DOCTORATE for CRNA's?

alansmith52 · Feb 14, 2005

I like your reply lois.

here is my question.

my program, is not a nursing prgram perse. the degree is "masters science nursing"

how will this change effect me? am I gonna have to go back to school and do all this over????

obviously not but I am sure not Having a nursing degree will have some ramafication.?

loisane · Feb 15, 2005

I like your reply lois.
here is my question.
my program, is not a nursing prgram perse. the degree is "masters science nursing"
how will this change effect me? am I gonna have to go back to school and do all this over????
obviously not but I am sure not Having a nursing degree will have some ramafication.?

If the profession of nurse anesthesia makes this change to require a doctorate for entry level, it will be phased in. A date will be announced by the Council for Accreditation, giving programs notice of the deadline for making this change. Any students enrolled after that date will have to earn a doctorate.

This will not (directly) affect people who are already certified and in practice. Of course, all new graduates will "out rank" you in degree, so it depends upon how you feel about that. But nobody will force you to go back to school to earn any further degree.

This is exactly what happened when we made the transition to masters degrees. Now most people have a masters, but there are still some people practicing that did not get a masters, and never did go back for that degree. Over the years since, states have begun to require a masters degree for licensure, but people who graduated before a particular date are grandfathered in, and allowed to practice without it.

Alan, if your degree is a MSN, that sounds like a nursing degree to me. If your program is housed within a school of nursing, and your program director reports to the dean of nursing, then you are getting a nursing degree.

The mandate from the AACN (at the beginning of this thread) only applies to nursing programs. But if our COA adopts this change, then it will apply to our non-nursing programs as well. There are many nurse anesthesia programs that are in non-nursing departments. I don't believe anyone wants to lose these programs. If a doctorate is required, they will just develop non-nursing doctorate degrees to transition toward, like the VCU program mentioned by another poster.

loisane crna

alansmith52 · Feb 16, 2005

Texas wesleyan is not housed in a nursing department i belive my degree in masters science Anesthsia does that sound right? but i understand what your saying, our potential doctorate simply wont be in nursing it will be somthing else if I understand right??? I wonder how long it will take if we decide to go back for it

If the profession of nurse anesthesia makes this change to require a doctorate for entry level, it will be phased in. A date will be announced by the Council for Accreditation, giving programs notice of the deadline for making this change. Any students enrolled after that date will have to earn a doctorate.
This will not (directly) affect people who are already certified and in practice. Of course, all new graduates will "out rank" you in degree, so it depends upon how you feel about that. But nobody will force you to go back to school to earn any further degree.
This is exactly what happened when we made the transition to masters degrees. Now most people have a masters, but there are still some people practicing that did not get a masters, and never did go back for that degree. Over the years since, states have begun to require a masters degree for licensure, but people who graduated before a particular date are grandfathered in, and allowed to practice without it.
Alan, if your degree is a MSN, that sounds like a nursing degree to me. If your program is housed within a school of nursing, and your program director reports to the dean of nursing, then you are getting a nursing degree.
The mandate from the AACN (at the beginning of this thread) only applies to nursing programs. But if our COA adopts this change, then it will apply to our non-nursing programs as well. There are many nurse anesthesia programs that are in non-nursing departments. I don't believe anyone wants to lose these programs. If a doctorate is required, they will just develop non-nursing doctorate degrees to transition toward, like the VCU program mentioned by another poster.
loisane crna

aRNnAR · Feb 17, 2005

Texas wesleyan is not housed in a nursing department i belive my degree in masters science Anesthsia does that sound right? but i understand what your saying, our potential doctorate simply wont be in nursing it will be somthing else if I understand right??? I wonder how long it will take if we decide to go back for it

I also attend TWU. Upon completion, you will be receive: M.S.N.A. Master of Science in Nurse Anesthesia. You're correct. It's not a MSN....if i were it would probably be Master of Science in Nursing with a nurse anesthesia option.

loisane · Feb 17, 2005

Texas wesleyan is not housed in a nursing department i belive my degree in masters science Anesthsia does that sound right? but i understand what your saying, our potential doctorate simply wont be in nursing it will be somthing else if I understand right??? I wonder how long it will take if we decide to go back for it

Thanks for the clarification, although I have heard much about your program, it is hard to keep track of specifics.

I would expect that non-nursing clinical doctorates will be developed. I think it is a little early to speculate on how long they will take for Master's prepared people. The guidelines for entry level will probably be done first. Maybe someone more in the know would have a guess.

loisane crna

Citadel Sam · Feb 17, 2005

So does this mean that CRNA's will be able to work independently as Dr.s and have no supervision whatsoever?

Also, it seems that this will create more "drama" between anesthesia providers. i.e. MDA's and AA's. Do you think it will?

skipaway · Feb 17, 2005

So does this mean that CRNA's will be able to work independently as Dr.s and have no supervision whatsoever?
Also, it seems that this will create more "drama" between anesthesia providers. i.e. MDA's and AA's. Do you think it will?

CRNAs can already work independently, without supervison. We work collaborately with physicians.

skipaway

squinkybear1 · Feb 19, 2005

Some CRNA/ologist relationships are collaborative. Some are concerned with maintaining the hierarchy. So, even in states where CRNA's have independent practices, the head of the anesthesia department might require that an ologist be in attendance when an anesthetist intubates, for example. That same CRNA can bill independently for his or her services, but may continue to do most of the anesthesia administration, on the majority of the cases, under the direction of the ologists. Also, depending on the facility, the CRNA may or may not be able to order meds for patients while in the PACU! It all depends on the department protocols and procedures that, in many places, the anesthesiologists continue to control.

