Who should "Pass Gas"?

  1. let's not create another new healthcare worker position!

    fla anesthesia assistants gain ground in senate over nurses' objections
    by mike salinero msalinero@tampatrib.com http://tampatrib.com/floridametronews/mgah0yoqcxc.html


    tallahassee - a senate committee on tuesday approved
    published: feb 6, 2002
    licensing anesthesia assistants to practice in florida under anesthesiologists' supervision.
    currently, only anesthesiologists, who are doctors, and nurse anesthetists may provide anesthesiology.

    anesthesiologists support the bill, saying there is a shortage of anesthesia providers in the state.

    but nurse anesthetists deny the shortage. they say the bill is a move to replace them with lesser-trained and lower-paid anesthesia assistants. only registered nurses with a minimum number of clinical hours may enter a two-year anesthesia program. candidates for anesthesia assistant can enter that program with a four-year degree in any field.

    ``the licensing of anesthesia assistants is an experiment, and florida patients would be the test subjects,'' said bruce weiner, a tampa resident and president of the florida association of nurse anesthetists.

    john mcdonough, a professor at florida international university, told the committee that he teaches nurse anesthetists and knows they are better trained.

    but jerome modell, who recently retired as chairman of the anesthesiology department at the university of florida, said training for nurse anesthetists and anesthesia assistants is ``different but comparable.''

    the sponsor of the bill, sen. debbie wasserman schultz, d-weston, confirmed she got a $1,000 campaign contribution from don sokolik, president of the state society of anesthesiologists. wasserman schultz said her vote was based on a ``deliberative'' study of the issue.

    the bill is scheduled for three more committees before going to the senate floor. a companion house bill has cleared all committees and is ready for floor action.


    reporter mike salinero can be reached at (850) 222-8382.

    ------------------------------------------------------------------------------
    info for letter writing campaign:
    key committees for healthcare
    florida senate and house of representatives members of the key healthcare committees

    from fla nurses assoc.:
    http://capwiz.com/fln/issues/alert/?alertid=8

    senate committees

    health, aging, and long-term care

    chairman: senator saunders
    vice chairman: senator dawson
    members: senators brown-waite, campbell, clary, cowin, klein, peaden, pruitt, silver and wasserman-schultz

    appropriations subcommittee on health and human services

    chairman: senator silver
    members: senators mitchell, peaden, sanderson, and saunders

    banking and insurance

    chairman: senator latvala
    vice chairman: senator holzendorf
    members: senators campbell, carlton, clary, constantine, dawson, garcia, geller, king, posey, rossin, and wasserman schultz

    senate health committee members links:
    http://www.leg.state.fl.us/cgi-bin/v...ees/senate/hc/


    house of representatives

    council for healthy communities

    chair: nancy argenziano
    vice chair: curtis richardson
    committee members: allan bense, gus bilirakis, nancy detert, frank farkas, mike fasano, carole green, ken littlefield, evelyn lynn, sandra murman, ken gotlieb, sally heyman, cindy lerner, eleanor sobel


    elder and long term care

    chair: carole green
    vice chair: mark weissman
    committee members: jeff atwater, hugh gibson, joe negron, jerry paul, dave russell, david simmons, leslie waters, phillip brutus, suzanne kosmas, richard mackek


    health and human services appropriations

    chair: jerry maygarden
    vice chair: frank farkas
    committee members: holly benson, heather fiorentino, rene garcia, hugh gibson, carole green, ken littlefield, phillip brutus, nan rich, irving slosberg, eleanor sobel


    health promotion

    chair: ken littlefield
    vice chair: mike hogan
    committee members: bob allen, ralph arza, holly benson, renier diaz de la portilla, manuel prieguez, susan bucher, joyce cusack, arthenia joyner, sara romeo, irving slosberg


    health regulation

    chair: frank farkas
    vice chair: eleanor sobel
    committee members: jd alexander, heather fiorentino, mike haridopolis, gayle herrell, randy johnson, marco rubio, stacy ritter, gary siplin, roger wishner


    house committee on health regulation:
    http://www.leg.state.fl.us/committee...tees&submenu=1
    Last edit by NRSKarenRN on Feb 7, '02
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  2. 27 Comments

  3. by   P_RN
    I never cease to be amazed. I say let every one of these folks who WANT this new position let an "assistant" pass gas on their loved ones. Wonder if that would change some opinions.

