Here's what AAs really think of CRNAs - page 21

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   apaisRN
    Quote from Nitecap
    Isn't this thread like 4-5 months old. Please quit bumping this thread back up. The debate between the 4-5 original peeps is over, quit trying to start a fire on the forum with ancient threads. Visit the forum more often if you want in on these types of threads.
    The debate appears to be alive and well. Relax.
  2. by   SnowymtnRN
    Quote from Nitecap
    Isn't this thread like 4-5 months old. Please quit bumping this thread back up. The debate between the 4-5 original peeps is over, quit trying to start a fire on the forum with ancient threads. Visit the forum more often if you want in on these types of threads.
    sheesh. don't read it if it bugs you.
  3. by   SnowymtnRN
    Right On! lol
    Last edit by TraumaNurse on Nov 8, '04
  4. by   gregsto
    [QUOTE=Carolina SRNA]I
    Now the REAL TRUTH...it's not that AAs drive the market down in Atlanta...it's that the combination of the enormous amount of AAs there and also the CRNAs somewhat saturate the market in the metro area.

    There is NO saturation of the market in Atlanta. In fact, there is a SHORTAGE of CRNA's/AA's. Job placement is 100%. Many facilities are struggling to fill their schedules. The simple fact is, in the eyes of the MDA's, AA's are there to assist their practice. The see CRNA's no differently and they certainly aren't going to pay their "assistant" the wages of the CRNA. Having worked in Atlanta, I can see no other explanation. Job saturation simply does not exist.
  5. by   surgpa
    "I am licensed as a PA in the state of Georgia. I hold the same physical license as a surgical PA, cardiac PA and so forth. The difference is that I am delineated as a subclass of PA with a job description on file with the state licensing board. In that description are most of the duties commonly performed by anesthetists. Anything not covered in that description can be delegated to me by my sponsoring physician. In my practice, I do not perform regional blocks, but neither do our CRNAs. I do, however, know many AA's that routinely perform spinals and epidurals everyday. I am primarily a cardiac anesthetist. I place all of my own lines including PA catheters. I can perform femoral cannulation and IJ cannulation but am not permitted to perform a subclavian stick (neither are the CRNAs). Again we are totally interchangable."

    Question:

    Are you suggesting you are the same as a "surgical PA, cardiac PA" or even the primary care PA, who is a different animal altogether? Or, are you suggesting you are a "specialty PA" who is not certified under the NCCPA? I know that both coexist, but very few are both the NCCPA critter and an AA.

    Mike
  6. by   jwk
    Quote from surgpa
    "I am licensed as a PA in the state of Georgia. I hold the same physical license as a surgical PA, cardiac PA and so forth. The difference is that I am delineated as a subclass of PA with a job description on file with the state licensing board. In that description are most of the duties commonly performed by anesthetists. Anything not covered in that description can be delegated to me by my sponsoring physician. In my practice, I do not perform regional blocks, but neither do our CRNAs. I do, however, know many AA's that routinely perform spinals and epidurals everyday. I am primarily a cardiac anesthetist. I place all of my own lines including PA catheters. I can perform femoral cannulation and IJ cannulation but am not permitted to perform a subclavian stick (neither are the CRNAs). Again we are totally interchangable."

    Question:

    Are you suggesting you are the same as a "surgical PA, cardiac PA" or even the primary care PA, who is a different animal altogether? Or, are you suggesting you are a "specialty PA" who is not certified under the NCCPA? I know that both coexist, but very few are both the NCCPA critter and an AA.

    Mike
    Read his quote again. IN GEORGIA, AA's are licensed as PA's. That's the way it was first set up 35 years ago and remains so to this day. Every PA licensed in Georgia has a specific job description on file with the state. Included in every AA's job description (and state law) is the requirement that an AA can only work with an anesthesiologist licensed in the state of Georgia.

    AA's ARE NOT the same as a surgical PA, cardiac PA, etc. We don't profess to be. We aren't suggesting that we are. Are you trying to confuse the issue, because we certainly aren't.

    The reason AA's are licensed as PA's in Georgia is that the original PA concept envisioned almost 40 years ago had a provision for both general (Type A) PA's and specialty (Type B) PA's. AA's would obviously fall into the latter category, and were thus licensed as PA's in Georgia, with specific language in their job descriptions limiting them to the practice of anesthesiology. Newer states coming online with AA's (Missouri, Vermont, South Carolina, Florida, etc.) all license us specifically as AA's, not PA's.

    There are a handful of dual certification PA / AA's, holding certification both from the NCCPA and the NCCAA. Those folks can work in any state performing anesthesia unless there is specific language in that state's PA law that prohibits it. There have been several PA/AA's working in Florida for years.
  7. by   Laughing Gas
    Alittle late to the party here. I will admit that I did not read all 27 pages of debate, so if I missed this please excuse me.

