CRNAs and Practice NC House Bill 181

lrnurse03 · Mar 19, 2013

Dear PatMac10:

I have to call you out here. Please do not post about regulations regarding NC Licensed CRNAs if you are unsure of, or have not researched what the NC Board of Nursing has to say about our practice.

Most importantly, there is absolutely NO law in NC that says CRNAs have to be supervised by an Anesthesiologist or other MD. Your comment that this bill will just "put into writing" what is already established practice is way off base. It is just not factual. Our (CRNA) practice is regulated by the NCBON. Period. Our Practice Act (specifically the CRNA rule) states that we shall work in collaboration with other healthcare professions in the process of administering anesthesia. Supervision is way different that collaboration. Do some research on this.

CRNAs are safe providers of anesthesia & we do not need an anesthesiologist supervising us to make it so. Are you from NC? If you are, did you realize that there at least 10 (possibly more) counties in our state that rely solely on CRNAs for their anesthesia services. This means that there are no anesthesiologists in those counties providing anesthesia. Therefore, CRNAs do not practice under the already established guidelines that you state above. As well, even in counties where there are anesthesiologists, CRNAs practice daily without an anesthesiologist. I do it everyday. I work for a large anesthesia group, comprised of/owned by CRNAs. We provide multiple types of anesthesia for different providers ranging from plastic surgeons to GI physicians.

The website that you quote here is run by the Anesthesiologists trying to push this bill through the assembly. Several CRNAs have challenged their information & left comments & questions on their site but the moderator doesn't approve them. Therefore the public never sees it.

I bet you also didn't know that CRNAs & Anesthesiologists in NC have an agreement dating back to 2007 when they last tried to pursue making supervision the law in NC. We entered into this agreement under the guise that we wouldn't try to block AAs in NC if they agreed not to pursue supervision. Here is a direct quote from that agreement:

"The Parties agree and acknowledge that the existing working relationship between nurse anesthetists and physicians in North

Carolina is beneficial to patients and the general public. The Parties agree not to take any legal, legislative, or rulemaking action to change the existing status quo in the legal scope of practice and clinical working relationship between nurse anesthetists and physicians, including advocating or seeking an “opt-out" of physician supervision requirements under the CMS Conditions of Participation. This Agreement is contingent upon NCBN and NCMB continuing separately that they will not take any of the above actions to change the existing status quo in the legal scope of practice and

clinical working relationship between nurse anesthetists and physicians." The end of this agreement also states that neither party will pursue future legislative action. I will be more than happy to provide you with more information on this agreement, just ask.

If you are a student nurse aspiring to be a future CRNA, which I am guessing you are since you are on this forum, PLEASE research your profession before you begin posting. This is serious business for us & for the public of NC. This is our way of life & it matters deeply to us all.

Check out this link from the NC BON, the body who governs CRNA practice:

North Carolina Board of Nursing

Thanks

Lori Dowell CRNA, MSN

PatMac10,RN, RN · Mar 19, 2013

Lori,

I have researched the Bill, actually my class just took part of the NC Nurses Day at the Legislature and talked with the NCNA's Lobbyist about the bill and what it could potentially mean/ lead too. I actually don't want to be a CRNA, I just got an Email from NCNA asking for members support for the matter.

If you notice, I put the put into writing in parentheses because I was quoting what they (the Physician Group) were saying, which means I wasn't quoting my thoughts. I feel that time and experience have been the most reliable proof that CRNAs have been able to effectively practice independently. I agree they shouldn't pass this unnecessary law, I never insinuated that I did.

So what are you calling me out on??????????????????

I simply asked for the thought or other Nurses and CRNAs about the law and what updates they have? Reading the information on the NC legislation website, it was reported that the bill was receiving support in the house, that's was a fact from the government, not me.

I don't make it a practice of speaking on in depth topic that I haven't studied on. I think you completely misinterpreted my post. How,??? I don't know..............

Geez. I was just asking a question. Which is what people typically do when they have things they don't understand btw. Apparently that is a crime.

PatMac10,RN, RN · Mar 19, 2013

I feel the same way you do. Why fix something that's not broken???? Why wouldnt I? A.) This is a nursing forum. B.) I'm a student nurse, who will be a licensed nurse on 9 weeks.

lrnurse03 · Mar 20, 2013

So you talked to our lobbyist & they gave you the indication that the bill has a very good chance at passing? Interesting. I am glad you are trying to get involved, but do educate yourself on the topic. As a future NC Nurse, promote our websites to the public for information (or at least ones with facutal info), not the MDs forging legislation against us.

