AANA (NON) membership anyone?

[ruler of kolob]

This is for CRNAs only....Are any of you NOT members of the AANA? if not, why not? Please do not go on and on about how it is my prefessional organization protecting my scope of practice etc etc etc. I am asking those who are NOT members why they chose to opt out. Are any of you angry enough about the AANAs inaction and abandonment of its members RE the MBCRNAs program for recertification? Maybe it's refusal to admit overproduction is a problem and it's unwillingness to address the problem? Cost of membership vs benefits received?

I know I am NOT the only non AANA member. According to the annual survey, about 5% of us are not members.

Thanks

[bread angel]

Do what you wish. Maybe you would be happier as a junior member of the ASA or even the ANA. I can guarantee that you will be vocal when you (1) lose your job, (2) have your hours cut, (3) have your hours extended, without additional pay or (4) be paid the same as other advance practice nurses. Then you will scream--how could the AANA let this happen? The AANA, while not perfect is the only organization that promotes our profession.

[ruler of kolob]

I am only stirring the pot because the vast majority of members are not dissatisfied with the services rendered by the AANA, COA or the NBCRNA. This is the only CRNA forum where nonmembers can post.

Bread Angel, If you think the AANA and it's lobbying group are resposible for your work conditions, hours and remuneration....US Department of Labor and market forces have much more resposibility.

Look, I GET you are all huge fans of the AANA... I was looking to find out why a meansurable percentage of my profession declines membership.

[wtbcrna, MSN, DNP, CRNA]

This is hardly the only site/forum that nonmembers of the AANA can post about their dissatisfaction.

[ruler of kolob]

You are obviously a satisfied customer... I am happy for you. I am looking for reasons why a CRNA would choose not to be a member...... Even if you are a member only to take advantage of CTAS.

[loveanesthesia]

CRNAs choose to not be a member because they think someone else (all the CRNAs that do belong to the AANA) will take care of their professional issues. They don't understand the importance of professional advocacy. They are not willing to spend time and money on issues that may not directly benefit them in the short term.

[nomadcrna, DNP, CRNA, NP]

I have been a member for 21 years. Even though I may be dissatisfied, I believe in supporting the CRNA profession. AANA may not be doing what I want it to do but it is still the best way to support CRNAs and the profession.

So if you don't support the AANA. Do you further the cause at the local level? Are you credentialed as full medical staff? That is a way ONE CRNA can make a difference. Get the bylaws changed.

Are you in an ACT practice? Work to get it changed or refuse to work that way.

There are things you can do to help the profession without being a member.

[ruler of kolob]

It is not an economic issue. The cost to renew certification costs as much as it would to be an AANA member... so no money is saved.

[ruler of kolob]

Once more ... I cannot make this more clear.. I do not want to be pilloried by AANA members about how non-membership is tantamount to pedophelia or high treason...I am looking for those who are NOT members and would like to know why they are not. It isthat simple. I GET you have a strong loyalty to the AANA, I GET you think those of us who do not will burn in a very special place in hell,, I truly understand all of that.. i am looking for CRNAs who are NOT members.. I understand your need to defend your organization when it appears threatened on any level,,,, Good for you.. this is not about that... and more importantly not anything you need to concern yourself with,,

[bread angel]

[quote

Bread Angel, If you think the AANA and it's lobbying group are resposible for your work conditions, hours and remuneration....US Department of Labor and market forces have much more resposibility.

I don't think you have any idea of how the AANA assisted at the US Dept. of Labor and other government entities who wanted to demote the value of our education and practice and reimbursement. They also assisted at the state levels to make sure the role of CRNAs was understood. BTW, it is a continuing battle.

As far as market forces goes, the ASA is pushing AA's to get licensure in all states. The AANA is strongly fighting this. When you have to compete with an AA for your ACT job, you will understand market forces.

I don't mind a good debate, but the facts will determine the winner.

[ruler of kolob]

[quote

Bread Angel, If you think the AANA and it's lobbying group are resposible for your work conditions, hours and remuneration....US Department of Labor and market forces have much more resposibi

The fight againts AAs

I don't think you have any idea of how the AANA assisted at the US Dept. of Labor and other government entities who wanted to demote the value of our education and practice and reimbursement. They also assisted at the state levels to make sure the role of CRNAs was understood. BTW, it is a continuing battle.

As far as market forces goes, the ASA is pushing AA's to get licensure in all states. The AANA is strongly fighting this. When you have to compete with an AA for your ACT job, you will understand market forces.

I don't mind a good debate, but the facts will determine the winner.

The US dept of Labor has nothing at all to do with the Value of our education...The Department of Education ( And I will be corrected if I recall this incorrectly) forced the move to establish the NBCRA and COA as seperates entitie from the AANA The Goverenmt determines what we are paid only as so far as Medicare, Medicaid ( State Govt.) Tri-Care and VA. Which are paid by the goverenmnt.

