Here's what AAs really think of CRNAs

Specialties CRNA

Published

And this comes from the PRESIDENT of the American Society of Anesthesiologist Assistants

Again, assertions that AAs and CRNAs function at the same level -absolutely misleading.

And, what's with "anesthesia nurse"? If it sounds condescending in print, can you imagine how it would sound out of his mouth? What arrogance.

At least there is a phone number listed at the end of the article. Let's call Rob and let him know what we think of his little article!

Read carefully, SRNAs, this is a grim foreboding...

Licensed anesthesiologist assistants help access to medical care

By Rob Wagner

MY VIEW

Re: "Don't weaken the standards for anesthesia providers" (My View, April 11).

Maybe you or someone you know has had surgery delayed. Perhaps hospitals in your

area have closed operating rooms as they have in Miami, Jacksonville, Tampa and

elsewhere in Florida.

One reason for growing problems of this nature for patients is a shortage of

anesthesia providers. These are the assistants who help

physician-anesthesiologists perform the critical task of putting you to sleep

before surgery.

There is a common-sense solution rapidly making progress in the Florida

Legislature and around the country, which is to license anesthesiologist

assistants (called AAs). Key legislative action is expected today in Florida's

House Health Care Committee on HB 1381/SB 2332 and it is important that

lawmakers support it.

They need to be assured that this legislation will not weaken standards because

AAs are highly trained and perform the same function as anesthesia nurses. AAs

like myself serve patients in 16 states and have impeccable safety records. AAs

have worked with a high level of safety for 30 years in Georgia and Ohio.

AAs are required to have three times the hands-on, clinical training than are

most anesthesia nurses who currently assist anesthesiologists. Before we are

allowed to enter AA school, we must take the same courses physicians take as

pre-med students. Nurses do not do that. In fact, as the chief anesthetist at

St. Joseph's Hospital in Atlanta, I am in charge of both AAs and anesthesia

nurses.

If you are "going under," who would you rather have assisting the

anesthesiologist; someone trained to work directly with him or her, or a nurse?

We enjoy our professional relationships with our nursing colleagues. Yet nursing

organizations in Florida continue to misinform, even scare the public, calling

our profession "new" and "experimental."

Try telling that to the prestigious Emory University in Atlanta or Case Western

in Cleveland, which have been training AAs for more than three decades. Or try

to tell that to boards of medicine that oversee AAs in the states in which we

practice and whose members readily vouch for our safety record.

Try telling that to Medicare, the nation's largest health insurer, which

reimburses AAs and anesthesia nurses at the same rate. This means our skill

levels are viewed equally. And tell the insurance companies. They charge no

difference in fees between anesthesia nurses and AAs,

meaning our safety records are equal. Try telling that to the Florida Medical

Association, American Medical Association and American Society of

Anesthesiologists, whose members resoundingly support our working in Florida. In

the era of malpractice crisis, doctors are certainly not going to support

"experimental" health care providers.

Why, then, would the anesthesia nurses be opposed to this? In a word, money.

Because of nurse shortages, their salaries are artificially high, up to $150,000

in Florida. If you made that kind of living, wouldn't you try to keep the

competition out?

This nursing shortage is well documented on the Web sites of Florida schools

that train anesthesia nurses, the U.S. Department of Health and Human Services,

and yes, even on the anesthesia nurses' own Web site, http://www.aana.org, where the

shortage is called "serious" and "acute."

To help relieve the problem, two institutions, the University of Florida and

Nova Southeastern, are ready to open special schools for anesthesiologist

assistants in Florida. Would those schools offer programs if they didn't think

AAs are in great demand? Would they risk their reputations on an "experimental"

profession? Of course not.

One AA can mean five more patients per day will get their surgery. That's 1,200

patients per year treated with the help of only one AA. If you are or know one

of those patients, I'm sure you would be grateful to the Florida Legislature for

passing this common-sense legislation.

--------------------------------------------------------------------------------

Rob Wagner is chief anesthetist at St. Joseph's Hospital in Atlanta and

president of the American Academy of Anesthesiologist Assistants, PO Box 13978

Tallahassee, FL 32317 Phone: 656-8848.

Specializes in Anesthesia.
....Did you really just compare MDAs to pedophiles? ....

Oh please, 69, have you never heard of metaphor and simile? If not, you can look them up in the dictionary. It's a comparison of modes of ABUSE. Many group practices controlled by MDAs are like (sorry) Pimps 'n' Ho's, a stable of workhorses exploited and ABUSED by MDAs in big hats, jewels and Cadillacs.

