The Importance of a Title: Anesthesiologist vs. Nurse Anesthetist

[Melissa Mills]

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.

[subee, MSN, CRNA]

An CRNA's were the first practitioners of anesthesia. The physicians came later when it became possible for them to send a bill. Before CRNA's, anesthesia was delivered by medical students (what could go wrong?). We had a professional association before the MDA's. The large bulk of anesthetics can be delivered by CRNA's safely but the public is paying waaay to much money. And this is where the politics come in. It's not as simple as a turf war. It is developing a rational plan to deliver health care in a safe and cost effective manner...period. Unfortunately, over the years I have seen more students who are content to do less because MDA's restrict the students from some procedures and keep them too ignorant to work independently. So, unfortunately, the MD's spends loads of money to their PAC and the CRNA's do the same for theirs. Money that could be used for education ends up going to lawyers. They have tried for years to tie up our hands and our brains, but we persist and survive. Non-CRNA nurses do not have to put up with this crap that takes up a lot of our energy and money.