dneill01

What are we going to do about the AA issue and the doctorate degree situation? The AANA needs to realize that meeting a shortage cannot equate to decreasing the quality of graduating CRNAs. We need to take a look at the didactics of the AA programs and compare them to ours. There is not a big difference and how much of your nursing education do you really use in CRNA school? Some! The way that we must separate ourselves from the AA is to increase the critical care setting requirements. 1 year is not enough. There are many CRNA students that have a total of one year of nursing experience hired into an ICU as a new grad. We all remember that first 6 months out of school we were still trying to figure out how to write a verbal order, how to start IVs and had limited knowledge of pharmacology. I do not believe that the nursing benefit of the CRNA to AA can be appreciated without a minimum of 3 years of true critical care experience and a CCRN certification to identify those that have wanted to excel. I know that this will not be a popular stand to many on these threads but the patient care experience is what we use to sell ourselves over the AA for this to be legitimate, we must make it somewhat substantial. Doctorate? give us our own degree/title.

As a SRNA/RRNA, I fully support the option of acquiring a doctorate degree in anesthesia. I have a problem allowing the AACN dictate how and what degree it will be. I personally do not want to share the same doctorate title with NPs etc. The difference in the educational requirements between a CRNA and a NP are tremendous. CRNAs go through an average of 30 months of FULL TIME SCHOOL, not part time for 18 months. Our credit hours are approx. 75 and a NP averages 50 hours. Clinical requirements: the NP average requirement is 650-700 hours in clinical practicum, ours is 800 hours of actual anesthesia time in cases not time in the clinical setting (which is closer to 2500 hours), with additionally 550 actual cases, this is the Minimums to sit the board exam. We both have lab practicums. All of this is to say that we end up with the same degree level? MSN? The AACN cannot truely consider the same doctorate degree until they bring the NP curriculum to the same level or have additional requirements of NP to achieve the same doctorate degree. This is not to slight the NP education only to bring a point that I feel needs to be considered. I support having separate degrees/titles.

Wow, this is getting nowhere. I am an RRNA/SRNA. I dont care what the hell they call me. I look at the patient introduction as an opportunity to educate my patients that more anesthesia is provided by CRNAs than MDAs and AAs combined. I introduce myself as a Resident Registered Nurse Anesthetist then I joke and say "now that that is out of the way, I have been a critical care RN for 11 years and am now in graduate training in anesthesia. I am yet to have one patient "freak out". It is all in presentation and professional approach. Emphasis on "working with....... " Now for my pet peeve.......comparing a NP to a CRNA and their education is rediculous. I could have become a NP going to evening classes 2-3 nights a week for 18 months! More graduate nursing classes?? Not a chance we are all aware of the importance of nursing theory. I am in 30 months of fulltime+ anesthesia school, residency whatever you like to call it. In ending the emphasis should be placed on Nurse. Anesthesia residents deserve the respect of being MD's but they are anesthesia students just as SRNA does for being a RN.

As far as equipment, not alot left to get. A nerve stimulator, maybe a couple of reference books ie. naglehout or morgan/mikhail, washington manual and jaffee surgical procedures but most of these things will be recommended in your program. Get a miniature mouse (USB) for your laptop as it is tedious after a long time using the touchpad, one other thing is get a Jump/flash drive that you can attach to your keys, it is invaluable (256mb should suffice for a while.). Make sure that it can attach to your keys and that it does not require drivers so that you can use it anywhere. get Microsoft Office, student version should be good enough. 3 ring binders for organization are vital, a pack of colored pencils for Pathophys, cadaver lab, biochem, etc. notes. Another thought is to get your eyes checked if it has been along time as lots of time in the books is the recipe for headaches and poor concentration. Dont do any reading preparation for classes, they will provide you the material that you need to know. Spend some good time with family or friends and maybe take a nice little vacation. Hope this helps David

First hope you did well on the CCRN. It was pretty straight forward when Itook it. I am a first semester CRNA student at Webster University in St. Louis MO. Patho-phys hasnt seemed to bad to this point. This is finals week so I guess I will find out. Biochemistry is the challenge at this point. Webster's program is a Masters of Science in Anesthesia not an MSN in anesthesia. Whats the difference? Alot more difficult science courses and no nursing theory courses. Now that creates some mixed emotions. Maybe the program that you are trying to go to does not have as strenous science courses, if this is the case take the patho class it will look good on your app as well as the CCRN. You might even consider joining your local AACN chapter. Regardless good luck to you! David

Webster University in September Good Luck to all!!

