Is the AA profession gaining ground?

Qwiigley, BSN, MSN, DNP, RN, CRNA · Feb 9, 2008

PS: When I was in school, we were not permited to work and I didnt have time either.

deepz · Feb 9, 2008

....In real life, are MDAs in the room with AA? or are they on their own (with little medical background?)....

Quiig, you are a true comedian!

jwk · Feb 9, 2008

The AA can do the easy lap choles. (times, what up to 4 rooms?).
The CRNAs will be happy because they will have a ton of interesting work. We can do more serious, critical cases.
PLENTY OF WORK, you guys.
I do have one questions. In real life, are MDAs in the room with AA? or are they on their own (with little medical background?) I don't/haven't worked with AAs so I really don't know this answer. (California CRNA)

The comment in bold tells all - you really don't know about AA's.

Easy lap choles for the AA's while the CRNA's do "a ton of interesting work"? Give me a break. AA's administer anesthesia for all surgical sub-specialties including hearts, neuro, transplants, and peds.

MD's do not hold AA's hands. In most practices, they're there for induction and emergence and at intervals during the case. I do my own drugs, tubes, A-lines, CVP's, PAC's, regionals, yada yada yada. The only difference is I don't practice independently - and lets face it - if you want to do hearts, heads, and transplants, those aren't done by independent CRNA's either.

deepz · Feb 9, 2008

......if you want to do hearts, heads, and transplants, those aren't done by independent CRNA's either.

Maybe not in your little world in Hotlanta, but that's too broad a generalization for the 36,000 American CRNAs in general. You don't know what you don't know.

!

Qwiigley, BSN, MSN, DNP, RN, CRNA · Feb 9, 2008

JWK;

I actually do neuro, and specialize in pediatrics. FYI.

My group CRNAs do hearts, and transplants. We let our students do them with supervision on intubation, extubation and periodically throughout the case. But this is California and I've been told its a whole different country!!!

I honestly didn't mean to offend you. I didn't understand how AA could do advanced cases with only 24 months (?) of schooling in anesthesia (with no other background). My mistake, I apologize. I know that when I had just graduated from nursing school with my BSN, what seems like a hundred years ago, there were LVN?LPNs that were so much better than I was. They had the experience. But with my education (BSN vs adult ed night school) I quickly surpassed them.

I can see how very experienced AA can be upset with some of the comments in this thread. With the experience under your belt, I'm sure you are well qualified to care for a case.

Where you work JWK, why do the anesthesiologists come in the room for intubations/extubations/ at intervals? Are you medically directed or supervised? (Medically directed is much different than supervised). What happens when you disagree with what the anesthesiologist wants you to do? (We all have worked with the psycho who doesn't know his butt from his hand, right?)

I only ask these questions to truly understand your (AA) role and not to offend. I've read your threads over the years and you have some pretty good comments and ideas.

jwk · Feb 10, 2008

JWK;
I actually do neuro, and specialize in pediatrics. FYI.
My group CRNAs do hearts, and transplants. We let our students do them with supervision on intubation, extubation and periodically throughout the case. But this is California and I've been told its a whole different country!!!
I honestly didn't mean to offend you. I didn't understand how AA could do advanced cases with only 24 months (?) of schooling in anesthesia (with no other background). My mistake, I apologize. I know that when I had just graduated from nursing school with my BSN, what seems like a hundred years ago, there were LVN?LPNs that were so much better than I was. They had the experience. But with my education (BSN vs adult ed night school) I quickly surpassed them.
I can see how very experienced AA can be upset with some of the comments in this thread. With the experience under your belt, I'm sure you are well qualified to care for a case.
Where you work JWK, why do the anesthesiologists come in the room for intubations/extubations/ at intervals? Are you medically directed or supervised? (Medically directed is much different than supervised). What happens when you disagree with what the anesthesiologist wants you to do? (We all have worked with the psycho who doesn't know his butt from his hand, right?)
I only ask these questions to truly understand your (AA) role and not to offend. I've read your threads over the years and you have some pretty good comments and ideas.

All AA's work in ACT practices. Services in my group are all billed as medical direction, so we satisfy the TEFRA requirements on each case. Some groups may bill as supervision instead of medical direction.

I've had very few instances over the years where I've disagreed enough to say "here - you do it", but I have on occasion.

Qwiigley, BSN, MSN, DNP, RN, CRNA · Feb 11, 2008

Yeh, I've worked with a couple of total jerks myself! Thanks for the info.

GASping · Mar 18, 2008

Why are CRNAs so much up in arms about AAs?

I assume the same reason anesthesiologists don't like CRNAs. I am not convinced with the type of arguments being made by both sides since really either side can't claim superiority or equality in patient care without any real studies. I think everything is on an individual basis. For example, I have seen a CRNA do a great job taking care of patients, but at the same time, I have seen an anesthesiologist figure out things that the CRNA had never seen before. So, I assume that both have their role in different situations.

I just wish that CRNAs wouldn't try to move toward being independent so hastily because I see this as shooting yourself in the foot. Who is going to pay our malpractice or liability? I assume we will be forced into this position sooner or later. Having docs around to fork that part of bill is kind of nice.

I don't see how all this will help in the end. I just don't believe Democrats will be looking out for all of us since they will just try to make us work harder in the end. Universal health care doesn't help nurses either. Politicians will find a way to abuse us too. Docs are not the only ones who shouldn't be worried. These politicians are just coaxing us for now to only turn their backs on us. Look at England. They are just starting to think of paying nurses more, especially working in more dense populated settings.

Just my 2 cents.

deepz · Mar 18, 2008

.......I just wish that CRNAs wouldn't try to move toward being independent so hastily .....

For your first post you choose to shoot at an awful lot of targets.

But ... basically, where have you been? CRNAs have been independent for a long, long time without, as you say, shooting themselves in the foot.

And BTW ... die, thread, die!