TEXAS CRNA's Call to action. Stop the potential AA bill! - page 4

WHY SB 1314 AND HB 3313 ARE BAD PUBLIC POLICY THIS IS A SCOPE OF PRACTICE FIGHT! FACTS: With insufficient funds for critical needs in the state, why create a licensure advisory board and... Read More

  1. by   Nitecap
    Quote from platon20
    Do any CRNAs have anything other than self-protectionism to back up their claims? I guess not because I havent heard any so far.

    The only thing I've heard so far is "dem aas gonna take our jobs!" spoken like a true anti-immigration right winger.

    you dont have a leg to stand on. This is a self-protectionist partisan tactic that is bad for society and bad for patients. This is just as bad as the attacks MDAs have launched against CRNAs in the past.

    You guys are absolutely no better than the MDAs you loathe so much.

    The shortages loom where MD's choose not to work. How can AA's fill these shortages when they cant work in these areas either. AA's arent any cheaper than CRNA's. In states that allow AA practice they make the same as CRNAs.
  2. by   platon20
    Quote from Nitecap
    The shortages loom where MD's choose not to work. How can AA's fill these shortages when they cant work in these areas either. AA's arent any cheaper than CRNA's. In states that allow AA practice they make the same as CRNAs.

    Providers should be increased at all levels to handle the shortage, CRNAs, AAs, and MDAs are all needed.

    I dont want to ever hear you complain about MDAs trying to attack CRNAs again. You have lost all sympathy from me. You are just as dirty as they are.
  3. by   zrmorgan
    Quote from paindoc
    1. My position is based on cold hard facts that are irrefutable. I have trained 3 RNs to give anesthesia over the past 10 years, and they have successfully administered propofol general anesthesia in an office setting to more than 10,000 patients without any hospital admissions of these patients, respiratory or cardiac arrests, or bad outcomes. This proves beyond a shadow of a doubt that RNs can do exactly what CRNAs would do in an office setting and with the same outcome for less than 1/3 the income of a CRNA. The patient chart includes charting similar to anesthesiologists and CRNAs use in practice.
    2. CRNAs may be useful in certain settings but they are certainly not required and cannot demonstrate enhanced safety over a RN trained to administer MAC or general to a ASA 1 or 2 outpatient for short procedures.
    Is your position based on the 3 RNs you trained? I am sure you have cold hard facts with three RNs you trained, I just dont agree with you that your position in irrefutable. It probably works great with a very narrow set of standards implemented by anesthesia departments. However, I am worried if more people agree with your position, it wont be you and I training the RNs/non-anesthetists, it will be the office based clinicians who may be very unprepared, untrained, and have immense secondary gain to supervise non-anesthetists in some back country office setting.

    Furthermore, I am very surprised that you undermine the importance of quality and safety in such a vast subset of cases "general to ASA 1 or 2 outpatient for short procedures". I am an RN and a CRNA and I will tell you there was a very profound change in my abilities after anesthesia school. To say that a trained RN is no different than a CRNA giving general anesthesia shows either how extreme, or how misinformed you are about the depth of CRNA training.

    Back to the discussion at hand, hopefully we can fill the void of providers one way or another, and not have to worry about extreme and dangerous measures to do so. If the voters want to allow AAs to fill the void, fine...its their choice, either way, it is up to all of us to educate the public to make an informed decision.

    http://www.asahq.org/news/propofoluse.htm
    http://www.asahq.org/publicationsAnd...andards/37.pdf
  4. by   paindoc
    I don't think salary parity is reality. The average AA makes 90-95K after graduation while the average CRNA in these venues makes 50% more.
  5. by   jwk
    Quote from Nitecap
    The shortages loom where MD's choose not to work. How can AA's fill these shortages when they cant work in these areas either. AA's arent any cheaper than CRNA's. In states that allow AA practice they make the same as CRNAs.
    Due to quirks in the CMS rules, MD's can't get the same medicare reimbursements that CRNA's can by taking advantage of Part A passthroughs.

    AA's haven't claimed to be the cure-all and end-all of anesthesia providers. We can indeed be part of the solution to the overall shortage in providers. As I've said many times before, if you want to work independently in a small rural practice, go for it. Put your money where your mouth is.

    Tell me - where do you work? I don't think I've ever heard what type of practice you work in. Independent? Anesthesiologists? Rural? Urban? Do tell.
  6. by   Alpha13
    Quote from platon20
    Do any CRNAs have anything other than self-protectionism to back up their claims? I guess not because I havent heard any so far.

