Here's what AAs really think of CRNAs - page 17

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   todabnrn
    AA2B

    Just one quick question. If AA's are such a great idea.........and correct me if I'm wrong.....have been in existance for 30+ years..........why is there only two schools? How long does it take for the the school to "come into favor"


    just a thought
  2. by   Sheri257
    Quote from todabnrn
    If AA's are such a great idea.........and correct me if I'm wrong.....have been in existance for 30+ years..........why is there only two schools? How long does it take for the the school to "come into favor"

    just a thought
    It probably wouldn't make sense to have many schools since AA's are only licensed in a few states. Afterall, why would anyone want to set up a school in states where AA's can't practice? And, of course, CRNA's have fought the licensing efforts so, with few states on board, there probably hasn't been much incentive for new schools.

    If AA's are more successful with the licensing effort, that may change. Since Florida now allows AA's, there are plans for two new schools there, and the Louisiana AA bill also includes support for a new school, if it becomes law.

    Last edit by Sheri257 on May 16, '04
  3. by   todabnrn
    "It probably wouldn't make sense to have many schools since AA's are only licensed in a few states".

    Why is this? Again, if they are such a good idea why are there not more schools?
  4. by   jewelcutt
    How could I not reply to this thread since every one involved in this forum would have to in order to create 22 pages :chuckle. I am so tired that I couldn't get through all of them. I have really enjoyed loisane's posts because they are right on the dot. It should be in our nature as nurses to fight for our professionalism because we distinguish our practice separate from that of medicine.

    It is insulting to us to be compared to AA's as equals because of our experience. Bsn's are required in addition to gen chem, micro, biochem, math, nutrition, etc to take pathophys, pharmacology and numerous nursing classes that teach systems and disease processes throughout four years of schooling. We learn every in and out of the human body and mind, that's why we are proud to be nurses. Then we are required to spend years in critical care where we are, in actuality, independent providers, ie, the sh#@ goes down and we are the first ones there. We understand PA cath monitoring, how and when to give all meds, when and why a patient is crumping. We join professional committees, organizations, and participate in numerous continuing education activities. Working in critical care is like going to school, you are always learning (certifications, classes)! Because of this training taking care of patients is ingrained in our souls, we instinctly act.
    And we do all of this before even applying to CRNA school.

    Next we take additional classes before applying to CRNA school (here's your oh-so-precious "premed" classes that obviously deem you superior to all others not having had 3 credits of undergrad physics). Most schools require physics, organic, statistics. Then we take additional graduate courses to make us look better candidates. We then pursue and intense 2 1/2 year program in anesthesia. So up to this point we have fours years (at least) of BSN learing about health, humans, pathophys/ 2-3 years of critical care nursing experience (not including those who worked elsewhere first) of learning how to become a professional practitioner/ extra time on classes to be admitted/ 2 1/2 years of crna school. This equates to approximately 9 1/2 years of hard work for us to become a CRNA. granted some may do it a year or so less but that's not the majority.


    AA's can have a bachelors in anything, as long as they have core courses, with two years of AA school with no previous training in the medical field. They could literally walk into school without never having touched or seen a patient before, and everything they learn about a patient is during two years. I'm not putting AA's down, but I simply don't want my education compared to that of theirs. I have worked soooooooo hard to get into school, I cannot even begin to explain how much I've grown just becoming a nurse. And I know every nurse out there feels the same way and will defend our professional standards.

