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.
Warzone, if you read what I wrote related to that quote, I did take the time to see where it was from. And I said, you need to consider the source of the quote before taking it seriously.
As far as my list of why CRNA's are competitive over AA's, Louisane, you took it and compared it to MDA's. It was not a CRNA vs MDA arguement and your arguments back are making into one.
I am not familiar with AAs. Work in a rural area where we have always used CRNAs and no anesthesiologists. This whole thing reminds me of several decades when docs were promoting nurse practitioners, then found out nurses could practice independantly and the docs couldn't control everything they did. Thus the PA programs were developed under medical auspices. Many members of the medical community still can't accept the fact that nurses can think and practice independantly. (Also a common misconception of the public in general)
I have been reading this site for months now -- I work in the IT field, because I've always had a nack with computers, and am pretty smart, and taught myself all of this networking stuff. Well, in case you didn't know, the IT field is dying, and not to mention, not having an IT degree hurts me in a lot of ways.
So, I'm going back to what I went to college for in the fist place -- Health Care.
I'm probably too old to be a doctor now (I'm 31 - it would be probably 2 years until I get in, then 7 years of working until I can start earning -- not to mention the incredible amount of student loans I'd have to pay back.)
So, then I thought about nursing -- I really liked the idea of CRNA. But then again, I already have a BS, and why would I want to get another BS(N), then spend time in the ICU, then 3 more years of CRNA school... I really like the idea of AA. Although there are only 2 schools in the US at the moment, I think this has a great chance of catching on, just like PA's have.
So, this is what I'm going to do -- it make more sense in my situation.
I have to agree, AA is a viable option for you. Be sure to check out if they are used where you want to work. They are not all that prevalent in all areas.
For the CRNA route, you would not need another BS. You could get a 2 year nursing degree, work a year of ICU, and apply to one of the schools that offers a non nursing masters. But that would take at least 5 years, compared to 4 for AA. And I am sure you have read the comments about the pros and cons of basic bedside nursing, found elsewhere on this board.
You are the one that has to make that decision for yourself.
Be very sure about the AA use in areas that you want to work and live for the rest of your life. Keep in mind that there are only two programs, they have been around for at least 15 years and there are only about 600 of them in the country. Compare that to CRNAs that have been in the United States since Sister Mary Bernard (the first documented nurse to engage in the practice of nurse anesthesia ----- in 1877), there are 86 programs in the US and Puerto Rico and there are over 29,000 practicing CRNAs in the country.
I believe the A$A has figured out another method for increasing their CONTROL of the practice of anesthesia and how to increase their $$$ at the same time! Woohoo!! "I'm SHOCKED I tell you - absolutely SHOCKED!" 8^O
Besides all the minutia and details presented here, try thinking about this for a moment:
There are approximately 27-28,000 CRNAs currently working providing 67% (2/3) of all anesthetics while there are approximately 35-37,000 MDAs/DOAs doing 33% (1/3) of actual hands on cases??
Does that ratio say anything to you about the supposed "shortage" of anesthesia providers? How about if say... 4-5,000 lounge-lizards (doctors "supervising") got up off their duffs, left the lounge (i.e. stopped reading the Wall Street Journal & buying gold on the internet) and actually started DOING THEIR OWN CASES?!? Maybe, just maybe, there wouldn't be a "shortage" anymore?
What a thought -
Frankly, I'm for INCREASING APNs' freedom to practice across the board which will include CRNAs. I think the economics alone will eventually dictate some of this trend. I'm very against anything smelling of "socialized medicine" but the camel's back (medical care) is about to break here in the USA and I believe the demands for care and availability will bring some of this change about.
I think about the "robber barrons" and how they monopolized the jobs, freedom to work in certain industries and especially the $$$ of the last century and before. I think the A$A is leaning the same direction - it's all about Control & GREED!
No, I do not think the A$A is being altruistic with their talk of "patient safety" and thus the need for "Physician trained assistants" like the AAs. Currently, we are in an uphill battle with doctors able to outspend us on lobbying and it appears Bush & certainly Frist are on the physicians' side. The fight is on and I, for one, refuse to be silent about my sentiments.
just a quick note from a lounge lizard (i am an mda):
i work 80hrs per week minimum - i get a total of 45 minutes to 50 minutes per day of free time (mainly for toilet/water/lunch breaks) --- i wish i had the opportunity to read the wall street journal and buy gold on the internet. Instead I am taking care of sick patients :)
but u-r-sleepy: your numbers are a bit skewed regarding number of anesthetics provided.... the percentage of "65% of all anesthetics provided" is very misleading especially since that number has no references whatsoever in the CRNA literature and is a gross assumption, and is also very misleading as it implies that 65% of all anesthetics are performed independently by CRNAs which we know is not the case.... Currently based on Medicare reports there are 40 million cases of anesthesia per year and anesthesiologists are responsible for over 90% of those - Now the figure 65% may represent that CRNAs are involved in some way or another in 65% of all cases, but that is all you can really extrapolate about that
I am also getting tired of the repetitive mantra that nurses have been providing anesthesia for a longer time - things evolve over time.... barbers used to do surgery, general surgeons used to do cardiac/thoracic/neurosurgery, general practictioners used to do high-risk obstetric deliveries....
what blows me away about your backhanded comments about MDAs: "lounge-lizards (doctors "supervising") got up off their duffs, left the lounge (i.e. stopped reading the Wall Street Journal & buying gold on the internet) and actually started DOING THEIR OWN CASES?!? " for heavens sake, you are a STUDENT-RNA: how much realworld anesthesia did you experience for you to have such an opinion, or are you just repeating what you have heard from the disgruntled few?
This is my first post; however, I have browsed this forum for about a year, as I start a program this week. One of the most disturbing issues to me is the fight between MDA's and CRNA's. I do not look forward to animosity in the clinical arena. In the words of Rodney King, "can't we all just get along?" I think both sides have valid arguments, but I have observed that most of the disagreement is based on misinfo, generalizations, assumptions, and paranoia. While I admit I'm green and that this is merely a subjective conversation post, I had been envisioning a more altruistic anesthesiasociety. Please don't critic this post, just take it for what it is: a roast of both PROFESSIONS.
Good Luck!!
warzone
53 Posts
Thanks Loisane for taking the time to see where that QUOTE came from.
DON'T KILL THE MESSENGER! LOL!