    UAP, UAP grrrrrrrrrrr
  4. by   OC_An Khe
    Historiclly whenever there has been a shortage of RN's,no matter what their specialty, some physician group and /or hospital administrators seek to solve the shortage by reducing the requirements to practise nursing or even remove the neccessity of becoming an RN first. This proposal needs to be fought.
  5. by   NRSKarenRN
    doctors, nurses squabble over anesthesia assistants
    florida doctors and nurses are bickering over legislation that would allow non-nurses assist anesthetists in operating rooms.

    bill kaczor
    associated press writer
    tallahassee democrat, feb. 28, 2002
    http://www.tallahassee.com/mld/talla...al/2765202.htm

    tallahassee, fla. - doctors and nurses are squabbling over legislation that would let non-nurses assist anesthesiologists in florida's operating rooms.

    the florida association of nurse anesthetists on thursday launched a media, lobbying and publicity campaign aimed at blocking a senate bill (sb 966). the nursing group lost its fight in the house where a similar measure (hb 599) passed 71-47 on feb. 13.

    the legislation would let non-nurses become anesthesiologist assistants with a year of clinical training. the measure is being sought by the florida society of anesthesiology, a doctors' group.

    some physicians, however, are lining up with the nurses and both sides are accusing each other of being more concerned about profits than patients.

    "it promotes the bottom line for one group of physicians, namely the anesthesiologists," dr. richard anderson, an internal medicine specialist from fort myers, said at a news conference held by the nursing group.

    he said anesthesiologists could pay non-nurses less but charge the same fees.

    jon johnson, a lobbyist for the anesthesiologists' society, agreed it was a bottom-line issue, but for the nurses, not the doctors. "they are not going to lose their monopoly without a fight," he said.

    the anesthesiologists are seeking the legislation because of a nursing shortage they don't expect to improve, johnson said.

    the required clinical training would be sufficient for assistants, who would have a college degree although not necessarily in a medical field, he said. they also would be under supervision of anesthesiologists, he said.

    anderson, however, contended that many doctors interpret supervision to including leaving a nurse or anesthesiology assistant alone in the operating room while the anesthesiologist is in the physicians' lounge or elsewhere nearby.

    johnson said at least a dozen states have similar programs yet there are no reports of patients being harmed.
  6. by   meandragonbrett
    I wouldn't let an AA do my anesthesia. I don't care if they have had " The required clinical training" I look at it this way.. . . Why would you allow somebody that possibly has no PRIOR medical experience hold your life in their hands? CRNAs have previous Critical Care experience and MDAs train for 4 years in anesthesia.
    Nope, i'll pass.

    brett
  7. by   NRSKarenRN
    check out:
    qualifications and capabilities of the certified registered nurse anesthetist
    http://www.aana.com/about/qualifications.asp

    history of nurse anesthesia practice
    http://www.aana.com/about/history.asp


    then read:
    opinion on anesthesiology assistant debate by darci on march 01, 2002 at 5:39pm
    free registraion at healthleaders required.
    http://www.healthleaders.com/news/ne...485775807a7ec5

    i am a current student in the emory university medical school's anesthesiology and patient monitoring systems program. after preparing for graduate school by obtaining a b.s. in biology degree at florida state university, i worked for 2 years on emory university hospital's neurology and neurosurgery floor and icu. then, i moved on to the pulmonary lab as a pulmonary function technologist.

    i am very proud of my educational accomplishments as well as my work experience which prepared me for the task of training to become an anesthesiology assistant. through my sacrifices and hard work, i will obtain a master's degree from emory university and begin practicing as part of highly regarded and proven anesthesiology team approach to deliver anesthesiology to patients on one of 13 states i am legally able to practice.

    i am very disturbed about the recent articles written by various newspapers in the state of florida about the ongoing debate which would legally allow anesthesiologist assistants to practice. each editor has misrepresented our profession as simply having a non healthcare based "college degree", as opposed to a master's degree from an accredited program at two of the most prestigious medical schools in the country. at the same time, anesthesiology assistants must pass a national board exam created by the american medical association every six years. also stating that we do "not necessarily have a healthcare background" is simply not true. almost every person in my program has a well established healthcare background, it is only those who have displayed a superb standing in their undergraduate studies that are waved.

    anesthesiology assistants have practiced across the us with great success since 1975, however, because there are only two schools in the country that graduate students there are only 580+ anesthesiology assistants.

    i encourage everyone who does not know about our profession to research it before writing an article that may impact the healthcare delivery of floridians in the future.

    sincerely, darci boshaw president anesthesiology assistant student class 2002
  8. by   jenn71
    Haven't Anesthesia Assistants been around for a while now? I believe the American Academy of Anesthesiologist Assistants has been around since 1975. Why all the hoopla in FL? Were they previously not allowed to practice there? After reading all the info I could find on the 'net, it seems that they have been providing anesthesia services for a while now, it's just that there aren't a whole lot of them out there since there are only 2 programs in the U.S..
    Also, what will be the basis for CRNA's to argue against allowing AA's to practice?
  9. by   jenn71
    Is there a brand new training program being started in FL for assistants or will it be the same type of program as the other 2 that already exist?
  10. by   Mijourney
    Hi. Thanks for the information Karen. This situtation with CRNAs vs AA is just another ruse to repress the bigger picture. It seems to me that there will always be a sizable group of physicians that will work to make sure they benefit the most when it comes to profits and prestige even if it means undermining nurses.

