Here's what AAs really think of CRNAs - page 12

And this comes from the PRESIDENT of the American Society of Anesthesiologist Assistants Again, assertions that AAs and CRNAs function at the same level -absolutely misleading. And, what's... Read More

  1. by   smiling_ru
    For those of you who can not discern a difference, and see this as a turf battle, I would like you to consider this.

    A nurse anesthesia student starts the program with a great deal of education and experience in the medical field. They all understand medical terminology, how to chart appropriately. Various disease processes, their effects, and treatment. Pharmacology, lab interpretation, EKG interpretaion, ventilator strategies, ACLS, PALS, CPR, sterile technique, this list could go on and on.

    On the other hand an AA student can walk in with very little of this knowledge. Consider that the AA programs are about the same length of time as the CRNA programs. That the AA has few if any of the aforementioned skills, and must also learn the art and science of anesthesia. Do you think there is enough time? Do you want that person providing your anesthetic?
    Last edit by smiling_ru on May 7, '04
  2. by   Sheri257
    Quote from ether
    You fooled me too. It's that punk-rock avatar and SoCal location, lizz! :wink2:
    Why? Is everybody from SoCal a punk rocking kid? There's 35 million people in this state. Surely some of them are older too and, maybe they just like music. :chuckle

    I understand why you guys are upset, and I never said you don't have a right to be upset. As I've stated before, my arguments come from a realistic PRACTICAL standpoint, i.e. losing Florida and, potentially, other states.

    Maybe the ASA did buy this but, in my experience, it's much easier to buy political influence when the other side doesn't have an argument. These arguments are great if your audience is mostly CRNAs, other nurses and medical professionals.

    But, outside of that, your arguments aren't so great unless you can prove patient endangerment. Forgive me for stating the obvious, but you all have a science background. Surely you know that mere predictions of patient endangerment aren't enough? You need proof that this is a public health hazard. Otherwise, everything else is mostly irrelevant, and you lose.

    That's the practical reality, IMHO.

    Last edit by Sheri257 on May 7, '04
  3. by   smiling_ru
    Quote: These arguments are great if your audience is mostly CRNAs, other nurses and medical professionals.

    That is the real problem for CRNA's. Because, while anyone working in US healthcare is familiar with what a nurse brings to the table, the public and legislators still have this picture of a person who only functions in the realm of what the physician orders. One of the many things that need to change....and it is getting better.

    The other point that I would like to make is that if this argument is " great if your audience is mostly CRNAs, other nurses and medical professionals." Then it obviously has merit, so why discount it just because John Q Public does not understand?

    These links are to the curriculum of both programs, I believe that they clearly demonstrate that upon graduation the AA's are ready to function as a technician. (Noun 1. technician - someone whose occupation involves training in a specific technical process). They are not learning about anything beyond anesthesia, and you should all know that most patients present with a myriad of issues which impact anesthesia.

    http://www.anesthesiaprogram.com/curriculum.html

    http://anesthesiology.emory.edu/PA_P...oursework.html

    READ the curriculum THINK about what is NOT there and then read this statement.

    Georgia AA's statement "As a senior anesthetist I am given free reign to manage my cases as I see fit. Very rarely does my attending dictate what the anesthetic should be. They may make a suggestion here or there like "work in a little Morphine towards the end" but I am not required to check with them about most decisions that come up during a case. New grads on the other hand (AA and CRNA) really are expected to communicate with their attendings a little more often. I commonly do extremely complicated cases from beginning to end with little to no involvement from my supervising MD."
    Last edit by smiling_ru on May 7, '04
  4. by   user69
    Quote from lizz
    Surely you know that mere predictions of patient endangerment aren't enough? You need proof that this is a public health hazard. Otherwise, everything else is mostly irrelevant, and you lose.
    Well said Lizz.

    Without some proof on outcomes that shows a difference between an AA with 2.5 years of medical training and a CRNA with 5+ years of training it can easily be turned on you. Your arguments can be thrown back at you as being overqualified for what you do.



    [font='Times New Roman']If it can be proven that the model of supervised AAs is detrimental to the public health that is an argument that the masses will get behind (including me). All of the other arguments IMHO will not stir the public masses.
  5. by   Sheri257
    Quote from smiling_ru
    The other point that I would like to make is that if this argument is " great if your audience is mostly CRNAs, other nurses and medical professionals." Then it obviously has merit, so why discount it just because John Q Public does not understand?
    This is where you don't understand. I don't discount the arguments from that perspective. My point is that the CRNA message gets sidetracked with all of this other stuff, and there's a real danger of losing this battle because of it.

    Afterall, it is John Q public (or, rather, his elected representative) who's going to decide this issue.

  6. by   loisane
    Quote from lizz
    Afterall, it is John Q public (or, rather, his elected representative) who's going to decide this issue.
    Liz, your point is not lost, I believe you are absolutely right.

    My comments here are directed to this audience of (mostly) nurses. Nurses are the largest group of health care professionals. If we would learn to support each other's causes, we would have tremendous influence. When I read the opinions from members of this forum that AA practice is benign, or doesn't affect them, it motivates me to action. I want to win these people over to understand why autonomous CRNA practice is important to all of nursing. I am also supportive of other APN issues, something I try to motivate CRNAs about (so it is a two way street).

