Is the AA profession gaining ground?

[georgia_aa]

You are an RN who went to CRNA school then went to AA school? If that were the case do you think that you would have an objective assessment of AA education having already been educated as a CRNA?

No, I am an AA who can do everything that a CRNA does (except bill for my services) and I was trained in 2 years. And I, unlike you have more insight into your profession than you have in mine since I have always, my whole carreer worked with CRNAs and I'm willing to bet that you have never even met an AA much less seen one working in the OR.

[georgia_aa]

Hey Georgia

I agree. I think the largest gap is in the begging and then it totally depends on the kind of cases you decide to do (or are avalaible in your area) as an AA. If its all "bread and butter" cases, codes will be rare and the experience will never build. All falls back to experience, clearly you have gotten good experience. However, i wouldnt want my first code experience to be in the OR on my first solo case, know what i mean? I cut my teeth surrounded by VERY experienced RNs slowly integrating me into the high risk/critical stuff. I had backup as a new learner and then became others backups based on my clinical ability and experience. That isnt happening in the OR. Ive never met a surgeon who knew anything about codes or drugs in general. That leaves the onus on the guy/girl at the head of the bed to run the code and make the critical decisions.

I think we are on the same page :)

Cool Mike.

New AA grads are brought along slowly in the ACT environment. Easy cases to start, lots of direct supervision. Over time, they become more independant and gravitate to the bigger more complex cases. Just like the mentoring that you got as a greenhorn.

[EMS/ICU/SRNA]

No, I am an AA who can do everything that a CRNA does (except bill for my services) and I was trained in 2 years. And I, unlike you have more insight into your profession than you have in mine since I have always, my whole carreer worked with CRNAs and I'm willing to bet that you have never even met an AA much less seen one working in the OR.

You're correct in saying that I have very little insight into your profession as I have lived in PA my entire life and up until OH allowed AA's to work the AA trend has been a southern phenomena. And I will concede that your knowledge of anesthesia is exponentially greater than mine (currently;) ). But to say that you are the equal of a CRNA because you "can do the everything that a CRNA does" is unfounded. First of all, you can not legally manage a patient without an anesthesiologist. Second of all, because you have been trained to perform similar skills does not make you the superior provider. As a paramedic I was able to intubate, perform needle decompression, intraosseous cannulation.....blah blah blah. I can not perform any of those skills as a bachelors prepared RN. Does that mean I was a superior provider as a paramedic? Absolutely not. Did it "appear" that I was a superior provider performing those skills? probably. And because you perform those skills and it "appears" that you are providing the same service it does not neccessarily make it so. And to say that you learned everything in two years that the CRNA did in SIX is also unfounded, simply a matter of mathematics. I am not forgetting that AA's have an undergraduate in any given area but as stated previously in this post it could very well be in elementary education.

If I sound a little heated I apologize.....the area in which I practice has been flooded with PA's and there are very few opportunities for NP's to practice and I am concerned that CRNA's may be facing a similar problem in to future.

[georgia_aa]

Second of all, because you have been trained to perform similar skills does not make you the superior provider. As a paramedic I was able to intubate, perform needle decompression, intraosseous cannulation.....blah blah blah. I can not perform any of those skills as a bachelors prepared RN. Does that mean I was a superior provider as a paramedic? Absolutely not.

If I sound a little heated I apologize.....the area in which I practice has been flooded with PA's and there are very few opportunities for NP's to practice and I am concerned that CRNA's may be facing a similar problem in to future.

Forgive me , but when did I ever say or even imply that I was the superior provider????

[deepz]

.... I am an AA who can do everything that a CRNA does (except bill for my services) and I was trained in 2 years.......

Patently false, sir ... unless one counts 'everything that a CRNA does' as only those few poor brow-beaten and dumbed-down CRNAs whom your notorious boss hires for his group after telling them at interview, "Lines? Blocks? No way! Forget that. You'll not be doing any of that here."

It's all derived from A$A policy: no 'nurse' will do blocks or lines, nor will they practice with any significant degree of autonomy. Big difference between those restrictions, and 'everything that a CRNA does' in my book.

Your boss won't let you do blocks or lines or practice autonomously either, will he? A falsehood, in other words -- a lie.

Why?

