Anyone have any experience with anesthesia assistants compared to CRNAs ?

Specialties CRNA

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I am about half way through my undergraduate classes. I was planning on going to medical school but and having serious second thoughts. I really enjoy the health care field and want to stay in it. The classes I have taken get me about half way through the science classes required for nursing school and almost all the way through the prereques for anesthesia assistant school.

Are the two degrees, CRNA and anesthesia assistant, very similar ? Are there any advantages to either one ? Which one is more employable ? Any thoughts ?

Here's an idea, if you want to be an AA then go to allAA's.com (if there's not one then start one up) and talk about it. This conversation is old, it's like the AA's come here because they don't have their own site and stir the pot and CRNA's and hopefulls feel compelled to defend their turf and bash AA's. Bottom line is we all want to practice Anesthesia and the best way to get there is any way you can! If I lived in Georgia and had a BA in english and decided I loved Anesthesia I would be high fiving with JWK talking smack about AA's ruling and so forth. As it is I am a nursing student who is getting a degree in nursing and then becoming a CRNA. Who do I think is more qualified, well CRNA's of course that's why I subscribe to a website centered around CRNA's.

Bottom line is the best way is the one you can swing. Maybe 5% of all of the people who frequent this website will ever practice Anesthesia and the ones who make it will have a great career in front of them no matter which way they choose to go. I have my opinion and you have your's and it is obvious that no one's mind is going to be changed by this type of thread. The only logical conclusion is that we all love to here ourselves talk :rotfl:

All practitioners of Anesthesia ROCK!!!

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Here's and idea, if you think internet forums are stupid and they're just to hear ourselves talk.......and you get tired of reading about one subject if it goes over 2 days.........don't join the forum and don't read the blogs.

Here's another idea,....don't say what you just said when you are interviewing for CRNA school if they happen to ask you why you chose this path.

Here's an idea, if you want to be an AA then go to allAA's.com (if there's not one then start one up) and talk about it. This conversation is old, it's like the AA's come here because they don't have their own site and stir the pot and CRNA's and hopefulls feel compelled to defend their turf and bash AA's. Bottom line is we all want to practice Anesthesia and the best way to get there is any way you can! If I lived in Georgia and had a BA in english and decided I loved Anesthesia I would be high fiving with JWK talking smack about AA's ruling and so forth. As it is I am a nursing student who is getting a degree in nursing and then becoming a CRNA. Who do I think is more qualified, well CRNA's of course that's why I subscribe to a website centered around CRNA's.

Bottom line is the best way is the one you can swing. Maybe 5% of all of the people who frequent this website will ever practice Anesthesia and the ones who make it will have a great career in front of them no matter which way they choose to go. I have my opinion and you have your's and it is obvious that no one's mind is going to be changed by this type of thread. The only logical conclusion is that we all love to here ourselves talk :rotfl:

All practitioners of Anesthesia ROCK!!!

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Thanks for clarifying the often confusing statements regarding CRNA supervision versus independent practice, especially as it relates to Medicare. But what's the difference, if any, in opt-out states?

well to try and avoid this firestorm again i needed to make a couple of comments.

1. "supervision is a term defined in medicare part A billing. the word "supervision" is not a term that is meant to imply that the surgeon, podiatrist, opthomologist etc has anything to do with the anesthetic. the physician does NOT in any way have an involvement in preoperative evaluation, perioperative management or postoperative evaluation/discharge. the supervision requirement just means that a physician must "request" the anesthetic. as a crna we cant just go around giving anesthesia, but i dont see where this is an issue unless you were opening a pain clinic. even in this environment patients are usually refered by a physician for pain management anyway. "supervision" again does not mean that the requesting physician be the "captain of the ship". if a crna is doing a case without "mda supervision" independantly, that crna is the sole provider responsible for the anesthetic. the surgeon is in no way responsible for the actions of the crna. this has been proven in several key lawsuits.

