Posted by Dave J on July 23, 2008, 3:11 pm, in reply to "Re: Confused now!"
Stanley has given you the facts as they now stand.
However, the future for AAs looks brighter in both regards.
First, when you combine all the schools of Nurse Anesthesia, they are turning out 1000 too few new CRNAs each year to keep up with demand and the aging population.
Second, when you add to that the fact that over 50% of the currently practicing CRNAs are baby boomers and will be retiring in the next 8-15 years, there is going to be one hell of a shortage of anesthesia providers.
Third, the nursing schools, the basis of the CRNA concept, are not turning out enough nurses. It seems what expansion that is being done to get more nurses out is coming from the two year associate degree programs, which are not (at this time) acceptable for entrance to a masters degree CRNA program. In other words, the source of CRNA students is getting dried up.
If you went and got your BS degree in nursing and got into a CRNA program and graduated, you would be looking at a yearly income of $200,000 in just a few years in any state and any practice setting you choose. Be it a major medical center with MDAs, a private hospital with MDAs or a smaller facility with CRNAs only. Any state, any location. That is probably the biggest advantage of being a CRNA over an AA....at this point in time.
However, with the shortage in nursing and nurse anesthesia, I think the AA concept is not only going to grow in the number of programs, but in the states that allow them. In the not too distant future (10+ years) I think AAs will be accepted in all 50 states. So the advantage that the CRNAs have in regards to that will disappear.
The catch to the AA concept is that they MUST by definition work under MDAs. That means they can not work in any setting without an MDA, such as rural hospitals or doing pain management. While this will have no major negative impact on the bigger facilities, it will be a definite "killer" for the small rural hospitals as AAs will not be able to cover those facilities.
UNLESS the practice law down the road for AAs changes so that they can work independently. I think in that case, the ASA and the MDAs would fight it tooth and nail as they do not want another group like the CRNAs around that can "compete" with them. (AANA and ASA relationships have pretty much always been antagonistic.)
If you decide to go the CRNA route, you would have to bet at least an associates degree in nursing as some schools may consider that along with your current bachelors. However more likely you will need a bachelors degree in nursing as the push in on now for the CRNA programs to be doctorate level programs. Either way you will have to work 2-3 years in a critical care nursing field before you can apply for a CRNA program.
Bottom line you are looking at 4-5 years before you can even get into a CRNA program and 7-8 years before you can be working in anesthesia.
VS
You can apply for an AA program right now and be out in 24-30 months practicing as an AA. In my 33 years of experience, when you work with MDAs, it is not always a bad situation. They seem much nicer in small groups than they do as the ASA.
I would say the AA future looks bright IF.
#1. You guys form some professional organization to speak for you and you do not become a subset of the ASA.
#2. You guys define your own practice laws and not let the MDAs so it for you. If you do, you can bet it will always be set up that you are always under their thumbs.
#3. You guys try to develop some sort of relationship with the AANA. (IMO the best move would be the AANA to rename itself the AANA + AAs and push for them to be the same and equal. But I do not seen the AANA doing that as it acts more like a union set up to protect the jobs of CRNAs.)
