Jane Fitch MD, prior CRNA, now Anesthesiologist elected president ASA

loveanesthesia · Oct 23, 2013

"AA's were created because of the overall manpower shortage in anesthesia that existed 40 years ago. Back when the vast majority of CRNA's had no degree of any sort, just a nursing diploma and anesthesia certificate, AA's came along with a masters-prepared provider, a totally new concept at the time."

An academic degree does not necessarily indicate a higher quality education. Due to the long history of nurse anesthetists (to the 1880's at least), the profession has progressed through several educational frameworks. As for master's degrees, discussion began in 1965 amoung nurse anesthesia educators, and between 30 and 40 nurse anesthesia program directors met in 1969 and recommended that nurse anesthesia education be raised to the master degree level. The first academic degree program for CRNAs was started by Ira Gunn in 1969, an Army program at Tripler. A severe shortage of CRNAs hampered efforts and the transition was slow in order to allow programs to make the necessary changes without drastically dropping the number of graduates. A master's degree was adopted by the newly created AA role in reponse to what nurse anesthetists were doing. There is no doubt that the only reason the AA role was created was in response to CRNAs. If there were no CRNAs in the US, there would be no AAs either.

jwk · Oct 23, 2013

"AA's were created because of the overall manpower shortage in anesthesia that existed 40 years ago. Back when the vast majority of CRNA's had no degree of any sort, just a nursing diploma and anesthesia certificate, AA's came along with a masters-prepared provider, a totally new concept at the time."

An academic degree does not necessarily indicate a higher quality education. Due to the long history of nurse anesthetists (to the 1880's at least), the profession has progressed through several educational frameworks. As for master's degrees, discussion began in 1965 amoung nurse anesthesia educators, and between 30 and 40 nurse anesthesia program directors met in 1969 and recommended that nurse anesthesia education be raised to the master degree level. The first academic degree program for CRNAs was started by Ira Gunn in 1969, an Army program at Tripler. A severe shortage of CRNAs hampered efforts and the transition was slow in order to allow programs to make the necessary changes without drastically dropping the number of graduates. A master's degree was adopted by the newly created AA role in reponse to what nurse anesthetists were doing. There is no doubt that the only reason the AA role was created was in response to CRNAs. If there were no CRNAs in the US, there would be no AAs either.

As indicated previously, how long the profession has been around means nothing.

The master's for AA's was formulated because there was essentially no such equivalent with CRNA's. The original AA concept was to be at a level in-between that of a CRNA and anesthesiologist. The first AA class started in 1969 - the idea of a master's degree most certainly was not as a response to CRNA's doing the same thing. Nurse anesthesia programs weren't even requiring ANY degree to start anesthesia school back then, and the requirement for a master's degree for all programs didn't happen until the mid-late 1990's.

You do make my point for me though - you indicated there was a shortage of CRNA's back in the late 60's. Again, that's one reason AA's came about. That's not due to under production of CRNA's (there were dozens upon dozens of community hospital CRNA programs during that time) as much as it was the huge jump in technology relating to anesthesia and producing more of a demand for services. That increase continues today as more and more areas require anesthesia services.

jwk · Oct 23, 2013

http://www.nmana.org/wp-content/uploads/2013/01/AA-CRNA-comparison-table.pdf
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If AAs were simply invented d/t a shortage of anesthesia providers it would have made more sense to increase the number seats in NA programs and more cost-effective to.

Citing your own propaganda again? It makes sense in your mind obviously, but again, simply increasing numbers of providers wasn't the goal.

allnurses Guide · Oct 24, 2013

Citing your own propaganda again? It makes sense in your mind obviously, but again, simply increasing numbers of providers wasn't the goal.

Yes, I know and have pointed out simply increasing the number of anesthesia providers wasn't the goal. The ultimate goal was to create a political rival to CRNAs that could not compete with MDAs. Thus, an inferior and dependent anesthesia provider model was born with the AA.

loveanesthesia · Oct 24, 2013

The master's for AA's was formulated because there was essentially no such equivalent with CRNA's. The original AA concept was to be at a level in-between that of a CRNA and anesthesiologist. The first AA class started in 1969 - the idea of a master's degree most certainly was not as a response to CRNA's doing the same thing. Nurse anesthesia programs weren't even requiring ANY degree to start anesthesia school back then, and the requirement for a master's degree for all programs didn't happen until the mid-late 1990's.
You do make my point for me though - you indicated there was a shortage of CRNA's back in the late 60's. Again, that's one reason AA's came about. That's not due to under production of CRNA's (there were dozens upon dozens of community hospital CRNA programs during that time) as much as it was the huge jump in technology relating to anesthesia and producing more of a demand for services. That increase continues today as more and more areas require anesthesia services.

