Anesthesia

[nursingsprettycool17, BSN]

While doing research I realized something kinda funny. Why is it that nurses are the only anesthesia providers required to have ICU experience? CRNA schools and forums really push for those years of ICU experience to be considered competent... yet AAs seem pretty safe without it. Maybe this is why CRNAs are allowed to practice independently of MDs? Those years of ICU? Just an interesting observation.

[brownbook]

I don't know what an AA is?

[nursingsprettycool17, BSN]

Anesthesiologist Assisstant

[Rose_Queen, BSN, MSN, RN]

AA are not allowed to practice in all states. According to https://aaaa.memberclicks.net/assets/aaaa%20practice%20map%20aug%2014.pdf they are only able to practice in 17 states. Another thing to take into consideration- why do 33 states not allow them when all states allow CRNAs?

[PeakRN]

Anesthesia assistants typically have a much lower scope of practice and less independence than CRNAs.

Like all advanced practice nurses the idea of CRNAs is that with additional graduate training on top of their RN experience nurses can provide more advanced medical care. The initiation and maintenance of anesthetics, paralytics, vasoactive drugs, hemodynamic support, invasive monitoring, et cetera is performed by nurses in the ICU/PICU more than most other care areas hence the requirement by most CRNA programs (some will accept specific ED or NICU experience). It is also hard ho have a competitive CRNA application without more experience than the minimum requirements, often nurses who apply have many years of critical care experience in multiple critical care areas.

[adventure_rn, MSN, NP]

Maybe this is why CRNAs are allowed to practice independently of MDs?

IMO, the main reason CRNAs have more autonomy than AAs is because AAs work under medical licensing boards, whereas CRNAs work under nursing licensing boards. Physician governing bodies have little incentive to provide more autonomy to non-MD providers if it means that physicians can be cut out of the picture. Meanwhile, nursing boards have every incentive to push for greater nursing autonomy. Some people argue that this is the reason we see autonomous NPs in some states, but there aren't autonomous PAs (as they, like AAs, are governed by state medical boards).

[loveanesthesia]

What makes you say an AA is pretty safe? There is no research on AA outcomes. Why do you think that is?

Nurse anesthesia students start their program knowing how to care for critically ill patients. AA programs have to include a medical terminology course. Think about that!