Working in a facility that also uses AAs

[Bucky1982]

Hey, looking for some input from fellow CRNAs who are working in a facility (ACT model) that uses AA’s in addition to CRNA’s. My family is moving to a state where AA’s are allowed to practice, and I will be leaving a state where they are not. I have a job opportunity at a hospital which seems to use AA’s and CRNA’s interchangeably. I have never worked alongside of AA’s, and honestly, I’m not even certain how the facility can be using CRNA’s “interchangeably” with AA’s… but, I do know that AAs are allowed to work within the care team model in states where they are allowed to practice.

This will be quite a change from where I am currently working, but there are very few options where we will be moving to, so I am seriously considering the opportunity. I’m just looking for some honest feedback, I’ve heard through the grapevine, that a mixed AA and CRNA environment doesn’t make for the greatest workplace, but I am hoping to get a few honest opinions from CRNAs currently working in this type of environment.

Thanks much!

[BeachCRNA]

I work in a facility that uses AA’s along with CRNA’s, and overall I am not a fan, and neither are most of my CRNA coworkers. This dynamic, in my opinion, has caused what can best be described as low workplace morale and a strange dynamic in cohesiveness within the ACT. Most of the AA’s we work with are nice people, however, their overall use as a political tool against CRNA’s by the Anesthesiologist’s (on the broad scale, as well as within our facility) makes it a bit like being forced into bed with someone you have no desire to sleep with.

Facilities that use both AA’s and CRNA’s “interchangeably”, have a tendency to try and merge the 2, as if there is no difference between an Anesthesiologist Assistant and a Certified Registered Nurse Anesthetist, when we all (clearly) know there is. Hopefully, someone has a more positive point of view for you on here, but as for my personal experience in working in this environment, I wouldn’t suggest it, if you had the option of working in a group or facility that only used CRNAs. In fact, we have lost quit a few excellent CRNA’s, who have decided to seek other opportunity’s where the work place isn’t so uncomfortable… and I actually will be following suit shortly.

[Gabby76]

@BeachCRNA, similar experience here. Work in a hospital where they lump AA’s and CRNA’s together, and like you stated the morale is strained. They can try to come up with all the similarities that they would like, but at the end of the day a CRNA is a RN first, with typically 2 to 5 years of Critical Care experience… before they even start CRNA school. An AA could have been a massage therapist 2 years prior, and now is practicing anesthesia (under the supervision of an anesthesiologist, of course)… our knowledge and experience is drastically different. Most of the AA’s I work with are nice people, but inevitably, the work environment is weird at times.

[Bucky1982]

Thanks for the perspective Beach and Gabby. I took the job because my options were limited, for the time being at least. Wish me luck, from the sounds of it, I may need it, haha! Interesting topic for discussion though, wouldn’t mind to keep the thread going… thanks again.

[teddy-byebye]

I’ve worked in facilities that use both CRNAs and AAs, and from a pro-CRNA standpoint, I will say the reality is usually much less dramatic than people imagine. It’s not like you’re working with them directly. BUT as CRNAs, we do know the difference. I work at a facility that made a very intentional push toward AAs. Administration sold it as interchangeable coverage and cost savings. A lot of experienced CRNAs saw where it was heading and left. What followed was the workplace didn’t function the same. Coverage became tighter, flexibility dropped, and cases that used to be absorbed smoothly required more coordination. The end result? The facility had to bring in locum CRNAs at the highest rates in the region just to keep rooms running. That alone should tell you something.

Eventually, the higer ups recognized that what worked on paper didn’t translate operationally. The model has shifted back toward a MD/CRNA structure, although we still have 2 or 3 AAs.

This isn’t about generalizing personalities based on titles, as most CRNAs and AAs likely work well with everyone. It’s about training, scope, and system resilience. CRNAs bring a depth of ICU-based clinical judgment, independent decision-making ability, and flexibility across all settings. When you remove too many of those pieces, the system shows strain. Facilities can choose whatever model they want. But from the CRNA side, we’ve seen this experiment play out. The places that run best long-term tend to be the ones that retain experienced CRNAs, not replace them and then pay a premium to get them back.