The only difficulty in meaningful thought patterns is by pathetic CRNA's like yourself who think that AA's have an MDA telling us how to do our job. An obvious result of not having any clue what an AA is other than what your organizations tell you. Don't worry though, we'll be working all around you soon enough and you will be educated. Granted, someone with an obviously overinflated ego like yourself will continue to spout lies and crap to anyone who is willing to listen. As far as the nurse anesthesia comment, tell me, when a mother wipes a childs ass at home is it parenting or nursing? Doing the exact same thing but you can call it whatever you want.