CRNA vs AA?

allnurses Guide · Jul 7, 2017

The biggest differences that you will see is the job opportunities for AAs is extremely limited compared to CRNAs and AAs cannot work without medical direction/supervision of an anesthesiologist. CRNAs can and do work independently and the percentage of CRNAs working independently has grown over the last several years. CRNAs work in every state and US territory.

loveanesthesia · Jul 10, 2017

All CRNAs are RNs with patient care experience prior to beginning an anesthesia program. The practice of anesthesia has much in common with the practice of nursing. It's continual patient assessment and adjusting according to the patient responce. Anesthesiologists Assistants do not have a nursing background so do not understand basic content such as medical terminology, physical assessment, patient communication and much, much more. AAs are taught to assist an anesthesiologist while CRNAs are taught to care for a patient. CRNA opportunities are growing as health care finance becomes more important. AAs must practice under medical direction which is becoming less common because the model is more expensive while there is no evidence patient outcomes are improved. Many AAs wish they were CRNAs, but no CRNAs wish they were an AA.

Bluebolt · Jul 10, 2017

Very well said.

offlabel · Aug 28, 2017

Any non physician anesthetists, whether individually or corporately, one day realize they don't need to have their hand held by a doctor to do anesthesia. CRNA's knew that very early on and AA's are beginning to realize this now. One day there will be such a thing as a "militant AA" as far as anesthesiologists are concerned, if that entity doesn't already exist.

The difference is that AA's practice at the pleasure of their state's board of medicine and can be dealt a lethal blow over a weekend. CRNA's are credentialed completely independently of any physician organization and as such are free to pursue or not pursue varying degrees of "independence" as they see fit.

Take away? AA's need to play nice, regardless of the skill and experience they bring to the table. CRNA's don't.

manusko · Oct 29, 2017

Any non physician anesthetists, whether individually or corporately, one day realize they don't need to have their hand held by a doctor to do anesthesia. CRNA's knew that very early on and AA's are beginning to realize this now. One day there will be such a thing as a "militant AA" as far as anesthesiologists are concerned, if that entity doesn't already exist.
The difference is that AA's practice at the pleasure of their state's board of medicine and can be dealt a lethal blow over a weekend. CRNA's are credentialed completely independently of any physician organization and as such are free to pursue or not pursue varying degrees of "independence" as they see fit.
Take away? AA's need to play nice, regardless of the skill and experience they bring to the table. CRNA's don't.

The problem with AAs being militant and wanting to break free is that they can not do this without going back to school and switching professions. They literally cannot practice independent of a anesthesiologist.

NovaAEC · Jan 31, 2018

All CRNAs are RNs with patient care experience prior to beginning an anesthesia program. The practice of anesthesia has much in common with the practice of nursing. It's continual patient assessment and adjusting according to the patient responce. Anesthesiologists Assistants do not have a nursing background so do not understand basic content such as medical terminology, physical assessment, patient communication and much, much more. AAs are taught to assist an anesthesiologist while CRNAs are taught to care for a patient. CRNA opportunities are growing as health care finance becomes more important. AAs must practice under medical direction which is becoming less common because the model is more expensive while there is no evidence patient outcomes are improved. Many AAs wish they were CRNAs, but no CRNAs wish they were an AA.

Your statements are very misleading to the AA profession.

1) The practice of anesthesia has much in common with the practice of nursing.

More in common with nursing compared to what? The practice of anesthesia is not synonymous with nursing.

2) Anesthesiologists Assistants do not have a nursing background so do not understand basic content such as medical terminology, physical assessment, patient communication and much, much more.

This statement makes it seem like AA's don't obtain any training or education in medicine. We both know this isn't true. Patient communication? Are nurses the only group of people who know how to have a conversation with others? AA programs require 2 years of education in science courses (pre-med) many of which take medial terminology as a prerequisite. Physical assessment is also learned in AA programs and again taught in CRNA programs.

3) AAs are taught to assist an anesthesiologist while CRNAs are taught to care for a patient.

Assistant is a little misleading when it comes to what AA's do in the OR. In fact, CRNA's and AA's do the exact same thing. Nurses just tend to use whatever ammo they can find to put down another profession that has the same goal they do. To care for the patient while they are in their hands.