    As Lizz states previously, she's only concerned about outcomes. Well licensure and training should be your first priority. Hell, why don't we cut med school down to 2 years and residency programs to 1 year as long as we have the same outcomes. Experience accounts for a lot.
  5. by   SnowymtnRN
    WOW, this article was pretty strong in its message to nurses. That is...you are no longer welcome in the "realm" of anesthesia delivery. Truth is no AA or MDA can produce any reliable, verifiable study that clearly demonstrates an increased hazard to pts. having surgery under the care of a CRNA. The cold fact is that MDA' not CRNA's are terrified of losing their grip of anesthesia profits and could care less about pt care. This reality is borne out of the hundreds of thousands of dollars spent by MDA organizations to buy off senators and congressman to support legislation to keep CRNA's from directly billing Medicare and MDA's supporting other efforts at the federal and state levels to maintain a physician supervision requirement for CRNA's delivering anesthesia care. The policy of requiring physician monitoring of anesthesia delivery by CRNA's only increases the amount paid by insurance companies and Medicare because these physicians are billing for services they are NOT providing. Since when have you ever heard of a MDA making 500k to 1m dollars a year ever care one bit about the patient on the table. This can plainly be seen by the MDA' support of AA education. The AA works for the PHYSICIAN. This person's role is to collect data about the pt, maybe even start an IV. Are we really going to hand over care of our loved one to a person who's primary undergraduate education may have been music, art or phys Ed??? A person with no REAL experience in health care? Truth is, nurses are highly educated individuals who must fiercely COMPETE for entry into any CRNA program. Their primary undergraduate education is in health care, pharmacology, and nursing process. Nurses spend a lot of time, money and FREE work (nurses don't get paid for clinical like residents) getting there education in a field that they were drawn to, not out of a love for money, like MDA's, but rather a commitment to there fellow man and a sense of advocacy for what amounts to helpless humans laying on an operating table. The article states that CRNA's are getting paid too much for their care in the OR. Reality, $150000 is CHICKEN FEED compared to the amount of money any hospitals or MDA for that matter is making on a case by case basis. Don't take my word for it!! Ask you local hospital how much money they make in a year for anesthesia delivery, then ask them how much they pay their CRNA's. Don't have the exact figures, but I suspect that their labor costs in this are run roughly 15-19%. Let's not forget nurses have been SAFELY delivering anesthesia care for over 90 years. The only reason physician began this practice was to generate another line of profit for themselves, NOT to create more access or safer care. Finally, if one wants a real eye opening experience as far as anesthesia care goes, spend some time in an ICU. No really. Spend some time there. I think you'll find, as I have, that many times, cases are brought back to ICU not PACU because its getting late and some MDA has a golf or softball game to get to. Pt's are not stable, can't get any orders for fluids or drugs to keep em going, or my favorite activity, the old perioperative "lets guess how much fluid the pt lost" game. Sound like patient advocacy to you??
  6. by   Sheri257
    Quote from jewelcutt
    As Lizz states previously, she's only concerned about outcomes. Well licensure and training should be your first priority. Hell, why don't we cut med school down to 2 years and residency programs to 1 year as long as we have the same outcomes. Experience accounts for a lot.
    Actually, as far as patient outcomes, I was referring to how legislators and other outsiders might view the issue. However, since you mention experience and training, I think the D.C. CRNA's have developed a better approach. Instead of trying to eliminate AA's, they want to require that AA's become PA's first, i.e. more education and training, which is what CRNA's have been complaining about all long.

    I don't know if it will work, but I personally think it's a brilliant argument and political move. For one thing, it thwarts the perception that CRNA's are trying eliminate the competition, since AA's will still be allowed. But it still benefits CRNAs since the additional requirements will limit competition from AA's, at least to some extent.

    And, not only does it address the CRNA criticisms about the lack of training, but it's also good public policy since, theoretically at least, you get more qualified anesthesia providers. I think it's possible that everybody could with win with this type of proposal.

    Last edit by Sheri257 on May 19, '04
  7. by   jwk
    Quote from Brenna's Dad
    I also have to agree, "anesthesia nurse" is not the appropriate term and does not denote respect. I have too long and hard for my education to not be respected.
    We AA's have also worked hard for our education.

    Using the term "anesthesia nurse" is offensive to some of you, and I see that point. However, it is offensive to AA's to see full page ads in Stars and Stripes asking "DO YOU WANT AN ASSISTANT DOING YOUR ANESTHESIA"
  8. by   athomas91
    well AA stands for anesthesia ASSISTANT.......... :uhoh21:

    no where in CRNA (Certified Registered Nurse Anesthetist) is there an anesthesia nurse....
  9. by   jwk
    Quote from lizz
    I have been listening. But, quite frankly, there doesn't seem to be compelling arguments coming from the CRNA side. They say AA's don't have enough training, but there's no evidence that patient outcomes are adversely affected. They say MDA's are greedy, but the same argument can be made against CRNA's. They say clinicals may be adversely affected but, once again, no one seems to know for sure.