I hope that you, if you become a CRNA in the future, are never mistreated and abused as I, and as many of my peers, have been in the past. Not to mention those pitiful AAs.

I said, "They know that we CRNAs see through their BS. We all know who does the real work. It's our shared 'secret' -- something akin to the way pedophiles have 'secrets' with their victims. Don't tell, or else. They have the power to fire us on a whim."

Perhaps you could read it again? There'll be a test at the end.....

deepz

Yes Alansmith, I agree with you. It is getting overrun by the "global allnurses.com network." Some posters are making remarks that make no sense. While I am a nursing student just finishing my ADN, I went into nursing for the sole purpose of pursuing a career as a CRNA.

Theresa

what?

granted there were a few post injected IMHO to add some levity to a hostile conversation. For the most part this has been a highly informative albiet contraversial thread....

i too am focused on getting my CRNA and am gaining insight into what the future holds. I now understand the differences between an AA and a CRNA and am hoping that any threat that AA's pose to the postition of CRNA are cancelled out in light of the differences in scope of practice.

What can I as a nurse/student/activist do to assist in maintaining the future of CRNAs? This comes from a student, mom of 3 and part time nurse...

If anyone can post some links I would greatly appreciate it...

signed,

one busy as h#ll mama,

Kate

i will say one thing to you lizz...i remember when i was younger..i too believed that "there was always a better way"...but then real life slapped me in the face and i realized that you cannot fight deceptive maneuvering with good hearted hopes.

I'm not a kid, and I'm not naive. I'm a 42 year old nursing student working on a second career. I've been around the block a few times. And I've known plenty of legislators, congressmen and senators in three states, as well as Washington, D.C. where I lived for eight years. I know the realities of how politics and government works. And I still think CRNA's need better arguments than what's been presented here, at least in the context of what the states are going to do on this issue. ;)

GeorigaAA and Gregsto: Thank you for posting. Some of us do appreciate the information, even if others were overtly hostile.

I realize that CRNA's have dealt with a lot crap from MDA's over the years, and that there's probably a lot of justified resentment there. But, at the same time, I think it's unfortunate that people from the other side have been chased away from the discussion. I would have liked to learn more.

:p

Specializes in Anesthesia.
....I realize that CRNA's have dealt with a lot crap from MDA's over the years, and that there's probably a lot of justified resentment there. But, at the same time, I think it's unfortunate that people from the other side have been chased away from the discussion......

Oh now, hold your horses, Lizz. Don't pout just yet. Georgia will be back, I'm sure, soon as he get the OK on what to say from his boss Doc supervisor.

deepz

Oh now, hold your horses, Lizz. Don't pout just yet. Georgia will be back, I'm sure, soon as he get the OK on what to say from his boss Doc supervisor.

deepz

C'mon Deepz. Can't you lighten up just a little? Why should they post? It's only an opportunity for you insult them some more.

I realize that most of us haven't had the same experiences as you. And that your opinions are probably justified, at least to some extent. But are we here to learn more about this issue, or just insult AA's?

:p

Specializes in Anesthesia.
....are we here to learn more about this issue, or just insult AA's?

Perhaps you missed the beginning of this thread, Lizz, which was in regard to a letter filled with insults for CRNAs by the perennial president of the AA group, a letter which has been recycled through many of the newspapers in Florida, perpetuating the same insults to the practice, the integrity and the safety of CRNAs. Remember? Anesthesia nurse, anesthesia nurse, anesthesia nurse?

This ain't beanbag. Sorry.

And this is a CRNA forum. I'm positive that, if you wish to learn what the other side has to say in more depth, there are other forums where you can learn about AAs.

Personally, I'll be there with the crowd at the State line to meet them with a hayfork. Yeah, just like the villagers in 'Frankenstein.'

deepz

Yeah, and this AANA ad isn't insulting?

https://allnurses.com/forums/attachment.php?attachmentid=2132

Seems to be plenty of mudslinging from both sides.

