Here's what AAs really think of CRNAs

Specialties CRNA

Published

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 with "anesthesia nurse"? If it sounds condescending in print, can you imagine how it would sound out of his mouth? What arrogance.

At least there is a phone number listed at the end of the article. Let's call Rob and let him know what we think of his little article!

Read carefully, SRNAs, this is a grim foreboding...

Licensed anesthesiologist assistants help access to medical care

By Rob Wagner

MY VIEW

Re: "Don't weaken the standards for anesthesia providers" (My View, April 11).

Maybe you or someone you know has had surgery delayed. Perhaps hospitals in your

area have closed operating rooms as they have in Miami, Jacksonville, Tampa and

elsewhere in Florida.

One reason for growing problems of this nature for patients is a shortage of

anesthesia providers. These are the assistants who help

physician-anesthesiologists perform the critical task of putting you to sleep

before surgery.

There is a common-sense solution rapidly making progress in the Florida

Legislature and around the country, which is to license anesthesiologist

assistants (called AAs). Key legislative action is expected today in Florida's

House Health Care Committee on HB 1381/SB 2332 and it is important that

lawmakers support it.

They need to be assured that this legislation will not weaken standards because

AAs are highly trained and perform the same function as anesthesia nurses. AAs

like myself serve patients in 16 states and have impeccable safety records. AAs

have worked with a high level of safety for 30 years in Georgia and Ohio.

AAs are required to have three times the hands-on, clinical training than are

most anesthesia nurses who currently assist anesthesiologists. 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. In fact, as the chief anesthetist at

St. Joseph's Hospital in Atlanta, I am in charge of both AAs and anesthesia

nurses.

If you are "going under," who would you rather have assisting the

anesthesiologist; someone trained to work directly with him or her, or a nurse?

We enjoy our professional relationships with our nursing colleagues. Yet nursing

organizations in Florida continue to misinform, even scare the public, calling

our profession "new" and "experimental."

Try telling that to the prestigious Emory University in Atlanta or Case Western

in Cleveland, which have been training AAs for more than three decades. Or try

to tell that to boards of medicine that oversee AAs in the states in which we

practice and whose members readily vouch for our safety record.

Try telling that to Medicare, the nation's largest health insurer, which

reimburses AAs and anesthesia nurses at the same rate. This means our skill

levels are viewed equally. And tell the insurance companies. They charge no

difference in fees between anesthesia nurses and AAs,

meaning our safety records are equal. Try telling that to the Florida Medical

Association, American Medical Association and American Society of

Anesthesiologists, whose members resoundingly support our working in Florida. In

the era of malpractice crisis, doctors are certainly not going to support

"experimental" health care providers.

Why, then, would the anesthesia nurses be opposed to this? In a word, money.

Because of nurse shortages, their salaries are artificially high, up to $150,000

in Florida. If you made that kind of living, wouldn't you try to keep the

competition out?

This nursing shortage is well documented on the Web sites of Florida schools

that train anesthesia nurses, the U.S. Department of Health and Human Services,

and yes, even on the anesthesia nurses' own Web site, http://www.aana.org, where the

shortage is called "serious" and "acute."

To help relieve the problem, two institutions, the University of Florida and

Nova Southeastern, are ready to open special schools for anesthesiologist

assistants in Florida. Would those schools offer programs if they didn't think

AAs are in great demand? Would they risk their reputations on an "experimental"

profession? Of course not.

One AA can mean five more patients per day will get their surgery. That's 1,200

patients per year treated with the help of only one AA. If you are or know one

of those patients, I'm sure you would be grateful to the Florida Legislature for

passing this common-sense legislation.

--------------------------------------------------------------------------------

Rob Wagner is chief anesthetist at St. Joseph's Hospital in Atlanta and

president of the American Academy of Anesthesiologist Assistants, PO Box 13978

Tallahassee, FL 32317 Phone: 656-8848.

Specializes in I know stuff ;).

Brian

If you want to understand why it is that there is friction between MDA and CRNA then you need to read watchful care. You can get it on amazon. This is the history of CRNAs and documents how MDAs have consistantly attempted to either make it illegal (via practicing medicine without a liscence) or totally restricted. This is a long standing political battle that still rages today. You may not see it in the OR because these groups have developed working relationships. However, be sure that the physician association for anesthesia is working daily to limit, restrict and remove CRNAs.

