Here's what AAs really think of CRNAs - page 8

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   CougRN
    Quote from alansmith52
    this a vauge discription of classes. what does "pre-med" classes mean. I always thought of "pre-med" as code for I dont' know what the hell i wanna do but i like science.
    anatomy, check
    physiology check
    micro check
    chem check
    nurtition check
    phycology check
    human developent check
    pathophysiology again check
    what is the diffrence in what we do and what they do?????
    physics?? lol.. is that it. physics.. hmmmmmmmm
    not to say you are wrong but most nurses don't take the upper level chem or biology classes. so there is a difference there. and only one of the AA schools requires the MCAT, Case I think. just clarifying these two points.

    gregsto, i really enjoyed your post. especially since you have first hand knowledge.
  2. by   Athlein1
    thanks much for the input swumpgas and gregsto. good to hear from you!

    and crnastudent, a 2.75 gpa and mcat 20 aren't going to get you into any med school worth its accreditation unless you go offshore, have a fairy godmother, or buy your admission. so, cwru's minimal standards are lower for aas than future physicians.

    i just dislike the notion that someone who majored in something like art history and can eloquently describe the difference between monet and manet, but who has never even touched a patient as a caregiver, need not acquire any patient care experience prior to admission, get through a program in 2 1/2 years, and then administer anesthesia, even if it is "supervised". and you can't tell me that those pre-med courses do anything to prepare you for patient care. what are you going to do, draw a diagram of succinylcholine during induction, for goodness' sake?

    georgia_aa,

    thank you for your response. however, my comments still stand.

    as you stated,
    the only thing that i cannot do is practice independantly. beyond that, i am trained and fully capable of doing anything that a crna can do. honestly, i can't rise to the level of crna practice by virtue of my training??
    i respectfully beg to differ with you on that statement. again, please understand that this is not an insult or personal attack. however, while your assertions may be true in your department, aa life beyond the perimeter offers the following reality (and i bet you know why):

    4731-24-04 anesthesiologist assistants: prohibitions.

    (a) nothing in this chapter of the administration code or chapter 4760. of the revised code shall permit an anesthesiologist assistant to perform any anesthetic procedure not specifically authorized by chapter 4760. of the revised code, including epidural and spinal anesthetic procedures and invasive medically accepted monitoring techniques. for purposes of this chapter of the administrative code, "invasive medically accepted monitoring techniques" means pulmonary artery catheterization, central venous catheterization, and all forms of arterial catheterization with the exception of brachial, radial and dorsalis pedis cannulation.

    (b) an anesthesiologist assistant shall not practice in any location other than a hospital or ambulatory surgical facility.

    (c) an anesthesiologist assistant shall not practice except under the direct supervision and in the immediate presence of a supervising anesthesiologist as defined in this chapter of the administrative code and chapter 4760. of the revised code.
    effective: may 30, 2003

    note: this excerpt from the ohio practic regs governing aas
    Last edit by Athlein1 on May 5, '04
  3. by   NCgirl
    Ah come on geecue, why can't I be "princess anesthetist" if you are "geecue"? Keep in mind this whole name thing came about to lighten up this thread, when things were heated over the title anesthesia nurse. I'd love to hear anything the rest of you have come up with!
  4. by   gaspassah
    athlein, i'm glad you looked that up, that was my project for when i got home today. seems there is some discrepency about what is allowed by the mda and allowed by law.
    questionable practices. proves a point. (many actually)
    d
  5. by   georgia_aa
    Hi Everyone,

    I was getting concerned that this thread was growing increasingly hostile. I was worried that all I was succeeding in doing was fanning the flames which was not at all my intent.

    To address the CRNA from Grady. Some of what you said is absolutely true. The restrictions placed on CRNA/AA practice are the norm in the Atlanta area. Very few anesthetists (I am referring to both CRNAs and AAs when I use this term) perform regionals in MD run practices. His observation that anesthetists don't do central lines may have been true at Grady, but we do them every day at my center. At St. Joseph's hospital, a major cardiac center, all anesthetists may insert central lines after demonstrating proficiency at it. I do know that there were some restrictions placed on AAs in Ohio that are in the process of being resolved, but in Atlanta I do everything except regional blocks. In Macon, I know for a fact that AAs are doing lots of regionals.

    As far as salary goes, yes my 160k was earned by working lots of OT. I have a young family and am willing to take on all I can get. My base is 115K and I typically work 2 doubles a week plus one weekend a month call from home. When I stated my salary I was not boasting as DEEPZ called it, but merely pointing out that we do not accept lower pay than CRNAs which has been commonly stated.

    I am absolutely committed to the anesthesia care team approach. I believe that it is the safest way to receive an anesthetic in the US. If my patient is not doing well or something happens surgically and I just need help, I like knowing that I can have 5 board certified anesthesiologists in the room within 60 seconds. I know, I know, your patients never have problems and nothing unexpected ever happens right?? To me, it's not about showing everyone that I can handle everything myself, but doing what is safest for the patient. Having more than one person in the room skilled at anesthesia during those critical moments is just intuitively more safe to me. The reality is that the MDA doesn't come into the room and take over and shove me out of the way, but rather we work together as a team to get the patient past whatever the problem may be. It is a collaboration where our skills and knowledge complement one another. The line that an AA will do nothing without being told is a total bunch of crap. We can just agree to disagree on that point and call it a day.

