Here's what AAs really think of CRNAs - page 24

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   firstaiddave907
    Quote from nec
    Waiting to hear your reply to Nilepoc, please educate us on your scope of practice and your training, I am not familar with AA's so please tell us your experience and your background if you would thank younec
    I agree with you nec
  2. by   firstaiddave907
    thanks for the clarification nec
  3. by   jwk
    Quote from MmacFN
    Now this is an excellent post/point

    The thing is, this is exactly what the history of of CRNA vs MDA has been. They want robots and CRNAs want autonomy and responsibility.

    Im surprised you has someone suggest a CRNA was better. Cool fellow and clearly a team player in the best interest of the patient.
    Ya know - there's now over 300 posts and 31 pages in this thread. Why don't you newcomers do a search instead of just fanning the flames. Nitecap and I actually agree (holy crap, how did that happen?)

    As far as Rayman's post - total BS. Don't throw the HIPAA crap up. All that shows is that you're probably making it up and trying to use that as an excuse not to include any identifying info (feel free to PM me with specifics - not that I have any illusions that you would have the guts to do that).

    And Mike - you're not even accepted to a CRNA school (conditional ain't in yet) yet somehow you feel like you understand the politics of this debate. Gimme a break.
  4. by   K_A_T
    Before we are
    allowed to enter AA school, we must take the same courses physicians take as
    pre-med students. Nurses do not do that.
    That's not correct. I took more than what med students take in order to get into med school. Med students are NOT required to take physiology in order to get into med school. Atleast to a fair number of med schools in the nation. I know this to be a fact, as my friend had ONLY anatomy and O chem I and II with physics, etc behind him WITHOUT physiology and he is currently enrolled in med school. He takes physiology IN med school.

  5. by   Jo Dirt
    Quote from georgia_aa
    Okay - I can't stand it any longer.

    I am an AA with over 14 years of experience and currently practicing in Georgia. I have nothing but the highest regard for my CRNA colleagues and count some of them as among my closest friends. The article that you are referring to was written by Rob Wagner our association president over 1 year ago during the unsuccessful bid for licensing legislation in Florida in 2003. If you do a Google search, his is the ONLY article that you will find written by an AA attempting to set the record straight. Meanwhile you will find article after article and editorial upon editorial written by CRNA's calling us a bunch of incompetents. Now I ask you, who has been more professional and courteous through this whole thing.

    Rob's characterization of AA's functioning the same as CRNA's is exactly correct in medically directed departments. Here in Georgia, our job descriptions and salaries are exactly the same (I made over $160k last year). That's alot of money for a tech isn't it?? .

    If you would like to engage in a friendly discussion about AA's in an attempt to educate yourselves about us, I would be very happy to participate. Please understand, I am PRO - CRNA. I have no reason not to be. I work by definition under the supervision of an MDA. I can't practice alone, nor do I want to. If you want to flame me and get me thrown off the forum, be my guest. But it would behoove you to learn more about us because we will be coming soon to a state near you.
    How do I become an AA?
  6. by   MmacFN
    jwk

    How long have you been in health care and its politics again? Oh thats right, stop lecturing me this isnt my first rodeo just a different set of clowns.

    I know about the politics because ive researched them throughly. Ive read both sides of the argument as well as all the position papers. Oh yes, and i have EXPERIENCE in healthcare that you clearly lack.

    Now, please, take your lack luster education and stop posting on a NURSE website. All your being here proves is how willing you are to fight for acceptance amoung a group that will NEVER accept AAs, get over it.

    I feel the same way about lesser providers such as paramedics being in the ER (BTW im a paramedic as well) or LPN filling RN positions. The politics are identicle.

    Quote from jwk
    Ya know - there's now over 300 posts and 31 pages in this thread. Why don't you newcomers do a search instead of just fanning the flames. Nitecap and I actually agree (holy crap, how did that happen?)

    As far as Rayman's post - total BS. Don't throw the HIPAA crap up. All that shows is that you're probably making it up and trying to use that as an excuse not to include any identifying info (feel free to PM me with specifics - not that I have any illusions that you would have the guts to do that).

    And Mike - you're not even accepted to a CRNA school (conditional ain't in yet) yet somehow you feel like you understand the politics of this debate. Gimme a break.
    Last edit by MmacFN on Mar 27, '06
  7. by   jwk
    Quote from MmacFN
    jwk

    How long have you been in health care and its politics again? Oh thats right, stop lecturing me this isnt my first rodeo just a different set of clowns.

