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September 5, 2012

What is the difference between Anesthesiologist Assistants and Nurse Anesthetists?


The difference between an Anesthesiologist Assistant and Nurse Anesthetists is primarily their scope of practice. When it comes to the American Association of Nurse Anesthetist (AANA) vs. the American Academy of Anesthesiologist Assistants (AAAA) there is politics in motion. Not all CRNAs are Anti-Anesthesiologist Assistants but the vast majority of CRNAs are against Anesthesiologist Assistants being licensed and working in all 50 states (the nurses just don’t want the competition).

Anesthesiologist Assistants work under the direction (supervision and/or medical direction) of a licensed Anesthesiologist in the Anesthesia Care Team. Anesthesiologist Assistants in the U.S. are either licensed or work under delegatory authority at hospitals, such as an academic teaching institution, private practice setting institution, or outpatient service day surgery centers in the Anesthesia Care Team (ACT). 100% of Anesthesiologist Assistants work in the ACT model.

CRNAs may work under the medical direction (and/or supervision) of an Anesthesiologist M.D. or D.O. part of the Anesthesia Care Team, or they may work under the supervision of a surgeon, dentist or independently licensed practitioner legally authorized to deliver anesthesia services delineated in the rules and regulation written in accordance with various state laws. 80% of CRNAS work in the ACT in the same manner as Anesthesiologist Assistants and the other 20% of CRNAs work out of the ACT independently mostly in rural areas of the U.S.

HOWEVER, one-third of all practicing nurse anesthetist have not earn an undergraduate degree. All Anesthesiologist Assistants must have obtained an undergraduate degree with pre-med core curriculum courses which is very “rigorous” and must take either the MCAT (Medical College Admission Test) or GRE (Graduate Record Examination Test).

Hospital that have both Anesthesiologist Assistants and CRNAs employed at their institution in the Anesthesia Care Team (ACT), their jobs are identical and both are used interchangeably doing the same exact job. Anesthesiologist Assistants and CRNAs in the ACT stay in the O.R. (suite) with their patients from the beginning of the case to the end of the case anywhere from 30mintues to 8 hours or more depending on the type of surgery that is being performed.

Anesthesiologist Assistants and CRNAs jobs are both amazing and intriguing professions in the Anesthesia Care Team. Nurses (R.N.s) who meet the criteria and prerequisites can also be admitted to an Anesthesiologist Assistant program (anesthetist), there are several nurses who are Anesthesiologist Assistants who chose to take the Anesthesiologist Assistant route vs. CRNA route for different or personal reasons.

FACT: there is a nurse who is an Anesthesiologist Assistant and her title reads R.N., M.M.Sc., A.A.-C., she has thirteen (13) years experience as an Certified Anesthesiologist Assistant – Anesthetist and twenty-three (23) years experience as Registered Nurse.

She is licensed as an R.N.,A.A.-C. (Anesthesiologist Assistant).

*AA School attended – Emory University School of Medicine, Atlanta, GA.

*B.S. Nursing (Bachelor’s of Science in Nursing).

*M.M.Sc. Anesthesiology (Master of Medical Science in Anesthesiology).

In closing, both Anesthesiologist Assistants and CRNAs are highly respected as anesthetists in the Allied Health/Nursing as mid-level providers in or out of the Anesthesia Care Team (ACT).

FACT: Anesthesiologist Assistants can train and teach SRNA (student nurse anesthetist) = CRNAs. Anesthesiologist Assistants also train and teach their own AA-S/RN,AA-S (student anesthetist/student nurse anesthetist) = AA-C/RN,AA-C.

August 14, 2012

Anesthesiologist Assistants Qualifications and Responsibilities

Filed under: General AA Information — Tags: , , — admin @ 7:41 pm

 

The text  below is only to be used as a suggested guideline for the Anesthesiologist Assistant (by University of Texas)  – Read Texas AA Press Release

 

1. Suggested Qualifications of an Anesthesiologist Assistant also known as (Anesthesia Assistant). The delegating physician should require that the Anesthesiologist Assistant (Anesthesia Assistant) provide evidence, satisfactory to the physician, of his/her qualifications, including but not limited to the following:

 

A. Successful completion of a training program accredited by the Committee on Accreditation of Allied Health Education Programs (CAAHEP), its predecessor agency (CAHEA), or successor agencies.

 

B. Successful completion of 60 semester hours of college courses, other than the above referenced training program, which courses would be acceptable, at the time of completion, for credit on a bachelor of arts degree or a bachelor of science degree.

 

C. Successful passage within three (3) attempts of the National Certifying Examination for Anesthesiologist Assistants as administered by the National Commission for Certification of Anesthesiologist Assistants (NCCAA) or its successor agencies.

 

D. Successful and current completion of the Advanced Cardiac Life Support program as administered by the American Heart Association or its successor organizations.

 

E. Successful completion of NCCAA (or its successor agencies) CDQ and CME activities as required to maintain NCCAA certification.

 

F. Submission of a standard evaluation form, used for all Anesthesiologist Assistants, indicating training, practice experience, character references, delegating physicians, etc.

