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Nurse Anethesists: thoughts on future practice?


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Recently there have been developments in BC regarding the potential introduction of nurse anethesists ( see globe and mail / Vancouver sun for articles ).

 

I'm curious what people who have experience in this field or discussed it with current residents/attendings think regarding the potential impact on Canadian wide practice for future MD graduates.

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Did you know that some NA's can make up to 250/yr?? Crazy.

 

From a Canadian perspective I think the #'s would be low 100's, in keeping with extra training required by NPs, RNs, etc.

 

I think the issue so much isn't what do they make, but are we following an American model whereby the future of anesthesia may be supervision of NAs opposed to managing the pt yourself, especially for less complicated patients?

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There are no CRNAs in Canada as of yet. As it stands some centres have AAs (Anesthesia Assistants, who typically are advanced RRTs) who provide some support to staff anesthetists. Were there to be expansion of the mid-level role, it would probably be with them.

 

My understanding is that one staff per patient is still the official CAS policy (maybe someone who is actually in anesthesia can comment!). It's worth mentioning as well that Canadian training standards are arguably higher (and certainly longer) than in the US, where there is much more variation in the quality of programs for physician-anesthesiologists let alone CRNAs.

 

And, really, patients are complicated until they're not.

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i wouldn't worry about it from a financial point of view. The introduction of CRNAs in the states just furthered the earning potential of anesthesiologists there. The only reason they implemented the 3:1 ratio of with anesthesiologists overseeing it all is so they could make more $

 

THANKfully in Canada we don't have a healthcare industry, we have a healthcare system and we will do what is best for the patients - not the doctors pocketbooks. It is for this reason that I don't see us following the american model.

 

Paying a CRNA 150k+ per year to work 40hrs a week plus benefits plus pension is not cost effective - if you do the math that would be equivalent to a physician payment (remember sans benefits etc) of ~200k for 40hrs a week - which isn't far off what anesthesiologist would make if they worked those limited hours with mandatory coffee and lunch breaks.

 

Could Canada maybe make this happen by paying significantly less? Maybe - but regular old RN's can already earn upwards of 80K so why would they take three years to further train (net cost tuition + 240k in lost earning) to become a CRNA if they payoff wasn't worth (which is why it pays so well in the USA).

 

I agree that the AA's who are RT's will likely expand their role - but they are there to assist - not to try and take over -

 

Surgeons need scrub nurses the same way anesthesiologists need AA's - its not a turf war its extra support which will only improve the efficiency of care and improve quality which is the name of the game!

 

There is an abundance of jobs in the anesthesia world - i think/hope it will be a safe and excellent bet for a future career but nothing is for sure - radiology could outsource - primary care could become mid level dominated, pathology could become automated - all possibilities but not very likely.

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