    I agree with GeorgiaAA that the Florida decision is probably significant and, IMHO, it's a sign that CRNA's aren't doing a great job of selling this to the public. Perhaps we don't fully understand all of the details and history on this issue, but then, the Florida legislators apparently didn't either.

    And, in the end, that's what really matters since the bottom line is: CRNA's have just lost another state on this issue. Not exactly a ringing endorsement that the CRNA arguments are working, is it?

    I'm sorry - what did the CRNA's lose in Florida, or anywhere else? None of you have lost or been denied a job in favor of an AA.
  10. by   gaspassah
    None of you have lost or been denied a job in favor of an AA.
    not today, but what about those out there trying to get into crna school, or 10 years from now or 5 years. dont look just at today, look to the long term ramifications to the profession. it should become quite clear.
    d
  11. by   dneill01
    All of this talk about AA versus CRNA is making my head hurt! I am a critical Care nurse of 12 years, I have been using sedation, inotropes, vasopressors, ventilators, IABPs, PA catheters, A-lines etc.........for many years. Those of us who have worked in the ICU know that autonomy that is afforded us especially at night. Nursing school provided us the basis for our practice but experience is what makes us what we are. Not all ICU nurses are created equal and I dont favor being clumped with all because so many are lazy slugs that come in get a pay check and go home, never expending their education, and never making a contribution to their profession. I cannot concur that an AA has "paid their dues" if their BS is in philosophy. Most CRNAs have a minimum of 5 years experience in critical care. Someone had stated that MDAs dont have this experience. This is crap of course, look at the length of residency and fellowship before they can function independently. The simple fact is: the ASA has never liked the CRNA and feels threatened by the practice. The ASA has gone as far as manipulating their date of origin (of anesthesiologist speciality) to look older than it is. Nurses are the forefathers of anesthesia care. The AMA and ASA feel threatened thus the reason for creating the AA. They now still have control over the provider, and can profit from their labor. If the ASA and the AMA where truely trying to meet a need of shortage, they would be courting more anesthesiology residencies (maybe they are). Hey what a scam, I can supervise 4 rooms (all at once WOW what a feat, kinda makes you wonder how well they are supervising) and bill for all of them! I can sit in the lounge and get paid, what a great gig! The ASA belittles the practice of anesthesia when they insinuate that they can supervise 4 at a time (makes anesthesia seem like a pretty simple practice). AS far as the titles: Many CRNAs are ashamed of their roots as a nurse, in my opinion this is pathetic. Nursing background is what makes such good anesthesia providers. Years of patient care (besides the technical aspects as I had mentioned previously) are what make us able to make a patient and family comfortable prior to surgery and give us the ability to interprete into laymans terms what they are about to experience in the few minutes that anesthesia providers are alloted.

    The AA will survive. Flourish? is yet to be seen. See, the shortage of anesthesia providers is more of a rural problem and it is here that CRNAs can indeed function independently.

    The AA who had the problem with the Stars and Stripes article depicting the AA as an assistance needs to look inward and at their profession and see it for what it is. A profession that is prostituted by the ultimate of pimps "ASA"!!! An AA is an assistant plain and simple, this is why they where created. To be under the thumb of the AMA and the ASA.

    I do not question the ability of AAs to provide anesthesia care as there are good and bad in all anesthesia professions. I do however take a stand that if the AA is to be an assistant and trained to do so, then they should not be providing independent care. If they do, they are only letting the MDA off even easier and practicing beyond their scope (unsafe situation).

    Professionalism: good and bad in all but the most unprofessional is the MDA as those of us with long term experience in healthcare know. HOwever,I work with some great MDAs, To many MDAs have been groomed to be the "all knowing better than everyone else physician".
    If a AA is a PA then that makes everything very clear, they work under the Physicians license and liability and their scope of practice is limited to whatever that physician allows them to do.

