Okay guys, here we go again. We're the latest state in which the MDA's are trying to restrict our practice, as well as make it legal for AA's to work here. A bill is currently being introduced into the NC legislature titled "NC Anesthesia Patient Safety and Access Act." I don' t know all the details, but it's my basic understanding that the NCASA is trying to make it seem that we need more supervision, that anesthesia needs to be provided by someone whom they can have more control over. Their proposed solution is AA's. I know in other states it's hard to tell the difference b/t an AA and CRNA within an anesthesia dept. This act makes it seem as if MDA's will be constantly over an AA's shoulder. It attempts to call us as CRNA's unsafe, in not so many words. It also says there is a shortage of anesthesia providers, despite the fact we've increased to FIVE anesthesia schools in our state alone. This bill is a DIRECT ATTACK on our profession, and we will all regret it if it passes!!!
So here's what you need to do. If possible, visit or send a letter to your NC state representative and senator. (from your county or district). You can find this out by going to http://www.ncleg.net and either entering your zip code or voter's registration number. Once you find out who your legislator's are, at the VERY LEAST give them a call. Here is a sample of what to say:" Hello, my name is _______ and I am a CRNA (or CRNA student) in your voting district. I'm calling to ask that you NOT support the NC anesthesia pt safety and access act. My contact information is ______, and I would be happy to give you or your staff more information regarding this recently proposed bill."
Even if you're not into politics, just consider this: if this passes and AA's come into NC, we will no longer be in as much demand and your salary will eventually go down. Maybe money will motivate you to call if simply supporting the profession of nurse anesthesia isn't enough.
So, before all the AA's on here flame me, just chill out. This act basically says you guys are incompetent without an MDA holding your hand. Be pi**ed at me if you want, but I'm just trying to protect my future profession and career.
If anyone wants more info, visit the NCANA website. Thanks!
Okay, I don't have time for this childish bickering. If you support nurse anesthesia (and this is our bulletin board after all), then contact your legislator. Nothing else to add from my standpoint. If anyone would like more info in how to help, please pm me and I'll try to help.
Actually, it's not that simple. There are no laws in NC that state a CRNA needs to be "supervised" by a physician. We work collaborately. There is a big difference. And, we read into the bill b/c that is exactly what the anesthesiologists in our state are saying to the public. We, CRNAs are "unsafe" to practice without a MD looking over our shoulder and they should be scared if the state allows this. The ASA has used this tactic in their battles, thus far. I remember ads in the newspaper saying that if we are not supervised by an anesthesiologist, old people will die. Current practice could change with this bill. Office based CRNAs could loose their jobs b/c it will be interpreted that an anesthesiolgist is needed to do the supervising. In NJ, and FL. the legislators are trying to say that surgeons need advanced anesthesia training if they are to "supervise" the CRNAs in their offices. So, not only are they trying to control my practice, but also those practices of office based physicians!!!! This is not about safety of the citizens of NC, it's about the almighty dollar! We have some of it, they want it all. The North Carolina Board of Nursing control my practice and they do a good job of it. The Board of Medicine, NC General Assembly and the NCASA need to just stay out of it.
respectfully
skipaway
Skip, correct me if I'm wrong. The bill does NOT require a CRNA to practice with an anesthesiologist. The wording from the bill is at the bottom of this post - there simply is NO requirement that CRNA's practice under the supervision of an anesthesiologist, only a physician, which is like it always has been in North Carolina.
As I recall, both NJ and FL courts have ruled in favor of CRNA's on the office-based anesthesia matter. Regardless, the NC bill as submitted doesn't address this.
You could certainly make the argument that the Board of Medicine doesn't make the rules for CRNA's - the Board of Nursing does. That's not my concern. However, the NC General Assembly DOES have the right to make the laws as they see fit, including the ones that allow you to practice now, OR one that may allow AA's to practice. You can't argue that point.
Supervision by a physician is not how the CRNAs in our state practice and we never have. We collaborate with them. There is a big difference. Supervision implies a control that they do not have, be it by a surgeon or an anesthesiologist. Collaboration implies working together, and doing our job as we see fit. So in that point we disagree.
They are still fighting the office based issue in Fl and NJ. They are now at the supreme court level in NJ.
And yes, the General Assembly makes laws, but this law is based on one group trying to impart their will on another for no other reason than, Finances and Control. Patient safety is just a cover.
Supervision by a physician is not how the CRNAs in our state practice and we never have. We collaborate with them. There is a big difference. Supervision implies a control that they do not have, be it by a surgeon or an anesthesiologist. Collaboration implies working together, and doing our job as we see fit. So in that point we disagree.
They are still fighting the office based issue in Fl and NJ. They are now at the supreme court level in NJ.
And yes, the General Assembly makes laws, but this law is based on one group trying to impart their will on another for no other reason than, Finances and Control. Patient safety is just a cover.
Call it what you want - it's still supervision. NC is not one of the Medicare opt-out states. This bill changes nothing for nurse anesthetists in NC, does it? I just don't see that in the language of the bill.
Collaboration - hmmmmmm, sounds a little like an anesthesia care team, don't you think? Everyone working together for the patient's benefit. Sounds a lot like a lot of the existing anesthesia practices in NC as well.
You're comparing apples to oranges with your understanding of the supervision opt out states vs changing our practice from collaboration to supervision.
The Medicare opt-out just means that supervision is not a requirement for payment of Part A in the medicare insurances. This is not what it's about for us. In fact this has nothing to do with what this bill is attempting to do.