As for AAs? That topic is seperate. Imagine spending 60-70 years fighting for your place in anesthesia care vs physicians; literally challenged legally in every state in the union and then federally. Imagine fighting that constantly against a rich physician group that tends to stick togeather like glue? It is a tough road that came before us, we are on (or soon to be on :)) and its a long road ahead. Imagine now that some upstart group (read: AAs) walks in and says they can do your job with less than 1/2 the education and none of the experience?? This is NOT acceptable and cheapens the fighting CRNAs have historically done to get where they are today. You should be more than upset, you should be angry that they arrogantly post on their website that they are as safe, as educated and as efficient as a CRNA is. These are people looking to take your job. Wouldnt you be upset tommorrow if the hospital decided that a new training program for CCT critical care techs was going to help solve the RN shortage by taking ICU jobs? After all, if we do a crash course in ICU and Healthcare/nursing for one year, isnt that as good as any ICU nurse?

Dont forget, associations and their politics are what have given professions what they have and fight to maintain it.

I just found this thread, so please forgive me if I wake up a sleeping dragon!

I just wonder, what is the big deal? I would like to be a CRNA one day, but a lot of this animosity is making me rethink things. I personally don't care if some MD has to sign off on my work, so long as I can find a good job doing what I enjoy.

I did a summer experience in college where I shadowed Anesthesia in the OR at the local teaching hospital and at a private hospital. I worked with residents, attendings and CRNAs at the teaching hospital and MDAs and CRNAs at the community one. There were CRNAs at the community hospital and there was one of the MDAs who was "in charge" of the OR (I mean, all the ORs - they took turns). He was available for consult in the PACU (so someone didn't have to come out of a case...), the floor/ICU (pre-op consults) and also "supervised" the CRNAs. He basically popped in for induction and emergance and was available if needed. He said, "I've worked with these guys and trust them to do a top-notch job." So, he let them pratice pretty much on their own except as required by law.

What I'm getting at is, I wouldn't have any problem with that. It seems like an ego thing. (I don't mean to sound offensive) If there's more to it, please educate me. From what I'm reading, I see a lot of "I worked hard enough and I want my respect" kind of thing. I can certainly understand that, but in the end, isn't that just a matter of pride? Again, not to sound offensive, but is there more to it?

As far as the public not respecting me, to the extent that that hurts my employement (ie public outcry for unwarrented restrictions based on erroneuos information) that's fine. I know it's not true, my collegues know it's not true.... (BTW, off the subject, but when you introduce yourself to pts, how do you identify yourself? Most of the people I saw - MDAs and CRNAs alike - said something like, "Hi I'm Bob from anesthesia." Never saw it as an issue whether or not they id'd themselves as MDA or CRNA)

I don't understand how the AA-CRNA thing hurts CRNAs in the job market. Isn't "a lot of AAs coming in taking our work away," the same as "more CRNAs graduating"? Would CRNAs be equally upset if there was a sudden increase in people wanting to be CRNAs?

That same MDA that I worked with that sumemr was the one who told me, "it's not the intials after your name that make you good." He said that he would gladly step away from a intubation he couldn't get and let a CRNA try and vice-versa.

Please understand that I am not trying to offend, simply understand what all the fuss is about as I decide a career path for myself.

bryan

A little dated huh. Their is simply no use bringing back these old threads.

Specializes in I know stuff ;).

Nitecap

While i understand how this might get frustrating to the people who have been on this forum for sometime, i have to totally disagree. The utility of keeping this thread alive (for those who want to learn about it) should be obvious. For those who are not interested, dont read the thread, its that easy.

Enlightening new people in the CRNA profession (or like myself people about to enter) about the political issues and how it is relevant to their future is invaluable. These threads serve more than just a place to rattle swords, they also cause inquiry by newbies who may currently be isolated from the contraversies within the field of anesthesia. As someone comming into the profession, I had NO idea that it was as hard fought and tried as it has been; and no doubt will be. Increasing awareness of how important it is to be active in the association (read: politically) can be nothing but helpful to all CRNAs.

In fact, let me quote you from a post you made on this very board.

Thread: https://allnurses.com/forums/f16/atten-future-crnas-threatened-103868.html

Ok peeps listen up, I am an SRNA now finally and am pumped. Im not sure how much CRNA politics you guys are farmiliar with but I encourage you whether you are a CRNA, SRNA or future SRNA to learn as much about this as possible. Legislation in Florida and other states is ongoing that may one day effect you and your dreams.

