CRNAs in Florida to require anesthesiologist supervision

  1. I just read in a magazine about a House bill being passed that mandates that CRNAs in that state must now be supervised by anesthesiologists. If this passes the senate, wouldn't this be the end of the CRNA profession in Florida? After all, why would anyone use CRNAs if they would also have to pay for the supervising anesthesiologist? Where are the Florida CRNAs, and what do they have to say about this? I'm surprised to not see more political activity from them.

    Just a thought.
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  2. 59 Comments

  3. by   Maxs
    This is a battle between Anesthesiologist and CRNA's. Leave it to them because this topic has been around so many times now and there's no solution to it as of yet. If it should pass the senate, then it's in the best interest of the people. If they were elected by the people to pass these mandated laws, I am sure they know what is the best interest of the Florida residents. If things don't work out, then they'll probably reverse it. Peace to CRNA's and MDA's.

    Maxs
  4. by   yoga crna
    Sorry Max. You are dead wrong. CRNAs must continue their legal right to independent practice. It affects all of us, especially all of you students and prospective CRNAs. If you don't want to get involved, please find another profession. Those of us who have put in countless hours and dollars for these battles have done so for all of you and to keep the practice of anesthesia honest. CRNA supervison by anesthesiologists is not necessary legally or clinically.

    By the way, that article must be old, because if it was related to office anesthesia, the CRNAs (and the patients) won the battle.

    Yoga CRNA
  5. by   Tony35NYC
    Sorry Yoga, but the article is not old. It is in the March 2005 issue of Nursing Spectrum magazine. And if you go to the Florida Association of Nurse Anesthetists website right now you will see that there are actually two bills currently floating in the Florida legislature intended to restrict the practice of CRNAs in that state. The House bill was passed only 2 days ago. 3/23/2005, and the CRNAs lost big time in this round.

    http://www.fana.org

    If the Florida Board of Medicine successfully gets its way to control the practice of CRNAs then perhaps other state Boards of Medicine will follow suit. What say you?
  6. by   yoga crna
    Tony, thanks for the info. You are correct and I apologize for not being current on what is going on in FL. There are a great group of CRNAs in that state and I know they are working hard on it.

    I am in the process of finding out who I can send some money to assist them to fight for their rights. Also, I have sent some emails to my retired friends (non-CRNAs) in Florida asking them to contact their legislators.

    The battle continues and we will continue to fight for what is right. It is my learned opinion that we need to explain that this is an economic, not safety issue. Economics is usually behind most of these battles and the public needs to understand that.

    Thanks again.

    Yoga
  7. by   Maxs
    How about making national advertisement, it's highly effective. It's the only way to effectively inform the public, if you're going to spent money, why not spend it the right way.

    Maxs
  8. by   Tony35NYC
    Quote from Maxs
    This is a battle between Anesthesiologist and CRNA's. Leave it to them because this topic has been around so many times now and there's no solution to it as of yet. If it should pass the senate, then it's in the best interest of the people. If they were elected by the people to pass these mandated laws, I am sure they know what is the best interest of the Florida residents. If things don't work out, then they'll probably reverse it. Peace to CRNA's and MDA's.

    Maxs
    Max,

    I disagree that the livelihood CRNAs should be left up to any state senate. The Board of Medicine is clearly pushing this initiative just so the MDs can have total control of anesthesia practice in the state. With the higher fees charged by anesthesiologists, I don't see how these initiatives will be in the best interest of Florida 's residents. This is not the first time that the Florida Board of Medicine has tried to squeeze the CRNAs out of the picture, and the physicians have a lot of money and some very powerful friends in the House so I'm not surprised they got this far. Still, I hope the CRNAs fight long and hard to defeat these bills in the state senate.
  9. by   gaspassah
    If it should pass the senate, then it's in the best interest of the people.
    Although i believe in a democratic society, special interest and lobby play a huge part in these types of bills.
    d
  10. by   Maxs
    Quote from Tony35NYC
    Max,

