AA vs. CRNA - Let's Discuss.

[warzone]

Let's have a discussion/debate (although it will probably be one sided) about AA vs. CRNA. These are just some topics I thought of off the top of my head. Any input or 'playing devil's advocate' would be appreciated.

- What is the difference in schooling/certification/academics?

- What is the difference in their scope of practice or autonomy?

- What economic factors are behind the push of AAs, if any?

- Can we relate this situation to another in Healthcare? Possibly LPN vs. RN?

- What are the best and worst case scenarios for CRNAs in the future, as it pertains to AAs vs. CRNAs?

- Why should one become a CRNA, rather than an AA?

- How does the MDA benefit from the increased use of AAs vs CRNAs?

- How does all this factor into the level of care a patient receives?

We need some AAs or MDAs to log on here to stir up the pot.

This is probably an emotional subject for some, but let's keep it civil. Ultimately we are all on the same team...I guess everyone just wants to be the MVP.

Who wants to cast the first stone?

[warzone]

Let's have a discussion/debate (although it will probably be one sided) about AA vs. CRNA. These are just some topics I thought of off the top of my head. Any input or 'playing devil's advocate' would be appreciated.

- What is the difference in schooling/certification/academics?

- What is the difference in their scope of practice or autonomy?

- What economic factors are behind the push of AAs, if any?

- Can we relate this situation to another in Healthcare? Possibly LPN vs. RN?

- What are the best and worst case scenarios for CRNAs in the future, as it pertains to AAs vs. CRNAs?

- Why should one become a CRNA, rather than an AA?

- How does the MDA benefit from the increased use of AAs vs CRNAs?

- How does all this factor into the level of care a patient receives?

We need some AAs or MDAs to log on here to stir up the pot.

This is probably an emotional subject for some, but let's keep it civil. Ultimately we are all on the same team...I guess everyone just wants to be the MVP.

Who wants to cast the first stone?

[warzone]

Here is an AA's description:

Anesthesiologist Assistants are highly educated allied heath professionals who work under the direction of licensed anesthesiologists to develop and implement anesthesia care plans. Anesthesiologist Assistants work exclusively within the Anesthesia Care Team environment as described by the American Society of Anesthesiologists (ASA). AA's are trained extensively in the delivery and maintenance of quality anesthesia care as well as advanced patient monitoring techniques.

Anesthesiologist Assistants educational programs are based on the masters degree model and require at least two full academic years. Programs are required to be co-directed by board certified anesthesiologists. AA educational programs accept students who have prior education in the sciences that would qualify the student to pursue careers in medicine, dentistry, or one of the basic medical sciences. Students are taught course work that enhances their basic science knowledge in physiology, pharmacology, anatomy, and biochemistry with special emphasis on the cardiovascular, respiratory, renal, nervous, and neuromuscular systems. Clinical instruction educates students extensively in patient monitoring, anesthesia delivery systems, life support systems, and patient assessment as well and in the skills need to provide compassionate, quality care.

[warzone]

Here is an AA's description:

Anesthesiologist Assistants are highly educated allied heath professionals who work under the direction of licensed anesthesiologists to develop and implement anesthesia care plans. Anesthesiologist Assistants work exclusively within the Anesthesia Care Team environment as described by the American Society of Anesthesiologists (ASA). AA's are trained extensively in the delivery and maintenance of quality anesthesia care as well as advanced patient monitoring techniques.

Anesthesiologist Assistants educational programs are based on the masters degree model and require at least two full academic years. Programs are required to be co-directed by board certified anesthesiologists. AA educational programs accept students who have prior education in the sciences that would qualify the student to pursue careers in medicine, dentistry, or one of the basic medical sciences. Students are taught course work that enhances their basic science knowledge in physiology, pharmacology, anatomy, and biochemistry with special emphasis on the cardiovascular, respiratory, renal, nervous, and neuromuscular systems. Clinical instruction educates students extensively in patient monitoring, anesthesia delivery systems, life support systems, and patient assessment as well and in the skills need to provide compassionate, quality care.

[warzone]

Here's a "FAQ" from a University with an AA program:

Is the job description for the Anesthesiologist Assistant (AA) profession equivalent to that for a Certified Registered Nurse Anesthetist (CRNA)?

Yes. When AAs are employed within the same organizations as CRNAs, the job description is usually identical. One fundamental difference is that AAs must work under the medical supervision of a licensed anesthesiologist. Conversely, in some unique clinical settings (usually not at tertiary care centers), a CRNA can practice under the medical supervision of any physician (not necessarily an anesthesiologist).

[warzone]

Here's a "FAQ" from a University with an AA program:

Is the job description for the Anesthesiologist Assistant (AA) profession equivalent to that for a Certified Registered Nurse Anesthetist (CRNA)?