Webster University in September Good Luck to all!!

I am glad to see that I may have churned the pot alittle regarding CRNAs being ashamed of their nursing background. What was really meant though is not being ashamed but rather so much better than their nursing coherts. I have seen this on numerous occasion (of course this is true with alot of advanced practice). The large majority are proud of the heritage and the steps they had to take to reach their goals. Maybe the problem that I see is from the CRNAs that acheived their Nursing degree with the sole intent of CRNA school (usually a degree in something other than nursing then attended a one year RN bridge)worked one year in nursing, then was picked up by some school that is concerned more with personality rather than ability. I truely believe that anyone pursueing an advance practice degree should have to pay their dues, not only for experience but also to develop a sense of pride for their foundation profession. I appreciate all of the great information and input by everyone on these boards, you have made me consider many things that I may not have realized regarding my CRNA education.

Starting in September cost of program:$48,000 (10 semesters). I have worked weekend nights for 3 years with bonus shifts during the week, grossing approx. $90,000/year. My wife works as an Outpatient nurse makes around $40,000. Obviously there is going to be a significant change in lifestyle. I have spoken with many friends/SRNAs/CRNAs that all sing the same tune: dont worry about the money, the loans are there and the reward is enough to offset them. Dont sign with anyone early to help with school, many will pay off loans when signing after school, and how are you to know what it is that you really want to do? Would you have wanted to work in long term care nursing so someone would help you during school? Not hardly! Particularly 2 friends of mine are now married finishing school this year and will be Appox. $200,000 in debt but will be starting with a combined income of approx. $320,000/annually not including maxed retirement, health and dental benefits, overtime and call pay etc. It will take care of itself. Think about this: most Undergrad nursing students (BSNs) graduate with $15-25,000 in loans yet make 32,000 starting, didnt think much about it, do the math: $100,000 debt load vs. $140,000-$220,000/annual? Hell, working days, 1:6 call, no weekends (except call) is enough to make it worthwhile to me. Good luck to all!!!

JWK I am all about good safe anesthesia care, that is why I am pursueing the profession. As long as it provided, I dont really care who gives it. The routes are different but the end result is hopefully the same "good practice". I stand corrected the AA where not created by the AMA or the ASA but where created at medical schools and are more and more starting to be pushed by the ASA. They dont want to lose their hold on the money or power, you know that is true. Regardless of AAs or CRNAs, there are more than enough jobs for each. I havent run into any AAs in Missouri but I am sure I will and I am sure that we will work side by side. I only hope that the AA programs and the CRNA programs continue to be selective and keep the standards high as to not flood the market with anesthesia providers and kill what is now becoming a good paying job. MDAs have been making >350k a year for too long as the CRNA have carried the load and now the AAs too. Note that the ASA is trying to rope AAs and CRNAs into their organization to provide better care according to them. This would be a grave mistake for AAs and CRNAs as it would suggest that AAs and CRNAs provide care substandard to that of an MDA. If it was sarcasm "Feel better? And all this from a non-CRNA - I'm impressed" That really isnt necessary, this is a forum of opinions and we know that everyone has one. Trauma Tom, speaking of Nurses ashamed of their nursing background, I feel being called an Anesthesia Nurse upsets some (not all) because it insinuates that they are nurses first, but then again we are. I may feel differently when I finish this program, I am of course speaking from ignorance rather then stupidity.