 

G. Submissions of evaluations from all prior employment as an Anesthesiologist Assistant and from all training programs.

 

H.  Any other information which is deemed necessary to evaluate the individual.

 

2. Functions and Duties of an Anesthesiologist Assistant/Anesthesia Assistant:

 

A. Individuals who meet the definition of an Anesthesiologist Assistant under Section (1) above may engage in the following functions and duties delegated to them by properly qualified supervising anesthesiologists.

 

B. There shall be at all times a direct, continual and close supervisory relationship between the Anesthesia Assistant and the supervising anesthesiologist. The supervising anesthesiologist shall, at all times, be responsible for the activities of the Anesthesiologist Assistant.

 

C. A written job description, signed by the Anesthesiologist Assistant and supervising anesthesiologist(s) must exist which delineates the medical tasks and services, which the Anesthesia Assistant may provide. Within the framework of the written job description, the Anesthesia Assistant may engage in the following functions and duties:

 

1. The Anesthesiologist Assistant shall provide delegated medical services within the education, training, and experience of the Anesthesia Assistant. These services may include perioperative patient evaluations as well as delegated teaching and research functions.

 

2. The Anesthesiologist Assistant may administer anesthesia under the direct supervision of a qualified anesthesiologist.

 

3. The Anesthesiologist Assistant/Anesthesia Assistant performs initial CPR/ACLS in life threatening situations as directed by a physician or protocol until the supervising anesthesiologist arrives.

 

4. The Anesthesia Assistant initiates multi-parameter monitoring prior toanesthesia or in other acute care settings.  Modalities include, but are not limited to, ASA Standard Monitor arterial and venous catheters. The Anesthesia Assistant may manipulate and interpret data from central venous, pulmonary artery and intracranial catheters and other monitors devices that are indicated. The Anesthesiologist Assistant administers the prescribed anesthetic with particular attention to the cardiovascular, respiratory and metabolic health of the patient. The Anesthesiologist Assistant may administer drugs commonly used in anesthetic practice by protocol or as directed by the supervising anesthesiologist.

 

5. The Anesthesiologist Assistant/Anesthesia Assistant may utilize advanced treatment modalities to effect the prescribed anesthetic plan; these may include but are not limited to advanced airway interventions, including intubation of the trachea; starting and adjusting vasoactive infusions, administering vasoactive and anesthetic drugs, administering blood and any other treatment modalities prescribed by the supervising anesthesiologist and within the training and expertise of the Anesthesia Assistant.

 

6. An Anesthesiologist Assistant is prohibited from performing medical services, procedures, functions or activities, which are not specifically listed in the Anesthesiologist Assistant’s job description.

 

3. Prohibited Activities and Functions for an Anesthesiologist Assistant/Anesthesia Assistant:

 

A. Any medical service, procedure, activity or function not specifically enumerated in the written and signed job description is prohibited.

 

B. Anesthesiologist Assistants/Anesthesia Assistants are prohibited from representing themselves as physicians, anesthesiologists, or physician assistants. Recommended nomenclature is: Anesthesiologist Assistant.

 

4. Supervisory Requirements for Anesthesiologists:

 

A. The Anesthesiologist to whom an Anesthesiologist Assistant is responsible must:

 

1. hold a current, unrestricted license to practice medicine in the State;
2. be engaged full time in the medical specialty of anesthesiology; and
3. be certified by the American Board of Medical Specialties or the Bureau of Osteopathic Specialists in anesthesiology.

 

B. Supervision of Anesthesiologist Assistants by Non-Anesthesiologist Individuals not meeting the criteria stated in Section 4(A) are prohibited from supervising or delegating tasks to Anesthesiologists Assistants.

 

C. Patient Choice

 

1.  Except under emergency circumstances, the supervising anesthesiologist is responsible for informing patients that they will receive anesthesiology care in the team mode, which includes the use of Anesthesiologist Assistants, and that the physician may not be present in the operating room at all times but must be present in the operating suite.

 

2. If the patient so wishes after having been informed of the use of Anesthesiologist Assistants, the supervising anesthesiologist(s) shall offer a personally administered anesthetic by a physician or referral.

 

D. Supervisory Ratios

 

1. Except under emergency circumstances, the supervising anesthesiologist may not concurrently direct more than four anesthesia services or simultaneously supervise more than a combination of four (4) certified registered nurse anesthetists, Anesthesiologist Assistants, or anesthesiology residents.

 

2. Responsibility for Compliance with Recommendations Anesthesiologist Assistants (Anaesthetic assistant) have no legal standing outside the general provisions of their State’s Medical Practice Act dealing with delegation of duties. As such, the primary responsibility for maintaining the standards set forth in this document will lay with the supervising anesthesiologists and the credentialing committees in the involved facilities. While the Board has no formal mechanism to monitor Anesthesiologist Assistant practice at this time, reports of deviations from these recommendations may be investigated, at the Board’s discretion, as violations of the appropriate sections of the State’s Medical Practice Act. The supervising physicians remain ultimately and completely liable for all acts of the Anesthesiologist Assistants, which may lead to disciplinary action.

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