Yes. When AAs are employed within the same organizations as CRNAs, the job description is usually identical. One fundamental difference is that AAs must work under the medical supervision of a licensed anesthesiologist. Conversely, in some unique clinical settings (usually not at tertiary care centers), a CRNA can practice under the medical supervision of any physician (not necessarily an anesthesiologist).

[SharonH, RN]

Isn't this comparable to the difference between a PA and APRN? Was the AA role developed by physicians, perhaps to compete with CRNAs? Why? AAs cannot work independent of anesthesiologist but CRNAs can, at least in some states. Am I on the right track?

[SharonH, RN]

Isn't this comparable to the difference between a PA and APRN? Was the AA role developed by physicians, perhaps to compete with CRNAs? Why? AAs cannot work independent of anesthesiologist but CRNAs can, at least in some states. Am I on the right track?

[New CCU RN]

Originally posted by warzone

Here's a "FAQ" from a University with an AA program:

Is the job description for the Anesthesiologist Assistant (AA) profession equivalent to that for a Certified Registered Nurse Anesthetist (CRNA)?

Yes. When AAs are employed within the same organizations as CRNAs, the job description is usually identical. One fundamental difference is that AAs must work under the medical supervision of a licensed anesthesiologist. Conversely, in some unique clinical settings (usually not at tertiary care centers), a CRNA can practice under the medical supervision of any physician (not necessarily an anesthesiologist).

Actually there are many other differences b/n an AA and a CRNA

1) CRNA's are employed in all 50 states, a growing number of those states are allowing CRNAs to practice independantly. AA's are only allowed to practice in less states than I can count on my hands.

2) CRNA's have previous clinical experience in comparison to an AA where they are either bs or ms prepared with their only clinical experience being while in school.

3) AA's are exactly what the word says.... anethesia assistants, they are assistants to the MD. CRNA's have their own scope of practice.

4) CRNA's administer 65 % of the anesthesia in the US, there is no stastic that I could find out there for AA.

5) CRNA's make about 100-150 thousand while AA's start off around 70-90

6) AA's must have the MDA in the room, as they are under DIRECT supervision. Thus decreasing their effectiveness. EVen if a CRNA is practicing under an MDA as this occurs in some states, the MDA does not have to be present.

7) Given the little autononmy that AA's possess, I do not see their role growing much more. They simply crowd the OR with another person, one who cannot make any decisions on their own. A person who may be educated but is NOT clinically educated and has very little hands on clinical experience.

8) CRNA's must have BS or BSN's, competitive GPA's, competitive GRE's, and a minumum of at least one year ... most usually have about five years experience of Critical Care nursing (ICU), managing high acuity patients. They have dealt with Swan Ganz, balloon pumps, CVVH, a coding patient, a direct post op patient. While RN's are not autonomous, ICU nursing involves ALOT of decision making, seeing the whole scope of the picture, convincing the physicians (usually no offense but baby doctors who have very little ICU knowledge) of a medical plan of care, recovered a patient post op. ICU RN's now CRNA's have this under their belt before they even begin their education to become a CRNA. CRNA's undergo 27-36 months of full time school and clinical... which also puts an AA program to shame.

9) If you look back into the history of CRNA's, they have been around for many years (over 100). I don't see them doing anything but expanding their current practice. Many studies are out there that find the same patient outcomes whether a CRNA or an MDA administered the anethesia. AA's... seem to be an MDA's handmaiden.

[New CCU RN]

Originally posted by warzone

Here's a "FAQ" from a University with an AA program:

Is the job description for the Anesthesiologist Assistant (AA) profession equivalent to that for a Certified Registered Nurse Anesthetist (CRNA)?

Yes. When AAs are employed within the same organizations as CRNAs, the job description is usually identical. One fundamental difference is that AAs must work under the medical supervision of a licensed anesthesiologist. Conversely, in some unique clinical settings (usually not at tertiary care centers), a CRNA can practice under the medical supervision of any physician (not necessarily an anesthesiologist).

Actually there are many other differences b/n an AA and a CRNA

1) CRNA's are employed in all 50 states, a growing number of those states are allowing CRNAs to practice independantly. AA's are only allowed to practice in less states than I can count on my hands.

2) CRNA's have previous clinical experience in comparison to an AA where they are either bs or ms prepared with their only clinical experience being while in school.

3) AA's are exactly what the word says.... anethesia assistants, they are assistants to the MD. CRNA's have their own scope of practice.

4) CRNA's administer 65 % of the anesthesia in the US, there is no stastic that I could find out there for AA.

5) CRNA's make about 100-150 thousand while AA's start off around 70-90

6) AA's must have the MDA in the room, as they are under DIRECT supervision. Thus decreasing their effectiveness. EVen if a CRNA is practicing under an MDA as this occurs in some states, the MDA does not have to be present.

7) Given the little autononmy that AA's possess, I do not see their role growing much more. They simply crowd the OR with another person, one who cannot make any decisions on their own. A person who may be educated but is NOT clinically educated and has very little hands on clinical experience.

