Psych NP vs Anesthesiology Assistant (AA). Please help!

[Jessie61195]

Hello everyone!

As the title of the thread implies, I am struggling to decide whether I want to pursue a Direct Entry Psych NP (Seattle University) program or an Anesthesiology Assistant (Nova Southeastern) program. I graduate this upcoming Fall semester and currently have a 4.0 GPA; I have completed all pre-medical prerequisites as well (Calculus w/ Analytical Geometry 1, Chem 1&2, Physics 1&2, Biochemistry, Organic Chemistry 1&2, Biology, etc.) but have yet to take the GRE, so I believe I have a decent shot at both programs, although I have not taken Anatomy and Physiology 1 & 2 or General Microbiology, which are pre-requisites for the NP program. I would be able to complete them before matriculation, but I would have to pack all three into my Spring semester, graduating later than intended.

I am aware that both career fields are entirely different; I have shadowed AAs and am currently a Psychology major with 350+ logged hours in psych trauma research (have shadowed as well), so I have a decent amount of experience with both fields. I am particularly interested in pharmacology and drug interactions, which makes both fields enticing; AAs push drugs in the OR, and Psych NPs are in charge of med management, and I believe I would thoroughly enjoy both fields.

My main apprehension about AA school is the limited scope of practice and constant political turmoil with CRNAs, but the field itself appears to be a hidden gem otherwise. The only other downside of AA school is the outrageous tuition costs (at least $40,000/ year for two years), but the high salary can offset the devastating student debt. I also worry about potential boredom working in the OR every day; do any of you ever get bored? I know that Psych NPs have high job placement and decent salaries, which is enticing as well. I have no interest in medical school; although I have a genuine passion for medicine, I do not want to spend 8+ years pursuing it.

If anyone could provide any input, I would be incredibly appreciative. I think I would be happy with either field, but I just don't know what to do. Should I reroute my career plans from AA school and complete the required pre-requisites for NP school, or do you think that I should stick with my original plan? I appreciate your time and aid.

J

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[deleted6669]

a few things about AA. in settings that use both AAs and CRNAs they are interchangeable. the geographic limitations are a bummer, but if you want to live in one of those 20 or so states or work at a federal facility it is not an issue. there is a PA to AA bridge program at one of the AA programs if you can't decide np vs pa this might shift things towards PA. crnas certainly do very well working independently, but there is some push back from the physician anesthesiologists and they are starting to hire AAs preferentially in some areas...I thought about the pa to aa bridge at one point, but thought I would be bored to tears. remember the abcs of anesthesiology: airway, book, chair. 99% routine, 1% panic.

 

[pamac]

If I understand it, the NP program you are looking at is fairly spendy as far as NP programs go. I'm not sure if it is $40k per year like AA school, but it has all the hallmarks of what I would imagine would make it an expensive program: private, Seattle, direct entry, DNP. If that program isn't close to $80k by the time you are done, they are giving you an exceptional bargain.

In theory, you could try to make the jump at some point from NP to NA, but I think you would be up against the fact that the traditional route to becoming an NA: working at least a couple years in a critical care unit as an RN before applying to CRNA school. I would assume its possible to go NP to NA, but I've never explored how that would go. I feel like trying to jump from being an NP to an NA would make you a glutton for punishment. But that's there if you wanted to explore it.

AA's are restricted geographically to something like 16 states, and exist in small numbers as a group overall. For them to expand pretty much depends on the good will of others advocating for them. I feel like their future isn't as bright because there will always be a ready supply of nurses who don't want to be floor nurses, and will move on become NA's. It just seems to me to be a niche profession, and an expensive one to break into. I also don't have a lot of confidence about what will happen with healthcare funding in the future. I've heard people say that AA's are cheaper (or have the potential to be), but there's no reason NA's couldn't adapt to that as well to be the more affordable choice. I don't see what pressure exists that would drive AA's to be preferred, and when belts tighten, if you aren't preferred, a lobby as big as nursing will eat you up.