    All parties involved here seem to be focused on the mechanics of anesthesia. A monkey can intubate and a smart monkey can perform SAB. My point being that it takes only minimal preparation to become able to even haphazardly perform the technical aspects of anesthesia. While some CRNA's didn't like the fact that they may have had to take tons of research and theory classes, this is what helps to delineate us from a tech status. We have a body of knowledge and research that is intentionally different from medicine. We bring an aspect to anesthesia that no other provider can MD and AA alike. All providers can arrive at the highest level of technical proficiency with practice. Only CRNA's can bring safe patient focused nurse anesthesia to the party.

    I paid my dues for 8 years as an RN. I have worked to get where I am. I am not ashamed to admit that like any other profession, I do not want to see my job prospects be altered by an outside force. AA's around this area make from 1/2 to 3/4 as much as a CRNA. The motivation to hire them is usually a financial one from the people I have spoken to. I spoke to an anesthesia director who told me that as long as he can get 2 AA's for 1 CRNA, he will continue to seek out AA's.

    Don't mean to step on any one's toes. Just my .02
  8. by   surgpa
    Quote from laughing gas
    alittle late to the party here. i will admit that i did not read all 27 pages of debate, so if i missed this please excuse me.

    all parties involved here seem to be focused on the mechanics of anesthesia. a monkey can intubate and a smart monkey can perform sab. my point being that it takes only minimal preparation to become able to even haphazardly perform the technical aspects of anesthesia. while some crna's didn't like the fact that they may have had to take tons of research and theory classes, this is what helps to delineate us from a tech status. we have a body of knowledge and research that is intentionally different from medicine. we bring an aspect to anesthesia that no other provider can md and aa alike. all providers can arrive at the highest level of technical proficiency with practice. only crna's can bring safe patient focused nurse anesthesia to the party.

    i paid my dues for 8 years as an rn. i have worked to get where i am. i am not ashamed to admit that like any other profession, i do not want to see my job prospects be altered by an outside force. aa's around this area make from 1/2 to 3/4 as much as a crna. the motivation to hire them is usually a financial one from the people i have spoken to. i spoke to an anesthesia director who told me that as long as he can get 2 aa's for 1 crna, he will continue to seek out aa's.

    don't mean to step on any one's toes. just my .02
    hello, laughing gas

    a few things here that interest me. i am neither an aa or crna, so i do not have an axe to grind.

    i am interested in what you mean by nurse anesthesia versus that pesky old medical anesthesia. what exactly differeniates the two? is it a more caring attitude while you administer the anesthesia? please be concise and not euphoric in your description.

    just how does this research and theory component of your crna program make you a better anesthetist compared to an aa? again, please be specific. does my having a doctoral degree make me better as a pa? only if i'm working on policy analysis or research related questions, otherwise, i write scrips for amoxicillin just like everybody else.

    i am interested by your thoughts on aas making significantly less than crnas. is this about who makes more or who can administer anesthesia proficiently? the only objection i have here is that money always seems to be a big part of the argument. i have looked at aa and crna curriculum and they seem fairly much the same. you both earn masters degrees. i do agree with you that the aas are not expected to have any significant clinical experience, which in my humble opinion, is the great equalizer.

    is there common ground between aas and crnas? i hope so. both are here and i don't see anyone throwing in the towel. good luck to you all.

    mike
  9. by   Laughing Gas
    Quote from surgpa
    hello, laughing gas

    a few things here that interest me. i am neither an aa or crna, so i do not have an axe to grind.

    i am interested in what you mean by nurse anesthesia versus that pesky old medical anesthesia. what exactly differeniates the two? is it a more caring attitude while you administer the anesthesia? please be concise and not euphoric in your description.

    just how does this research and theory component of your crna program make you a better anesthetist compared to an aa? again, please be specific. does my having a doctoral degree make me better as a pa? only if i'm working on policy analysis or research related questions, otherwise, i write scrips for amoxicillin just like everybody else.

    i am interested by your thoughts on aas making significantly less than crnas. the only objection i have here is that money always seems to be a big part of the argument. i have looked at aa and crna curriculum and they seem fairly much the same. you both earn masters degrees. i do agree with you that the aas are not expected to have any significant clinical experience, which in my humble opinion, is the great equalizer.

    is there common ground between aas and crnas? i hope so. both are here and i don't see anyone throwing in the towel. good luck to you all.

    mike
    good thing you have no axe to grind, otherwise you would have sounded opinionated had you not prefaced your post.

