Nurse Anesthesiologist Name Change

[BigPappaCRNA]

To be clear, the profession did not change its name.  The professional association for CRNAs changed their name.  The AANA does not have the power to change the professions name.  Our ability to practice is by state, and with our state nursing license.  There will be 50 different opinions from them, plus, the NBCRNA will get a say in it as well.

While the association changing their name is a good first step in the process, it is a marathon, not a sprint, and we are still on the first lap.

[jfratian, DNP, RN, CRNA]

Back to the actual topic here: 

Professions change their names all the time; a profession gets to decide what to call themselves unless it is a specifically protected title in law.  'Anesthesiologist' is not a protected title; 'physician' is a protected title.  There are vet techs out there right now calling themselves Veterinarian anesthetists for the same reason. 

 PAs are now going to be 'physician associates.' The MDs and CRNAs called themselves physician and nurse anesthetists, respectively, until 1945.  The ASA has been using 'physician anesthesiologist' since 2013.  The AANA has been using 'nurse anesthesiologist' since 2018.

A 2013 survey commissioned by the American Society of Anesthesiologists (ASA) found only 40% of Americans associated 'Anesthesiologist' with a physician.  That's why the ASA has been trying to get docs to refer to themselves as 'Physician Anesthesiologists' for the last decade. 

I would point out that 5 states' boards of nursing (Arizona, Alaska, New Hampshire, Florida, and Idaho) already recognize the term Nurse Anesthesiologist.  When New Hampshire's board of medicine tried to sue the board of nursing over this, the state supreme court threw out the case.  Today, their state nursing license reads "Certified Registered Nurse Anesthesiologist."  

The term anesthesiologist is widely recognized in American case law as profession neutral protected free speech...dental and veterinarian anesthesiologists also use it.  Here's an opinion from the 5th circuit court of appeals in Texas from 2017 explaining the rationale.

http://www.ca5.uscourts.gov/opinions/pub/16/16-50157-CV0.pdf

 

[wtbcrna, MSN, DNP, CRNA]

17 hours ago, matthewandrew said:

I know… a rose by any other name…

but for those who care, what’s your thoughts on the name change for CRNAs to nurse anesthesiologists? Is it good for the profession or just deceptive advertisement? Thanks!

The term nurse anesthesiologist has been around and in use since at least the 1950s. What is deceptive is the ASA’s encouragement of AAs calling themselves anesthetists and promoting that there is no difference between AAs and CRNAs. 

[matthewandrew, NP]

Yeah. That’s not appropriate, especially when nurses are the first to provide anesthesia care in the US.

[Mikie Sarabia]

Out of curiosity, in your personal life to do call yourselves nurse anesthesiologist or anesthesia. Have you experienced any controversy depending on your response?

[matthewandrew, NP]

3 hours ago, Tegridy said:

It just really sounds like a way to blur the lines between an anesthesiologist and CRNA.

I think nurse anesthesiologist is a good description for the philosophy, education and training they receive. There are dentist anesthesiologists too. No profession should claim the term. 

Anesthetist can be reserved for AA. 

[Tegridy]

But they do an actual 3 year residency similar to an MDA in addition to whichever other training they do. (did not count the prelim MDA year)

Nurse anesthetist is a fine title and again its just blurring the lines and confusing patients.

[matthewandrew, NP]

Tegridy said:

But they do an actual 3 year residency similar to an MDA in addition to whichever other training they do. (did not count the prelim MDA year)

Nurse anesthetist is a fine title and again its just blurring the lines and confusing patients.

CRNA students are nurses building on their previous clinical experience beyond the RN role. There is no direct comparison. I think physician anesthesiologist is also a fine title that clearly identifies the clinician. Same for a nurse anesthesiologist. 

[wtbcrna, MSN, DNP, CRNA]

Tegridy said:

But they do an actual 3 year residency similar to an MDA in addition to whichever other training they do. (did not count the prelim MDA year)

Nurse anesthetist is a fine title and again its just blurring the lines and confusing patients.

It's funny how the ASA had no issues blurring the lines or confusing patients by promoting AAs being called anesthetists, and telling everyone that AAs and CRNAs are the same. 

Now suddenly a 70+ year title for CRNAs has become popular again and suddenly now patient confusion and "blurring the lines" is an issue. Physician associations don't care about blurring the lines or confusing patients. They care about monopolizing medicine for their bottom lines everything is secondary to that. 

Physicians are reaping what they have sown. 

[jfratian, DNP, RN, CRNA]

And shadowing doctors treating patients (med school) isn't really medicine either.  Both are relevant clinical experience few AAs have.  The need to differentiate ourselves from them is the point here. 

If you take a hard look at the hours spent in the operating room in a 3 year doctoral CRNA program vs a physician anesthesia residency, there is not a massive difference.  Physician anesthesia residents have an intern year and a significant portion of their remaining 3 years outside of the OR in the ICU and doing research.  We train alongside one another and use many of the same textbooks.  In the OR we both get asked the same questions, we both do all types of cases (transplants, hearts, etc), and we do all types of procedures (peripheral nerve blocks, spinals, epidurals, central lines, a-lines, etc).  Based on the comparable time actually rendering anesthesia care, I believe both groups can fairly call themselves experts in anesthesia care and anesthesiologists.

I would point out that our 2nd year MD/DO anesthesia residents come in very green and are often trained by CRNAs for the first 6 weeks or so.  Our physicians don't want to deal with them, since they come to the OR with no idea how to work an IV pump, start an IV, or set up a ventilator to name a few.  No new CRNA student has that issue; CRNA students have a initial leg up on them in several areas.  However, I find the MDs have a initial stronger grasp of didactic content.  It really does even out by the end and you would not be able to tell the difference between one of our senior CRNA students and a 4th year MD/DO resident if you removed nametags.  I suspect a blind experiment would be quite revealing.

 

[wtbcrna, MSN, DNP, CRNA]

Robin Wilson said:

I think they tried to blur the lines by letting AA's call themselves anesthetist. 

The ASA has run a campaign for decades stating that CRNAs and AAs are equivalent while promoting AAs to call themselves anesthetists.  

[jfratian, DNP, RN, CRNA]

https://pubmed.ncbi.nlm.nih.gov/8418748/https://pubmed.ncbi.nlm.nih.gov/8418748/

Also wanted to share this little beauty with the group.  Table 3 on page 3 shows that physician anesthesia residents are only providing 31.5 to 35.3 hours per week of patient care in the OR and PACU combined during their CA-1 to CA-3 years.  Yikes.

Keep in mind that a physician anesthesiologist did this research and it's based on self-reporting from the residents.  Also, this research is from 1993 before restrictions on resident hours.   So the truth is likely lower than this.