There was never a requirement for a BS degree, because nurse anesthesia leaders determined the nurse anesthesia academic degree needed to be at the graduate level. The requirements of many certificate in anesthesia programs were beyond a BS degree with the exception of the general education requirements.

The shortage of CRNAs post WWII through the end of the decade are well documented. Actually the shortage was probably at it's most severe around 1990. The AA role had been launched for 20 years but had done little to increase the number of anesthesia providers, and nothing to increase the number of independent anesthesia providers. In 1990 I believe there were around 700 AAs in the country (correct me if I'm wrong). Only in the past 5 years has the shortage of CRNAs been relieved, and ironically that is the same time the number of AAs also began to increase-once the shortage has largely been solved. Why? as a political response to increasing pressure to remove barriers to practice for APRNs. It really never was about the shortage.

allnurses Guide · Oct 24, 2013

The reason for the increase is simple. The ASA has stated they want AAs in every state to combat CRNA independent practice. AAs are a political tool of the ASA.

Gentleman_nurse, MSN · Oct 24, 2013

I just happened to be browsing this forum. I don't know much the Anesthesia profession or Dr Fitch's career. But I don't have high opinion of someone who forgot where they came from by denigrating a profession she was once part of as evidenced by the youtube video. She could use her position and experience to build a partnership than increasing the divide.

loveanesthesia · Oct 25, 2013

I just happened to be browsing this forum. I don't know much the Anesthesia profession or Dr Fitch's career. But I don't have high opinion of someone who forgot where they came from by denigrating a profession she was once part of as evidenced by the youtube video. She could use her position and experience to build a partnership than increasing the divide.

Thanks for your persepective, I couldn't agree more. I don't think she is a threat to CRNAs, although that is obviously her intent.

jwk · Oct 25, 2013

There was never a requirement for a BS degree, because nurse anesthesia leaders determined the nurse anesthesia academic degree needed to be at the graduate level. The requirements of many certificate in anesthesia programs were beyond a BS degree with the exception of the general education requirements.
The shortage of CRNAs post WWII through the end of the decade are well documented. Actually the shortage was probably at it's most severe around 1990. The AA role had been launched for 20 years but had done little to increase the number of anesthesia providers, and nothing to increase the number of independent anesthesia providers. In 1990 I believe there were around 700 AAs in the country (correct me if I'm wrong). Only in the past 5 years has the shortage of CRNAs been relieved, and ironically that is the same time the number of AAs also began to increase-once the shortage has largely been solved. Why? as a political response to increasing pressure to remove barriers to practice for APRNs. It really never was about the shortage.

There would be far more AA's except for the interference of the AANA and CRNA's by opposing expansion of AA practice at every turn. Again - the hypocrisy is blinding. It's that "glass houses" thing, ya know?

allnurses Guide · Oct 25, 2013

There would be far more AA's except for the interference of the AANA and CRNA's by opposing expansion of AA practice at every turn. Again - the hypocrisy is blinding. It's that "glass houses" thing, ya know?

And CRNAs would be able to bill Medicare independently, if it weren't for the lies of the ASA and there still wouldn't be a need for AAs...

US Army MAJ,CRNA · Nov 5, 2013

Dr Fitch was a diploma graduate CRNA, long before a Masters was required for certification, only things available to her was Curare and Cyclopropane......of course she "didn't know what she didn't know".......advances in CRNA practice increased exponentially in parallel to her own education....she paints an unrealistic and intentionally deceptive picture that CRNA practice remained right where she left it. Now she sits at the seat that has the sole purpose of protecting MD anesthesia practice at ALL costs.....a "shoot them all now, sort them out later" mentality. She not only drinks the ASA koolaid, she's now in charge of making sure there are enough cups to go around........

jwk · Nov 6, 2013

Dr Fitch was a diploma graduate CRNA, long before a Masters was required for certification, only things available to her was Curare and Cyclopropane......of course she "didn't know what she didn't know".......advances in CRNA practice increased exponentially in parallel to her own education....she paints an unrealistic and intentionally deceptive picture that CRNA practice remained right where she left it. Now she sits at the seat that has the sole purpose of protecting MD anesthesia practice at ALL costs.....a "shoot them all now, sort them out later" mentality. She not only drinks the ASA koolaid, she's now in charge of making sure there are enough cups to go around........

Nice try on dating her techniques but she's not that old. Intentionally deceptive? Hmmmmmmmm.

No different than the AANA koolaid being partaken by those posting here. You're telling me the AANA doesn't exist to protect CRNA practice "at ALL costs"? Puhleeeeze.