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 malpractice insurance 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 $150,000
in Florida. If you made that kind of living, wouldn't you try to keep the
competition out?
This nursing shortage is well documented on the Web sites of Florida schools
that train anesthesia nurses, the U.S. Department of Health and Human Services,
and yes, even on the anesthesia nurses' own Web site, http://www.aana.org, where the
shortage is called "serious" and "acute."
To help relieve the problem, two institutions, the University of Florida and
Nova Southeastern, are ready to open special schools for anesthesiologist
assistants in Florida. Would those schools offer programs if they didn't think
AAs are in great demand? Would they risk their reputations on an "experimental"
profession? Of course not.
One AA can mean five more patients per day will get their surgery. That's 1,200
patients per year treated with the help of only one AA. If you are or know one
of those patients, I'm sure you would be grateful to the Florida Legislature for
passing this common-sense legislation.
--------------------------------------------------------------------------------
Rob Wagner is chief anesthetist at St. Joseph's Hospital in Atlanta and
president of the American Academy of Anesthesiologist Assistants, PO Box 13978
Tallahassee, FL 32317 Phone: 656-8848.
Please be patient with me as I am in the middle of moving and they have turned off my DSL service until next week so I am struggling with dialup. I don't have time right now to respond to everyone but I will attempt to answer everyone this evening with what I'm sure will be a long post. Please post additional questions in the meantime.
can we keep this extraordinarily interesting discussion civil please? there are many of us watching and waiting that happen to not be so skeptical. TIA
Skeptical? Not me. I clearly recognize lies, distortions and half-truths when I see them, having seen them many, many times from the A$A andf it's toadies over the years. It's all part of their long-term campaign of obfuscation.
Civil? I certainly don't consider it civil when A$A minions employ their term 'anesthesia nurse' to apply to me. It's an insult, a putdown. That is by no means civil. My title is nurse anesthetist. My profession defines itself. We don't need another group to name us. As a full-fledged ANESTHETIST I can do it all, without a crutch at my elbow.
Yet Mr Wagner claims the title anesthetist for himself -- chief anesthetist, no less -- but he is only, by definition, an ASSISTANT to his anesthesiologist employers. Stick with your own title, AAs, don't appropriate others'.
And when Mr Wagner states ".....Medicare, the nation's largest health insurer ...reimburses AAs and anesthesia nurses at the same rate. This means our skill levels are viewed equally" he conveniently forgets to mention that Medicare pays CRNAs at the same rate as it does MDAs, making CRNAs, by his own smug logic, 'equal in skill levels' to anesthesiologists. More obfuscation.
Civil? When GeorgiaAA posts a veiled threat to invade my state? Don't make me laugh. Folks, there are merely a few hundred AAs ... and 31,000 CRNAs.
Bring it on.
deepz
i am surprised by some of the comments that people would prefer an AA over a CRNA. why? do people really feel they won't get quality care with a CRNA? actually i would think the care would probably be just as good or better because nurses are usually more patient focused than most physicians. also CRNA's HAVE to be competent or else they wouldn't be in the OR. i think it is an insult to CRNA's that people feel this way. everyone has a right to want what they want, but i guarantee you if i had have an emergency surgery and there was only a CRNA on board i wouldn't complain. is there evidence that CRNA's have caused more pre/post surgery complications or deaths? if that is the case then there would be cause for concern, if not, then we need to support our nurses who choose this as a career.
Most of my procedures that I have ever had done have been with CRNAs.
And I actually prefer them when given the choice. Many anesthesiologists just supervise several rooms, and do not always do a case from start to end.
Of course there are exceptions to this rule when you do find an all MD anesthesia department. I definitely prefer a SRNA to be in the room and not an anesthesia resident.......................
:balloons:
......is there evidence that CRNA's have caused more pre/post surgery complications or deaths? .....
Angel, there has never been a scientific study that could distinguish ANY significant difference in quality of care between anesthesia provided by a CRNA and anesthesia provided by an anesthesiologist.
http://www.aana.com/crna/prof/quality.asp
deepz
Most of my procedures that I have ever had done have been with CRNAs.And I actually prefer them when given the choice. Many anesthesiologists just supervise several rooms, and do not always do a case from start to end.
Of course there are exceptions to this rule when you do find an all MD anesthesia department. I definitely prefer a SRNA to be in the room and not an anesthesia resident.......................
:balloons:
Anesthesiologists working in an "anesthesia team" environment do NOT generally administer the anesthesia. This is why I laugh when a patient insists that an anesthesiologist provide theirs. They are basically asking for the person with the LEAST day to day experience in anesthesia administration. (One of our jokes is that their oral airway is an OETT), as they frequently roll into PACU with a patient that is still intubated, this is because they only perform cases to meet their certification requirements.
Now before the flames start, I am not saying this is true of all MDA's but it is certainly true of MDA's in the "anesthesia care team". Which is the most common practice, especially in larger hospitals.
nec
50 Posts
Waiting to hear your reply to Nilepoc, please educate us on your scope of practice and your training, I am not familar with AA's so please tell us your experience and your background if you would thank you nec