When you put all the time and effort into a career field, you want mobility and freedom. Imagine wanting to move to a neighboring state and can't because AA's don't have any legal standing in the state. That kind of patchwork is killer. I looked into it years ago, and I think it would have been a cool profession if they had been able to get it off the ground years ago and expand like CRNA's. My only reservation about it simply has to do with the restrictions they face at this point. That would have been cool if they could have taken off like PA's and experienced the same kind of success. I hear about the high job placement AA's have out of school in the markets that they can function in, but even NA's are starting to face a tightening environment where the field is beginning to show signs of oversaturation. When that happens to a CNRA, they have other places they can go. Less so with AA's. Here's where you can live if you want to be an AA, and only if the particular facilities there actually use AA's:

• Alabama

• Colorado

• District of Columbia

• Florida

• Georgia

• Indiana

• Kentucky

• Missouri

• New Mexico

• North Carolina

• Ohio

• Oklahoma

• South Carolina

• Vermont

• Wisconsin

With physician delegation:
Texas and Michigan.

You can also work for the VA. But if you work for the VA and get sick of it and want to bail, and aren't in an AA approved state, you are out of luck.

 

[CaliforniaDreamingAA]

Have you considered pharmacy? I'm a former AA who is unable to work where I currently live (CA) and if I had to do it all over again, I would choose a PharmD. Why? PharmD have incredibly flexible career options from working in retail pharmacy, medication therapy management where you are counseling patients how to take their drugs, working in drug research, clinical pharmacy in hospitals, public health policy, to pharma or medical device product development, clinical trials....the list goes on. And industry accord PharmDs the same respect as MDs or PhD - just look at any job description in pharma or med device and you will see that PharmDs are considered on par with doctors. My husbands med device company employs PharmDs so I know this to be true.
I loved pharmacology in AA school and even considered going on to a PhD in pharmacology. If you say you love studying drug interactions, then pharm is the way to go. As an AA or PsychNP you are only going to be dealing with a very narrow class of drugs. And depending on the institution, you may not have much choice of which drugs to use anyways. These are very specialized fields so you will only be employed in your niche so there is no career advancement and you will be doing the same duties from day one til you retire. And as others have pointed out, you are very limited in where you can work - it has been an uphill battle in CA and I don't see it changing anytime soon. It's correct also that even if a state is "open" to AAs that doesn't mean you can apply to any hospital to work in that state. The hospital has to specifically allow AAs to work. Yes, you can make good money, but in the long run, a few more thousand isn't that big a deal if you can't work where you want or do what you want. My advice to young people - do what will give you the most flexibility in terms of job options bc you just never know where you will end up in life and your interests will probably change.[/QUOTE]

 

[deleted480308]

I would really investigate the pharmacy job market and perhaps stop by the pharmacy discussion forums here on SDN. They get jobs, but they're not often ideal or at the salary they anticipated. Cool job though. If I didn't abhor talking on the phone, I would've considered pharm.

I'll ditto the reluctance for pharm......walmart just announced no new hires get full time. They don't have to offer that because there are so many grads

 

[pamac]

Pharmacy started tightening up a few years ago. I talked to some students about to graduate a while back, and they sounded rather dour about prospects. I'm seeing some subtle changes in the CRNA field that make me think things are changing for them too. My hospital is modifying how they are utilized in ways that they wouldn't have if they weren't in a market flush with CRNAs. Like I say, nothing dramatic, but it signaled to me that the facility is negotiating from a poisition of power.

I once met a pharmacist that got a BMW from Walmart as a new grad for a sign on perk in 2009. Job markets wax and wane. Right before I started nursing, perks were dissapearing and the job market was tight. Now we are always looking for staff, overtime is plenty, and they shower you with prepaid cash cards if you pick up an extra shift. I expect when the economy tanks and everyone runs to healthcare again, perks will dry up.