    I know about the politics because ive researched them throughly. Ive read both sides of the argument as well as all the position papers. Oh yes, and i have EXPERIENCE in healthcare that you clearly lack.

    Now, please, take your lack luster education and stop posting on a NURSE website. All your being here proves is how willing you are to fight for acceptance amoung a group that will NEVER accept AAs, get over it.

    I feel the same way about lesser providers such as paramedics being in the ER (BTW im a paramedic as well) or LPN filling RN positions. The politics are identicle.
    Yeah I know - you've got a zillion initials after your name. Big deal. So do I , but I don't really feel the need to use them. You've only READ about the whole CRNA/AA/MD political happenings, but you've not been INVOLVED in it.

    I'm not sure what experience you think I lack - I've been in anesthesia since 1979 (27 years and counting, certainly more than you) and, oh yeah, a paramedic here as well. I don't presume to spout off about things I know nothing about. However, clinical anesthesia and the politics of the professions are not in that list.

    As far as my "lack luster education", I had a master's degree in anesthesiology while CRNA programs were still handing out certificates to RN's with associates degrees and hospital diplomas.

    Funny - you have no problem posting on the physician and PA websites, yet now that you're a CRNA wannabee somehow feel you can tell me to disappear? Right.

    I help run the anesthesia department for the busiest surgical hospital in the southeast - almost 40,000 cases a year. I work with dozens of CRNA's every single day, and they do a great job. I don't have a single bad thing to say about any of them. As with so many others who post here - you've never met an AA much less worked with one, you don't know anyone who knows one, so you simply take the propaganda of the AANA at face value and assume it's correct. You've read "both sides of the argument" as presented by just one side. And here you are, not even IN the profession and thinking you know more about it than I do. That's laughable. And although nitecap and I (and deepZ, and rn29306, and others) will disagree, sometimes vehemently, about our professions, at least they have a little bit of a basis for their opinions. You don't.

    Sure, I'll keep fighting for the acceptance of my profession. You think I'm going to stop because of you? Hardly. Most people on this board obviously won't be swayed. Fine - I understand that. Will I let misconceptions or outright lies slide by unchallenged? Nope, sorry, ain't gonna happen.
    Last edit by jwk on Mar 27, '06
  8. by   georgia_aa
    JWK -



    Okay - why you guys resurrected this old thread is beyond me but I'll play.

    Here's how my day went today:

    Met my patient in preop. He's posted for an off-pump CABG X 4 with bilat. mammaries. He's got a normal EF but has unstable angina and is on heparin and NTG. He had a right Carotid endarterectomy last Wednesday. I put in a 16g IV and art-line. PA catheter has to go on the left side. I have a little trouble locating the IJ and finally get it using a Sono-site Ultrasound machine. I then float the PA catheter without problem. BTW - all of this took place without an attending in sight.

    Attending present for induction and TEE exam. After that, I'm on my own for the take down of the mammaries and the first graft to the LAD. The patient got a little ischemic during the LAD anastamosis but it was never a real concern. During the distal to the RCA, the patient's lateral leads began to display some rather ominous ST changes. I call my attending because the patient was starting to develop ectopy and looked like he was getting ready to arrest. I didn't call him because I was unsure of what to do, I called him because if an arrest was imminent, it was going to take both of us to get him through it safely. The surgeon ended up shunting the vessel, and the ST's came back down. With that potential problem averted, my attending left the room and that was the last I saw of him the rest of the case.

    The anesthesia care team approach worked exactly as intended during this case. My attending knew that I would recognize when the patient was getting into trouble and that I would not try to handle a potentially disastrous situation myself. With that trust, he knew that he could leave me to manage the entire case without him.


    I can assure you of two things:

    1) I am not a robot (whatever that means).
    2) That patient today got excellent care.