2. TEFRA rules stipulate that an mda must do the preop eval, be present at induction, any crisis period / issue during the case, check on the case at intervals, be present at extubation and evaluate the patient for postop discharge. i cant think of the last one there are 7 steps. this is for medicare part B billing. if these 7 specific steps are not met, then the group is practicing medicare fraud. so for jwk who i would think is a very safe and qualified practitioner, if at any time during the case where a patient became unstable, started or ended a case or if the mda didnt make a visit during the case then there is medicare fraud. as a student i have circulated through several different hospitals and i can tell you that if all cases were medicare patients / cases then most everyone of them is commiting fraud. but i have yet to see a mda ask or evaluate a patients billing status (medicare vs non-medicare).

3. It is already becoming apparent that medicare and hmos are becoming aware that crnas and mdas are doing the same job and that medicare is paying 2 ppl to do one case. ie mda "supervising" crna. my personal opinion is that crnas will soon be in direct competition with mdas/ and if these companies dont want to pay for 2 ppl doing one case i dont see them paying mdas/aas to do one case. CRNA's are the most cost efficient use of anesthesia time. we have shown a history of quality safe anesthesia practice outside of the Anesthesia care team model.

of course these are just my opinions/ jwk i aint bashing you my friend. but again we have to agree to disagree.

d

:coollook:

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There are both case # and hour requirements for CRNA school. Oftentimes, people think that 800 is the total number of hours we have, which is totally untrue. The number of hours are anesthesia hours (start time to end time of a case, as stated in the above post) and our program has over double the requirment alone. It would be nice if programs would total up the anesthesia time and clinical time not spent in the OR. I bet that would total over 3500 hours. I know mine will be.

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Thanks for clarifying the often confusing statements regarding CRNA supervision versus independent practice, especially as it relates to Medicare. But what's the difference, if any, in opt-out states?

:coollook:

I believe the difference is that in order for the facility (hospital, surgicenter, etc.)to get paid from the Medicare Part A pool, then CRNA's need to be "supervised" by a physician. In the states that have opted-out, the CRNA does NOT have to be supervised by a physician for the facility to get Medicare Part A funds. This is not a monetary benefit to the CRNA him/herself, but it definitly makes utilizing CRNA's by the facility more attractive.

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Thanks for clarifying the often confusing statements regarding CRNA supervision versus independent practice, especially as it relates to Medicare. But what's the difference, if any, in opt-out states?

if i am not mistaken the opt out clause in state regulations just removes the "supervision" wording from medicare part A billing. the reason this is important to crnas: it wont change practice much in those states that opt out, it just clarifies confusing wording. the real step is that it's a stepping stone to changing the billing setup in medicare part B. that is where if a crna is medically directed, the anesthesiologist gets 50% payment and the crna gets 50%. the bad thing for crna is we get 50%. the good thing for anesthesiologist they can "supervise" up to 4 rooms,,,so 4 x 50% = 200% one anesthesiologist can recieve 100% payment for "supervision 2 rooms 200% for "supervision" of 4 rooms. yet not really do any work. now if a mda "supervises" more than 4 rooms the multiplier decreases and the financial incintive becomes less.

if a hospital chose not to use mda to "supervise" then crna's can bill 100%

same as if a hospital chose not to use crnas, the mda could bill 100%.

although the monies are the same coming in, it is a poor use of resources to use both. and if you take into concideration retitement plans insurance etc, it is very costly to hospitals to employ both.(considering they were both hospital employees and not groups contracted to provide the anesth service) and even in this case it's probably more economical to hire crnas as employees than to pay the group for anesth services.

feel free to correct me on any part that i may be misinformed on. we just had a lecture on this very thing,

d

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There are both case # and hour requirements for CRNA school. Oftentimes, people think that 800 is the total number of hours we have, which is totally untrue. The number of hours are anesthesia hours (start time to end time of a case, as stated in the above post) and our program has over double the requirment alone. It would be nice if programs would total up the anesthesia time and clinical time not spent in the OR. I bet that would total over 3500 hours. I know mine will be.

