[airrn]

Yup, they both might be very similar 10 yrs down the road since most occupations do most of their learning on the job but this is precisely the difference between the professions. CRNA's are REQUIRED to have critical care experience before starting school and this is simply not the case for AA's. What is so hard to comprehend about that?

[Alpha13]

It's only hypocrisy if we try to attack the AA professon based on their standard of care. Get past that and acknowledge that this is is a political/monetary battle and suddenly it is obvious again why we dislike AAs. THEY ARE OUR COMPETITION. The field of prospective AA students (anyone with a BS degree) is much larger than the base than the base of BSN nurses that can become CRNAs, so the only obstacles preventing this profession from taking off are the lack of schools, and inability for them to practice in all states. More states allowing AAs will create a demand for more AA programs which can open much faster because they know there are hordes of people stuck with useless sociology degress dying to have a decent job.

I'll be brutally honest here for a second: Artificial boundaries are not necessarily a bad thing. especially for those that position themselves in the right way to take advantage of them. AA's are a very real threat to the anesthesia shortage because they can bring down the supply/demand ratio of anesthesia providers and possibly even saturate the field. You can call me greedy if you want, I don't really care. I do like the fact that CRNAs make a lot of money given the relatively short educational period. (I'm comparing to other professionl degrees) But that's not what I'm afraid of. What I am afraid of is not being able to find a job in 10 years because the AANA decided to hold hands with the ASA and allow the AAs to merrily skip into all states and take over.

No handholding from me. We must fight them like spartans! (Sorry I can't wait to see 300)

[core0]

Actually it is all about money. This is a direct result of the AANA drive for independence. From the Anesthesiology point of view AA's are preferable since they can only work under an anesthesiologist. No question of independence, no question of working under dentist's. What they would like is to put the genie back in the bottle.

[paindoc]

Given the CRNA penchant to proclaim they are just as good as MDs and want to make just as much money as MDs because they claim to be as good as MDs, it is just a matter of time until AAs become a common competitor for CRNA positions. MDs would much rather support AAs that work for them than CRNAs that work against them.

[jackson74]

I've been a critical care nurse for 7 years I'm starting anesthesia school (CRNA) this aug. If you have ever precepted a new graduate RN into the ICU you understand the huge difference between individuals who have ICU experience and those that don't. 1st year AA students aren't even the functional equivalant of a new grad RN because the new graduate RN's have nursing school clinical experience to prepare them. AA's are required to have NO clinical experience! Personally, if I were going to AA school I would be terrified going in to the OR having no hemodynamic experience, experience with vents, vasoactive drips, IV's, and just monitoring patients. I guess if you don't know what you don't know it really wouldn't bother you then.

[paindoc]

Perhaps it just goes to show one really doesn't need a year of critical care to learn how to use ephedrine, labetolol, NTG, or phenylephrine boluses. Drips are used during less than 2% of all surgeries in the US. For those 2% of cases, CRNAs would definitely have an advantage. But for the other 98% of cases, I wonder if one could really tell the difference in outcome.

[jwk]

Originally Posted by paindoc

Perhaps it just goes to show one really doesn't need a year of critical care to learn how to use ephedrine, labetolol, NTG, or phenylephrine boluses. Drips are used during less than 2% of all surgeries in the US. For those 2% of cases, CRNAs would definitely have an advantage. But for the other 98% of cases, I wonder if one could really tell the difference in outcome.

You can't tell the difference anyway. Places that have both AA's and CRNA's use them interchangeably.

[platon20]

SHOW ME THE EVIDENCE THAT CRNAS HAVE BETTER OUTCOMES THAN AAS

You cant, because that evidence doesnt exist. However, there is ample evidence in peer reviewed pulbications like JAMA, NEJM, etc that outcomes are the SAME regardless of whether you are an MDA, AA, or CRNA.

Until then, all this talk about ICU experience, training period is worthless. MDAs go to school a lot longer than CRNAs, so using your logic MDAs must be better than CRNAs. The evidence shows clearly that is NOT the case. Therefore, all that "extra" training doesnt mean jack.

Again, it is extremely hypocritical for the CRNAs to attack AAs based on training. MDAs have been pushing for years trying to cut out CRNAs, and what was the AANA response? That CRNAs have equivalent outcomes to MDAs. The MDAs didnt have a leg to stand on, and the CRNAs likewise dont have a leg to stand on regarding attacking AAs for lack of training.

Until you prove that CRNAs have better outcomes, then this is all just posturing based on politics and money that hurts patient care. It hurts patient care when MDAs try to force out CRNAs, and it also hurts patient care when CRNAs try to force out AAs. Patients need all of us for their anesthesia care. For CRNAs to fight against AAs when they dont have any evidence of superiority means that those CRNAs are just as greedy/hypocritical/politically motivated as the MDAs were who tried to keep CRNAs out of the OR

[paindoc]

Excellent analysis!!

[rodvigcrna]

I say CRNA's and AA's UNITE !!!!

Here is my view:

First of all, I want to make a point.
I feel CRNA's and AA's all went into their perspective careers for the same reasons. More opportunity and a better life for them and their families. I'm sure no one chooses to enter anesthesia so they can fight with another group of people. For that matter, anesthesiologists do not enter anesthesia residency thinking of how fun it is going to be to crush CRNA's.

I am not going to attempt to predict the future. However I want to point something out. In the sate I live in, Doctors prefer to hire physician assistants rather than nurse practitioners. This has resulted in substantially higher salaries for PA's than NP's. However, a new trend is emerging. Some surgeons are trading their higher paid PA's for RN first assistants. Paying them less money than PA's but more money than RN's. So prominent is the trend that RN's are entering this field in droves.

Similarly, the anesthesiologists are protecting their best interest. No one can blame them for doing this. It is not wrong. It is just the capitalist way. They want to make sure they retain control, so they always maintain their field as lucrative.

So here is my point. If AA's feel safe because they are protected by the umbrella of the ASA, they are terribly mistaken. And, if CRNA's feel that AA's are a threat to us, we are terribly mistaken.

Stop and think before everyone starts bashing each other.