8) CRNA's must have BS or BSN's, competitive GPA's, competitive GRE's, and a minumum of at least one year ... most usually have about five years experience of Critical Care nursing (ICU), managing high acuity patients. They have dealt with Swan Ganz, balloon pumps, CVVH, a coding patient, a direct post op patient. While RN's are not autonomous, ICU nursing involves ALOT of decision making, seeing the whole scope of the picture, convincing the physicians (usually no offense but baby doctors who have very little ICU knowledge) of a medical plan of care, recovered a patient post op. ICU RN's now CRNA's have this under their belt before they even begin their education to become a CRNA. CRNA's undergo 27-36 months of full time school and clinical... which also puts an AA program to shame.

9) If you look back into the history of CRNA's, they have been around for many years (over 100). I don't see them doing anything but expanding their current practice. Many studies are out there that find the same patient outcomes whether a CRNA or an MDA administered the anethesia. AA's... seem to be an MDA's handmaiden.

[EmeraldNYL, BSN, RN]

Oh yea, this is going to be a fun thread!

- What is the difference in schooling/certification/academics?

Well, both are master's prepared but the CRNA has previous ICU experience, while the AA may or may not have any previous medical experience.

- What is the difference in their scope of practice or autonomy?

CRNA's obviously have a lot more autonomy because they have the capacity to practice independently, such as in a rural setting. However, in a tertiary care center in a city setting, there may not be a whole lot of difference in job description between AA's and CRNA's.

- What economic factors are behind the push of AAs, if any?

Duh, AA's are cheaper! MDA's have a lot more control over AA's while they may view CRNA's as a threat to their profession.

- Can we relate this situation to another in Healthcare? Possibly LPN vs. RN?

Sure, for example, some job ads advertise for either an LPN or an RN. In the future we may see some ads recruiting AA's or CRNAs, so the CRNA's will have to make sure they remain extra competitive to warrant their larger paychecks.

- What are the best and worst case scenarios for CRNAs in the future, as it pertains to AAs vs. CRNAs?

Best case scenario-- AAs never gain in popularity and the profession slowly dies. Worst case scenario-- AAs take CRNAs jobs because they are cheaper and threaten CRNAs job security.

- Why should one become a CRNA, rather than an AA?

Right now there are more opportunities for CRNA's and they can practice more independently.

- How does the MDA benefit from the increased use of AAs vs CRNAs?

More control over the AA and they are cheaper.

- How does all this factor into the level of care a patient receives?

Studies have shown that CRNA's are just as safe as MDAs. However, studies remain to be completed about the safety of AAs. So it may or may not affect patient safety.

Really, I think this debate is extremely similar to the whole PA vs. NP argument. PA's have little medical experience prior to PA school and they have proven themselves to be competent care providers. In most situations the job description of the PA and NP are interchangeable. (Just trying to play devil's advocate a little bit, I really want to be a CRNA and it would really stink if an AA took my future job!)

[EmeraldNYL, BSN, RN]

Oh yea, this is going to be a fun thread!

- What is the difference in schooling/certification/academics?

Well, both are master's prepared but the CRNA has previous ICU experience, while the AA may or may not have any previous medical experience.

- What is the difference in their scope of practice or autonomy?

CRNA's obviously have a lot more autonomy because they have the capacity to practice independently, such as in a rural setting. However, in a tertiary care center in a city setting, there may not be a whole lot of difference in job description between AA's and CRNA's.

- What economic factors are behind the push of AAs, if any?

Duh, AA's are cheaper! MDA's have a lot more control over AA's while they may view CRNA's as a threat to their profession.

- Can we relate this situation to another in Healthcare? Possibly LPN vs. RN?

Sure, for example, some job ads advertise for either an LPN or an RN. In the future we may see some ads recruiting AA's or CRNAs, so the CRNA's will have to make sure they remain extra competitive to warrant their larger paychecks.

- What are the best and worst case scenarios for CRNAs in the future, as it pertains to AAs vs. CRNAs?

Best case scenario-- AAs never gain in popularity and the profession slowly dies. Worst case scenario-- AAs take CRNAs jobs because they are cheaper and threaten CRNAs job security.

- Why should one become a CRNA, rather than an AA?

Right now there are more opportunities for CRNA's and they can practice more independently.

- How does the MDA benefit from the increased use of AAs vs CRNAs?

More control over the AA and they are cheaper.

- How does all this factor into the level of care a patient receives?

Studies have shown that CRNA's are just as safe as MDAs. However, studies remain to be completed about the safety of AAs. So it may or may not affect patient safety.

Really, I think this debate is extremely similar to the whole PA vs. NP argument. PA's have little medical experience prior to PA school and they have proven themselves to be competent care providers. In most situations the job description of the PA and NP are interchangeable. (Just trying to play devil's advocate a little bit, I really want to be a CRNA and it would really stink if an AA took my future job!)