Feeling kind of wishy-washy huh Nitecap?

First you are all gung ho as demonstrated by your first post on page two.

https://allnurses.com/forums/f16/question-about-aas-148907-2.html

Now you are saying it's dumb to revive the forum.

Make up your mind.

Feeling kind of wishy-washy huh Nitecap?

First you are all gung ho as demonstrated by your first post on page two.

https://allnurses.com/forums/f16/question-about-aas-148907-2.html

Now you are saying it's dumb to revive the forum.

Make up your mind.

Nah Im as gung ho as they come. I have debated this issue till blue in the face here and on other forums. Though a good one just feel that when a thread dies out months and months ago that reviving it again is ineffective b/c people end up aurguing or disagreeing with posts that were posted forever ago and half the time that poster wont even respond. Start a new thread and go off be my guest, I will even contribute no doubt. This forum does need to be revived and I feel like you may feel the same way.

And dont take shots at me "wishy-washy", dont forget we are on the same side here.

And dont take shots at me "wishy-washy", dont forget we are on the same side here.

Just kidding man. Wanted to get a response from you.

Me and you = soldiers for the same side. :)

Specializes in I know stuff ;).

hey hey!

Im working toward soldier!

Nitecap

While i understand how this might get frustrating to the people who have been on this forum for sometime, i have to totally disagree. The utility of keeping this thread alive (for those who want to learn about it) should be obvious. For those who are not interested, dont read the thread, its that easy.

Enlightening new people in the CRNA profession (or like myself people about to enter) about the political issues and how it is relevant to their future is invaluable. These threads serve more than just a place to rattle swords, they also cause inquiry by newbies who may currently be isolated from the contraversies within the field of anesthesia. As someone comming into the profession, I had NO idea that it was as hard fought and tried as it has been; and no doubt will be. Increasing awareness of how important it is to be active in the association (read: politically) can be nothing but helpful to all CRNAs.

In fact, let me quote you from a post you made on this very board.

Thread: https://allnurses.com/forums/f16/atten-future-crnas-threatened-103868.html

Ok peeps listen up, I am an SRNA now finally and am pumped. Im not sure how much CRNA politics you guys are farmiliar with but I encourage you whether you are a CRNA, SRNA or future SRNA to learn as much about this as possible. Legislation in Florida and other states is ongoing that may one day effect you and your dreams.

I'm all about education and debate. Lord knows I am. But here is the difference. Those who want to learn about something presented in this forum need to do exactly what you did; go back and do research on what's already been discussed. Read every post line by line and you will learn what the debate is all about. If you have questions at that point, by all means ask. I guarantee (because this has happened before) we will have a new "CRNA vs. AA" thread EVERY WEEK just for the sake of "we need to educate those who are choosing this profession" and "we have the right to debate". Debate is healthy when knowledge is present before one debates. You get the knowledge by reviewing past threads which I suggest all the newbies (those who haven't started classes yet) do. Oh yeah, congrats on your acceptance in CRNA school. Where did you decide to go?

Specializes in I know stuff ;).

hey Sigma

I have not be accepted yet, just had conversations with directors who have asked me to consider conditional acceptance. Im lucky in that i have time to decide ;)

Either Jan 07 or sept 07. Not sure which ill be in yet.

Just something to toss out to the hungry...I was speaking with an MDA last week, in the interest of HIPAA we'll leave it at that, and he wanted to talk to me because one of my co-workers told him I was soon off to na school. He comes from an "AA state" and he brought them up of his own accord and I will quote him as accurately as I remember: "AA's are just college graduates. They are like little robots that you can stick in a room and let them do the standard stuff. It is much better to be a crna. He's laughs and says again they are just little robot college grads." I'm not trying to cut anyone down. Never met an AA, sure they are nice folks. I just found his unsolicited commentary interesting.

Specializes in I know stuff ;).

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.

Just something to toss out to the hungry...I was speaking with an MDA last week, in the interest of HIPAA we'll leave it at that, and he wanted to talk to me because one of my co-workers told him I was soon off to na school. He comes from an "AA state" and he brought them up of his own accord and I will quote him as accurately as I remember: "AA's are just college graduates. They are like little robots that you can stick in a room and let them do the standard stuff. It is much better to be a crna. He's laughs and says again they are just little robot college grads." I'm not trying to cut anyone down. Never met an AA, sure they are nice folks. I just found his unsolicited commentary interesting.
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
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