All of this talk about AA versus CRNA is making my head hurt! I am a critical Care nurse of 12 years, I have been using sedation, inotropes, vasopressors, ventilators, IABPs, PA catheters, A-lines etc.........for many years. Those of us who have worked in the ICU know that autonomy that is afforded us especially at night. Nursing school provided us the basis for our practice but experience is what makes us what we are. Not all ICU nurses are created equal and I dont favor being clumped with all because so many are lazy slugs that come in get a pay check and go home, never expending their education, and never making a contribution to their profession. I cannot concur that an AA has "paid their dues" if their BS is in philosophy. Most CRNAs have a minimum of 5 years experience in critical care. Someone had stated that MDAs dont have this experience. This is crap of course, look at the length of residency and fellowship before they can function independently. The simple fact is: the ASA has never liked the CRNA and feels threatened by the practice. The ASA has gone as far as manipulating their date of origin (of anesthesiologist speciality) to look older than it is. Nurses are the forefathers of anesthesia care. The AMA and ASA feel threatened thus the reason for creating the AA. They now still have control over the provider, and can profit from their labor. If the ASA and the AMA where truely trying to meet a need of shortage, they would be courting more anesthesiology residencies (maybe they are). Hey what a scam, I can supervise 4 rooms (all at once WOW what a feat, kinda makes you wonder how well they are supervising) and bill for all of them! I can sit in the lounge and get paid, what a great gig! The ASA belittles the practice of anesthesia when they insinuate that they can supervise 4 at a time (makes anesthesia seem like a pretty simple practice). AS far as the titles: Many CRNAs are ashamed of their roots as a nurse, in my opinion this is pathetic. Nursing background is what makes such good anesthesia providers. Years of patient care (besides the technical aspects as I had mentioned previously) are what make us able to make a patient and family comfortable prior to surgery and give us the ability to interprete into laymans terms what they are about to experience in the few minutes that anesthesia providers are alloted. The AA will survive. Flourish? is yet to be seen. See, the shortage of anesthesia providers is more of a rural problem and it is here that CRNAs can indeed function independently. The AA who had the problem with the Stars and Stripes article depicting the AA as an assistance needs to look inward and at their profession and see it for what it is. A profession that is prostituted by the ultimate of pimps "ASA"!!! An AA is an assistant plain and simple, this is why they where created. To be under the thumb of the AMA and the ASA. I do not question the ability of AAs to provide anesthesia care as there are good and bad in all anesthesia professions. I do however take a stand that if the AA is to be an assistant and trained to do so, then they should not be providing independent care. If they do, they are only letting the MDA off even easier and practicing beyond their scope (unsafe situation). Professionalism: good and bad in all but the most unprofessional is the MDA as those of us with long term experience in healthcare know. HOwever,I work with some great MDAs, To many MDAs have been groomed to be the "all knowing better than everyone else physician". If a AA is a PA then that makes everything very clear, they work under the Physicians license and liability and their scope of practice is limited to whatever that physician allows them to do. I hope that the family of anesthesia can know their practice, abilities and limitations and continue to work together to provide the best anesthesia care possible. Everyone be proud of what you are but always remember what you are: CRNAs, are not physicians you are highly educated nurses, AAs, are not independent anesthesia providers you are trained assistants, and MDAs, you are not GOD you are doctors!

Tiffany I am starting Webster in September and have heard nothing but good things about it. I am quiet familiar with the program as it has taken more than one attempt to get accepted. I would suggest that you attend one of their all-class meetings once you have graduated nursing school. You can call the program and get information. I definately would wait until you have completed you BSN program first.

Finally!!!!!!!!!!!!Webster University in September. Will work some more overtime to bank some cash and take some of the workload off the wife. Will take the 2 weeks off prior and spend some time with the kids and a short vacation with my spouse. Not planning on studying much of anything as I am more than confident they will provide me everything I will need. Maybe a little reading at work, review gas laws, and some physiology of the nervous system. My suggestion would be to take it easy and enjoy some quiet time as it is going to end shortly! I am just so thankful that Webster is all science based and there is no "nursing" classes. Dont think i could handle another nursing theory class if I had to. lol GOOD LUCK to all

