CRNAs we are losing the battle.

[badass]

New Jersey Supreme Court Unanimously Upholds Office-Based Surgery Regulations

The New Jersey Supreme Court affirmed the Appellate Division's decision and held that the office-based surgery regulations challenged by the New Jersey Association of Nurse Anesthetists were within the Board of Medical Examiners' delegated authority. The Court agreed with the Appellate Division's holding that the administration of anesthesia is the practice of medicine and that the regulations fall squarely within the Board's core jurisdiction, the licensing and qualifications of physicians, and how they perform their professional services. It also agreed that while the regulations have an indirect impact on the CRNAs' profession, the BME is not regulating the nursing profession, but rather the physicians who offer anesthesia in an office setting.

Recognizing the unique nature of the office setting, the Court held that the "wealth of testimony adduced at the public hearings on the regulations supported the need for enhanced education and oversight." This decision upheld the requirement that a qualified physician must supervise a nurse anesthetist who administers and monitors general or regional anesthesia. The regulations specify how many hours of continuing medical education in anesthesia the supervising physician must have completed. Lastly, the Court recognized the value of having an anesthesiologist involved in the delivery of anesthesia care. It is "fundamentally reasonable that additional education and training would enable anesthesiologists administering or overseeing anesthesia to better protect patients and to respond when complications occur."

I guess we were not as powerful as we thought we were and this shows doctors will always be above us.

[lmdscd]

If they are going to instate supervision then they need to take full responsibility because as it stands now they will not back us up in a court of law. The way it is now at my clinical site the MD's just walk around and sign charts so the hospital can bill Medicare for 2 providers. I guess they need that extra education and extra residency time to learn how to sign their name.

[deepz]

.....I guess we were not as powerful as we thought we were and this shows doctors will always be above us.

Somehow I doubt very much that you are a CRNA, projecting as you do this negativity. New Jersey ain't history yet.

And while you await the next chapter:

http://www.gaspasser.com/animal%20farm.html

.

[rn29306]

Moderators, please allow this link to stay up. I cannot type this again. I am not trying to incite a flame war on another website, but please don't make me type this again. It is an excellent response to the OP on this site.

Thanks.

http://forums.studentdoctor.net/showthread.php?t=212277

A precedent has been set by the Florida Supreme Court pm 12/21/04 in Florida HB629/SB1452 that "APRNs are RNs for purposes of the statute that precludes the Board of Medicine from prohibiting any service provided by a registered nurse under the supervision of a physician" and "the court upheld that the Board of Medicine cannot directly or indirectly take action that restricts the practice of nurses". The FSC also ruled that the case cannot be reopened by the FBOM for rehearing purposes. End result is case closed for now.

Legal precedents are powerful leverages. Don't think the AANA won't fight this.

Oh yeah, and Wisc governor Jim Doyle just notified Washington, DC's Center for Medicaid and Medicare Services that "effective immediately" that his state is opting out of the federal supervision requirement for CRNAs.

[badass]

Somehow I doubt very much that you are a CRNA, projecting as you do this negativity. New Jersey ain't history yet.

And while you await the next chapter:

http://www.gaspasser.com/animal%20farm.html

.

The point of my post is to illustrate that we are fighting a tough battle and I am concerned about how this will affect our jobs. I sound pessimistic in my post because seeing things like this makes me angry and, at times, makes me wonder if made the right decision to pursue a CRNA degree.

I wonder if this decision can be appealed or if it is final.

[cutelilmiss_2000]

The point of my post is to illustrate that we are fighting a tough battle and I am concerned about how this will affect our jobs. I sound pessimistic in my post because seeing things like this makes me angry and, at times, makes me wonder if made the right decision to pursue a CRNA degree.

I wonder if this decision can be appealed or if it is final.

I just finished my bachelors in nursing and was considering going to crna school or nurse practitioner school. Being unaware of the many things going on with anesthesia, what do you all suggest I do? :uhoh21: To pursue or not to pursue. That's the question. While ultimately the decision is mine, please respond with all honesty.

[Sheri257]

And while you await the next chapter:

http://www.gaspasser.com/animal%20farm.html

I don't know why you keep posting this link deepz. It's a tasteless, unprofessional way to present your arguments. You're not doing CRNA's any favors with this one.

[loisane]

The NJ ruling is a dissapointment for nurse anesthetists everywhere, and most especially the ones in NJ who were passionate and determined in their efforts. On the other hand, the Florida ruling was a great positive development for nurse anesthesia practice rights.