Once again the two AAs are straining on this NURSES BB to receive validation. Fact is, all the bragging in the world will never convince us that AAs are equal to CRNAs, fellas ... except perhaps the naive wannabees and the newbies who know no better. Experientia docet. We who've been around the block, and around the world in anesthesia, we know better.

I'm reminded of Aesop's fable of the blind men describing a elephant. Having spent too long in Atlanta, these two think all the US resembles Atlanta, instead of being the quite singular anomaly that Atlanta is. They should get out more. (Incidentally, they could benefit from making fewer 'you' statements and more 'I' statements in their dialog. Comes across as whiny.)

Are AAs gaining ground? Sure. By my rough calculations, if five schools can graduate 30 grads each year, in roughly 220 years, AAs might catch up to the number of CRNAs extant in 2006.

So ... never mind.

....yawn....

deepz

[georgia_aa]

Hey, it looks like he's getting ready to say something. Shhhhh everybody, let's hear what he has to say........

Patently false, sir ... unless one counts 'everything that a CRNA does' as only those few poor brow-beaten and dumbed-down CRNAs whom your notorious boss hires for his group after telling them at interview, "Lines? Blocks? No way! Forget that. You'll not be doing any of that here."

It's all derived from A$A policy: no 'nurse' will do blocks or lines, nor will they practice with any significant degree of autonomy. Big difference between those restrictions, and 'everything that a CRNA does' in my book.

Your boss won't let you do blocks or lines or practice autonomously either, will he? A falsehood, in other words -- a lie.

Why?

Once again the two AAs are straining on this NURSES BB to receive validation. Fact is, all the bragging in the world will never convince us that AAs are equal to CRNAs, fellas ... except perhaps the naive wannabees and the newbies who know no better. Experientia docet. We who've been around the block, and around the world in anesthesia, we know better.

I'm reminded of Aesop's fable of the blind men describing a elephant. Having spent too long in Atlanta, these two think all the US resembles Atlanta, instead of being the quite singular anomaly that Atlanta is. They should get out more. (Incidentally, they could benefit from making fewer 'you' statements and more 'I' statements in their dialog. Comes across as whiny.)

Are AAs gaining ground? Sure. By my rough calculations, if five schools can graduate 30 grads each year, in roughly 220 years, AAs might catch up to the number of CRNAs extant in 2006.

So ... never mind.

....yawn....

deepz

Ahh forget it. Same crap he said in the other thread. Again, Deepz , you add nothing of substance to the discussion. You really are quite talented at putting people to sleep as you have always said you are. By the way, I do lines everyday. I don't do blocks but many, many AAs do everyday. You know nothing about me, but profess to know everything. And no, quoting an Aesop fable does not make you seem more intelligent. Go back to sleep Deepz and bury your head in the sand and go on believing that AAs will never be what you are (thank God!!!).

[rn29306]

.....and I'm willing to bet that you have never even met an AA much less seen one working in the OR.

Bull. I have, in fact quite often.

You might not want to hear this story, but here goes. BTW, I'm sure everyone has a story of incompetant providers, so here is mine. Rotating somewhere in Georgia. Me a junior SRNA (didactic work of 7 months, clinical 7 months) and a senior AA are at the same facility. Keep in mind she graduates in the Spring and will most likely take boards before graduation. Head MD says "quiz time" in front of a room full of anesthesia providers, mostly CRNAs, a couple AAs. I'm thinking she's had all this science background and I'm gonna get killed here.

First question to the AA (senior) student - "What is anectine?"

Her answer: "A non-depolarizing NMB".

The two staff AAs get up and leave at this point, along with several CRNAs. Other staff settle in because they just wanna hear this I guess.

I'll spare you the details of the rest of the conversation and I'm not giving out location information because that isn't the point of the conversation.

She didn't know what populations you can and can't give anectine to, much less what is was, nor did she know much else about the muscle relaxants or volatiles for the matter. MD basically told her not to come to clinical until she could at least answer these questions. Not to brag, but it is sad when a junior SRNA cleans a senior AAs clock during a pimping session in front of an audience.

I'm going to take a couple of arguements away right now. This information was not the type of information that comes with recently reading something and repeating it, say some obscure fact or study. This was what should be basic provider knowledge. Someboy's probably gonna give a million stupid SRNA stories and mistakes here and that's a part of learning. Everybody did them, including the clinical studs here on this board when they were learining. No senior should be publically embarassed like that by a junior on basic provider knowledge.