Funny you should mention education, One of the reasons for my unhappiness is the move to DNP. There is no really good reason to make all programs DNS programs...This was a move to align with NP programs. The profession was doing quite well until an alighmnet was sought with the NP community. It has ben said by wiser people than m yself they have a lot more to gain from us than we do from them.

As for AA's , What is being spent to defeat AAs is a delaying tactic and nothing more. More AA schools are opening around the country and more states are allowing them all the time. AAs are a result of the failure of the leadership of both the AANA and the ASA to negotiate a solution to disagreements between the two entities. Is it wise to spend that much money to delay an inevitability? Talk all you want about the evils of AAs... but the fact is they give anesthesia care in this country every day. They are a product of ,and utilized by the medical community.While they were not, as far as I know practicing in the military when I was in, I have heard rumors they are or will possibly be soon...Again Just something i heard., They are not going away.

I am glad you are an independent practitiopner and the money spent to insure you can do chronic pain interventions under flouroscopy,etc, by the AANA, helped you. It was not, however, a utilitarian use of time, money and effort.

Not all of us do that... nor have the desire to do that. I dare say the vast majority of members.

While my employer does not utilize AAs, yet, they are in my metropolitan area, this, along with the large numbers of new CRNAs being graduated locally and nationally have depressed salaries for years. My income has dropped about $30K/annum, due to loss of convenient and desireable locums gigs/ OT opportunties. This is not a compalint so ,much as it is an illustration of how the local market is affected. The AAs cannot fill the solo practice and CRNA only gigs I used to fill in on for vacation relief etc. If i recall correctly... and since I am not an AANA member I cannot verify this, the vast majority of CRNAs are in ACT situations. The COA is responible for the aproval of programs and they could adjust requiremnets to limit the number of schools. The present adjustment of rrequirements is too little, too late.

In the end, the last numbers I saw showed 5% of us are not AANA members.. I was just looking for other like-minded CRNAs and garner the reasons why they are not. Again...If you are happy with the AANA , great. I am not taking you to task you for being a member nor am I looking to convert you.

.

[wtbcrna, MSN, DNP, CRNA]

The US dept of Labor has nothing at all to do with the Value of our education...The Department of Education ( And I will be corrected if I recall this incorrectly) forced the move to establish the NBCRA and COA as seperates entitie from the AANA The Goverenmt determines what we are paid only as so far as Medicare, Medicaid ( State Govt.) Tri-Care and VA. Which are paid by the goverenmnt.

Funny you should mention education, One of the reasons for my unhappiness is the move to DNP. There is no really good reason to make all programs DNS programs...This was a move to align with NP programs. The profession was doing quite well until an alighmnet was sought with the NP community. It has ben said by wiser people than m yself they have a lot more to gain from us than we do from them.

As for AA's , What is being spent to defeat AAs is a delaying tactic and nothing more. More AA schools are opening around the country and more states are allowing them all the time. AAs are a result of the failure of the leadership of both the AANA and the ASA to negotiate a solution to disagreements between the two entities. Is it wise to spend that much money to delay an inevitability? Talk all you want about the evils of AAs... but the fact is they give anesthesia care in this country every day. They are a product of ,and utilized by the medical community.While they were not, as far as I know practicing in the military when I was in, I have heard rumors they are or will possibly be soon...Again Just something i heard., They are not going away.

I am glad you are an independent practitiopner and the money spent to insure you can do chronic pain interventions under flouroscopy,etc, by the AANA, helped you. It was not, however, a utilitarian use of time, money and effort.

Not all of us do that... nor have the desire to do that. I dare say the vast majority of members.

While my employer does not utilize AAs, yet, they are in my metropolitan area, this, along with the large numbers of new CRNAs being graduated locally and nationally have depressed salaries for years. My income has dropped about $30K/annum, due to loss of convenient and desireable locums gigs/ OT opportunties. This is not a compalint so ,much as it is an illustration of how the local market is affected. The AAs cannot fill the solo practice and CRNA only gigs I used to fill in on for vacation relief etc. If i recall correctly... and since I am not an AANA member I cannot verify this, the vast majority of CRNAs are in ACT situations. The COA is responible for the aproval of programs and they could adjust requiremnets to limit the number of schools. The present adjustment of rrequirements is too little, too late.

In the end, the last numbers I saw showed 5% of us are not AANA members.. I was just looking for other like-minded CRNAs and garner the reasons why they are not. Again...If you are happy with the AANA , great. I am not taking you to task you for being a member nor am I looking to convert you.

.

1. First and foremost AAs cannot serve in the military as anesthesia providers. All military anesthesia providers have to be able to deploy and work independently. That cannot be done with AAs. Only CRNAs and anesthesiologists can provide independent anesthesia care.

2. The AACN (American Association of Colleges of Nursing) made the recommendation that APNs move to a clinical doctorate as an entry into practice. The NP credentialing body have not supported the move to entry level DNP for NP as of yet. The AANA did not make the move to a clinical doctorate to align with NPs. The move to an entry level clinical doctorate by the CRNA community was to make our curriculum consistent with the amount of credit hours being taught, and to help make CRNAs more consistent leaders in EBP/EBM. This is nothing new as CRNAs have went from OJT, to certification, to Bachelors, to Masters over the span of 150 years.

