The number of CRNAs being graduated each year is 1000 TOO FEW to meet current demand generated by population growth and the aging population. Add to that the fact that there will be a massive loss of CRNAs in the next 10-15 years due to the retirement of the baby boomers and there will be a real problem in Anesthesia.
(The MDA situation is not much better by the way.)
Nursing, the source of students for nurse anesthesia programs is also in a bad state. When the three year hospital programs got closed down years ago, the number of nurses coming out of Bachelor programs was suppose to compensate. To help with the transition, they allowed two year Associate degree nurses. The problem is, even with the combination of the two, they did not graduate enough nurses to meet demand. And now that they are starting to realize the problem, it is the two year Associate degree programs that are being expanded, not the four year programs.
This really generates a problem for nurse anesthesia. More nurses are coming out of the Associate degree programs but the master degree nurse anesthesia programs will not take them. They only take bachelor degree program nurses. The pool for potential nurse anesthetist students is very limited. And each time they take a nurse and turn them into a nurse anesthetist they lose a nurse on the wards and clinics.
This situation is not going to work. And it is the same kind of situation the military services found themselves in over 20 years ago.
US Army, USAF, US NAVY had problems getting nurses. They also had problems with getting doctors. So they came up with the idea of physician extenders. Nurse Practitioners. It seemed like a good idea.
But then the services saw a new problem. They would take a nurse off the ward and send them to a practitioner program. They would lose a nurse on the ward that had to be replaced. And when the nurse practitioner served their payback time, they often got out of the service to make more money as a civilian..
It just was not working. So they started using PAs. They would take an enlisted troop with 8+ years of service, send them to college to become a PA and then they would go to work. And after they finished their pay back time they only had a few years to go to retire so they stayed in. The services got their physician extenders, they got to keep the nurses on the wards and they had all areas covered.
It was a better system for the services than using nurse practitioners. The only area that did not change was nurse anesthesia but even there, the services recognized AAs and did have plans to use them down the road. (However, the massive draw down of the services in the 1990s put an end to that. They had so many anesthesia providers they gave many of them a 15 year retirement. There was no need to go ahead with plans to use AAs.)
Now nurse anesthesia in the civilian world is in the same shape. Take a nurse to make a CRNA and you lose a nurse on the ward. But if you take someone with a bachelors degree in something other than nursing and make them an AA, you keep the nurses on the wards and you get the anesthesia providers you need.
I see the AA concept expanding to cover the whole USA. However, I also see that THEY need to set up their practice laws so they can truly be a profession unto themselves and not totally under the control of the MDAs. They AAs need to be proactive and ensure they have some freedom of action in regards to employment and at the very least, be equal to CRNAs who work for MDAs.
Eventually I see a coming together of AAs and CRNAs, perhaps into one professional association as their interests and jobs are the most similar in the anesthesia field. And you can bet if the CRNAs and AAs started cooperating instead of fighting each other, the ASA and MDAs would have shit fits over it.