You can believe this story or not, really doesn't matter to me. This was in fact my first encounter with AAs. Then I met some more in clinical settings where I was actually in the room with them.

So there goes your arguement about not knowing much about your profession and not ever working with one.

[rn29306]

New AA grads are brought along slowly in the ACT environment. Easy cases to start, lots of direct supervision. Over time, they become more independant and gravitate to the bigger more complex cases. Just like the mentoring that you got as a greenhorn.

Do AA students ever have a room solo with a supervising MD?

How many cases do AAs typically graduate with?

[georgia_aa]

Bull. I have, in fact quite often.

You might not want to hear this story, but here goes. BTW, I'm sure everyone has a story of incompetant providers, so here is mine. Rotating somewhere in Georgia. Me a junior SRNA (didactic work of 7 months, clinical 7 months) and a senior AA are at the same facility. Keep in mind she graduates in the Spring and will most likely take boards before graduation. Head MD says "quiz time" in front of a room full of anesthesia providers, mostly CRNAs, a couple AAs. I'm thinking she's had all this science background and I'm gonna get killed here.

First question to the AA (senior) student - "What is anectine?"

Her answer: "A non-depolarizing NMB".

The two staff AAs get up and leave at this point, along with several CRNAs. Other staff settle in because they just wanna hear this I guess.

I'll spare you the details of the rest of the conversation and I'm not giving out location information because that isn't the point of the conversation.

She didn't know what populations you can and can't give anectine to, much less what is was, nor did she know much else about the muscle relaxants or volatiles for the matter. MD basically told her not to come to clinical until she could at least answer these questions. Not to brag, but it is sad when a junior SRNA cleans a senior AAs clock during a pimping session in front of an audience.

I'm going to take a couple of arguements away right now. This information was not the type of information that comes with recently reading something and repeating it, say some obscure fact or study. This was what should be basic provider knowledge. Someboy's probably gonna give a million stupid SRNA stories and mistakes here and that's a part of learning. Everybody did them, including the clinical studs here on this board when they were learining. No senior should be publically embarassed like that by a junior on basic provider knowledge.

You can believe this story or not, really doesn't matter to me. This was in fact my first encounter with AAs. Then I met some more in clinical settings where I was actually in the room with them.

So there goes your arguement about not knowing much about your profession and not ever working with one.

Umm.... Okay...not exactly a scathing indictment of the AA profession, but if it really happened I see that as nothing more than you coming across a slack AA student. Maybe she did not know you were discussing Succinylcholine. If she came from the Emory system, she really might not know that drug by it's brand name. Maybe she's one of these people who just blanks out when put on the spot in front of an audience. I have a hard time believing that a soon to graduate student can't recite chapter and verse about Succinylcholine but that is definitely the exception and not the rule. No matter how hard we try, weak under-performers slide into every program under the radar from time to time - CRNA programs included. I mean, do you really want to get me started on all of the SRNAs (or CRNAs for that matter) that I've encountered over the years that didn't know basic stuff?

How about elaborating on your perception of how the real staff AAs seemed to perform clinically instead of recounting some lame story about a student who flamed out during a Q&A. C'mon and enlighten all of your CRNA brethren on how the AAs were led around by ropes by their supervising physicians and did little more than put on the tegaderm after the MDA started the IV. You have so much first hand knowledge... let's hear it.

[jwk]

Do AA students ever have a room solo with a supervising MD?

How many cases do AAs typically graduate with?

Nope - that's called billing and/or Medicare fraud. I hear it happens frequently in "other programs".

[Nitecap]

Nope - that's called billing and/or Medicare fraud. I hear it happens frequently in "other programs".

Can you explain the medicare fraud allegations. Though the supervision ratio for SRNA's/residents and even AA's was 2 students : 1 attending.

[midwestsrna1]

Any one else take issue with AAs calling themselves "anesthetists"? If I am correct, the title is Anesthesiologist Assistant.

Do PAs go around calling themselves "practitioners" or some other title? No, they call themselves Physicians Assistants. Hmmm...vaguely reminds me of regulations in some states where you can only call yourself a nurse if you are an RN (not a CNA, nursing student, etc.).