    BTW - since this thread's inception, two more AA programs have started up bringing the total to 5. The latest is at Univ of Missouri School of Medicine in KC. This one is significant because it is the first program in a public university and it's also the first AA program west of the Mississippi. There are 3 others in the works, two of which are at major university departments and will be huge for the advancement of AA practice when they are announced.
    Last edit by georgia_aa on Mar 27, '06
  9. by   rayman
    As far as Rayman's post - total BS. Don't throw the HIPAA crap up. All that shows is that you're probably making it up and trying to use that as an excuse not to include any identifying info (feel free to PM me with specifics - not that I have any illusions that you would have the guts to do that).

    jwk,

    I tried to pm you, but it says your box is full and it won't accept it until you delete some stuff...should I accuse you of being gutless now? I will therefore put most of the response here...minus the stuff that would be censored...I not only have guts, my friend, but I have a pair of B!@! too. Seriously, the guy was a patient in my unit last week and was a MDA from a midwest state, I am in the south. He wanted to shoot the breeze with me and what i posted was what he said...that's what quotation marks mean. I didn't say a word about aa's , they aren't even used in my state to my knowledge...the dude just spewed it out on his own. If you will notice I said it was something to throw out to the hungry as I know some wil jump on it like hyenas. I also said "I'm sure you are a nice group of folks". I wasn't trying to personally offend, I've seen docs act like me and others were the best thing since sliced bread, but once they are around others from their "peer group" we are just like something the stuck to their shoes off of the sidewalk...seems like same case here. I've enjoyed your posts and am smart enough not to even pretend I know a fraction of the anesthesia that you do at this point. Yes it stirred sh$%, but the dude said it. I wouldn't make up crap to piss someone off...that's easy enough to do legitemately. I wasn't trying to bust your ba%^#....don't question mine.

    Ray

    ps..empty your box if you really want pm's
  10. by   MmacFN
    Heh

    Let me say a few things since you dont know me either.

    You've only READ about the whole CRNA/AA/MD political happenings, but you've not been INVOLVED in it.

    That is true, i am not a stake holder. However, I have spent much time discussing it with MDAs & CRNAs before I made the decision to persue the CRNA profession. From my perspective after hearing each biased side (i suppose including yours here), I have a firm grasp on the politics of an issue which has faced nurses since the beggining of time, fighting for, lobbing for and protecting a niche in the health care field. Its not new.

    I'm not sure what experience you think I lack - I've been in anesthesia since 1979 (27 years and counting, certainly more than you) and, oh yeah, a paramedic here as well. I don't presume to spout off about things I know nothing about. However, clinical anesthesia and the politics of the professions are not in that list.

    Yes you have been in anesthesia longer than i have (which would be 0 years). However, that dosent make me ignorant to the politcs which occur. I came to the USA without any of those hang up (since CRNAs, AAs, PAs do not exist in Canada). I was not indoc'd like many ppl suggest RNs are toward MDAs and AAs. Im educated and certainly able to figure out the politics of economy, which is exactly what this is all about. lets follow a basic timeline

    Anesthesia is needed
    -> Interns suck at it because they want to be surgeons
    -> No MD wants to do it as it isnt profitable.
    -> RNs take over the job and the niche is filled (and compentantly)

    MDs see anesthesia is profitable
    -> All the sudden the MD Anesthesiologist is born.
    -> MDs and RNs fight it out for years with numerous salient case law backing RNs.

    AAs ?

    Come out of nowhere without history, need or justifiable existance.
    translation = Want a piece of the money pie.

    If an RN is 4 yrs BSN and 2 years critical care (on average its much higher numbers) then 2-2.5 years CRNA = min total 8.5 years.
    AA = 6 with no relevant experience in health care needed Whatsoever.


    Hello LPN, hello emt-p in the ER. You think these politics are new to me? Ive been fighting them for 10 years. Same story different intitials. Lower level of education to assume the same job claiming "need"

    Its an age old easy formula. Im not saying its wrong, but call a spade a spade.

    As far as my "lack luster education", I had a master's degree in anesthesiology while CRNA programs were still handing out certificates to RN's with associates degrees and hospital diplomas.

    Hey I think thats great. Im all for education and I dont pretend to know more about anesthesia than you do at all.

    Funny - you have no problem posting on the physician and PA websites, yet now that you're a CRNA wannabee somehow feel you can tell me to disappear? Right.

    I was posting on SDN (for over 2 years btw) because i was trying to decide between medical school and CRNA school. Its called The Student Doctor Network because people pre med and in med post there. In order to avoid regret, i had decided i couldnt make the decision until i had an acceptance in my hands. Hence the reason i have all the pre reqs and was accepted to an Irish school. After doing my research, i decided against it and for CRNA school.

    I dont post on PA sites.

    Sorry jwk, but if you think that it isnt Trolling and suspicious that an AA is posting and promoting AAs on a website called ALLNURSES.com you must be clinically insane. How can you expect any other reaction? I dont pop onto the AA forums (i assume there are some) and yap about it. Nor do i frequent physician websites and promote nursing. It screams of a need for acceptance that, in spite of all your achievements, is elusive.