 

[kozmo1994]

As a psych NP, and a bit of an anomaly in the field, I suggest you pick the fastest, cheapest option available. It's very unscientific training, but if you're interested in science you'll make up for the many deficiencies of NP training. I love having my own office, setting my own schedule, having no supervision, making a lot of money, and working with autonomy and efficacy.

My state doesn't have AAs. Seems like bad hours, little flexibility in working conditions, and a lot of competition. However, if you're into critical carefoo then it's probably fun.

I assumed in undergraduate nursing that critical care would be interesting. It wasn't. I never 'liked' ER eother althougj that's where I RN'd the most. Urgent carenwas better. However, I can't stand inpatient psych either. Find your niche.

I give a thumb up for Psych NP if you have that much of autonomy

 

[kozmo1994]

Have you considered pharmacy? I'm a former AA who is unable to work where I currently live (CA) and if I had to do it all over again, I would choose a PharmD. Why? PharmD have incredibly flexible career options from working in retail pharmacy, medication therapy management where you are counseling patients how to take their drugs, working in drug research, clinical pharmacy in hospitals, public health policy, to pharma or medical device product development, clinical trials....the list goes on. And industry accord PharmDs the same respect as MDs or PhD - just look at any job description in pharma or med device and you will see that PharmDs are considered on par with doctors. My husbands med device company employs PharmDs so I know this to be true.
I loved pharmacology in AA school and even considered going on to a PhD in pharmacology. If you say you love studying drug interactions, then pharm is the way to go. As an AA or PsychNP you are only going to be dealing with a very narrow class of drugs. And depending on the institution, you may not have much choice of which drugs to use anyways. These are very specialized fields so you will only be employed in your niche so there is no career advancement and you will be doing the same duties from day one til you retire. And as others have pointed out, you are very limited in where you can work - it has been an uphill battle in CA and I don't see it changing anytime soon. It's correct also that even if a state is "open" to AAs that doesn't mean you can apply to any hospital to work in that state. The hospital has to specifically allow AAs to work. Yes, you can make good money, but in the long run, a few more thousand isn't that big a deal if you can't work where you want or do what you want. My advice to young people - do what will give you the most flexibility in terms of job options bc you just never know where you will end up in life and your interests will probably change.

[/QUOTE]
So let me get things straight, you wasted two years of life, 60k-80k for AA school knowing that you will not be able to practice in California and now you're complaining?

 

[Mad Jack]

Hello everyone!

As the title of the thread implies, I am struggling to decide whether I want to pursue a Direct Entry Psych NP (Seattle University) program or an Anesthesiology Assistant (Nova Southeastern) program. I graduate this upcoming Fall semester and currently have a 4.0 GPA; I have completed all pre-medical prerequisites as well (Calculus w/ Analytical Geometry 1, Chem 1&2, Physics 1&2, Biochemistry, Organic Chemistry 1&2, Biology, etc.) but have yet to take the GRE, so I believe I have a decent shot at both programs, although I have not taken Anatomy and Physiology 1 & 2 or General Microbiology, which are pre-requisites for the NP program. I would be able to complete them before matriculation, but I would have to pack all three into my Spring semester, graduating later than intended.

I am aware that both career fields are entirely different; I have shadowed AAs and am currently a Psychology major with 350+ logged hours in psych trauma research (have shadowed as well), so I have a decent amount of experience with both fields. I am particularly interested in pharmacology and drug interactions, which makes both fields enticing; AAs push drugs in the OR, and Psych NPs are in charge of med management, and I believe I would thoroughly enjoy both fields.

My main apprehension about AA school is the limited scope of practice and constant political turmoil with CRNAs, but the field itself appears to be a hidden gem otherwise. The only other downside of AA school is the outrageous tuition costs (at least $40,000/ year for two years), but the high salary can offset the devastating student debt. I also worry about potential boredom working in the OR every day; do any of you ever get bored? I know that Psych NPs have high job placement and decent salaries, which is enticing as well. I have no interest in medical school; although I have a genuine passion for medicine, I do not want to spend 8+ years pursuing it.