Oh well, rant on. For some reason, I didn't realize this was the "AA Bashing" forum which required AA bashing posts, only. ;)

:p

Woah.....

i don't remember "slinging mud" at any AA's - as a matter of fact - i do believe i stated that i am sure most are very competent....that is not the point of the arguement...and if you don't want to hear both sides - then don't read...if you have been around the block - especially in washington - then you should know that the ASA is one of the major powerhouses both financially and influencially...

the facts are:

1. AA's must be supervised by MDA's - CNRA'S DO NOT REQUIRE this supervision

2. if you do the math (for financial purposes) it is more fiscally responsible to employ CRNA's for the mere fact that you do not have to have a mandated 4:1 (MDA to AA) ratio for CRNA's

3. CRNA's bring years of critical patient care experience to the table which by any amount of logical reasoning makes them a better practitioner from the starting line.

4. for the ASA it IS about money, and it IS about maintaining "control" they feel is theirs in this field.

when you do become a nurse - you will realize that fighting for what you believe in FOR YOUR PATIENTS is the priority and that is all I and others are doing here. There were several very misleading and near false statements that equated AA's to CRNA's - and that IS offensive to those of us who have put in our time caring for patients and learning by experience to make us better and more prepared to show grace under pressure in a demanding field. I am sorry if the truth hurts feelings...but the truth is - i have coded hundreds of patients, done thousands of IV's, given hundreds of thousands of meds, and seen just about everything out there - and i bring that to the table PRIOR to any anesthesia training...but some try to tell you that their english major plus their anesthesia training makes them my equal...WRONG ANSWER. it is not about ego and it is not about money - it is about common sense and telling the truth. When you become a nurse...and someone confuses your tech's with you - you let me know if your hair bristles a bit...because you put in the time, training, dedication, and money to become a nurse...if it doesn't - you are not being honest. i think the arguments have been more than sufficiently made - so i have nothing further to say on the matter other than it is important for the SRNA's to be educated on these things so that they can be effective in the promotion of our profession.

I'm not a kid, and I'm not naive. I'm a 42 year old nursing student working on a second career.

You fooled me too. It's that punk-rock avatar and SoCal location, lizz! :wink2:

Specializes in CRNA, Finally retired.
The times that I have surgery, I said "I do not want a CRNA or other anesthesia assistant. You will provide an MD or you will have a problem."

Jailhouse RN - you are showing your ignorance about your own profession. I have to laugh when I think of the one patient I've had in twenty years who insisted on an MDA instead of a CRNA. That patient, and all others who insist on an MDA, are assigned to a very junior MDA since they're requests are considered an insult to the chief of department - as if he or she would want to associated themselves with an incompetent practitioner.

Specializes in Vents, Telemetry, Home Care, Home infusion.

i want a crna to provide my anesthesia care: at my side before , during and after surgery for i know from experience that in the majority of american hospitals, it's the nurses that keep the patient's safe and facilities functioning.

why choose a crna--a look at history reveals the depth of this profession:

a brief look at nurse anesthesia history-- a timeline of nurse anesthesia history

start of nurse anesthesia

1861-1865

catherine s. lawrence and other nurses provided anesthesia for surgeons operating on the wounded during the civil war

1877

sister mary bernard, a catholic nursing sister at st. vincent's hospital in erie, pennsylvania, was the first nurse known to have specialized in anesthesia

1953

nurse anesthetists were historically recognized in the publication of history of anesthesia with emphasis on the nurse specialist by virginia s. thatcher (able to read online karen)

through the years in nurse anesthesia history

http://www.aana.com/archives/through_years.asp#1890

1890s | 1900s | 1910s | 1920s | 1930s | 1940s | 1950s

1960s | 1970s | 1980s | 1990s | 2000

code of ethics for the certified registered nurse anesthetist

studies and reports:

the study, "surgical mortality and type of anesthesia provider," shows that surgical death rate is not linked to type of provider.

how to get involved?

check out the state websites, read their history and governement links section , write/ email/visit your legislators office regarding legislation that impacts our profession

For those of you who can not discern a difference, and see this as a turf battle, I would like you to consider this.

A nurse anesthesia student starts the program with a great deal of education and experience in the medical field. They all understand medical terminology, how to chart appropriately. Various disease processes, their effects, and treatment. Pharmacology, lab interpretation, EKG interpretaion, ventilator strategies, ACLS, PALS, CPR, sterile technique, this list could go on and on.

On the other hand an AA student can walk in with very little of this knowledge. Consider that the AA programs are about the same length of time as the CRNA programs. That the AA has few if any of the aforementioned skills, and must also learn the art and science of anesthesia. Do you think there is enough time? Do you want that person providing your anesthetic?

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