The nursing board has been outstanding when it comes to supporting nurses (including CRNA's). That is not up to debate. However, when you have posts like this where you purposefully put down a profession with false anecdotes of experience or abilities -- you lose credibility.

allnurses Guide · Jan 31, 2018

Your statements are very misleading to the AA profession.
1) The practice of anesthesia has much in common with the practice of nursing.
More in common with nursing compared to what? The practice of anesthesia is not synonymous with nursing.
2) Anesthesiologists Assistants do not have a nursing background so do not understand basic content such as medical terminology, physical assessment, patient communication and much, much more.
This statement makes it seem like AA's don't obtain any training or education in medicine. We both know this isn't true. Patient communication? Are nurses the only group of people who know how to have a conversation with others? AA programs require 2 years of education in science courses (pre-med) many of which take medial terminology as a prerequisite. Physical assessment is also learned in AA programs and again taught in CRNA programs.
3) AAs are taught to assist an anesthesiologist while CRNAs are taught to care for a patient.
Assistant is a little misleading when it comes to what AA's do in the OR. In fact, CRNA's and AA's do the exact same thing. Nurses just tend to use whatever ammo they can find to put down another profession that has the same goal they do. To care for the patient while they are in their hands.
The nursing board has been outstanding when it comes to supporting nurses (including CRNA's). That is not up to debate. However, when you have posts like this where you purposefully put down a profession with false anecdotes of experience or abilities -- you lose credibility.

The only time AAs and CRNAs are interchangeable is when they both work in restrictive ACT environments.

When you can find one study comparing outcomes of independent AAs giving comparable care to independent CRNAs or anesthesiologists then you will have valid argument about AAs until then you need to go a forum that is for AAs not CRNAs.

loveanesthesia · Jan 31, 2018

Your statements are very misleading to the AA profession.
1) The practice of anesthesia has much in common with the practice of nursing.
More in common with nursing compared to what? The practice of anesthesia is not synonymous with nursing.
Nursing has more in common with the practice of anesthesia compared to any other profession. Nurses monitor patient responses and adjust their care based on patient responses on a minute to minute basis. Anesthesia providers also do this. Who else does?
2) Anesthesiologists Assistants do not have a nursing background so do not understand basic content such as medical terminology, physical assessment, patient communication and much, much more.
This statement makes it seem like AA's don't obtain any training or education in medicine. We both know this isn't true. Patient communication? Are nurses the only group of people who know how to have a conversation with others? AA programs require 2 years of education in science courses (pre-med) many of which take medial terminology as a prerequisite. Physical assessment is also learned in AA programs and again taught in CRNA programs.
Yes, but every SRNA from day one already has a basis in this prior to beginning their anesthesia program. The SRNA then spends 3 years advancing their knowledge in the practice of anesthesia.
3) AAs are taught to assist an anesthesiologist while CRNAs are taught to care for a patient.
Assistant is a little misleading when it comes to what AA's do in the OR. In fact, CRNA's and AA's do the exact same thing. Nurses just tend to use whatever ammo they can find to put down another profession that has the same goal they do. To care for the patient while they are in their hands.
Some CRNAs in some settings may function as AAs, but that does not mean AAs are the same as CRNAs. Every CRNA has the capability to function without medical direction. Every AA must practice with medical direction.
The nursing board has been outstanding when it comes to supporting nurses (including CRNA's). That is not up to debate. However, when you have posts like this where you purposefully put down a profession with false anecdotes of experience or abilities -- you lose credibility.

It's important to understand that CRNAs are proud of our capabilities and history. You may feel that my demonstration of the differences between a CRNA and an AA is a 'put down', but I'm just stating facts.

Bluebolt · Feb 1, 2018

Your statements are very misleading to the AA profession.
1) The practice of anesthesia has much in common with the practice of nursing.
More in common with nursing compared to what? The practice of anesthesia is not synonymous with nursing.
2) Anesthesiologists Assistants do not have a nursing background so do not understand basic content such as medical terminology, physical assessment, patient communication and much, much more.
This statement makes it seem like AA's don't obtain any training or education in medicine. We both know this isn't true. Patient communication? Are nurses the only group of people who know how to have a conversation with others? AA programs require 2 years of education in science courses (pre-med) many of which take medial terminology as a prerequisite. Physical assessment is also learned in AA programs and again taught in CRNA programs.
3) AAs are taught to assist an anesthesiologist while CRNAs are taught to care for a patient.
Assistant is a little misleading when it comes to what AA's do in the OR. In fact, CRNA's and AA's do the exact same thing. Nurses just tend to use whatever ammo they can find to put down another profession that has the same goal they do. To care for the patient while they are in their hands.
The nursing board has been outstanding when it comes to supporting nurses (including CRNA's). That is not up to debate. However, when you have posts like this where you purposefully put down a profession with false anecdotes of experience or abilities -- you lose credibility.

