[n_g]

Another point. It doesn't matter if someone thinks that CRNA's can adequately trained in a weekend to do pain. What matters is what the courts and practice acts say. So it's pointless here to argue that CRNA can do pain. The people you need to convince are the states to amend their practice acts. But what justification can CRNA's provide? That I took a weekend course for it? While on the other side, the physicians say that pain is a 1-2 year fellowship. It's a huge uphill battle.

[smileyRn96]

Originally Posted by platon20

Let me throw that right back in your face. Why are CRNAs fighting against allowing AAs in a bunch of states since there is no evidence that they are inferior providers of anesthesia?

The ego and money issues work both ways, my friend.

I hear what your saying pal, but I applaud the AANA for stepping in and making any effort to stop AA practice. The same way that the Nursing assoc. should have stepped in to stop PA practice in it's infancy. Unfortunately for NPs they were asleep behind the wheel. Well the AANA is not!!!!! We will not allow the AMA or A$A to back door in another profession to maintain there strangle hold on health care.
Smiley

[stanman1968]

scope of practice for CRNA's is determined by state board of nursing, not medical boards. If the ASA or medical boards would like me to define their practice then they may define mine, until then thier opinion is not wanted or appreciated.
As for AA's I am sure they are fine providers just exploited by the ASA, hell a completly dependent provider (by law not ability) is a dream just imagine people who have to do your work and you get to bill for "direction" give oxygen, or "supervision. OHHHH SWEEEEET.

[Oldsalt]

Originally Posted by jwk

I need research to show that CNM's don't do C-Sections?

And I asked a question - I haven't raised an argument that I need to support. The question, one more time, is at what point does something cross the line and become the practice of medicine? Or in your opinion does no such line exist, for anesthesia or otherwise?

This question cannot be answered in this type of forum for the basic fact of origin of differing definitions.

AANA's argument is based on the historic origins in the US of anesthesia providers, its rural provider percentages, and that anesthesia does not heal per se or treat an existing disease (this does not include pain patients/clinics - where anesthetist are rarely found) - it deals with management of existing states and returning the patient to the condition which they were received in.

The ASA point is that anesthesia is a field of critical care and pain medicine, which does include treating existing pathologic states in addition to the end of the above sentence.

But both will agree (grudgingly) that in appearance and function (& outcomes) - one private practice CRNA compared to a MDA doing a lap chole - is the same...so ...there is and there isnt a difference in function or.... as you asked does it cross the line. No I am not going to discuss the ACT. Nor will I argue the outcome studies

The lines are muddied and will continue to be so- matters who you ask....the ASA has long pointed out that in addition to the above the are obvious differences in education which is expressed in level of diagnosis and treatment to augment their practice....CRNAs will tell you that the training in pure anesthesia sciences are equal. Diagnosis and treatment experience be damned - I can say that ICU experience is a varied substitution for ones ability for differential diagnosis - that CRNAs can obtain this skill but with a great degree of effort and study.

So you decide..you cannot ask a CRNA or a MDA this question - we are too wired to answer in a specific fashion...

thanks

[platon20]

Originally Posted by smileyRn96

I hear what your saying pal, but I applaud the AANA for stepping in and making any effort to stop AA practice. The same way that the Nursing assoc. should have stepped in to stop PA practice in it's infancy. Unfortunately for NPs they were asleep behind the wheel. Well the AANA is not!!!!! We will not allow the AMA or A$A to back door in another profession to maintain there strangle hold on health care.
Smiley

thats all fine and good. But lets quit playing games and call a spade a spade. The CRNAs are just as greedy as the MDAs are, and these turf battles have absolutely NOTHING to do with patient safety and EVERYTHING to do with fear and $$$$

As long as you are willing to admit that, then I agree with your post 100%

[Qwiigley]

JWK and PainDoc, Why are you trying to stir the pot on a nursing website?
It would be better to learn from each other and not antagonize the other.

You may be amazed at what other practicing professionals have to offer.

There are so many jobs out there, don't worry about yours going away anytime soon.
When the babyboomers start needing their new hips, we'll all be busier than we can stand.

[ready4crna?]

Originally Posted by n_g

Nowhere in this country are CNM's allowed to do c-sections and that won't change anytime soon.

The Louisiana decision is a major blow. It's not one judge. It went all the way to the Louisiana Supreme Court and they decided that pain management is medicine. If CRNA's want to legally do pain management, they have to change the practice acts. That's like saying CNM's just need to convince the state legislatures to let them do c-sections. Don't hold your breath.

Please provide a citation for the LA supreme court decision. The only decision I am aware of is the district court ruling-http://www.asipp.org/documents/CRNA-Judgment.pdf

Again, a single judges ruling, currently in appeals process unless you have some info on the process completion.

[n_g]

Plaintiffs argued that nursing boards circumvented the legislature in order to expand nurse anesthetist scope of practice by adopting “statements.” Additionally, plaintiffs argued that the “statements” were invalid because the documents were not adopted in accordance with administrative procedures. A Louisiana Court of Appeal recently reversed a trial court’s order by ruling that the nursing board’s “statement” constituted a rule that required compliance with the procedural requirements of the Louisiana Administrative Procedures Act (LAPA).

In response to a petition by an individual nurse anesthetist for an advisory opinion on nurse anesthetist scope of practice, the Louisiana State Board of Nursing adopted the following statement....

http://www.asahq.org/Newsletters/200...Beat02_07.html

[n_g]

A Louisiana court recently held that the Louisiana State Board of Nursing’s advisory opinion substantively expanded the scope of practice of a nurse anesthetist into an area where they have not traditionally practiced (i.e. - chronic or interventional pain management). The advisory opinion was issued in 2005 in response to a nurse anesthetist’s request for clarification on this issue. Subsequently, Spine Diagnostics Center of Baton Rouge, Inc brought a lawsuit against the nursing board that, among other things, sought an injunction to prevent the nurse anesthetist who requested the opinion from continuing to perform pain management procedures....

In its entirety:

http://www.asahq.org/news/news011508.htm

[n_g]

http://www.lanacrna.com/Modules/Prac...ceUpdates.aspx

As all know there has been an ongoing lawsuit against the LSBN by Spine Diagnostics Center of Baton Rouge Inc. relative to the LSBN affirming CRNA practice to include interventional and chronic pain management services. This lawsuit is considered by all in nurse anesthesia who work to protect our practice rights as a potentially precedent-setting case that would have far-reaching implications.

I think you were right. This was not the Supreme Court of Louisiana decision. If this decision stands, it will have nationwide impact no doubt. CRNA's are on shaky ground trying to argue that pain is part of their scope and they know it.