If anyone could provide any input, I would be incredibly appreciative. I think I would be happy with either field, but I just don't know what to do. Should I reroute my career plans from AA school and complete the required pre-requisites for NP school, or do you think that I should stick with my original plan? I appreciate your time and aid.

J

So you've been accepted to both programs?

I mean, I'm a psych guy, so I'd say psych, largely because there is predicted to be a flood of practitioners entering anesthesia due to the rapid expansion CRNA schools experienced, which will drive down wages and potentially push out some AAs due to the lack of oversight required of CRNAs (a CRNA can take independent call without a physician in many states, an AA cannot). Psych, well, it's a growth field, lots of need, etc etc.

 

[NP 2 DPM]

My main apprehension about AA school is the limited scope of practice and constant political turmoil with CRNAs, but the field itself appears to be a hidden gem otherwise. The only other downside of AA school is the outrageous tuition costs (at least $40,000/ year for two years), but the high salary can offset the devastating student debt. I also worry about potential boredom working in the OR every day; do any of you ever get bored? I know that Psych NPs have high job placement and decent salaries, which is enticing as well. I have no interest in medical school; although I have a genuine passion for medicine, I do not want to spend 8+ years pursuing it.

Correct, you need to understand the increased scope of practice for CRNAs, which are now requiring new grads to complete their DNAP. My recommendation is if you are indeed interested in going into Anesthesia , then complete your requirements to be an sRNA. Provided that requires a completion of a BSN and at least a minimum of 1-2 years ICU nursing experience.

The CRNA program is rigorous and extremely competitive -- but with hard work and continued preservation there's no reason why you can't do it. Or for those considering that route.

Good Luck.



Here's a great reading reference:
DNAP vs DNP: Understanding The Difference

 

[steem_dnap]

Hello everyone!

As the title of the thread implies, I am struggling to decide whether I want to pursue a Direct Entry Psych NP (Seattle University) program or an Anesthesiology Assistant (Nova Southeastern) program. I graduate this upcoming Fall semester and currently have a 4.0 GPA; I have completed all pre-medical prerequisites as well (Calculus w/ Analytical Geometry 1, Chem 1&2, Physics 1&2, Biochemistry, Organic Chemistry 1&2, Biology, etc.) but have yet to take the GRE, so I believe I have a decent shot at both programs, although I have not taken Anatomy and Physiology 1 & 2 or General Microbiology, which are pre-requisites for the NP program. I would be able to complete them before matriculation, but I would have to pack all three into my Spring semester, graduating later than intended.

I am aware that both career fields are entirely different; I have shadowed AAs and am currently a Psychology major with 350+ logged hours in psych trauma research (have shadowed as well), so I have a decent amount of experience with both fields. I am particularly interested in pharmacology and drug interactions, which makes both fields enticing; AAs push drugs in the OR, and Psych NPs are in charge of med management, and I believe I would thoroughly enjoy both fields.

My main apprehension about AA school is the limited scope of practice and constant political turmoil with CRNAs, but the field itself appears to be a hidden gem otherwise. The only other downside of AA school is the outrageous tuition costs (at least $40,000/ year for two years), but the high salary can offset the devastating student debt. I also worry about potential boredom working in the OR every day; do any of you ever get bored? I know that Psych NPs have high job placement and decent salaries, which is enticing as well. I have no interest in medical school; although I have a genuine passion for medicine, I do not want to spend 8+ years pursuing it.

If anyone could provide any input, I would be incredibly appreciative. I think I would be happy with either field, but I just don't know what to do. Should I reroute my career plans from AA school and complete the required pre-requisites for NP school, or do you think that I should stick with my original plan? I appreciate your time and aid.