    I hope that the family of anesthesia can know their practice, abilities and limitations and continue to work together to provide the best anesthesia care possible. Everyone be proud of what you are but always remember what you are: CRNAs, are not physicians you are highly educated nurses, AAs, are not independent anesthesia providers you are trained assistants, and MDAs, you are not GOD you are doctors!
  12. by   jwk
    Quote from dneill01
    All of this talk about AA versus CRNA is making my head hurt! I am a critical Care nurse of 12 years, I have been using sedation, inotropes, vasopressors, ventilators, IABPs, PA catheters, A-lines etc.........for many years. Those of us who have worked in the ICU know that autonomy that is afforded us especially at night. Nursing school provided us the basis for our practice but experience is what makes us what we are. Not all ICU nurses are created equal and I dont favor being clumped with all because so many are lazy slugs that come in get a pay check and go home, never expending their education, and never making a contribution to their profession. I cannot concur that an AA has "paid their dues" if their BS is in philosophy. Most CRNAs have a minimum of 5 years experience in critical care. Someone had stated that MDAs dont have this experience. This is crap of course, look at the length of residency and fellowship before they can function independently. The simple fact is: the ASA has never liked the CRNA and feels threatened by the practice. The ASA has gone as far as manipulating their date of origin (of anesthesiologist speciality) to look older than it is. Nurses are the forefathers of anesthesia care. The AMA and ASA feel threatened thus the reason for creating the AA. They now still have control over the provider, and can profit from their labor. If the ASA and the AMA where truely trying to meet a need of shortage, they would be courting more anesthesiology residencies (maybe they are). Hey what a scam, I can supervise 4 rooms (all at once WOW what a feat, kinda makes you wonder how well they are supervising) and bill for all of them! I can sit in the lounge and get paid, what a great gig! The ASA belittles the practice of anesthesia when they insinuate that they can supervise 4 at a time (makes anesthesia seem like a pretty simple practice). AS far as the titles: Many CRNAs are ashamed of their roots as a nurse, in my opinion this is pathetic. Nursing background is what makes such good anesthesia providers. Years of patient care (besides the technical aspects as I had mentioned previously) are what make us able to make a patient and family comfortable prior to surgery and give us the ability to interprete into laymans terms what they are about to experience in the few minutes that anesthesia providers are alloted.

    The AA will survive. Flourish? is yet to be seen. See, the shortage of anesthesia providers is more of a rural problem and it is here that CRNAs can indeed function independently.

    The AA who had the problem with the Stars and Stripes article depicting the AA as an assistance needs to look inward and at their profession and see it for what it is. A profession that is prostituted by the ultimate of pimps "ASA"!!! An AA is an assistant plain and simple, this is why they where created. To be under the thumb of the AMA and the ASA.

    I do not question the ability of AAs to provide anesthesia care as there are good and bad in all anesthesia professions. I do however take a stand that if the AA is to be an assistant and trained to do so, then they should not be providing independent care. If they do, they are only letting the MDA off even easier and practicing beyond their scope (unsafe situation).

    Professionalism: good and bad in all but the most unprofessional is the MDA as those of us with long term experience in healthcare know. HOwever,I work with some great MDAs, To many MDAs have been groomed to be the "all knowing better than everyone else physician".
    If a AA is a PA then that makes everything very clear, they work under the Physicians license and liability and their scope of practice is limited to whatever that physician allows them to do.

    I hope that the family of anesthesia can know their practice, abilities and limitations and continue to work together to provide the best anesthesia care possible. Everyone be proud of what you are but always remember what you are: CRNAs, are not physicians you are highly educated nurses, AAs, are not independent anesthesia providers you are trained assistants, and MDAs, you are not GOD you are doctors!
    Feel better? And all this from a non-CRNA - I'm impressed.

    Last I looked, there is a shortage of anesthesia providers everywhere, urban, as well as rural. There are THOUSANDS of anesthesia vacancies nationwide.

    Yes, AA's work WITH the anesthesiologist. That is not some earth-shattering discovery. We've done it for more than 30 years.

    No, we were NOT created by the ASA and the AMA (where did THAT come from?). Check my upcoming AA history post for the facts.

    Oh, and just in case you didn't know, we're legally licensed in Missouri.
    Last edit by jwk on Jun 4, '04
  13. by   Trauma Tom
    Many CRNAs are ashamed of their roots as a nurse, in my opinion this is pathetic.

