June 11, 2004
4 Times Square, Floor 12
New York, NY 10036-6518
Dear Ms. Jones,
In anesthesia, nurse anesthetists would be grossly negligent if they did not check their patient's records and care plan, equipment, and drug and supply inventory prior to surgery. In journalism, writers and editors would be grossly negligent if they did not check their facts prior to publication. The editors and writers of Vogue demonstrated the latter in not checking their facts before printing the outlandish and inaccurate statement about nurse anesthesia safety in the article "Shopping for Surgery" (Vogue, June 2004).
One possible result of nurse anesthetists failing to do their job properly is patient death. Fortunately, according to the Institute of Medicine, the American Society of Anesthesiologists, and the American Association of Nurse Anesthetists (AANA), anesthesia is nearly 50 times safer today than it was in the early 1980s, regardless of whether the provider is a physician anesthesiologist or a nurse anesthetist. And it just so happens that 65 percent of the time a Certified Registered Nurse Anesthetist (CRNA) is involved with the patient's care-administering the anesthetic, monitoring the patient's vital signs, staying with the patient throughout the surgery.
The result of credible journalists failing to do their job properly can be misinformed/frightened readers and defamed individuals. Vogue managed both by publishing Dr. Abergel's ill-advised and uninformed comments about nurse anesthetists.
The facts are these: Nurse anesthetists have been around since the Civil War, with their focus on patient comfort and safety since day one. These advanced practice nurses with a minimum of seven years of education and training are one of the main providers of anesthetics in this country, working with and without their physician counterparts. CRNAs are also the primary anesthesia providers to mothers in labor and delivery, in office-surgery settings, in rural hospitals, and in the U.S. Military. In fact, when the special forces rescued Pfc. Jessica Lynch from her Iraqi captors, the anesthesia provider who accompanied the team was a CRNA.
Plastic surgery is, indeed, risky business. Patients are smart to check out the facility, the providers, and any number of factors before going under the knife. With so much plastic surgery today being conducted in physicians' offices, prospective patients should rest easy knowing the following two facts about nurse anesthetists:
1. The AANA developed the first and still most comprehensive Standards for Office Based Anesthesia Practice.
2. According to a study published in the January 2003 issue of Plastic and Reconstructive Surgery, "Outpatient surgery is an important aspect of plastic surgery. It was shown that office-based surgery with intravenous sedation, performed by board-certified plastic surgeons and nurse anesthetists, is safe."
Whenever any anesthesia requirement goes beyond local anesthesia or light conscious sedation, the AANA firmly believes that a qualified anesthesia provider such as a nurse anesthetist or anesthesiologist should be involved in the patient's care.
An apology for and retraction of Dr. Abergel's statement would be in the best interests of your readers and only fair to the nation's 30,000+ nurse anesthetists.
Tom McKibban, CRNA, MS