J

Hey there, I am a CRNA and as a former RN with 3 years of experience in a level one Trauma facility, I will give you my two cents. The reason hostility exists between AAs and CRNAs is this: anesthesiology is the one field where patient care exists. This isn’t an ER or a minute clinic where you see a patient very briefly, run lab work, write a script, and send them on their way. If it were such, the ICU experience would not be required as a CRNA. This is necessary because in the OR, there is an unbelievable amount of autonomy. I Preop my patients, choose the safest anesthetic for each individual, and tailor my anesthetic completely to that patient. I am often inducing and emerging patients alone, and if a rhythm change, PE, CA, MH, severe bleeding occurs, guess who notices this BEFORE it happens and must treat it? We are very well trained and competent providers for this reason, anesthesia is humbling for this reason. AAs enter into studying anesthesia without ever touching a patient. If this doesn’t terrify you, you have no idea what anesthesia is. AAs and CRNAs are not cut from the same cloth. CRNAs have managed critically ill patients for years before beginning anesthesia training, then are able to tie Nursing experience in with 3-4 additional years of anesthesia training and in my programs case, 2,000 hours of real anesthesia administration. It is that knowledge that is put to use in emergency situations. We learn the anesthesia knowledge, physics, pathophysiology, and pharmacology at the cellular level, sure, but you can’t teach someone who has NO PATIENT INTERACTION how to critically think with a patient that has never touched one. There is a reason anesthesiologists don’t hire AAs in most states, it’s because it’s unsafe. I highly recommend you take the extra time to become a CRNA. Do not take the shorter easier route to become an AA. It is not commendable , we are not interchangeable, and you will be significantly limited on where you can live/ practice.

 

[AdmiralChz]

Hey there, I am a CRNA and as a former RN with 3 years of experience in a level one Trauma facility, I will give you my two cents. The reason hostility exists between AAs and CRNAs is this: anesthesiology is the one field where patient care exists. This isn’t an ER or a minute clinic where you see a patient very briefly, run lab work, write a script, and send them on their way. If it were such, the ICU experience would not be required as a CRNA. This is necessary because in the OR, there is an unbelievable amount of autonomy. I Preop my patients, choose the safest anesthetic for each individual, and tailor my anesthetic completely to that patient. I am often inducing and emerging patients alone, and if a rhythm change, PE, CA, MH, severe bleeding occurs, guess who notices this BEFORE it happens and must treat it? We are very well trained and competent providers for this reason, anesthesia is humbling for this reason. AAs enter into studying anesthesia without ever touching a patient. If this doesn’t terrify you, you have no idea what anesthesia is. AAs and CRNAs are not cut from the same cloth. CRNAs have managed critically ill patients for years before beginning anesthesia training, then are able to tie Nursing experience in with 3-4 additional years of anesthesia training and in my programs case, 2,000 hours of real anesthesia administration. It is that knowledge that is put to use in emergency situations. We learn the anesthesia knowledge, physics, pathophysiology, and pharmacology at the cellular level, sure, but you can’t teach someone who has NO PATIENT INTERACTION how to critically think with a patient that has never touched one. There is a reason anesthesiologists don’t hire AAs in most states, it’s because it’s unsafe. I highly recommend you take the extra time to become a CRNA. Do not take the shorter easier route to become an AA. It is not commendable , we are not interchangeable, and you will be significantly limited on where you can live/ practice.

Why isn’t this line of reasoning true for PAs? I work with some excellent AAs and at a busy academic center I couldn’t distinguish between a nurse anesthetist and an AA - I’ve worked with solid providers from both camps and they function the same. AAs must work in an anesthesia care team model under physician direction by definition (PAs as well), and get plenty of patient care experience in school.

