CRNAs in Florida to require anesthesiologist supervision

Specialties CRNA

Published

I just read in a magazine about a House bill being passed that mandates that CRNAs in that state must now be supervised by anesthesiologists. If this passes the senate, wouldn't this be the end of the CRNA profession in Florida? After all, why would anyone use CRNAs if they would also have to pay for the supervising anesthesiologist? Where are the Florida CRNAs, and what do they have to say about this? I'm surprised to not see more political activity from them.

Just a thought.

Speaking as an interested observer (since I don't really have any experience in anesthesiology.) I don't think it's all about money and control. Much of it is, but let's say you remove money and control from the arguments. From what I gather, it seems both MDAs and CRNAs are ingrained with their concept of what's best for patients. So I'm going to try to bring in some balanced arguments here.

from the perspective of the nurse anesthetist

CRNAs believe that they provide cost-effective access to anesthesia care and that their education and training is sufficient for safe practice. CRNAs cite their data/studies and criticize data and methodology of MDA studies. They lay claim to starting the specialty (in the U.S.) and for providing 65% of anesthetics. Furtermore, CRNAs do not think a medical (school) education and internship is necessary (or perhaps even relevant) in the care of patients undergoing and recovering from anesthesia.

from the perspective of the anesthesiologist

Anesthesiologists believe that the best care is provided when CRNA's involve the anesthesiologists in the care (if even only as a readily available consultant). MDAs cite their data/studies and criticize data and methodology of CRNA studies. MDAs also say their model of anesthesia practice is cost-effective. Physicians say they were the ones who trained nurses in the first place to deliver anesthesia (in the U.S.) and state that in reality 10-20% of anesthetics delivered are without MDA supervision. Furthermore, MDAs say their medical education and internship gives them greater insight in the care of patients undergoing/recovering from anesthesia.

My conclusion? I'm concluding that this debate will never cease. I guess who you believe largely depends on your loyalty, experiences, and inherent bias. For every point, there's a counterpoint. Everything has become so predictable. This paper pretty much sums up the differing views:

http://www.outpatientsurgery.net/2000/os12/f2.htm

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Let's get a couple definitions set here...

Supervision implies a legal relationship. There is no implication that the physician will ever touch or see the patient. The CRNA may be the only anesthesia person taking any clinical role in the care of the patient.

Direction implies that one is carrying out medical orders for another. Direction implies control and the ability to change the coorifice of action only when ordered by a physician.

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I don't think it's all about money and control. Much of it is, but let's say you remove money and control from the arguments. From what I gather, it seems both MDAs and CRNAs are ingrained with their concept of what's best for patients.

Yes both are interested soley in the well being of the patient. I firmly believe that with both CRNA and MDA. But the ugly matter of housekeeping does arise.

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This has been on the Florida Association of Nurse Anesthist Websites:

"The full Florida House passed HB 629 today 4/22 on a vote of 99-13 without ANY debate. Although we lost the vote in the House, the Senate has yet to hear the bill in committee. It is still imperative that Floridians contact their Senators and let them know the effect this bill with have nursing practice.

WHAT CRNAs NEED TO DO NOW:

1. Call, write and/or email members of the Senate and ask them to NOT to support SB 1452

2. Get a physician to call, write or email members of the Senate and ask them to "Vote No" on SB 1452. Please make sure that copies of these letters are faxed to Jim Linn at 850-224-1600."

I highly recommend that you visit the link below and read more about the Ortiz case if you haven't.

http://www.fana.org/default.html

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The MDAs on the Student Doctor Net are providing the e-mail addresses of the Florida legislators hoping that their faithful will pressure them into passing the bill. Those idiots don't realize that many of us monitor their threads and will use the e-mail addresses to defeat the bill. Invest a little time in a broadcast e-mail to those legislators. Here is the link

http://forums.studentdoctor.net/showthread.php?t=197770

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Those idiots...[/url]

Wow... real professional.

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The MDAs on the Student Doctor Net are providing the e-mail addresses of the Florida legislators hoping that their faithful will pressure them into passing the bill. Those idiots don't realize that many of us monitor their threads and will use the e-mail addresses to defeat the bill. Invest a little time in a broadcast e-mail to those legislators. Here is the link

http://forums.studentdoctor.net/showthread.php?t=197770

Very good! I just e-mailed them a very nice letter.

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Wow... real professional.

I have a question...how professional are the professional medical doctors and students on the student doctor forum when referring to nurse anesthetists....I think we are much more professional here. What do you think? :angryfire

WRITE THE FLORIDA LEGISLATORS.

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The MDAs on the Student Doctor Net are providing the e-mail addresses of the Florida legislators hoping that their faithful will pressure them into passing the bill. Those idiots don't realize that many of us monitor their threads and will use the e-mail addresses to defeat the bill. Invest a little time in a broadcast e-mail to those legislators. Here is the link

http://forums.studentdoctor.net/showthread.php?t=197770

You think those are top-secret email addresses or something, only available on SDN?

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You think those are top-secret email addresses or something, only available on SDN?

Lighten up. If you can't find something useful to say, then keep it to yourself.

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Specializes in Anesthesia.
Wow... real professional.

You may be forgetting where you are, young med student. This is a CRNA board. American anesthesia is a highly politicized arena. Perhaps you'd be well advised to gain a broader perspective before offering us your neophyte opinions, especially as to what constitutes professionalism.

deepz

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You may be forgetting where you are, young med student. This is a CRNA board. American anesthesia is a highly politicized arena. Perhaps you'd be well advised to gain a broader perspective before offering us your neophyte opinions, especially as to what constitutes professionalism.

deepz

If your peers qualifies that remark ("those idiots") as within the boundaries of professionalism, I'll yield. Hey, I even agree there are unprofessional behaviors on the SDN forum but I haven't seen a post where CRNAs were called idiots. And if I came across one, I'll probably have the same reaction as I did over here.

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