    crna versus md anesthesia; asking me to sum this up without euphoria (again, glad you have no axe to grind), can be assessed in numerous ways depending on what nursing system theories you are working with. if you truly seek a thourough answer for your own edification, i suggest you read some nursing theory books. in pedestrian terms, yes i feel it is a more caring approach. medicine seeks to cure disease. nursing attempts to deal with the effects of disease. if you are looking for easily defined lines between nurse and md anesthesia in clinical settings, they are blurred. the processes that formulate the how's and why's are different. i was not attempting to draw comparisons, simply that there is a difference and that the alternative views of nurse anesthesia greatly expand the capabilities of the anesthesia team.

    your comments on theory and research indicate a lack of vision if you truly believe what you posted. a body of research knowledge allows you to advance your practice. i hope that you do not honestly feel that your phd makes you simply qualified to write scripts for ear infections. we focus on patient anxiety and alternative methods of augmenting already accepted regimens. on a day to day basis does this make an crna better than an aa clinically? absolutely not! it does provide evidence that crna's use their body of knowledge to advance anesthesia... many times in close collaboration with md's. anesthesia is a team sport.

    is this about who makes more or who can administer anesthesia proficiently?
    as for money...no it is not about crna's making more money. it was an illustration showing that decisions to hire aa's are based on hospitals having to spend less money. there is more to anesthesia than the daily grind of intubate, extubate, repeat. if you hire crna's you get more than technical skill. in case you are unaware, every decision that health care administrators make is somewhere based in finances. it is a business.

    clinical experience is another major plus for crna's. many of us have years upon years of clinical experience in numerous fields of patient care. this background only augments an already very well rounded history and prepatory process.

    most definitely there is common ground between crna's and aa's. we are all concerned with safe anesthesia for the patient. it is my opinion, and the opinion of some state legislatures that crna preparation is the gold standard for certification of anesthetists. crna's provide an overwhelming number of yearly anesthetics in the us with an outstanding safety record.
  10. by   surgpa
    Quote from Laughing Gas
    Good thing you have no axe to grind, otherwise you would have sounded opinionated had you not prefaced your post.

    CRNA versus MD anesthesia; Asking me to sum this up without euphoria (again, glad you have no axe to grind), can be assessed in numerous ways depending on what nursing system theories you are working with. If you truly seek a thourough answer for your own edification, I suggest you read some nursing theory books. In pedestrian terms, yes I feel it is a more caring approach. Medicine seeks to cure disease. Nursing attempts to deal with the effects of disease. If you are looking for easily defined lines between nurse and MD anesthesia in clinical settings, they are blurred. The processes that formulate the how's and why's are different. I was not attempting to draw comparisons, simply that there is a difference and that the alternative views of nurse anesthesia greatly expand the capabilities of the anesthesia team.

    Your comments on theory and research indicate a lack of vision if you truly believe what you posted. A body of research knowledge allows you to advance your practice. I hope that you do not honestly feel that your phd makes you simply qualified to write scripts for ear infections. We focus on patient anxiety and alternative methods of augmenting already accepted regimens. On a day to day basis does this make an CRNA better than an AA clinically? Absolutely not! It does provide evidence that CRNA's use their body of knowledge to advance anesthesia... many times in close collaboration with MD's. Anesthesia is a team sport.

    Is this about who makes more or who can administer anesthesia proficiently?
    As for money...no it is not about CRNA's making more money. It was an illustration showing that decisions to hire AA's are based on hospitals having to spend less money. There is more to anesthesia than the daily grind of intubate, extubate, repeat. If you hire CRNA's you get more than technical skill. In case you are unaware, every decision that health care administrators make is somewhere based in finances. It is a business.

    Clinical experience is another major plus for CRNA's. Many of us have years upon years of clinical experience in numerous fields of patient care. This background only augments an already very well rounded history and prepatory process.

    Most definitely there is common ground between CRNA's and AA's. We are all concerned with safe anesthesia for the patient. It is my opinion, and the opinion of some state legislatures that CRNA preparation is the gold standard for certification of anesthetists. CRNA's provide an overwhelming number of yearly anesthetics in the US with an outstanding safety record.
    Hi, Laughing Gas

    Thanks for your thoughtful reply. Having known many CRNAs and MDAs over the years, I understand what you are saying. I just wanted to see what your take on it was.

    I have not as of yet worked with any AAs, so I'll reserve my comments until I do. Truth be told, I wanted to become a CRNA many years ago, but somehow ended up a surgical PA. Go figure.

    My comment on my doctoral degree was that it did not necessarily make me a better clinician, but enables me to delve into other aspects of medicine. As to the money issues, it is a sad commentary that we have become the "Wal-Mart" model of providing healthcare....the cheaper, the better. That does not jive with reality since we are not producing widgets here.

    In any event, continued good luck to you all. Thank you for the enlightenment regarding the current status of CRNAs and AAs.