I agree - my actual OR time will be more than twice the requirement, and if you count total clinical time (spent on pre-op visits, post-op visits, etc) it would be even more.

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Specializes in CRNA, Finally retired.
We're not the same. Thank god.

There's something wierd about someone who has the time to troll a NURSING forum to trash talk nurses. Wouldn't it be nicer to have a life free of the feeling of constantly having to defend yourself? Just go to work and enjoy your job.

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Specializes in CRNA, Finally retired.
I really wonder when people say that they are VERY interested in becoming a CRNA, then don't know hardly anything about the profession. The funny thing is that EVERYONE can state the starting pay??????? Sorry, I know I shouldnt write anything b/c I am not a CRNA or SRNA, but since being exposed to the profession in 2001, I've been preparing for that special day when I might be able to apply. The last 4 years in nursing school was very challenging, (even if not true) hoping never to get a B just so I might have a chance when I apply to CRNA school. Now that that hells over with, here comes GRE, more Chem. classes, and the hope to transfer into an ICU once I complete my 1st year as a new grad in cardio.. All this to become a CRNA. As you can see, there is so much preparation needed in becoming a CRNA, so maybe just doing basic research would help you. I know I'll probley get blasted for writing this, but as a hopefully SRNA one day, I know how hard I've worked and will have to work if I ever want to accomplish this goal and it really urks me when people "act" interested, but can't state the very basics as the differences b/t AA's and CRNA.

I'm done, blast away :rolleyes:

Amen, the anesthesia forums dedicate an awful lot of space to people who even haven't GONE TO NURSING SCHOOL YET! And they "know" they want to be a CRNA. Let's make it the final statement on these boards, which are supposed to be CRNA's conferring with other CRNA's, if you think you want to be a CRNA, go to AANA.com. It's all there. Please demonstate that you have enough competence to do your research before you start with the questions.

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There's something wierd about someone who has the time to troll a NURSING forum to trash talk nurses. Wouldn't it be nicer to have a life free of the feeling of constantly having to defend yourself? Just go to work and enjoy your job.

I'd love to go blissfully to work each day and not to have to defend myself and my profession against people who really don't know any better, but some of y'all make that darn near impossible. So here I am...

As for why I participate (I don't troll, thank you), I actually learn a lot here, even from those that I disagree with or that disagree with me, whether those discussions are political or clinical in nature.

Amen, the anesthesia forums dedicate an awful lot of space to people who even haven't GONE TO NURSING SCHOOL YET! And they "know" they want to be a CRNA. Let's make it the final statement on these boards, which are supposed to be CRNA's conferring with other CRNA's, if you think you want to be a CRNA, go to AANA.com. It's all there. Please demonstate that you have enough competence to do your research before you start with the questions.

And what's that old saying about nurses eating their young?

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Specializes in CRNA, ICU,ER,Cathlab, PACU.
And what's that old saying about nurses eating their young?

Very accurate statement, to the posters who are ragging on the simply interested...I agree...must say to the op though, being a nurse gives you one hell of a contingency plan if you don't make it through crna school (or if you are not accepted)...you can always fall back on your RN and make an honest and interesting living. Not sure what aiming for AA school will get you if you are not accepted, or need a contingency. Of course you could technically be an RN first, then an AA, or is that automatic grounds for rejection?

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very accurate statement, to the posters who are ragging on the simply interested...I agree...must say to the op though, being a nurse gives you one hell of a contingency plan if you dont make it through crna school (or if you are not accepted)...you can always fall back on your RN and make an honest and interesting living. Not sure what aiming for AA school will get you if you are not accepted, or need a contingency. Of course you could technically be an RN first, then an AA, or is that automatic grounds for rejection?

:chuckle Nope, we've actually had a number of RN's go through the AA program. They usually do very well. It will be interesting to see if the RN applicant #'s go down with the 2nd CRNA school in Georgia opening in Macon. One of the CRNA's in my group resigned to help with that program.

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