    I believe it's been proven over and over again the importance of nurses in patient care at every level. It's been proven that excellent quality nursing care is the most cost effective, and that this nursing care results in an overall improvement in the public's health. I really believe that if you were to replace all the CRNAs with AAs, you would see a significant decline in the quality of anesthesia services.

    I do have one question though, are there nurses going through these AA programs?
  11. by   meandragonbrett
    I'm not trying to sound like a butt but why would a nurse become an AA and only be allowed to practice in 13 states? When they can be a CRNA and more than likely make more money and be able to practice in any state? If there is a nurse out there in an AA program, I want to ask you, Why did you chose AA over CRNA? I have nothing against AAs personally. I agree w\what journey said "that if you were to replace all the CRNAs with AAs, you would see a significant decline in the quality of anesthesia services." Nurses have been giving anesthesia since the late 1800s and they were the first professional group to give it.

    Brett
  12. by   jfpruitt
    No AAs out there?
  13. by   Allizar
    i have been considering and researching the differences between crna and aa for a while now, and finally decided on advancing toward the aa route.

    i do not believe crna's will become a thing of the past, however i do believe that aa's will dramatically increase while crna's will maintain or begin to decrease.

    the most common defense coming from crna's to prove aa's should not practice is that they are lesser trained, which from what i have seen is not the case:

    crna training programs must include a minimum of 24 months in a master’s level program accredited by the coa. the training programs may be based at any college or university offering a master’s level degree. many nurse anesthetists do not possess a master’s degree as this was not required until 1998. nurse anesthetist programs do not require involvement of a medical school or academic physician faculty. community hospitals may serve as main clinical sites. a minimum of 450 hours of classroom/laboratory education, 800 hours of clinical anesthesia education, and administration of 450 anesthetics, including all types of surgery, must be achieved for the student to successfully complete the training program.

    aa training programs must include a minimum of 24 months in a master’s level program accredited by the commission for the accreditation of allied health educational programs (caahep). the programs must be based at, or in collaboration with, a university that has a medical school and academic anesthesiologist physician faculty. main clinical sites must be academic medical centers. an average of 600 hours of classroom/laboratory education, 2600 hours of clinical anesthesia education, and more than 600 anesthetics administered, including all types of surgery, are required to successfully complete aa training.

    upon completion of an accredited nurse anesthetist program, a student may become certified by passing the council for certification of nurse anesthetists certification exam. this examination is an adaptive computer examination consisting of 90-160 questions. forty hours of approved continuing education units (ceu) are required every two years in order to recertify. to be recertified, nurse anesthetists do not take an additional exam.


    upon completion of an accredited aa program, a student may become certified by passing the nccaa examination, which is co-validated by the national board of medical examiners. this six-hour examination is administered in a classroom and consists of 200 questions. in order to re-certify, an aa must complete 40 hours of cme every two years. additionally, aas must take the continuing demonstration of qualification exam every six years. this exam follows the same format as the initial certification exam.

    another point is that aa's are trained, taught and encouraged in a medical setting with anesthesiologists to work as a medical team and not independently.

    i realize that bsn's usually have at least 1 year experience in a critical care setting before attending a crna program (just as aa's usually come from a very strong medical background), however while caring for sickly elders or working with babies in nicu is amazing and respectable work, i do not believe it should be a prerequisite or considered training directly towards administering anesthesia.

    the main reason i am going the aa route is that it basically requires a pre-med bachelor degree. (regardless of what you hear about finger painting from crna's) aa schools require master levels in anatomy, biochemistry, physiology and pharmacology. this opens many doors in the medical field should i ever decide that being an aa is not for me.

    i know this is an old thread, i just wanted to respond with my opinion and see if there are any more up to date facts on the difference, they both seem highly trained toward a specific job to me.
    Last edit by Allizar on Apr 18, '09
  14. by   wtbcrna
    Here are some web links on the differences between AAs and CRNAs:

    www.asahq.org/asarc/AA-CRNA_Comparison.pdf
    http://www.ala-crna.org/index_news_comparison.html (same table as above but different format)

    Here is one part of the comparison on the number clinical hours for AAs:
    Anesthesia Clinical Education: No minimum number of anesthesia cases required in CAAHEP accreditation criteria. AA programs indicate that total clinical hours range from 2000 to 2718. Published descriptions of the AA programs' total clinical hours, greater in number than anesthesia hours, include experiences apart from anesthesia time (e.g., learning to do physicals, taking patient histories, training and certification processes for life support training, and other learning experiences that a licensed professional RN has already mastered prior to nurse anesthesia program entry).

    Survey on public opinion of AAs...
    http://www.scienceblog.com/community...0/pub0888.html


    Here is blog from an AA about their daily life as an AA.
    https://aajobsearch.com/forum/forum_...sp?TID=49&PN=1

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Who should "Pass Gas"?