I see your argument about patient care experience, but I have some difficulty equating ICU nursing where you are directed by intensivists to anesthetic care. Maybe titrating vasoactives and pushing IV medications is similar. But ICU nurses aren’t intubating, adjusting ventilator settings or sedating on their own. I was an EMT for a long time before medical school, while it was very valuable for patient interactions/interviews, IV placement and overall comfort with tough situations I don’t view it as a requirement for an MD.

 

[762513]

Why isn’t this line of reasoning true for PAs? I work with some excellent AAs and at a busy academic center I couldn’t distinguish between a nurse anesthetist and an AA - I’ve worked with solid providers from both camps and they function the same. AAs must work in an anesthesia care team model under physician direction by definition (PAs as well), and get plenty of patient care experience in school.

I see your argument about patient care experience, but I have some difficulty equating ICU nursing where you are directed by intensivists to anesthetic care. Maybe titrating vasoactives and pushing IV medications is similar. But ICU nurses aren’t intubating, adjusting ventilator settings or sedating on their own. I was an EMT for a long time before medical school, while it was very valuable for patient interactions/interviews, IV placement and overall comfort with tough situations I don’t view it as a requirement for an MD.

ICU nurses standard protocol is to titrate our sedation to a RASS of -1/-2. We make frequent changes to sedation while assessing for patient changes in real time. This experience is necessary for the CRNA.

 

[AdmiralChz]

ICU nurses standard protocol is to titrate our sedation to a RASS of -1/-2. We make frequent changes to sedation while assessing for patient changes in real time. This experience is necessary for the CRNA.

I understand that, but how is this an advantage? That level of sedation isn’t appropriate for any invasive procedure done in the OR. A physician directs all procedural sedation in the ICU for cardioversions, EGDs and the like. The RN just pushes the meds.

Titrating general anesthetic gases and meds is very, very different and “consciousness” Or RASS is not used.

 

[762513]

I understand that, but how is this an advantage? That level of sedation isn’t appropriate for any invasive procedure done in the OR. A physician directs all procedural sedation in the ICU for cardioversions, EGDs and the like. The RN just pushes the meds.

Titrating general anesthetic gases and meds is very, very different and “consciousness” Or RASS is not used.

Everyday intubated patients experienced SBT and cessation of sedation for "weening," and often not resulting in extubation. The RN then resedates the patient usually with a small bolus and with intention of smaller continuous maintenance. So we have a RN giving sedation to a sometimes conscious patient and evaluating the effects vs a physician doing the same. Just because the goal of the level of sedation differs does not make this experience without merit, not even bringing into the discussion nurses paralyzing sedation and train of 4 and BIS monitoring. I agree it's not apples to apples exactly, but it's in the ball park, which is why ICU experience is required for CRNA. An ICU RN has done this hundreds to thousands of times.

 

[psychMDhopefully]

Hey there, I am a CRNA and as a former RN with 3 years of experience in a level one Trauma facility, I will give you my two cents. The reason hostility exists between AAs and CRNAs is this: anesthesiology is the one field where patient care exists. This isn’t an ER or a minute clinic where you see a patient very briefly, run lab work, write a script, and send them on their way. If it were such, the ICU experience would not be required as a CRNA. This is necessary because in the OR, there is an unbelievable amount of autonomy. I Preop my patients, choose the safest anesthetic for each individual, and tailor my anesthetic completely to that patient. I am often inducing and emerging patients alone, and if a rhythm change, PE, CA, MH, severe bleeding occurs, guess who notices this BEFORE it happens and must treat it? We are very well trained and competent providers for this reason, anesthesia is humbling for this reason. AAs enter into studying anesthesia without ever touching a patient. If this doesn’t terrify you, you have no idea what anesthesia is. AAs and CRNAs are not cut from the same cloth. CRNAs have managed critically ill patients for years before beginning anesthesia training, then are able to tie Nursing experience in with 3-4 additional years of anesthesia training and in my programs case, 2,000 hours of real anesthesia administration. It is that knowledge that is put to use in emergency situations. We learn the anesthesia knowledge, physics, pathophysiology, and pharmacology at the cellular level, sure, but you can’t teach someone who has NO PATIENT INTERACTION how to critically think with a patient that has never touched one. There is a reason anesthesiologists don’t hire AAs in most states, it’s because it’s unsafe. I highly recommend you take the extra time to become a CRNA. Do not take the shorter easier route to become an AA. It is not commendable , we are not interchangeable, and you will be significantly limited on where you can live/ practice.