    I am also active in my state association. Do I use the same arguments in lobbying as I do here? Heck, no. Do I really think I am going to get anywhere with a legislator if I say "You should vote against AAs because nurses have the right to practice autonomously". He/she would laugh in my face. We have to tailor our arguments to the audience. As professionals develop in leadership, they learn how to do this. I am no expert, but I have witnessed experts in action.

    But Liz's message is an important one. The factors in an issue that have influenced your personal opinion, are not necessarily the most important factors to use in presenting your message to "outsiders" who have different goals and priorities. The way to influence people is to identify how your position makes a positive impact on the things they value.

    How to present our case to the media, politicians and outsiders is a different discussion than the one we are having here, IMHO. And it is one not completely appropriate for this forum. That explains why you are not seeing it here, not because it does not exist.

    loisane crna
  7. by   loisane
    Quote from nurseunderwater
    What can I as a nurse/student/activist do to assist in maintaining the future of CRNAs? Kate
    Kate, I am really glad you asked that. I love the attitude it displays, and it makes me consider something I had never thought of. I always tell CRNAs and SRNAs to get involved in their state association. But surely there is a role for RNs and SRNs as well.

    The things that come to my mind quickly are to promote nurse anesthesia in your everyday life. Make sure whenever anesthesia is discussed, socially or professionally, that you spread the message that most anesthesia in this country is provided by CRNAs. Just tell people we exist, and the work we do. Request CRNAs for your anesthesia, and your family's, and encourage other people to do the same. Yes, odds are that even without a request, it will be a CRNA providing that anesthesia. But to request a CRNA shows that you know how things are really done.

    It is also important to get involved politically. Get to know your local representatives, attend political functions, stuff envelopes, etc. I know that is tough for a student/mom, but maybe there will be a point in the future when it is more fesible. It is those personal connections that are important to getting any message across when issues come up for vote.

    Stay informed, know when bills are being discussed in your area and write letters/make phone calls making your opinion known to your representatives.

    I am sure there is more. Participating in discussions like this is a good place to stay involved, and get ideas.

    loisane crna
  8. by   Sheri257
    Quote from loisane
    How to present our case to the media, politicians and outsiders is a different discussion than the one we are having here, IMHO. And it is one not completely appropriate for this forum. That explains why you are not seeing it here, not because it does not exist.

    loisane crna
    The article cited in this thread was published in Florida newspapers as part of that debate. And there have been numerous threads on the board and, even, posts in this discussion about the Florida decision. As GeorgiaAA pointed out, this will issue will probably be considered by other states. I thought it was relevant but if you don't, ok.

    It's rather strange: I guess the point of this forum is to criticize AA's and make CRNA's feel better about the issue. Seems like anything else is "not completely appropriate."

    Perhaps the moderators should post that restriction so we'll all know what to post and what not to post in the future.

    Last edit by Sheri257 on May 7, '04
  9. by   loisane
    Quote from lizz
    Perhaps the moderators should post that restriction so we'll all know what to post and what not to post in the future.

    You're right, I should have been more clear. This is simply the reason I won't personally speak to it. Others are, of course, free to do as they like.

    loisane crna
  10. by   nurseunderwater
    Quote from loisane
    Kate, I am really glad you asked that. I love the attitude it displays, and it makes me consider something I had never thought of. I always tell CRNAs and SRNAs to get involved in their state association. But surely there is a role for RNs and SRNs as well.
    thanks for the direction loisane....and for the nice feedback

    have a great day,

    Kate
  11. by   athomas91
    Lizz, i agree with your point that a more "tangible" proof of safety would be nice...the problem with that theory is however that AA's DO NOT practice like CRNA's in that they are not responsible for their patients - the MDA's are - so it would just be another CNRA vs MDA study that couldn't be accurate. the safety problem doesn't lie alone in the use of AA's but more specifically in the misuse of AA's ...to be more exact - when there are written guidelines basically saying that a MDA is responsible for all major decisions, yet are not present during the case like GeorgiaAA alluded to....and let's face it...in a study - what AA or MDA is going to admit they weren't following the guidelines?? - your study would be signifigantly misdirected and the results false........that is where our burden of proof problem lies.
  12. by   nurseunderwater
    Quote from athomas91
    Lizz, i agree with your point that a more "tangible" proof of safety would be nice...the problem with that theory is however that AA's DO NOT practice like CRNA's in that they are not responsible for their patients - the MDA's are - so it would just be another CNRA vs MDA study that couldn't be accurate. the safety problem doesn't lie alone in the use of AA's but more specifically in the misuse of AA's ...to be more exact - when there are written guidelines basically saying that a MDA is responsible for all major decisions, yet are not present during the case like GeorgiaAA alluded to....and let's face it...in a study - what AA or MDA is going to admit they weren't following the guidelines?? - your study would be signifigantly misdirected and the results false........that is where our burden of proof problem lies.
    i agree...didn't someone post earlier about it being like comparing apples to oranges???
  13. by   Jailhouse RN
    Call the Ref and let them make a ruling.

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