    Again, if you read my posts I have never said anything that could be construed as CRNA bashing. That being said, I do believe that your leadership is hurting you on the national level. In every instance that we have sought legislation allowing us to practice, the AANA has argued that we are not qualifed by virtue of not being nurses first. They completely ignore the fact that 60-70% of every AA class did indeed have healthcare experience before enrolling in AA school (resp therapy, EMT, and yes even a few RNs being the most common). In each and every case, the legislators travelled to Atlanta, Ohio, or other states in which AAs practice and saw with there own eyes AAs and CRNAs coexisting peacefully and doing the EXACT SAME JOB. In many instances CRNAs train AA students and vice versa (shocking!!). So in light of what they see with their own eyes, the AANA rhetoric just doesn't ring true and you come off as a group with a huge chip on your shoulders just trying to protect your turf.

    Please, I want to keep this friendly. I really think that most of you don't really know the first thing about us and I'm just trying to dispel some of the falsehoods. I know for a fact that you don't have to be a nurse to be a talented, skilled, compassionate anesthesia provider. What you DO have to be is intelligent, analytical, able to think fast on your feet, and have the ability to funtion in a fast paced, and at times very tense environment. If you don't possess those attributes, nurse or otherwise, you will not be a good anesthetist.

    BTW, I did get into medical school (3 acceptances) but chose AA instead. I was a little older and decided not to invest the amount of time it would take to get there. I'm very happy with my choice.
    Last edit by georgia_aa on May 5, '04
  6. by   duckboy20
    The reality is that the MDA doesn't come into the room and take over and shove me out of the way, but rather we work together as a team to get the patient past whatever the problem may be.
    I am sure you work "together in the OR room" but I would bet that the MDA is laughing his butt off all the way back to his comfy chair while he is living the good life off of you. Don't mean that just towards an AA either, do it with CRNA's as well.
  7. by   swumpgas
    Quote from georgia_aa
    The ONLY thing that I cannot do is practice independantly. Beyond that, I am trained and fully capable of doing anything that a CRNA can do. Honestly, I can't rise to the level of CRNA practice by virtue of my training?? Now who is insulting whom??

    Ahh, the difference in background training... can you give an enema and not have the sheets all discolored?

    When you spend time ducking Mortar fire in combat in Vietnam and trying to provide safe anesthesia to our troops, I'll consider your statement as being able to do all a CRNA can, as a possibility. There were no MDA's in the line hospitals. They were back in the rear. in the big towns. There are 2 CRNAs names on the Vietnam Memorial Wall

    Jerome E. Olmsted
    Kenneth R. Shoemaker

    among other RN's that gave it all
    Sharon Ann Lane

    How many AA's are in Iraq?

    When you are called out of bed at 3AM to provide anesthesia for a bunck of teens that have wrappeed their car around a telephone poll, without having a back up MDA to call in to help or "supervise"... then the situation will be different.

    Surgeons have said for years tha monkeys can be trained to do anesthesia, maybe a bit of exaggeration, but just as the MDA's tout a background in medicine is needed for anesthesia, it also applies to AA's with NO background in medicine, or medical science.

    You are and will always be technicians, or "Bag squeezers". Serving at the whim of your overseer. doing their bidding. Asking permission..

    Your restrictions on performance are not the doing of CRNA's, it is the doing of the control freak MDA's that establish the legislation FOR YOU to practice, so there is never another group of bagsqueezers that are allowed independance.

    You may be the finest person in the world, but do not equate youself with those that have gone before you and paved the way, and have a 120 year track record for safety.

    Send me an email fro Iraq
  8. by   loisane
    I can identify two related, but separate goals to this discussion.

    First,we are all sharing information in order to make a more informed decision about what each of us personally believe about the appropriate model for the delivery of anesthesia.

    Second, we are identifying appropriate, arguments to make the case for our respective positions to the public, legislators, etc.

    This forum is more about the first than the second. I think the distinction is important. I am concerned that so many RNS and even SRNAs do not appreciate the full impact of these issues. But the points I emphasize to this audience are not necessarily the same arguments I would make in lobbying my legislator. This is not really the place to discuss lobbying strategy, so I have not really spoken to that aspect of this issue.

    But I speak loud and clear to all RNS. If you are not concerned about the proliferation of AAs, you are buying into the physician-always-in-charge model. Is that how you view yourself as a professional nurse?

    Hear me now, and believe me later. ASA tried for decades to gain complete control of nurse anesthesia practice. They are driven by many motives. Power, greed, and maybe even the honest belief that anesthesia really is the practice of medicine. We have successfully fought them off at every turn. The latest round was the supervision regulations. They decided then to try an alternate approach. If they could not be succesful making CRNAs the type of dependent practitioner they wanted, they would create/promote another type of provider. One that is more congruent with their philosophy.

