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The Importance of a Title: Anesthesiologist vs. Nurse Anesthetist

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by Melissa Mills Melissa Mills, BSN (Member) Writer Innovator Member

Melissa Mills has 20 years experience as a BSN and specializes in Health and Wellness Writing, Leadership.

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What's the difference between anesthesiologist vs. Nurse Anesthetist?

When you think of the terms anesthesiologist and nurse anesthetist, do you view them as the same or different? One APN argues that they are the same and he should be able to use either one to describe his role to his patients. Learn more and let us know if you agree.

The Importance of a Title: Anesthesiologist vs. Nurse Anesthetist

Your job title probably means a lot to you.It might even be as important to you as your birth-given name. You went to school so that you could write specific letters behind your name, such as LPN, RN, or FNP. However, if you decided that it was easier to tell your patients that you were a caregiver, caretaker, or health assistant, would it matter? What if your preferred title was one that other professionals feel is reserved only for them?

For one advanced practice registered nurse, it mattered quite a bit. In fact, it was important enough for him to be able to call himself an anesthesiologist that he fought for this right in front of the Florida Board of Nursing. 

Nurse Anesthetist vs. Anesthesiologist

John McDonough has identified himself to his patients as a nurse anesthesiologist for years. After recently appearing before the Florida Board of Nursing, McDonough can legally use this title. However, the Florida Society of Anesthesiologists doesn’t agree with the decision. Chris Nuland, an attorney, and lobbyist for the organization told The News Service of Florida, “The FSA firmly believes that, although this declaratory statement only applies to this one individual, this sets a dangerous precedent that could confuse patients.”

McDonough didn’t mince words regarding how he feels about his right to call himself an anesthesiologist. He was quoted in an article on nwfdailynews.com saying, “I’m not a technician. I am not a physician extender. I am not a mid-level provider. I am, in fact, a scientific expert on the art and science of anesthesia. So I think anesthesiologist is a perfectly acceptable term, especially since the term anesthetist has been hijacked from my profession.” He goes on to offer similar examples to his situation like dentists who identify as physician anesthesiologists.

Florida's Board of Nursing seems to make several statements about the role of advanced practice nurses these days. They are also deciding if advanced practice nurses can practice independently from physicians. Other nursing boards across the country are making critical decisions about the expansion of advanced practice nurses to work with greater autonomy. Given the continued expense of healthcare and the increased need due to an aging population, it only seems logical to allow these nurses more ability to work with less oversight.

Understanding the Role of the APN

It’s essential to know that the term APN refers to several different types of nursing professionals. These various roles perform tasks such as diagnosing illnesses, performing head-to-toe physical exams, providing specialized exam such as functional and developmental testing, ordering lab tests, performing a variety of testing, and dispensing medications.

APN includes the following

  • Certified Nurse Practitioner
  • Certified Registered Nurse Anesthetist
  • Certified Nurse Midwife
  • Clinical Nurse Specialist

Advanced practice nurses have various levels of autonomy across the country. Some states allow APNs to operate clinics or offices independently. Other states require physician collaboration or supervision at all times. Because each type of APN has a different job description and role, the settings in which they practice and how they practice varies too. For example, a family nurse practitioner may work in an office with one or two MD’s and only consult on cases as needed. For roles like a nurse anesthetist, the setting is likely larger, and they usually work with doctors and surgeons while performing their job functions.

What Do You Think?

So, what’s in a name? Does it matter if you call yourself a nurse or caregiver? Should nurse anesthetists be limited to this term or should they be allowed to call themselves an anesthesiologist since this is the specialty for which they are certified? Let us know your thoughts by leaving a comment below.

About Melissa Mills, BSN (Member) Melissa is a professor, medical writer, and business owner. She has been a nurse for over 20 years and enjoys combining her nursing knowledge and passion for the written word. She is available for writing, editing, and coaching services. You can see more of her work at www.melissamills.net.

9 Followers; 119 Articles; 23,058 Profile Views; 281 Posts

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Skeptic specializes in Skepticism, Anti Quackery.

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

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CastiMcNasti specializes in Exercise and Wellness.

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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.

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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.

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subee has 45 years experience as a MSN, CRNA.

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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.

 

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272 Posts; 6,198 Profile Views

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?

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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. 

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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. 

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MinasTurning specializes in Anesthesiology.

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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

Edited by MinasTurning

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globalwarrior specializes in ICU.

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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. 

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Codeman5788 has 7 years experience as a MSN, APRN and specializes in CRNA - Nurse Anesthesiologist.

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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. 

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Undercat has 41 years experience as a BSN, MSN, CRNA and specializes in Retired.

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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.

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