    I disagree that the livelihood CRNAs should be left up to any state senate. The Board of Medicine is clearly pushing this initiative just so the MDs can have total control of anesthesia practice in the state. With the higher fees charged by anesthesiologists, I don't see how these initiatives will be in the best interest of Florida 's residents. This is not the first time that the Florida Board of Medicine has tried to squeeze the CRNAs out of the picture, and the physicians have a lot of money and some very powerful friends in the House so I'm not surprised they got this far. Still, I hope the CRNAs fight long and hard to defeat these bills in the state senate.
    All I was saying was that since the state of Florida has many retired people, of course most of them would be on medicare. Now, if the senator's want to serve again, I think they would want to keep health care costs as low as possible. I am sure they have economists and etc who figure all these units out. When they get to the bottom line, which is, MDA's crying out loud for superiority or CRNA's (affordable anesthesia services in the best interest of the public). That's not easy to decide, unless you get the judge drunk and flood money on every representatives mailbox. However, if the bill passes, you can always take it to the Supreme Court. One thing we all should know is to never give up hope. We can test the constitutionality of the bill for se if it's passed. Again, once one of these little cases reaches the Honorable United State Supreme Court, that's when an informed decision well be made. As of now you will see cases pop out like popcorn per state every other month. I just hope it reaches the Supreme Court, that way one decision will be reached and I am sure it will be in the best interest of the public aka CRNA independency. If you look at it, this is not in the best interest of Podiatrist, dentist, and surgeons plastic surgeons.

    Max
  11. by   athomas91
    Maxs.... first and foremost - one should always be aware that bills ARE NOT usually passed "for the good of the population in a state" -
    when you ask an old person (say age 75-80) - "who do you want to do your anesthesia - a nurse or a doctor" - what do you think they will answer.... well - the majority of them aren't given ALL the CORRECT information they need to make the right decision - they were born/raised in a time when a doctor was the greatest of greats - i bet you don't hear anyone (other than the hardworking CRNA's) telling them that nurses started the profession and trained the doc's -
    it is a complete money game - the board of medicine wants it and they are fighting to monopolize it. it is and will continue to be a long fought battle for CRNA's - like Yoga stated - that is why it is important for anyone in this profession to have dedication to it and support the cause.
  12. by   Maxs
    Quote from athomas91
    when you ask an old person (say age 75-80) - "who do you want to do your anesthesia - a nurse or a doctor" - what do you think they will answer.... .
    Funny, if you asked me I would say a doctor of course. See here's where the deception comes from. It's all on the way you say it, you said a nurse, not a certified registered nurse anesthetist.
    For example, look at the Johnson & Johnson $20 million dollar campaign ad, it has proven succes. When you say a Nurse and a Doctor, the mentality I accommodated as a kid is still present "the woman with the white dress and hat and the man who wears the white coat and stetscope around his neck."
    You should show commercials that get the message straight, otherwise in America money buys justice and you're out numbered in that case.

    Max
  13. by   Tony35NYC
    I'm seeing this for the first time today. And in case anyone hasn't seen it yet, the following is a piece from the ANA's website, showing that state boards of medicine are not as all-powerful as they think they are when it comes to restricting the practice of CRNAs:


    ANA Defends CRNA Autonomy
    3/11/05
    The Supreme Court of New Jersey has granted a petition by the New Jersey Association of Nurse Anesthetists (NJANA) to stay an appellate decision limiting the authority of certified registered nurse anesthetists (CRNAs). The Court has agreed to hear arguments in the case. ANA has supported NJANA throughout its endeavors to have the decision overturned and will continue to work with the group to protect the practice of CRNAs.

    The decision stems from regulations set by the New Jersey Board of Medical Examiners (BME) that require all CRNAs administering anesthesia in an office setting to be directly supervised by an anesthesiologist or an anesthesia-qualified physician.

    BMEs in many states have fought to obtain regulatory authority over CRNA practice, but their attempts have been rejected by state courts, concluding that such rules were unsupported by evidence or by consumer need.

    In an amicus brief filed with the court, ANA argues that the decision "raises important and unresolved questions of public importance regarding the BME's authority in New Jersey to use delegated rulemaking authority to undermine the practice of nursing that is regulated by the BN [Board of Nursing]." ANA also is concerned about the BME's failure to consider available empirical data on the safety and efficacy of CRNA practice in the state.

    The brief cites data from the National Practitioner Data Bank and the Health Integrity Protection Data Bank that demonstrate that over the past 13 years, nurse anesthetists were named in only 14 adverse incidents in New Jersey. The cases in question account for less than .01 percent of all CRNA cases reported in the United States and are substantially lower than those reported for New Jersey physicians and anesthesiologists

    http://www.ana.org/news/ananews.htm
  14. by   London88
    It is usually a good indicator for the CRNAs when the case makes it to the supreme court as is the case in New Jersey. If the supreme court agreed with the ruling of the appellate court then they would not have agreed to the hearing. Interestingly, the Supreme Court issued a stay on the BME's new rules on the very day it was to take effect. It is great that nursing has come together as one to support each other in these issues, and I am hoping that CRNAs, and the AANA will lend their support to other disciplines of advance practice nursing should an issue arise to restrict their practice.

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