Roland IQ scores show nothing of the ability to learn nor do GPAs reflect what someone has learned. I have known many people that have the ability to take an exam and retain for a period long enough to pass the exam, yet could no pass it 2 months later (great short term memory rather than comprehension) GREs, MCAT etc. reflect what a person has actually retained from their education. These tests are a much better indicator of a persons ability to truely learn rather than regurgitate information for a brief period of time. These exams give you the chance to shine and give a better depiction of yourself than school grades alone. Think about this, I graduated for a Nursing program with a 3.12 GPA but a board pass rate of 100% for 6 years straight, and that was the top of my class. All programs are different some have GPAs of 4.0 yet a board pass rate of approx. 50% now how do you evaluate these students side by side? Standardized tests take out the "Spoon fed" factor that some schools have.\ this evens the playing field. If I had to compete against the 4.0s all the time, I wouldnt stand a chance on GPA alone yet would venture to say that I am every bit maybe more intelligent than most of them. Hope this helps

I am an RN and find myself somewhat confused by your statements. I feel that your statements would be more valid stated as "SOME RNS" are ignorant/stupid Remember the definitions of both. But I think that we find that in both nursing and medicine. I can tolerate ignorant to a point and they will remain that way so long as physicians such as yourself view them as stupid. You want them to function at the level that you do (generally during your sleeping hours) and are angered when they do not but are also angered by those that do think for themselves. Both your anger and ignorance amazes me coming from such a highly educated individual. I want to encourage you to take a spelling class, repeat english 101 or review your posts for errors prior to posting. (I truely hope that you are more thorough with your anesthesia care.) You appear to be the "class A"pompous azz physician that every nurse dreads to deal with. Generally your type allows your arrogance to get in the way of your better judgement and as a result the patient suffers. Of course you then feel out of control so you look for someone else to blame for your shortcomings. Its a sad cascade of events. Thank God they are not all like you. Now for the topic at hand. You are absolutely right, CRNAs are not as highly trained as MDAs. No doubt about it. My question is how much of that education is actually used in practice? (this is an honest question) CRNAs should never be used as a substitute for MDAs! They should be used to supplement an anesthesia practice. Many procedures that are performed are skills learned rather than scholar based. I sense that it is actually a money issue that bothers you as opposed to a true concern for patient safety and quality of care. The issue of quality of care has been a controversial topic for years with no truely revealing studies to date. Studies by the AANA can be viewed as biased as well as studies by the AMA. The only facts that we can look at is that Anesthesia care has improved over the past 20 years. To say that it is because of MDAs is once again truely arrogant. Is this to say that you ignore the role that better agents have played? Better monitoring equipment? Better diagnostics revealing underlying issues prior to the cases? Lighter patient loads and shorter hours (CRNAs have contributed to this) providing more time for MDAs to focus on more complicated cases? Better trained PACU and ICU nurses that recognize issues earlier? WOW, the list goes on and on....... This should'nt be viewed as a competition issue it is a supply and demand issue plain and simple. Its the weekend and your commode goes out, you call the plumber Whats he/she charge you? Its simple supply and demand. There are more CRNAs today because Anesthesia residencies couldnt even be filled 10 years ago. Its a long road for an MDA and not many wanted to make that sacrifice. Yes, many GPs hire PAs or NPs to work for them, is this because they are lazy? Maybe they have gotten over the arrogance of believing that they are so superior to everyone and they have come to the realization that parts of their job can be performed without the lengthy education that they had. Once again, supply and demand, think they would use these "paraprofessionals" if they could handle the patient load? Not likely. Should patients suffer because they cant get anesthesia care? MDAs are having to face what Nurses have been for years. BSN VS. diploma vs. ADN. Their jobs are the same their pay is similar but the training is different. One must take the time to look back and ask, what does it really take to do my job? Can someone with less education function near the same level? My bottom line is: CRNAs contribute to quality of care and efficiency of care. They should if possible function with MDA supervision/assistance. Halothane, you do your profession and physicians an injustice by posting such ignorant borborygmus statements without engaging your swollen head first. RN, BSN CCRN