So, independent practice may extend to the billing process only and not be very apparent in the day-to-day operation of the department or elevate the status of the CRNA within the structure of the facility. On the other hand, in areas where anesthesiologists are absent, (rural, poor, underserved parts of the country), CRNA's do EVERYTHING. They practice independently and bill independently, as well. Depends on where you choose to practice.

Some states are challenging the independent practice of CRNA's. Texas is cooking up some new legislation to take away the independent practice of CRNA's and they have already accomodated Anesthesiology Assistants in the practice laws. Such moves toward a greater number of A. Assistant programs and a trend toward the acceptance and use of A. Assistants by the medical community, probably plays a role in the AANA's consideration of raising the basic level of ed for the CRNA. As it stands, the A.A. programs are rigorous and require prereqs that resemble premed curriculae. There are only a couple of programs, however, that are exclusively designed to train Anesthesiology Assitants. The programs require about the same time commitment (after prereq and/or bachelors degree are satisfied) as the CRNA programs: 28-33 months. Prereqs are heavier in physics, organic and math.

Even with a doctorate, the states will continue to determine whether or not a CRNA practices independently. A doctorate does not quarantee independence.

It seems like it's a costly degree, in terms of bucks and time spent without an income. Practically speaking, it may be a hard sell to those of us who need to get to work and generate income so that we can take care of our families.

As far as the doctoral programs are concerned: it's my understanding that you are eligible to participate in a COA-approved doctoral program as long as you have earned any masters degree required to qualify to sit for the credentialing exam to become a Certified Registered Nurse Anesthetist. That would include all the MS degrees that are granted in programs currently approved by the COA. They include the MS (Health Science, Biology, Medical Scinece, etc.), MSN, MSNA. Not all approved programs offer a "nursing" designated masters degree.

mwbeah · Feb 20, 2005

some crna/ologist relationships are collaborative. some are concerned with maintaining the hierarchy. so, even in states where crna's have independent practices, the head of the anesthesia department might require that an ologist be in attendance when an anesthetist intubates, for example. that same crna can bill independently for his or her services, but may continue to do most of the anesthesia administration, on the majority of the cases, under the direction of the ologists. also, depending on the facility, the crna may or may not be able to order meds for patients while in the pacu! it all depends on the department protocols and procedures that, in many places, the anesthesiologists continue to control.
so, independent practice may extend to the billing process only and not be very apparent in the day-to-day operation of the department or elevate the status of the crna within the structure of the facility. on the other hand, in areas where anesthesiologists are absent, (rural, poor, underserved parts of the country), crna's do everything. they practice independently and bill independently, as well. depends on where you choose to practice.
some states are challenging the independent practice of crna's. texas is cooking up some new legislation to take away the independent practice of crna's and they have already accomodated anesthesiology assistants in the practice laws. such moves toward a greater number of a. assistant programs and a trend toward the acceptance and use of a. assistants by the medical community, probably plays a role in the aana's consideration of raising the basic level of ed for the crna. as it stands, the a.a. programs are rigorous and require prereqs that resemble premed curriculae. there are only a couple of programs, however, that are exclusively designed to train anesthesiology assitants. the programs require about the same time commitment (after prereq and/or bachelors degree are satisfied) as the crna programs: 28-33 months. prereqs are heavier in physics, organic and math.
even with a doctorate, the states will continue to determine whether or not a crna practices independently. a doctorate does not quarantee independence.
it seems like it's a costly degree, in terms of bucks and time spent without an income. practically speaking, it may be a hard sell to those of us who need to get to work and generate income so that we can take care of our families.
as far as the doctoral programs are concerned: it's my understanding that you are eligible to participate in a coa-approved doctoral program as long as you have earned any masters degree required to qualify to sit for the credentialing exam to become a certified registered nurse anesthetist. that would include all the ms degrees that are granted in programs currently approved by the coa. they include the ms (health science, biology, medical scinece, etc.), msn, msna. not all approved programs offer a "nursing" designated masters degree.

in all 50 states this is the criteria:

a certified registered nurse anesthetist (crna), as defined in 410.69(b) of this chapter, who, unless exempted in accordance with paragrpah © of this section, is under the supervision of the operating practitioner or an anesthesiologist who is immediately available if needed

when crnas provide anesthesia, this is the requirement. you can see that having an anesthesiologist does not always happen (and this is for all 50 states)

mike

mwbeah · Feb 20, 2005

in all 50 states this is the criteria:
a certified registered nurse anesthetist (crna), as defined in 410.69(b) of this chapter, who, unless exempted in accordance with paragrpah © of this section, is under the supervision of the operating practitioner or an anesthesiologist who is immediately available if needed
when crnas provide anesthesia, this is the requirement. you can see that having an anesthesiologist does not always happen (and this is for all 50 states)
mike

this is from http://www.asahq.org/washington/narules.htm

squinkybear1 · Feb 21, 2005

This is from http://www.asahq.org/Washington/narules.htm

The ASA "rules" are not legislation. They only suggest the relationship of the CRNA with the ologist as THEY define it. They are not necessarily consistent with practice laws and/or reality.

skipaway · Feb 21, 2005

The ASA "rules" are not legislation. They only suggest the relationship of the CRNA with the ologist as THEY define it. They are not necessarily consistent with practice laws and/or reality.

Absolutely right!!!! In NC, our Board of Nursing defines through it's rules and regulations the practice of CRNAs not the ASA or the Board of Medicine for that matter. And in NC, our rules and regulations specify the word collaboration, not supervison. The ASA has never had sway over how CRNAs are able to practice. They just like to think they do.