    I am afraid I am going to challenge you on this line. Where did you come up with this information? I have not had extensive exposure to CRNA's, however I have never met any CRNA's who were ashamed that they are nurses. In fact, all I have met have been proud of their training as nurses because they feel that being a nurse is what seperates them for other anesthesia providers. It is their background as nurses that gives them their unique perspective in dealing with the holistic care of the patient. I just completed my first day of orientation as a SRNA. The director commented during class that anyone can be taught to push medication to relieve a patient's anxiety. However, a skilled anesthesia provider can often talk to their patient to reduce their anxiety as opposed to always using medication. That is the difference between that art and science of anesthesia. I feel that as a nurse my training will help me to be that skilled anesthesia provider. Remember, CRNA stands for Certified "REGISTERED NURSE" Anesthetist.

    Quote from dneill01
    All of this talk about AA versus CRNA is making my head hurt! I am a critical Care nurse of 12 years, I have been using sedation, inotropes, vasopressors, ventilators, IABPs, PA catheters, A-lines etc.........for many years. Those of us who have worked in the ICU know that autonomy that is afforded us especially at night. Nursing school provided us the basis for our practice but experience is what makes us what we are. Not all ICU nurses are created equal and I dont favor being clumped with all because so many are lazy slugs that come in get a pay check and go home, never expending their education, and never making a contribution to their profession. I cannot concur that an AA has "paid their dues" if their BS is in philosophy. Most CRNAs have a minimum of 5 years experience in critical care. Someone had stated that MDAs dont have this experience. This is crap of course, look at the length of residency and fellowship before they can function independently. The simple fact is: the ASA has never liked the CRNA and feels threatened by the practice. The ASA has gone as far as manipulating their date of origin (of anesthesiologist speciality) to look older than it is. Nurses are the forefathers of anesthesia care. The AMA and ASA feel threatened thus the reason for creating the AA. They now still have control over the provider, and can profit from their labor. If the ASA and the AMA where truely trying to meet a need of shortage, they would be courting more anesthesiology residencies (maybe they are). Hey what a scam, I can supervise 4 rooms (all at once WOW what a feat, kinda makes you wonder how well they are supervising) and bill for all of them! I can sit in the lounge and get paid, what a great gig! The ASA belittles the practice of anesthesia when they insinuate that they can supervise 4 at a time (makes anesthesia seem like a pretty simple practice). AS far as the titles: Many CRNAs are ashamed of their roots as a nurse, in my opinion this is pathetic. Nursing background is what makes such good anesthesia providers. Years of patient care (besides the technical aspects as I had mentioned previously) are what make us able to make a patient and family comfortable prior to surgery and give us the ability to interprete into laymans terms what they are about to experience in the few minutes that anesthesia providers are alloted.

    The AA will survive. Flourish? is yet to be seen. See, the shortage of anesthesia providers is more of a rural problem and it is here that CRNAs can indeed function independently.

    The AA who had the problem with the Stars and Stripes article depicting the AA as an assistance needs to look inward and at their profession and see it for what it is. A profession that is prostituted by the ultimate of pimps "ASA"!!! An AA is an assistant plain and simple, this is why they where created. To be under the thumb of the AMA and the ASA.

    I do not question the ability of AAs to provide anesthesia care as there are good and bad in all anesthesia professions. I do however take a stand that if the AA is to be an assistant and trained to do so, then they should not be providing independent care. If they do, they are only letting the MDA off even easier and practicing beyond their scope (unsafe situation).

    Professionalism: good and bad in all but the most unprofessional is the MDA as those of us with long term experience in healthcare know. HOwever,I work with some great MDAs, To many MDAs have been groomed to be the "all knowing better than everyone else physician".
    If a AA is a PA then that makes everything very clear, they work under the Physicians license and liability and their scope of practice is limited to whatever that physician allows them to do.

    I hope that the family of anesthesia can know their practice, abilities and limitations and continue to work together to provide the best anesthesia care possible. Everyone be proud of what you are but always remember what you are: CRNAs, are not physicians you are highly educated nurses, AAs, are not independent anesthesia providers you are trained assistants, and MDAs, you are not GOD you are doctors!

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