    The only thing I've heard so far is "dem aas gonna take our jobs!" spoken like a true anti-immigration right winger.

    you dont have a leg to stand on. This is a self-protectionist partisan tactic that is bad for society and bad for patients. This is just as bad as the attacks MDAs have launched against CRNAs in the past.

    You guys are absolutely no better than the MDAs you loathe so much.

    What makes you think that the CRNA profession is above the task of fighting for its interests? Are nurses special in some regard that the docs and AAs just aren't? And do you honestly think that CRNAs should just sit back and allow the AA's to expand to every part in the country and merrily co-exist with the other anesthesia providers?

    Be very thankful, platon, that not all CRNAs have their heads in the clouds to believe such non-sense. They live in the real world where money and politics are real, and not some strange indecency to be shied away from. They fight for your profession and your interests while you ridicule them with your holier than thou attitude. How sad.
  7. by   georgia_aa
    Quote from Nitecap
    The shortages loom where MD's choose not to work. How can AA's fill these shortages when they cant work in these areas either. AA's arent any cheaper than CRNA's. In states that allow AA practice they make the same as CRNAs.
    Very simple. We take the jobs in the cities working with the anesthesiologists, thereby freeing you guys up to take the jobs in the underserved rural areas. You don't want to work under MDA supervision anyway ... no problem - we'll do it.
  8. by   TexasGas
    Quote from paindoc
    1. My position is based on cold hard facts that are irrefutable. I have trained 3 RNs to give anesthesia over the past 10 years, and they have successfully administered propofol general anesthesia in an office setting to more than 10,000 patients without any hospital admissions of these patients, respiratory or cardiac arrests, or bad outcomes. This proves beyond a shadow of a doubt that RNs can do exactly what CRNAs would do in an office setting and with the same outcome for less than 1/3 the income of a CRNA. The patient chart includes charting similar to anesthesiologists and CRNAs use in practice.
    2. CRNAs may be useful in certain settings but they are certainly not required and cannot demonstrate enhanced safety over a RN trained to administer MAC or general to a ASA 1 or 2 outpatient for short procedures.

    I have been there, and done that, so there is simply no sophistry here. CRNAs in many situations could certainly be replaced by AAs and in most cases of outpatient office anesthesia by RNs. Then the anesthesia shortage would disappear, and CRNAs could use their skills to treat the ASA 3-5 patients that would benefit from their efforts.
    If I knew who you were, I wouldn't come to you for any procedures. There is no better person to manage another person's LIFE than one that has been adequately trained and tested on the physiology of the human body. Not to mention intensive study of the pharmacodynamics and pharmacokinetics of the drugs and agents used. I can only hope you have disclosed to your patients that you have enlisted the aid of an untrained anesthesia provider to assume the reigns while you do what ever it is that you do. Its amazing that you have apparently placed a value system on which patients deserve high level anesthesia and those that could just "get by". Tell me.. is the money saved by a patient what they gamble on with their life by having untrained anesthesia providers?
  9. by   TexasGas
    Quote from nurse_god
    So how long do you guys think these salad days will last? Being paid $140k for just a master's degree out of CRNA school can't last indefinitely. How many people were foolish to think that the dot-com bubble would last indefinitely too? Medicare will catch on and reduce reimbursements drastically in the future. Of all the specialties, I heard that anesthesiology is getting hit the hardest by the Medicare cuts in the next few years. I think that this is because anesthesiology has been regarded for a long time as a physician occupation. If the CRNA's are showing that it can be done, then they are proving that it doesn't require a physician to do it. Therefore, the reimbursements will drop to reflect a job that can be done by someone with only a master's degree. I think that the CRNA's own success will hurt them down the road.
    What a bitter person. How big is the spoon that you are stirring this pot with?
  10. by   jwk
    Quote from paindoc
    I don't think salary parity is reality. The average AA makes 90-95K after graduation while the average CRNA in these venues makes 50% more.
    I'm not sure how you came up with this statement. Your estimate is low to begin with, and in practices that utilize both AA's and CRNA's, the compensation packages are identical.
  11. by   Outdoor1
    There is a bottom line to this whole discussion. There are a million small points to argue back and forth we could go on forever. The point is....AA's are a threat to CRNA's. As so many have pointed out they can take our jobs. Will AA's decrease patient safety....not necessarily. Will they increase Physician control over anesthesia.....most definitely! This is the whole point. Ever since the position of Anesthesiologist was invented these docs have been trying to take anesthesia from nurse anesthetists. Is a CRNA not wanting AA's around similar to MD's not wanting CRNA's to exist....somewhat. The only difference is that CRNA's were delivering anesthesia before Anesthesiologists. Has patient safety improved because the almighty doctor has become involved in anesthesia? I believe it has, not because they are actually administering the anesthetics, but they have had the power to do so much more research than CRNA's. And let's not forget the contribution of science to the safety of anesthesia. Anesthesia has evolved so much in development of new and safer drugs. Just think about that for a minute. No matter what differences of opinion we all post here the AA bill is only a push for physicians to have more MONEY & POWER. Anyone who cannot see that is blind. I am sure even the AA's realize this....buy why would they care. They are controlled by medicine already.