    Mike
  11. by   Laughing Gas
    Quote from surgpa
    Hi, Laughing Gas

    Thanks for your thoughtful reply. Having known many CRNAs and MDAs over the years, I understand what you are saying. I just wanted to see what your take on it was.

    I have not as of yet worked with any AAs, so I'll reserve my comments until I do. Truth be told, I wanted to become a CRNA many years ago, but somehow ended up a surgical PA. Go figure.

    My comment on my doctoral degree was that it did not necessarily make me a better clinician, but enables me to delve into other aspects of medicine. As to the money issues, it is a sad commentary that we have become the "Wal-Mart" model of providing healthcare....the cheaper, the better. That does not jive with reality since we are not producing widgets here.

    In any event, continued good luck to you all. Thank you for the enlightenment regarding the current status of CRNAs and AAs.

    Mike
    Agreed!
    I am really not judging AA's. Truth be told I have never even seen a real live breathing one. I am sure that they are sufficiently trained to administer safe anesthesia. But I feel that the comparisons that are being assumed make CRNA's and AA's sound interchangeable.

    Your phd does allow you to see beyond many of your cohort's scope due to your realization of more abstract and theoretical topics. I was hoping your statement was rhetorical and not literal!

    So many of today's practitioners have had to make addendums to their credo... cost effective care. ie, keep it cheap, use as little as possible, and keep your patient safe.

    What area of surgery do you cover?
  12. by   jwk
    Oh god, where do I begin?

    Quote from Laughing Gas
    Alittle late to the party here. I will admit that I did not read all 27 pages of debate, so if I missed this please excuse me.
    Maybe you should read all 27 pages - it will enlighten you significantly. Much of this has been discussed ad nauseum.

    Quote from Laughing Gas
    While some CRNA's didn't like the fact that they may have had to take tons of research and theory classes, this is what helps to delineate us from a tech status. We have a body of knowledge and research that is intentionally different from medicine. We bring an aspect to anesthesia that no other provider can MD and AA alike. All providers can arrive at the highest level of technical proficiency with practice. Only CRNA's can bring safe patient focused nurse anesthesia to the party.
    So MD's and AA's are only techs because they don't have NURSE before or after their name?

    Quote from laughing gas

    I paid my dues for 8 years as an RN. I have worked to get where I am. I am not ashamed to admit that like any other profession, I do not want to see my job prospects be altered by an outside force.
    Here's a news flash - I have paid my dues as well.

    Quote from Laughing Gas

    AA's around this area make from 1/2 to 3/4 as much as a CRNA. The motivation to hire them is usually a financial one from the people I have spoken to. I spoke to an anesthesia director who told me that as long as he can get 2 AA's for 1 CRNA, he will continue to seek out AA's.
    I'll challenge that statement as 100% BS. It is blatantly false.

    AA's and CRNA's working for the same practice with comparable level of experience in anesthesia make the same. I would challenge you to cite even one specific example where an AA is paid 1/2 of what a CRNA would be paid at a given facility. I am familiar with many of the anesthesia practices in Ohio that employ both AA's and CRNA's. There is NO such disparity in compensation as you claim.

    Quote from Laughing Gas
    Don't mean to step on any one's toes.
    Sure you do!
  13. by   jwk
    Quote from laughing gas
    good thing you have no axe to grind,
    as if you don't.

    Quote from laughing gas
    on a day to day basis does this make an crna better than an aa clinically? absolutely not! it does provide evidence that crna's use their body of knowledge to advance anesthesia... many times in close collaboration with md's. anesthesia is a team sport.
    so you're saying that aa's have no body of knowledge? gee, why did i take all those medical school physiology classes and all that pharmacology stuff?

    and wait - did i hear a crna say something about anesthesia team?

    Quote from laughing gas
    is this about who makes more or who can administer anesthesia proficiently?as for money...no it is not about crna's making more money. it was an illustration showing that decisions to hire aa's are based on hospitals having to spend less money. there is more to anesthesia than the daily grind of intubate, extubate, repeat. if you hire crna's you get more than technical skill.
    i've already spoken to the financial issue. and if you hire aa's, you certainly get more than technical skill as well.

    Quote from laughing gas
    it is my opinion, and the opinion of some state legislatures that crna preparation is the gold standard for certification of anesthetists. crna's provide an overwhelming number of yearly anesthetics in the us with an outstanding safety record.
    ah, you must be a fan of the louisiana state legislature. there was not a single piece of original thought in that legislation. they essentially did a "cut and paste" from an aana brochure or article and plugged it into a piece of legislation.

    yes crna's provide a majority of anesthetics in this country. that's pretty simple math to figure out - no earth-shattering revelation there.

    aa's provide safe and competent anesthesia care every day, also with an outstanding safety record. no studies exist comparing aa and crna safety records. but i can tell you that malpractice insurors that provide coverage for both providers have seen no difference in claims between the two.

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