    There is not doubt in my mind that AAs are being promoted in an attempt to displace CRNAs from the market. Face it, and accept it. Then if you can still feel supportive of the concept of AA practice, at least you are seeing the big picture.

    I mean absolutely no disrespect to any individual AA or anesthesiologist. I am speaking globally and philosophically regarding policy. It is important to remember that not all anesthesiologists agree with the ASA. But this is a NURSING forum, so you cannot be surprised that I am taking a very PRO-NURSING position. I would like to see the day that CRNAs and anesthesiologists work together, collaboratively, as professional equals.

    loisane crna
  9. by   srna04
    I use to work with a AA at a ICU in Chicago. He originally got his AA degree from Georgia, and wanted to practice in Illinois and was not allowed to. He went back to school for his BSN then later went onto CRNA school at Rush. Now that is what I call dedication.
  10. by   georgia_aa
    No Swumpgas, I probably can't give an enema and not muss up the sheets. Great skill to have for an anesthetist though....

    And while I have not served in the armed forces, I do travel to Equador every year with a Plastic Surgeon that I know personally and give anesthesia for reconstructions on children with cleft palattes and other craniofacial abnormalites. We do travel with an MDA but he runs his own room, while I run mine. No requirement for supervision there, they are just thrilled to have us.

    Technician, bag squeezer - again name calling and hostile responses.

    What is it with you guys?? Get off your high horses - you are starting to sound a little shrill.
  11. by   deepz
    Quote from georgia_aa
    ........
    BTW, I did get into medical school (3 acceptances) but chose AA instead. ,,,,,,
    But, of course, you're not boasting ....?! Right?

    Georgia, when you come into a public forum for CRNAs, SRNAs and wannabees, and post incendiary taunts such as you do, and THEN boohoo that the dialog is becoming hostile ... I just shake my head. And laugh.

    You come off much like your masters. Always the A$A repeats the mantra: Our only concern is patient safety. Ridiculous obfuscation. You say you only want to educate us. Ditto.

    Another of your masters' propaganda standby lines comes to mind, as it seems to apply to you, Georgia: you just don't know what you don't know.

    You think you are my professional equal. You are grossly mistaken.

    Be clear: I bear you no personal enmity. No doubt you are an intelligent and articulate person, and possibly you are a superior anesthesia provider as an AA. Never mistake that for being the equal of a CRNA -- not all CRNAs at least. Not me.

    So what if you work with a brow-beaten crew of dumbed-down, oppressed nurse anesthetists forced to accept you as their organizational superior, the "Chief Anesthetist.' Sorry, Georgia, you are an AA, an *assistant*, not an anesthetist. The fact of your functional work description does not entitle you to the professional title Anesthetist. An anesthetist does it all. Names are funny that way. It's like the difference between lightning and a lightning bug.

    So, as the saying goes: you want to be my equal? "Send me an Email from Iraq."

    deepz

    Just MHO. I could be wrong, as I've been observing the anesthesia scene from inside for only 40 years (but of course I'm not boasting!) ... and it's possible I may yet change my mind.

    http://www.gaspasser.com/CRNAinIraq.html
  12. by   duckboy20
    Nice link Deepz to that article about the Military CRNA.
  13. by   swumpgas
    Quote from georgia_aa
    No Swumpgas, I probably can't give an enema and not muss up the sheets. Great skill to have for an anesthetist though....

    And while I have not served in the armed forces, I do travel to Equador every year with a Plastic Surgeon that I know personally and give anesthesia for reconstructions on children with cleft palattes and other craniofacial abnormalites. We do travel with an MDA but he runs his own room, while I run mine. No requirement for supervision there, they are just thrilled to have us.

    Technician, bag squeezer - again name calling and hostile responses.

    What is it with you guys?? Get off your high horses - you are starting to sound a little shrill.
    It is a matter of correcting misinformation spread by yourself and your MDA masters. Lies will not go unchallenged, just as touted studies by the ASA in regard to saftey of anestheisa (Silber, Pine et all), but did not stand up to scrutiny by independant clinicians.

    Technician and bagsqueezer are terms MDA's use to designate and denigrate those that are not trained in the medical model, part of the old boys club.

    I admire your trips for humanities sake. There is not enough recognition of those that do volunteer work for the poor, either on purpose or the poor and indigent population.

    Let us not forget the sole purpose for the creation of the anesthesia assistant 40 years ago I bellieve. CRNA's got too uppity, did not jump to the whim of those that would dictate methods of practice and needed to be slapped down. This cannot be ignored. Statements from the ASA "leaders", your own Atlantian MDA Neeld, who claims to have pesonally performed 300,000 anesthetics in his lifetime.. as a clinician, you should see that is impossible for anyone younger than Methuselah.

    Misinformation, Misrepresentation, and outright lies are rampant among your MDA mentors, in an effort too control anesthesia services.

    I do not have a quarrel with MDA's that do their own cases, but those that sit back and sponge off the efforts and labors of others, be it CRNA, or AA, I hold in contempt.

    Do not equate an AA with a CRNA. The keyword ASSISTANT is placed in your title by design by your bosses. You are their assistant, not a colleague, not a peer.

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