I'm really not sure where AA's get this confusion that we are the same. Perhaps because you are only allowed to work in a strict medically directed ACT practice you only see anesthesia from within your small snowglobe of direction. Out of the 15 sites, we rotate through during our 3-year doctorate only one site is medically directed and that is because it's a huge well known teaching hospital. CRNAs are not taught to work under medical direction, it's something we would have to adapt to if we took a job in an environment an AA practices within. During rotations it's essentially learning to work at 50% of your capability because there are so many hands involved in your case.

CRNAs are not trained or educated to practice like AAs, they are trained and educated to practice like MDAs. This is why they are successfully running their own practices and working collaboratively with MDAs doing QZ billing. You'll find that is the heart of the matter and where you seem to get confused.

Anesthesiaman · Sep 12, 2022

A lot of this hostility toward AAs is unfounded. AAs are not trained to merely "assist" we are trained to provide complete anesthesia care beginning to care. Anesthesiologist do not need to be legally present at any time during the surgery they merely have to be in the building. Most times they will come in at induction but it's not necessary and some don't come at all. The sole purpose of the AA profession was to protect the anesthesiologist from CRNAs ongoing attempt to provide anesthesia without them. By offering a care team model they can hire us and not have to deal with CRNAs who are corporately trying to push anesthesiologist out the door. But in terms of quality of care there is no difference in quality between a CRNA or an AA. My hospital staffs both and we perform. The same jobs, the same tasks, in fact some of our stronger anesthetists are AAs...not CRNAs. Though both of us are well trained and qualified. I have nothing against the CRNA profession and know this ...we are not competing for jobs...if AAs didn't exist I would have simply went to CRNA school instead...and competed for that same job as a CRNA....and with the anesthesia shortage you can't say your struggling to find jobs bc of AAs...if you are a CRNA in GA and can't find a job message me bc we're almost always hiring. So please CRNAs please stop preaching negative things about AAs....Either you are ignoring and don't know about what we really can do or you are malicious and just out to condemn my profession but at the end of the day patient care is most important and we are just as qualified. I read an article that literally said the outcomes between AAs and CRNAs was the same but it said CRNAs must be better because they aren't required to work with an anesthesiologist...that's what I'm saying....really it said they are better after showing similar outcomes? Give me a break!

loveanesthesia · Sep 24, 2022

On 9/12/2022 at 2:07 PM, Crimson0087 said:

. “Anesthesiologist do not need to be legally present at any time during the surgery they merely have to be in the building. “

Here are the regulations for medical direction https://www.aapc.com/blog/24070-follow-7-rules-for-billing-anesthesia-medical-direction/amp/ You can see that the physician anesthesiologist must be physically present in the OR at several points in the anesthetic including personally conducting the Preop assessment, and present at induction and emergence. If the 7 rules are not followed and a bill for payment is submitted, then it’s billing fraud. Also read your state laws/regulations and your hospital regulations. Often they are written to be consistent with the 7 rules for medical direction. Then not having a physician anesthesiologist present as described is ‘illegal’.

In 50 years of AA practice in GA and OH, only 1 study of AA practice is published (in 2018). And in the study only 5% of the cases were done by AAs, and 95% were done by CRNAs. In contrast a Cochrane review was done of nurse anesthesiology practice which found a large body of evidence of high quality practice.

“The solepurpose of the AA profession was to protect the anesthesiologist fromCRNAs ongoing attempt to provide anesthesia without them.” This is correct. The care team model is just a bad idea and one of the unfortunate effects is some/many physician anesthesiologists loose their ability to provide anesthesia independently. So as practices transition to a collaborative model, they no longer have a place. And some just don’t want to provide hands on anesthesia. But requiring 2 expensive providers to administer 1 anesthetic is not sustainable.

If you are still interested in becoming a CRNA there is a bridge program at TCU. You’ll have a lot more opportunities.