    To all the nurses on this site who are even somewhat sympathetic to this situation....you are exactly what is wrong with nursing. As Yoga put it....this "can't we just all get along mentality" is not going to work. Until you are a CRNA or in some type of advanced practice you will NEVER understand. The one difference about regular nursing and advanced practice as a CRNA is a bond. As a new grad nurse other nurses try to eat you alive and show off how little you know as a new grad. As a CRNA student....don't get me wrong you definitely have to prove yourself, but it's more like welcome to the club, we'll stand behind you. This is why nurse anesthetists have survived the attacks of the A$A for so many years. We have learned that we are stronger together, than individually trying to show eachother up.

    If you have not already emailed your senator and representative about this issue please take the 5 minutes that it takes to do so. Here is the link. It's very easy. www.txana.org

    Go to voter voice in the bottom right hand corner. Please don't think your voice doesn't count. Already thousands of emails in support of CRNA's have been sent in Texas!
  12. by   jwk
    Quote from Outdoor1
    There is a bottom line to this whole discussion. There are a million small points to argue back and forth we could go on forever. The point is....AA's are a threat to CRNA's. As so many have pointed out they can take our jobs. Will AA's decrease patient safety....not necessarily. Will they increase Physician control over anesthesia.....most definitely! This is the whole point. Ever since the position of Anesthesiologist was invented these docs have been trying to take anesthesia from nurse anesthetists. Is a CRNA not wanting AA's around similar to MD's not wanting CRNA's to exist....somewhat. The only difference is that CRNA's were delivering anesthesia before Anesthesiologists. Has patient safety improved because the almighty doctor has become involved in anesthesia? I believe it has, not because they are actually administering the anesthetics, but they have had the power to do so much more research than CRNA's. And let's not forget the contribution of science to the safety of anesthesia. Anesthesia has evolved so much in development of new and safer drugs. Just think about that for a minute. No matter what differences of opinion we all post here the AA bill is only a push for physicians to have more MONEY & POWER. Anyone who cannot see that is blind. I am sure even the AA's realize this....buy why would they care. They are controlled by medicine already.
    It's not about control. The bottom line is money. Always has been - always will. Despite the thousands of job openings for anesthetists nationwide, both urban and rural, and despite the fact that the number of new anesthetists each year still doesn't keep up with attrition and expansion of services, CRNA's simply don't want to share with ANYONE. AA's are not out to take your jobs. There's plenty to go around. We've never tried to push CRNA's out of a state, a hospital, or a group practice. The majority of AA's work with CRNA's every day. You of course can't say the same.

    Physicians, whether you like it or not, will always be at the top of the medical "food chain". Although we all have our little anecdotes about bad physicians and bad CRNA's and bad AA's, it really makes no difference. By and large, we all do an excellent job. The difference between AA's and CRNA's is that AA's have no illusions that we know all there is to know about anesthesia and medicine, that we are the be-all and end-all of anesthetic care. We recognize the breadth of knowledge and contributions that anesthesiologists bring to the table. We understand that even though we do excellent work, our 6 years of training, and your 6 years of training and a year in the ICU still don't equal the 12 or more years of a board-certified anesthesiologist. Unfortunately, many CRNA's think that they are the equal to physicians in everything but name only. Even those lines are attempting to be blurred to the general public, through such concepts as the DNP programs and the "Resident RNA" instead of an SRNA, as well as moving into areas outside the OR like chronic pain management (clearly never envisioned by the authors of Watchful Care).

    I am so tired of hearing that nurses did anesthesia before physicians (despite the fact that neither Morton or Crawford Long were nurses). Even 500 years from now, you'll still be claiming nurses have been doing it longer. Who cares?!?!?!? Have you PERSONALLY been doing anesthesia for 100 years? NO! That's just propaganda - it means nothing. The same line of reasoning is applied to AA's - we've only been around about 36 years, so we'll always be behind CRNA's about 65 years or so, even in 2607.

    Let your profession stand on it's own merits without cutting down mine in the process. Except for "they're taking our money", you really have no argument to stand on. Anything besides that is simply a lie.
  13. by   TexasGas
    Fantastic post, Outdoor.

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