There is a lesson here. The issues are complex and far reaching. You cannot look at one small piece of the whole, and make inferences on the entire state of affairs. You would not make a clinical decision based on one, isolated piece of information. You would want to cover all the bases and get repeated measures over time. It is the same thing in the arena of politics and health policy.

I also would encourage people to not depend entirely on the mainstream media for their information. The real story is often untold, or glossed over. Get involved in your state association to get behind the scene details, and learn how to be an effective protector of your practice rights, and an agent for change when needed.

All of health care is somewhat volatile right now, and anesthesia maybe a bit more than other aspects of the system. But so what? Change and conflict are part of life, and part of workplace economics. If you want to just cash paychecks, and not get involved, you can do that in anesthesia or any other career choice. But you will always be subject to changes not of your own making. Nurse anesthesia is not unique in that regard.

Get informed. Get involved. See the big picture. Don't expect black and white answers. Network, make personal connections. When the horse knocks you off, dust yourself off and get back in the saddle. This isn't the end of nurse anesthesia. We lost a round, we'll probably lose others. But the fight isn't over until we give up and quit. And believe me, there is absolutely no chance of that.

loisane crna

[NRSKarenRN, BSN, RN]

from sandy kerr- njsna enews for 6/30/2005:

supreme court issues decision on crna supervision regulation

the supreme court issued a short nine page decision yesterday morning (6/29/05) upholding the validity of the board of medical examiner's (bme's) anesthesiologist supervision regulations for crna practice in physician offices.

therefore, the stay has been vacated which means that the supervision regulation will go into effect. at this time, it is not known if the bme is prepared to implement the regulations immediately. njsna will continue to monitor the regulations. for future updates go to www.njsna.org.

much to the entire nursing community's disappointment, the court held that the nj association of nurse anesthetists did not meet the heavy burden imposed upon it in challenging the validity of the bme's regulation. the new jersey state nurses association and the american nurses association both filed amicus briefs in support of njana.

----------------

previous febuary 05 njsna info: http://www.njsna.org/regulatorreupdate/regulatorre_update.htm

http://www.southjersey.com/articles/?articleid=12538

[NRSKarenRN, BSN, RN]

nj supreme court recent rulings:

http://lawlibrary.rutgers.edu/cgi-bin/recent.cgi

docket no.: a-92-04

decided: 2005-06-29

caption: new jersey association of nurse anesthetists, inc. v. new jersey state board of medical examiners

summary:

per curiam in 1997, the state board of medical examiners (bme) proposed regulations, later codified at n.j.a.c. 13:35-4a.1 to -4a.18, setting forth standards for the administration of anesthesia during surgery performed in a physician's office (as opposed to anesthesia administered in a hospital or in ambulatory care settings). the proposal established that anesthesia could be administered only by physicians meeting certain standards or by certified registered nurse anesthetists (crnas) under the supervision of a physician meeting those standards. the physician administering or supervising the administration of anesthesia was required, depending on the type of anesthesia, to meet additional educational or certification requirements. on june 15, 1998, the bme adopted the proposed regulations. further proceedings regarding privilege followed, resulting in the adoption of alternative privileging procedures on november 13, 2002. the bme withheld implementation of the supervision requirements during the pendency of the privileging issues.

click here to get this case.

[deepz]

I don't know why you keep posting this link deepz. It's a tasteless, unprofessional .......

Many disagree with your opinion but of course you are entitled to it. And with your 2000 posts, Lizz, certainly you *do* share your opinions freely! Good for you.

As to WHY, in short, the NJ court had this to say:

[it is] "fundamentally reasonable that additional education and training would enable anesthesiologists administering or overseeing anesthesia to better protect patients and to respond when complications occur."

They are simply mistaken. 'Fundamentally reasonable' is one thing; facts backed up by scientific research is another. 'To better protect patients' is an assertion with no basis in fact. It is an unwarranted presupposition with NO PROOF. Lack of proof of MDAs' vaunted superiority over CRNAs is exactly the main point of

http://www.gaspasser.com/animal%20farm.html

deepz

[Lambert5883]

They are simply mistaken. 'Fundamentally reasonable' is one thing; facts backed up by scientific research is another. 'To better protect patients' is an assertion with no basis in fact. It is an unwarranted presupposition with NO PROOF. Lack of proof of MDAs' vaunted superiority over CRNAs is exactly the main point of

http://www.gaspasser.com/animal%20farm.html

deepz

Good point. You would think that any analysis on the matter would warrant critical thinking based on empirical data, as opposed to "golly gee, this seems, fundamentally, reasonable." Just makes you shake your head.