AAs: Antidote for Chronic Lack of Anesthesia Professionals
We know it’s coming. Just as we hold our collective breaths for an impending hurricane, so too, do we dread the worsening, critical nursing shortage. According to the American Association of Colleges of Nursing Fact Sheet, October 2007, the impending crisis will only intensify by the year 2020, when our national shortage will surge to over 340,000 nurses. The situation is much like the perfect storm: retiring nursing faculty members; a nursing workforce of advanced age and retiring; our local population swelling 22% by 2020; and baby boomers’ ranks continue to age and require acute health care services. As the forces merge, the problem heightens. The result: disaster. As if this were not enough, staffing hospitals with sufficient nurses is virtually impossible. When nurses leave for additional certifications, their departure exacerbates the increasing tempest. But, there is hope for relief; Anesthesiologist Assistants. Anesthesiologist Assistants’ Qualifications The term Assistant is misleading. These are degreed professionals who have taken the premedical coursework prerequisites. They must take the MCAT or the GRE to be admitted to a two-year AA program – accredited by the Commission for the Accreditation of Allied Health Educational Programs – where they will earn master’s degrees in science. They complete training programs and the required number of hours in a hospital setting. The programs must be offered at, or in collaboration with, a university medical school and an academic anesthesiologist physician faculty. Main clinical sites must be academic medical centers. Their learning includes classroom/laboratory education totaling about 600 hours. Couple that with 2,600 hours of clinical anesthesia education, all types of surgery, and more than 600 possible anesthetics administered, in order to successfully complete the AA training program. Additionally, students may become certified by passing either the Council for Certification of Nurse Anesthetists (CCNA) certification exam or by the National Commission for Certification of Anesthesiologist Assistants (NCCAAA). The latter is co-validated by the National Board of Medical Examiners. Re-certification is required every two years with 40 hours of Continuing Medical Education (CME). And every six years, AAs must take the Continuing Demonstration of Qualification Exam. These rigorous standards make it possible to hire highly qualified individuals – like Certified Registered Nurse Assistants (CRNAs) – but do not deplete the nursing ranks. AA Programs in the U.S. To date, there are only five AA programs in the United States. Fortunately for us, the first school in Florida is south Florida’s Nova Southeastern University. NSU began its first 27-month program in 2006 with 29 students and they will graduate this year. NSU professor Mike Nichols, MSA, AA-C, president of the American Academy of Anesthesiologist Assistants has stated, "The more students NSU can matriculate, the greater the chances are for Floridians and people across the country to get access to health care." Two other schools are in Georgia; Emory, in Atlanta and South University in Savannah. Emory’s 27-months’ AA program begins each June. Upon successful completion, individuals earn Master of Medical Science degrees. Graduates function as anesthetists; indispensable members of the anesthesia care team (ACTs) led by an anesthesiologist. In January 2005, the AA program at South University received its initial accreditation from the Commission on Accreditation of Allied Health Educational Programs (CAAHEP) through their Accreditation Review Committee for Anesthesiologist Assistant Programs (ARC-AA) for the maximum five-year period. South collaborates with Mercer University (Macon, GA). At the present time Mercer provides anesthesia instruction for South University’s AA program. Cleveland, Ohio’s Case Western Reserve University began offering baccalaureate degrees in 1969, expanding into a professional postgraduate program in 1987, where students are awarded Master of Science degrees in Anesthesiology. The program is accredited by CAAHEP. The University of Missouri in Kansas City prepares students with pre-med undergraduate degrees to become AAs. Their 24-month program allows eligible graduates to sit for the Certification Exam offered by the NCCAA and work within an ACT as a fully qualified and valued member. Prognosis The prognosis for averting the imminent nursing shortage isn’t good. Stanching the hemorrhage of exiting nurses is a sensible remedy and welcoming Anesthesiologist Assistants as members of ACTs, is good medicine. When the gales of the nursing shortage increase – and they will – it’s comforting to know that AAs will be there to help us weather the tempest.
Sharon Beverly, Ph.D., is a free lance writer and editor, who writes for AnestaWeb, Inc. and various publications. She may be reached at: SheronBeverly.com. For AA job placement visit AnesthesiologistAssistant.com or e-mail Info@AnesthesiologistAssistant.com.