The Importance of a Title: Anesthesiologist vs. Nurse Anesthetist

[Skeptic, NP]

I feel like they should be different titles. Nurse Anesthetist and Anesthesiologist, not Nurse Anesthesiologist.

[NICU_Nurse_Casti, BSN, RN]

I was present for Dr. McDonough’s presentation to the FL BoN. It was very interesting. However, it was explicitly stated that it would not be used as an official title. “Nurse Anesthesiologist” can only be used as a descriptor. He stated that in New Hampshire, CRNAs can now use the descriptors Certified Registered Nurse Anesthesiologist or Nurse Anesthesiologist. The same for AZ, I believe. I understand where Dr. McDonough is coming from, but I do not know how I feel about it just yet. My understanding is anesthesiology is a “medical” specialty; a “medical” practice.

[Oldmahubbard]

Surely there must be very extensive research about these APRN's outcomes, as opposed the outcomes of the MD.

While I admit that the physicians who practice in my speciality have more training on paper, for some reason it rarely seems to translate to improved outcomes.

And sometimes worse outcomes.

It could be we are over educating physicians in this country, to the point where they have to have 500k to live. The model is just not sustainable, when the same job is apparently done by someone with fewer years of sacrifice.

[subee, MSN, CRNA]

This is an arcane issue amongst the CRNA's now because the next guys down on the food chain, anesthesiology assistants, are now calling themselves anesthetists. "Anesthesiology " merely means the mastery of the science of anesthesia. CRNA's have much more classroom experience compared to MD's who learn their tradecraft through apprenticeships. It just kills so many of the MD's that CRNA's are independent practitioners that they created their own layer of provider, the anesthesia assistant, who must be physically supervised by the MDA. These folks have no prior medical or nursing experience and do not add to cost effectiveness. It's all about controlling the billing. I can say from 31 years if experience that, as a rule, MDA's are an extremely greedy group if practitioners. G_d forbid that you run up to OB to do a difficult IV and dont fill out a billing form. Geez. Things I always did for free in the olden times when I worked without an anesthesiologist. I'm not one of those people who thinks I can do everything alone. We need anesthesiologists but just not so many of them. 90% if the cases are bread and butter and can be done independently by CRNA's. But I've noticed in the past decades that CRNA students don't want the responsibility of working alone and are content to be supervised in a team situation.

[zbb13]

Personally I think it’s wrong that nurses are attempting to use labels that other people have earned after years of education and attaining medical degrees, in addition to sacrificing even more years to specialize. It doesn’t sit well with me. Why can’t we be happy with what we have? Why do we insist on being called something we are not?

[JR1120]

I guess, in all fairness, since the term "anesthetist" has been essentially hijacked from the Nurse Anesthetist, as Dr. McDonough so appropriately stated, it seems only fair to patients to differentiate. The term "nurse" cannot be used to describe medical assistants. In the same regard, "Anesthetist" is misleading to patients who may know, understand, and trust the label but are actually getting an Assistant. At least these Advanced Practice Nurses are including the word "Nurse" to differentiate between themselves and their physician colleagues. This is contrary to how frivolously the term "anesthetist" is being thrown around. And, the fact that it's a descriptor and not a title simply clears up confusion related to the new umbrella of "Anesthetist," which could be considered misleading to the patient.

[Mariann Aiello Trice]

As a CRNA who practices independently and without supervision, I think the term Nurse Anesthesiologist is actually clarifying to my patients- not misleading. I always introduce myself as a nurse anesthetist first. Many patients don’t know what a CRNA is, even after a 150 + year history of our profession. I used to say a “nurse practioner of anesthesia” when I tried to explain my role. As soon as I started saying “some people say nurse anesthesiologist”, the light bulb went off and the patients understood immediately. They did not confuse me with a physician anesthesiologist. I also am a firm believer that professionals should define themselves. It is time that all nursing professionals are recognized for their education and training and that nursing professionals advocate and define themselves. Physicians should concern themselves with their profession, not ours. We work together, collaborate and should focus on caring for patients not fighting antiquated hierarchies.

[MinasTurning]

Thanks for posting this important topic. The name of the article should probably be amended as the title in question is "Nurse Anesthesiologist" - not "anesthesiologist" alone. It's key to recognize the ASA now uses the term "Physician Anesthesiologist". Also key that the ASA found that the public does not recognize anesthesiologist as a physician.

Second, there is an important context to this topic which is available at nurseanesthesiologistinfo.com.

Readers should also know that CRNAs deliver the full scope of anesthesiology services, and despite remaining outdated regulations, practice independently in all 50 states.

I am one of the original proponents on this issue and am happy to answer questions. My experience on this issue is that the concept of "nurse anesthesiologist" has gained tremendous support in the nursing community after being educated on the topic.

Joseph A. Rodriguez, CRNA

Former President, Arizona Association of Nurse Anesthetists

Co-Founder, Committee for Proper Recognition of CRNAs

[globalwarrior]

Although I believe the majority will still use CRNA (which works for both Nurse Anesthesiologist and Nurse Anesthetist), I think that Nurse Anesthesiologist helps those outside the profession to understand that they are anesthesia experts. This became even more important when Anesthesiologist Assistants decided to also be called anesthetists. There is a clear difference between the training and education of the two.

[Codeman5788, MSN, APRN]

The title of the article is misleading. In no way are CRNAs trying to use the title of anesthesiologist alone, but are using the descriptor/title of NURSE Anesthesiologist. The title explains itself especially when the physicians changed their title to PHYSICIAN Anesthesiologist. And anesthesiology is not just a medical speciality. It is simultaneously a NURSING speciality and was a nursing speciality before it was a medical specialty.

[Subee2, BSN, MSN, CRNA]

It has been my experience that the majority of RN's have no idea of what we do. A few years back, one of the nurses in the holding area told me she thought that all the intubations were done by the docs! No idea we were doing any of the regionals and legally didn't need an anesthesiologist in the house to do cases. I guess when the hip fractures came to the recovery room, she thought the surgeon did the spinal:). Our internecine warfare is difficult for outsiders to understand but the bottom line is that multiple studies have shown no different outcomes between CRNA's and MDA's. We are no better, nor are we any worst than physician providers.