I dont think this falls within the practice standards...

  1. Hey everyone I found out that a surgery center that I am loosly affiliated with (one ENT/plastics doc ASC accredited) uses a CRNA to provide general anesthesia, a scrub tech, and a medical assistant to circulate. The CRNA fills out the anesthesia and circulating paperwork, then recovers the patient. Would any of you do this? I am not a CRNA but I would be concerned about being designated as the RN one the case and the anestheisa provider. Would anyone else do double duty and liabilty?
    Jeremy
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    About jer_sd, DNP, NP, CNS

    Joined: Oct '04; Posts: 370; Likes: 134
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    5 Comments

  3. by   Jolie
    Quote from jer_sd
    Hey everyone I found out that a surgery center that I am loosly affiliated with (one ENT/plastics doc ASC accredited) uses a CRNA to provide general anesthesia, a scrub tech, and a medical assistant to circulate. The CRNA fills out the anesthesia and circulating paperwork, then recovers the patient. Would any of you do this? I am not a CRNA but I would be concerned about being designated as the RN one the case and the anestheisa provider. Would anyone else do double duty and liabilty?
    Jeremy
    I'm not a a CRNA either, but I don't think it is necessary to have those credentials to know that this is not acceptable pratice, and probably illegal.

    I realize that physicians who operate out of free-standing surgical centers have more leeway in terms of the qualifications and supervision of their staff members than those who do their procedures in a hospital setting. It may be perfectly legal for a surgeon to utilize a medical assistant as a circulator in an out-patient center. But to have the CRNA do the documentation (in order to create the appearance of having an RN circulator) is clearly misleading and probably illegal. I can't begin to imagine why any CRNA would be willing to do this, given the risk to the CRNA's license should a patient experience an anesthesia complication, or surgical complication.

    This sounds like falsification of a medical record to me.
  4. by   subee
    Quote from jer_sd
    Hey everyone I found out that a surgery center that I am loosly affiliated with (one ENT/plastics doc ASC accredited) uses a CRNA to provide general anesthesia, a scrub tech, and a medical assistant to circulate. The CRNA fills out the anesthesia and circulating paperwork, then recovers the patient. Would any of you do this? I am not a CRNA but I would be concerned about being designated as the RN one the case and the anestheisa provider. Would anyone else do double duty and liabilty?
    Jeremy
    How can anyone respond to this without knowing what the law is in your state? Is the surgeon under any obligation to provide an RN to circulate, especially in a small office facility? The CRNA isn't leaving the patient since someone else is circulating. What's the problem here?
  5. by   Jolie
    Quote from subee
    How can anyone respond to this without knowing what the law is in your state? Is the surgeon under any obligation to provide an RN to circulate, especially in a small office facility? The CRNA isn't leaving the patient since someone else is circulating. What's the problem here?
    The problem is that the CRNA is charting for a function s/he isn't performing.
  6. by   FlGasman
    You can NOT circulate and monitor anesthesia as an anesthetist. It is a violation. You can be a CRNA then go recover the patient.
    FlaGAS SRNA
  7. by   ali anesthesia
    Easy answer. All of the accrediting agencies (including those who accredit office surgery centers) require an RN to circulate. There are not two different standards of care, one for hospitsls, one for office surgery. There is one standard and the CRNA will be held to that standard. It is particularly important to practice to a high standard in a solo practice doing elective surgery.

    I do anesthesia, I don't circulate, I do not document anything on the Intraoperative Nures Notes.

    Amen
    Ali

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