Get outta here with that bull crap. WTF do you think AAs do in school just sit around and read books? There is a lot of patient experience during the training, as much as you need to do a competent job as an anesthetist. AAs most likely have better training than CRNAs just like PAs have better training than NPs. Nurses are nowhere near as smart as they think they are, and its the most annoying thing ever. The only reason AAs can't practice in more states is because of political push back from brain dead nurses who have no idea what AA training requires.

I will most likely apply to AA school in the near future, I honestly don't know why they can't practice in more states and why anesthesiologist don't advocate for them, If I were a physician I'd rather deal with AAs than a brain dead, brain washed CRNA that was been taught they are equal to physicians. But in some ways I can't blame CRNAs, physicians never speak up as CRNAs take bigger and bigger slices of the pie, its one of the things as a med student I could never respect about the medical field.

 

[762513]

Get outta here with that bull crap. WTF do you think AAs do in school just sit around and read books? There is a lot of patient experience during the training, as much as you need to do a competent job as an anesthetist. AAs most likely have better training than CRNAs just like PAs have better training than NPs. Nurses are nowhere near as smart as they think they are, and its the most annoying thing ever. The only reason AAs can't practice in more states is because of political push back from brain dead nurses who have no idea what AA training requires.

I will most likely apply to AA school in the near future, I honestly don't know why they can't practice in more states and why anesthesiologist don't advocate for them, If I were a physician I'd rather deal with AAs than a brain dead, brain washed CRNA that was been taught they are equal to physicians. But in some ways I can't blame CRNAs, physicians never speak up as CRNAs take bigger and bigger slices of the pie, its one of the things as a med student I could never respect about the medical field.

It’s not acceptable to call CRNA’s “brain dead, brain washed” Thats against the TOS of these forums.

 

[pamac]

Get outta here with that bull crap. WTF do you think AAs do in school just sit around and read books? There is a lot of patient experience during the training, as much as you need to do a competent job as an anesthetist. AAs most likely have better training than CRNAs just like PAs have better training than NPs. Nurses are nowhere near as smart as they think they are, and its the most annoying thing ever. The only reason AAs can't practice in more states is because of political push back from brain dead nurses who have no idea what AA training requires.

I will most likely apply to AA school in the near future, I honestly don't know why they can't practice in more states and why anesthesiologist don't advocate for them, If I were a physician I'd rather deal with AAs than a brain dead, brain washed CRNA that was been taught they are equal to physicians. But in some ways I can't blame CRNAs, physicians never speak up as CRNAs take bigger and bigger slices of the pie, its one of the things as a med student I could never respect about the medical field.

You are really adamant about “AAs having better training than CRNAs, just like PAs have better training than NPs”, even though you are just speculating (and speculating incorrectly). As a pre AA, how many codes have you been on? How much ICU experience do you have? How many patients lives have hinges on your skills and abilities? Since the answer is probably “none”, you might not be the best person to call a CRNA names, nor draw conclusions about how they and their training stack up to you.... someone who doesn’t even “know why they can’t practice in more states”.

I imagine AAs are trained well enough to function in their role as anesthesia providers directly supervised by anesthesiologists. I don’t know any of them because they are rare, and practice in a handful of states. There are comments on SDN from AAs who have run into problems with that fact, and it has affected their ability to relocate to places like California, where they needed to be. Anyone opting to go to AA school needs to understand and be comfortable with that. They also shouldn’t expect that to change anytime soon.