3. The AA fight is hardly a forgone conclusion. Medicare just eliminated one of the billing modalities that AAs had been using, and requiring billing for AAs to be only billed as medically directed. As medical billing becomes more complicated and every dollar is accounted for ACT practices are going to become more scrutinized. It has already been proven that the majority billing done in ACT practicing do not meet the TEFRA requirements. The ACT system will either change or die out leaving a lot of AAs without jobs.

4. Yes, spending money to allow CRNAs to bill for things that they already due is worthwhile reason to have a PAC. A lot of rural CRNAs are involved in chronic pain care, because they are often the most qualified to offer chronic care and to do invasive procedures in those communities. The AANA also had a big part in the USAF CRNA scope of practice changes, and often advocate for all military CRNAs.

5. The changes by the COA are hardly to little to late. There is only regional overabundance of CRNAs, if you want more opportunities you are going to have to move to another region. It is no one else's fault if you choose to stay where you are. I am betting you do not even know all the changes that the COA recently made. There are several schools now that won't even be able to be reaccrediting due to the new change.

It doesn't matter if you are only trying to hear from other bashers of the AANA, but every time you make inaccurate statements I am going to correct them.

[nomadcrna, DNP, CRNA, NP]

Come on, be a scientist. Don't just pull numbers out of your butt. "The vast majority are in ACT practices"?

You would be wrong.

You are also wrong about AA and the military. No plans AT ALL to have AA practice in the military. They can't practice independently. You MUST be able to practice independent anesthesia in the military.

[h=3]Scope of practice [edit][/h]Today, nurse anesthetists practice in all 50 United States and administer approximately 34 million anesthetics each year (AANA). Approximately 65% of CRNAs practice in collaboration with anesthesiologists, in what is termed the "Anesthesia Care Team.” However, CRNAs are educated to work independently. CRNA practice varies from state to state, and is also dependent on the institution in which CRNAs practice. The following paragraphs clarify CRNA practice.

CRNAs practice in a wide variety of public and private settings including large academic medical centers, small community hospitals, outpatient surgery centers, pain clinics, or physician's offices, either working together with anesthesiologists, CRNAs, or in independent practice. They have a substantial role in the military, the Veterans Administration (VA), and public health.

The degree of independence or supervision by a licensed provider (physician, dentist, or podiatrist) varies with state law.^[26] Some states use the term collaboration to define a relationship where the supervising physician is responsible for the patient and provides medical direction for the nurse anesthetist. Other states require the consent or order of a physician or other qualified licensed provider to administer the anesthetic. No state requires supervision specifically by an anesthesiologist.^[27]

The licensed CRNA is authorized to deliver comprehensive anesthesia care under the particular Nurse Practice Act of each state. Their anesthesia practice consists of all accepted anesthetic techniques including general, epidural, spinal, peripheral nerve block, sedation, or local.^[28] Scope of CRNA practice is commonly further defined by the practice location's clinical privilege and credentialing process, anesthesia department policies, or practitioner agreements. Clinical privileges are based on the scope and complexity of the expected clinical practice, CRNA qualifications, and CRNA experience. This allows the CRNA to provide core services and activities under defined conditions with or without supervision.^[29]

In 2001, the Centers for Medicare and Medicaid Services (CMS) published a rule in the Federal Register that allows a state to be exempt from Medicare's physician supervision requirement for nurse anesthetists after appropriate approval by the state governor.^[30] To date, 17 states have opted out of the federal requirement, instituting their own individual requirements instead.^[31]

More than 40 percent of the CRNAs are men, a much greater percentage than in the nursing profession as a whole (Ten percent of all nurses are men).^[32]

Because many less-developed countries have few anesthesiologists, they rely mainly on nurse anesthetists.^[33] In 1989, the International Federation of Nurse Anesthetists was established.^[34] The International Federation of Nurse Anesthetists has since increased in membership and has become a voice for nurse anesthetists worldwide. They have developed standards of education, practice, and a code of ethics. Delegates from 35 member countries participate in the World Congress every few years. Currently there are 107 countries where nurse anesthetists train and practice and nine countries where nurses assist in the administration of anesthesia.^[33]

This is not a compalint so ,much as it is an illustration of how the local market is affected. The AAs cannot fill the solo practice and CRNA only gigs I used to fill in on for vacation relief etc. If i recall correctly... and since I am not an AANA member I cannot verify this, the vast majority of CRNAs are in ACT situations. The COA is responible for the aproval of programs and they could adjust requiremnets to limit the number of schools. The present adjustment of rrequirements is too little, too late.

In the end, the last numbers I saw showed 5% of us are not AANA members.. I was just looking for other like-minded CRNAs and garner the reasons why they are not. Again...If you are happy with the AANA , great. I am not taking you to task you for being a member nor am I looking to convert you.

.