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.
By your own admission, though, you I should point out that if you are running your cases with no involvement from your supervising MD, s/he is committing billing fraud and you are practicing beyond the scope of your license. This illustrates beautifully one of the main issues regarding AA practice.
I am in no way practicing beyond the scope of my license. I am performing those tasks which are fully within my practice description as accepted by the Georgia Board of Medical Examiners. I said little to no involvement. This does NOT mean that I never see my attending again. What I'm trying to point out is that I am not being told what to do step by step as has been alleged in CRNA written propaganda. I do not need to call my attending for every 5mg dose of Ephedrine. For billing purposes, the MDA must be present for induction, present for emergence and continuously available. The intent is to disallow having an anesthesiologists covering locations blocks or miles away. This also satisfies the definition of supervision. Our MDAs check on the room at regular intervals and sign the chart when they do so. All perfectly legal and normal practice. Your statement that this is an issue with AA practice is misleading since they afford the same level of supervision to the CRNAs.
The other key issue at stake here is that the acceptance of this "anesthesia care team" model in which AAs and CRNAs function interchangeably serves as a springboard for the future restriction of CRNA scope of practice. AAs cannot rise to the current level of practice of CRNAs by virtue of their training and licensure, so the CRNA scope of practice is restricted to allow for equitable working conditions. This is not acceptable.
The ONLY thing that I cannot do is practice independantly. Beyond that, I am trained and fully capable of doing anything that a CRNA can do. Honestly, I can't rise to the level of CRNA practice by virtue of my training?? Now who is insulting whom??
I'm not so sure about that Tenesma. In Canada at least which is of course based on the British medical system, an Anesthetist is a physician who practices anesthesia. .........[/quote']And so it is throughout Great Britain, Australia, New Zealand, etc, etc, all the old British Empire. Aneeesthetists, the Brits pronounce it, of course.
Anaesthetists practice all over the world. Anesthesiologist, the word, was devised in about 1937, to distinguish Dr Waters and his crowd from CRNAs. Today, nurse anesthetists, in various international descriptions, practice in over one hundred nations around the globe.
AAs, what few do exist, work in only a handful of States in one nation.
deepz
"Certified Registered Nurse Anesthetists, recognized leaders in anesthesia care, advancing patient safety and excellence in anesthesia."
NCgirl
188 Posts
Since I do love to call myself a princess, I'm going for "Princess Anesthetist". Kinda has a nice ring to it!