 

[Mad Jack]

a few things about AA. in settings that use both AAs and CRNAs they are interchangeable. the geographic limitations are a bummer, but if you want to live in one of those 20 or so states or work at a federal facility it is not an issue. there is a PA to AA bridge program at one of the AA programs if you can't decide np vs pa this might shift things towards PA. crnas certainly do very well working independently, but there is some push back from the physician anesthesiologists and they are starting to hire AAs preferentially in some areas...I thought about the pa to aa bridge at one point, but thought I would be bored to tears. remember the abcs of anesthesiology: airway, book, chair. 99% routine, 1% panic.

The other major issue is that AAs can't take solo call, as their practice acts require supervision. CRNAs can. This provides an incentive to hire CRNAs over AAs, unfortunately.

 

[762513]

Get outta here with that bull crap. WTF do you think AAs do in school just sit around and read books? There is a lot of patient experience during the training, as much as you need to do a competent job as an anesthetist. AAs most likely have better training than CRNAs just like PAs have better training than NPs. Nurses are nowhere near as smart as they think they are, and its the most annoying thing ever. The only reason AAs can't practice in more states is because of political push back from brain dead nurses who have no idea what AA training requires.

I will most likely apply to AA school in the near future, I honestly don't know why they can't practice in more states and why anesthesiologist don't advocate for them, If I were a physician I'd rather deal with AAs than a brain dead, brain washed CRNA that was been taught they are equal to physicians. But in some ways I can't blame CRNAs, physicians never speak up as CRNAs take bigger and bigger slices of the pie, its one of the things as a med student I could never respect about the medical field.

Instead of hating on nurses, why don’t you become a RN yourself? Once you have your bachelors in nursing you can be a psych NP, CRNA, educator, researcher, virtually any route you can imagine. Since it appears you’re not going to be a physician, why not?

 

[jwk]

The other major issue is that AAs can't take solo call, as their practice acts require supervision. CRNAs can. This provides an incentive to hire CRNAs over AAs, unfortunately.

For Anesthesia Care Team (ACT) practices, where an anesthesiologist is involved with every patient, there is no incentive to hire CRNAs over AAs.

 

[Mad Jack]

For Anesthesia Care Team (ACT) practices, where an anesthesiologist is involved with every patient, there is no incentive to hire CRNAs over AAs.

For hospitals or practices that are looking to minimize costs and do not utilize the ACT model, there is a strong disincentive against hiring AAs

 

[jwk]

For hospitals or practices that are looking to minimize costs and do not utilize the ACT model, there is a strong disincentive against hiring AAs

The majority of anesthetists and anesthesiologists are not employed directly by hospitals, but rather by groups or management companies. Academic settings are the major exception.

I have little respect for practices that provide MD anesthesiology coverage 7-3 M-F and leave the rest of the work to the CRNAs on nights, weekends, and holidays. I have worked for both a small and large practice, and 24/7 MD coverage is perfectly manageable.

 

[Mad Jack]

The majority of anesthetists and anesthesiologists are not employed directly by hospitals, but rather by groups or management companies. Academic settings are the major exception.

I have little respect for practices that provide MD anesthesiology coverage 7-3 M-F and leave the rest of the work to the CRNAs on nights, weekends, and holidays. I have worked for both a small and large practice, and 24/7 MD coverage is perfectly manageable.

It is, but many places are penny wise and pound foolish.

There is also the issue that CRNAs are eligible for Medicare passthrough dollars but AAs and anesthesiologists are not

 

[jwk]

It is, but many places are penny wise and pound foolish.

There is also the issue that CRNAs are eligible for Medicare passthrough dollars but AAs and anesthesiologists are not

Interestingly, AAs ARE eligible for passthrough $, but there has to be an anesthesiologist as well. Strange regulation for sure, and one that should be repealed. Why would a hospital not want an anesthesiologist if one is willing to go there?