Laser

The latest word according to my MDA resident friends is that an MDA residency will soon be 4 years long. The key here is that internship will not be required. Instead of doing an internship, MD's will go straight into a residency program. This is an other good move on the part of the ASA. They can now claim that MDA's have an additional four years of concentrated anesthesia studies after MD school.

First of all, Swumpgas and deepz; I LOVE YOU MAN........ ok, enough of my tears. There are some things that are self evident here. The ASA is doing what they do, out of self interest. Heck, they have been blatantly coming after CRNA's since the 1920's or so. As for the creation of AA's, I believe this was a stroke of genius. Yes the AA's started 30 years ago and their numbers are still small but, the ASA appears to be gaining ground. The ASA is a powerful bunch and they have all the time in the world. They also have ample medical schools to train their assistants. Realistically, I believe you can slow them down but, I doubt you can stop them completely. So, what can we do? I suggest it is time to get involved! This is not a time to assume everything will be ok. Believe me, the ASA has a battle plan and they have Juice. Support your state and national nurse anesthetist organizations and donate to their political action committees. I donate and I am a CRNA wannabe. As for the rest of my ideas on this matter, I'll wait until I can speak confidentially as a member of my state and national nurse anesthetist organizations.

Whether anyone likes it or not, the general public sees the MDA world as the preeminent anesthesia authority / leader in this country and this seems reasonable to me. They possess a graduate medical education in anesthesia and are by definition experts. On the other hand, ask any 100 or so people on the street what a CRNA is, or does. I know that the vast majority will not know. Fortunately for the CRNA world, demographics have been good to us throughout the years. (I say us as a wannabe CRNA). Unfortunately, no one knows who we are. This has to be dealt with if we are to equitably differentiate ourselves within the anesthesia community. Why are MDA's pushing AA's? It's political. Everything I see and read tells me that it's about controlling the profession of anesthesia, which by the way, they have been largely successful at. There is a part of me that wants to say, ok, cool. After all, they are the MD experts. Unfortunately, the ASA doesn't think like mother Teresa. I personally have no problem working with MDA's in a collaborative relationship. The care team concept is reasonable and provides for a high quality patient care. The vast majority of surgeons and MDA's that I have worked with are great people both personally and professionally and they value the intrinsic worth of nurses. But, let's face it; the ASA political leadership has an agenda and they are very up front about it. If you have any doubts, just look at the article in the April 2004 issue of the AANA Journal, "Standards of Care and the ASA Medical Direction Statement" on page 91. Look at medicare's November 13, 2001 Federal Register: "A final rule concerning the federal Medicare and Medicaid physician supervision requirement for Certified Registered Nurse Anesthetists." This was a major victory for the ASA. Think about how much time is being spent by state CRNA Associations to try and minimize the impact on CRNA practice. Fortunately, some states have successfully opted out. Although there are not that many AA's at this time, demographics are now helping the AA cause. I genuinely feel that they will be a force to be dealt with within the mid to distant future by virtue of the ASA pushing for them. Think about how many medical school anesthesia departments are capable of absorbing AA classes. The ASA has power, both real and perceived. The recent push for using more AA's is not happening accidentally. From my point of view, AA's coming up in the world isn't the end of the world. It's going to take some time for their numbers to reach significant levels. The real challenge is how CRNA's differentiate themselves from MDA's /AA's in the public's mind. Heck, the general public doesn't even know what a CERTIFIED REGISTERED NURSE ANESTHETIST is. Do you think they might imagine what an ANESTHESIA ASSISTANT is? I think so. I can already hear some, not all, MDA's referring to CRNA's as there assistants. We all know that a CRNA's scope of practice encompasses more than AA's scope of practice. AA's can not practice independently anywhere. This along with other issues needs to be differentiated. In the end the CRNA profession really needs to differentiate themselves and it has to be simple so that the public knows who we are and what we do. I believe that the future is bright for CRNA's. CRNA's have over 100 years of providing quality anesthesia care. This is powerful stuff.... Man, I can't wait to get started.

Yee Haa. Congrats to you. Keep us posted on your new adventure!

To all who got accepted into Kaiser, congrats. All of you sound like a great bunch of people and I wish I could be there with you to celebrate. As for me, I just stopped licking my wounds. Unfortunately, I only applied to one program (Kaiser) and did not get in. I scored high on my GPA and interview according to the Kaiser folks but the competition was brutal. However, being the person that I am, I will NEVER, EVER, GIVE UP!!!! After 10 years, I am finally at a point in my life, both financially and family wise (kids growing up) where I can pursue my dream of becoming a CRNA and I will not stop until I have achieved my objective! If there is a lesson to be learned here, it is to apply to more than one school and be flexible. Anyway, I look forward to reading about your progress at Kaiser and I hope to be celebrating with all of you next year.

I went to Loma Linda University for my BSN and I have also worked at their surgical/trauma unit for 10 years. You couldn't ask for a better bunch of people. Very supportive environment. It is a Christian based institution but they don't cram it down your throat. As with all religious groups you will find ultraconservatives but I have never bumped into any. As for the cult label, there have been splinter groups, most famous probably being David Koresh? as in Waco. Realize though, that he splintered from SDA and is not part of SDA. Hope this helps.