And again, ACT is generally an anesthesiologist and CRNA or AA in those states that allow them. But, here in NC, I'm in an ACT and I and the anesthesiologist both take care of the patient but I'm not "supervised." There are CRNAs who are solo practioners in NC and they collaborate with the surgeons/podiatrists/dentists that they work with. They are not supervised by them. The surgeons et al.. have no control how the anesthesia is done except by request. It's a question of control of the CRNA practice by non-CRNAs.
Legally it's a big difference for us if the law passes. I can see the day if this passes that the next step will be just like in NJ. Oh, did we mean any physician can supervise? Oh, no what we mean is any physician who specializes in anesthesia, b/c how can a surgeon know what the CRNA is doing if he's not a specialist? Patients will die if there isn't a doctor who knows anesthesia in the setting. And voila, we have a new law stating that anesthesiologists need to be in all settings to supervise the stupid CRNAs. And there goes the practice of all solo CRNAs and office based CRNAs.
It will happen if we citizens of NC do not fight this bill.
Someone please tell JWK that he is not the same as a CRNA even if they perform the same functions or share the same job description in HIS hospital. There are other hospitals in this country! In many of them CRNA's are the sole providers. They function INDEPENDENTLY, and bill medicare INDEPENDENTLY.
JWK as much as you try to deny it, you are a Assistent, not an independent practitioner. I question whether you should even call yourself an anesthetist.
Anesthetist Assistent maybe, but assistant none the less.
Finally I have said what I feel and I believe many others feel on this board.
I mean Hello! this is a Nurse Anethetist forum, go find an assistant forum somewhere else. UR
Okay, I don't have time for this childish bickering. If you support nurse anesthesia (and this is our bulletin board after all), then contact your legislator.
Or send money if you are able. My check goes out this Monday. And yes, the last time I checked this is a CRNA/SRNA site!
Why don't you all spend your money, letters, calls and energy petitioning your governor to "opt out"--that would solve alot of your problems.
Mike (from New Mexico--an opted out state)
Because, our governor has decreed, when he was our Attorney General, that anesthesia is the "practice of medicine." He also has a brother who is an MD. I don't believe we have a snow balls chance to "Opt-out."
Someone please tell JWK that he is not the same as a CRNA even if they perform the same functions or share the same job description in HIS hospital. There are other hospitals in this country! In many of them CRNA's are the sole providers. They function INDEPENDENTLY, and bill medicare INDEPENDENTLY.
JWK as much as you try to deny it, you are a Assistent, not an independent practitioner. I question whether you should even call yourself an anesthetist.
Anesthetist Assistent maybe, but assistant none the less.
Finally I have said what I feel and I believe many others feel on this board.
I mean Hello! this is a Nurse Anethetist forum, go find an assistant forum somewhere else. UR
Wow sleepy, those are some profound thoughts there. Other hospitals in this country. Gee, I thought mine was it!
I didn't say I was the same as a CRNA. I said in any given hospital or practice that uses CRNA's and AA's, the job descriptions, responsibilities, and compensation are THE SAME.
Did I deny my title somewhere? Hmm, don't think so. AA=Anesthesiologist Assistant. Happy? I even spelled it correctly. It's similar to PA=Physician Assistant. I'm curious, do you rag on the PA's you work with as much as you do me? And "Anesthetist Assistent" (your spelling, not mine) - nope, not in your wildest dreams. CRNA's don't supervise me, I don't supervise them. Oh, except that I do manage a 70+ member anesthetist department with about an equal number of AA's and CRNA's.
I wasn't aware "anesthetist" referred just to CRNA's. Why don't you just use the title CA for Certified Anesthetist? Well gee, I guess it's because you have to specify what type of anesthetist you are - an RN. In some countries, oh let's see, Canada and England come to mind, an anesthetist is also an MD.
Yes, there are differences. I'm well aware of them. You obviously don't have a clue what they are, outside of what you have heard or read from your cohorts, none of whom have ever even met an AA, much less worked with one.
Here's a radical idea. Perhaps even a challenge for you. Why don't you toot your own horn and not knock AA's (since you don't know what they are anyway outside of what you have heard)? You think CRNA's are great? I'm OK with that - tell everyone you know. I know some great CRNA's as well - I might even join you. Just don't spread lies and misinformation and regurgitate what you think you know (and obviously don't) about AA's. For my part, I won't knock CRNA's (which actually, I never have, except for those who rag on AA's because it's the politically correct thing to do in AANA-dom) and I'll just promote my own profession. I know what I am, I know what I can do. I don't need to knock CRNA's along the way to do that. I'm perfectly capable of extolling the virtues of AA's, based on their education and capabilities, and never mentioning CRNA's. What do you think? Is that possible for you and your buddies?
PS - It may be a Nurse Anesthetist forum, but it's open to anyone - check the Terms of Service. Just like the MD forums and PA forums and any other forums are generally wide open to the public, so is this one. I don't try and chase CRNA's off of those other forums. In fact, several who post on this exact forum post in those forums as well, and we have very polite, civil discussions about a variety of issues.
You should check out the differences in the laws from the two states-there is more diversity and latitude in NC. So, if you're not practicing in NC how do you know things are EXACTLY the same? I can tell you, they are not. I was in Atlanta last week when nurses gathered to protest the laws in GA regarding distributing medication. Sad thing to work so hard to have your hands tied.
In a department with anesthesiologists, they don't hold my hand any more than they do yours. In a department with anesthesiologists, CRNA's and AA's do EXACTLY the same thing - same job description, same responsibilities, same pay for comparable experience.
NCgirl
188 Posts
Okay, I don't have time for this childish bickering. If you support nurse anesthesia (and this is our bulletin board after all), then contact your legislator. Nothing else to add from my standpoint. If anyone would like more info in how to help, please pm me and I'll try to help.