as it isnt something that can be taught in an educational setting. It is a skill and mindset, learned through YEARS of experience and patient management.

Like I said an AA/CRNA of ten years are prob equal as far as their abilities and knowledge. Im just talking about students and new grads. I see the PA students at my program. They are just learning how to assess a pt. Just learing how to interpret ecg's, just learing medical terminology they have never titrated drugs, never titrated epidurals, never done even simple things like suction an ETT, never placed a stethoscope on a pt, never given any drug, never assessed lab values, never volume resuscitated a pt, never coded a pt. Though some of these skills may be more simple than others they all take practice which comes with experience and time.

Absolutely I do. I know it for a fact because I did it.

Mike - thank you for the kind words in your earlier post. That being said, I take issue with your statement that ""AAs will never have this experience.."

I, too, have coded many,many patients. I practice in a large academic city hospital where the acuity level is very high. I do primarily cardiac anesthesia and work with one of the pre-eminent off-pump heart surgeons in the world. Let me tell you, when you ligate the left main and try to sew a graft to it, very scary things can happen - ischemia, ectopy, full arrest. We commonly have to code our open heart patients right in the middle of their distals. Why is your experience more valuable than mine. Could I do it right out of school?? No, probably not. But now, with 16 years under my belt there isn't anything that you have seen that I haven't dealt with either - I promise you.

You are an RN who went to CRNA school then went to AA school? If that were the case do you think that you would have an objective assessment of AA education having already been educated as a CRNA?

Hey Georgia

I agree. I think the largest gap is in the begging and then it totally depends on the kind of cases you decide to do (or are avalaible in your area) as an AA. If its all "bread and butter" cases, codes will be rare and the experience will never build. All falls back to experience, clearly you have gotten good experience. However, i wouldnt want my first code experience to be in the OR on my first solo case, know what i mean? I cut my teeth surrounded by VERY experienced RNs slowly integrating me into the high risk/critical stuff. I had backup as a new learner and then became others backups based on my clinical ability and experience. That isnt happening in the OR. Ive never met a surgeon who knew anything about codes or drugs in general. That leaves the onus on the guy/girl at the head of the bed to run the code and make the critical decisions.

I think we are on the same page

No, I am an AA who can do everything that a CRNA does (except bill for my services) and I was trained in 2 years. And I, unlike you have more insight into your profession than you have in mine since I have always, my whole carreer worked with CRNAs and I'm willing to bet that you have never even met an AA much less seen one working in the OR.

Second of all, because you have been trained to perform similar skills does not make you the superior provider. As a paramedic I was able to intubate, perform needle decompression, intraosseous cannulation.....blah blah blah. I can not perform any of those skills as a bachelors prepared RN. Does that mean I was a superior provider as a paramedic? Absolutely not.
If I sound a little heated I apologize.....the area in which I practice has been flooded with PA's and there are very few opportunities for NP's to practice and I am concerned that CRNA's may be facing a similar problem in to future.