    I help run the anesthesia department for the busiest surgical hospital in the southeast - almost 40,000 cases a year. I work with dozens of CRNA's every single day, and they do a great job. I don't have a single bad thing to say about any of them.

    Hey, congratz, clearly you have worked hard for that goal. You are probably a great guy. Im not trying to pass judgement on your personality, simply the politics of your job title.

    As with so many others who post here - you've never met an AA much less worked with one, you don't know anyone who knows one, so you simply take the propaganda of the AANA at face value and assume it's correct.

    In fact that is absolutely true and i dont need to meet one, all i have to do is read the drivel on your assoc. website. Speaks volumes about the motives and Modus operandi promoted by your group. I dont assume what anyone, or any group says is truth without doing my own research. Ive done it and come to my own conclusions. This is not a comparison just an analogy; I dont have to know a theif to create an informed opinion of him.

    You've read "both sides of the argument" as presented by just one side. And here you are, not even IN the profession and thinking you know more about it than I do. That's laughable.

    Your misquoting me. I never said i know more about the profession. What i said is that ive been apart of these politcs for a very long time. They arent new. Again, simply changing the initials.

    Sure, I'll keep fighting for the acceptance of my profession. You think I'm going to stop because of you? Hardly. Most people on this board obviously won't be swayed. Fine - I understand that.

    Then why are you here?

    Will I let misconceptions or outright lies slide by unchallenged? Nope, sorry, ain't gonna happen.

    Hey thats OK. I would (and have) fight for my own group in the same way.

    This isnt personal, its political. This isnt the "various workers in anesthesia" .com site. Its for nurses of all types. If i wanted to be an AA (which i researched as I did CRNA) id be over there asking questions. I dont. Again, why are you even here but to promote your own agenda? You have to see that as odd. Even long time ppl on this site have PM'd me stating they think it as well, im just the guy who says it out loud.

    Anyway, regardless of how irrelevant this argument is, it makes for good reading and increased posting. Politics aside, we are making it interesting
  11. by   zaggar
    As a nursing student, I hope to heal patients sometime soon, and to do what I believe God has called me to do.

    Like most nursing students, I have considered what the future may hold. So, I have contemplated running all the way up the education ladder to CRNA.

    But the greed, ego and protectionist issues are a turn off that remind me of times past.

    As a former computer programmer, this conversation reminds me of the conversations I used to hear between egocentric dot-com'ers. Let me just summarize by saying a lesson in humility was brought upon us all.

    Be hostile to each other all you wish, but face the facts - if you are ANY employee earning more than $100K, there are legions of managment personnel who are committed to replacing you. Eventually they will win.

    P. S. - Bonus points for the "Until you've served in Vietnam" / "Performed an enema" / "Walked 6 miles up hill to school each day" arguments. Those were great. Because, yeah, I DID perform enemas on my way to school in the snowy jungle!
  12. by   FL-RN
    Just read this whole thread - wow.

    Brief intro: I'm an SICU nurse of 5 years, finishing the BSN bridge this semester and have interviewed for a CRNA program this fall.

    Deepz, I've enjoyed your posts greatly, and you've given me some real insight into the politics underlying this issue.

    My two cents: I think that any anesthesia provider without significant "bedside" type experience (MDA and AA) is going to be at a disadvantage for some time when beginning practice. An example is this semester when I shadowed a CRNA for 180 hours as part of the BSN coursework. It was in an "anesthesia team" practice with 1 MDA overseeing around four rooms that could have CRNA's or MDA-residents. When providing a lunch break to an MDA-resident with a CRNA for a CABG case I witnessed firsthand why the CRNA's spoke so poorly of some of the residents... ACT's not done timely, proper meds not drawn up and ready, Nitro gtt infusing onto the floor, dosing "cheat sheet" w/ wrong pt. weight, etc. Basically a comedy of novice mistakes and general disorganization. And this provider would soon be in a sort of "supervisory" role as she was in the latter half of her last year. For what it's worth, I think all the talk of prereq's and such is of far less concern than actual hands-on experience. Time management and organization is so much more critical in anesthesia.
  13. by   rn29306
    Quote from FL-RN
    An example is this semester when I shadowed a CRNA for 180 hours as part of the BSN coursework.


    Man I tried to do this as a part of my BSN coursework in my last semester and the program nixed it. That's awesome they allowed you to do that.

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