Much luck to you on the NCLEX & what lies ahead.

PatMac10,RN, RN · Mar 20, 2013

So you talked to our lobbyist & they gave you the indication that the bill has a very good chance at passing? Interesting. I am glad you are trying to get involved, but do educate yourself on the topic. As a future NC Nurse, promote our websites to the public for information (or at least ones with facutal info), not the MDs forging legislation against us.
Much luck to you on the NCLEX & what lies ahead.

............ My assessment of the chance of the bill passing was from the summary of the introduction of the bill to the house on nc legislative website. I give the nurses and on here enough credit to know to reference ncbon. I wasn't trying to get opinions about the ncbon s comments. I wanted to know what everyone's thoughts in what the physicians were "claiming" and the summary of the bills journey in congress. That's why I referenced their websites. The 2 lobbyist (one is new) told us that the letter did receive attention, and it was something that would need to be watched closely.

Apparently you didn't discern that, and that's ok.

It's a simple misunderstanding. Thanks did the well wishes. I stay in the NCBON website. I'm not trying to get involved I just wanted to know how everyone else felt about the Medical Association trying to impose this request in CRNAs.

Even though I don't plan on being a CRNA, I enjoy learning from them. I think they are awesome.

lrnurse03 · Mar 20, 2013

You referenced one website -- the protectnc patients one. At least on this thread anyway.

The first thing you should realize is that this is a public website. We have to be extremely vigilant about what is posted about us & this bill. There is no way for us to know who is who, and there is much more false information being posted, than there is truth. Any person can join any forum & post what they want to. This is not only a battle of legislation, it has turned into a PR battle. Which is my reason for setting the record straight & laying the groundwork for this bill & the history behind it.

My colleagues & I came across your comment simply by Googling this specific bill. If the general public were to click on your first post (which they can b/c one doesn't have to be registered or even logged in to see it) it reads as though supervision is already law-whether you meant to say that or not. That is not what we need or want the public or our representatives to believe because it is just not true. And again, the only website you list in the above initial comment is the the site run by the MDAs. I am sorry if you meant to add two, I don't see the second one that you are referencing. When I wrote you back, I added the NCBON website simply for this reason. You'll learn & you'll be surprised at the number of your future colleagues that don't understand what the practice act says about APRN practice.

We have to cover all our bases & be very thorough because all of our posts & comments are in the public domain.

PatMac10,RN, RN · Mar 20, 2013

So maybe I should have said looks like there is a chance this bill could pass.

I agree we must watch what we post, however I don't feel I posted anything that would degrade nursing. But that's just how I feel.

Either way. I posed my original question and post because it is being reported that the bull is reviving report, that is also public knowledge.

See:

http://www.wral.com/nurse-anesthetists-would-need-supervision-under-bill-moving-through-house-/12212379/

If someone see seething on here that is misleading or confusing, they've shown no problem with asking for clarification in the past......

People are going to come on allnurses all day and see things that may deter them from nursing. If one will let the comments of a public nursing forum (where some may not even work in healthcare) deter them from pursuing a career they think they want without doing personal research theirselves, I'm sorry. I really am. I am not so "unstudied", as some may falsely believe me to be, to think that people who aren't NC Nurses utilize the forums when making career decisions, maybe some a little more than others.

I like to believe that the majority of people who visit the side know that there is always multiple sides to one story/issue they may see here, but that could be my young mind thinking to highly of intellectual capabilities of the general public. Idk.

I've been working in this whole "tact" thing for a while, but it annoys me when people blatantly assume that others are so misinformed and incapable of research. The reason I posted this was simply to get CRNAs and nursing profession members to give their opinions in this attempt at control and how they think it would affect the desire for ones to practice as a CRNA in NC, nothing more. Now if you want to take it there, by all means.....

My original question still stands.

rndad1 · Mar 21, 2013

irnurse03 - I was not a member here until I read your postings. GEEZ!!!! I realize this issue is very important and I do believe that this is unneccessary legislation, however......You can make your point without attacking other members. You would have much more credibility. All you have done is show that you are very very stresed and currently undstable which supports your opposition on this issue. Just wanted to make you aware of the impression your leaving.

PatMac10,RN, RN · Mar 21, 2013

irnurse03 - I was not a member here until I read your postings. GEEZ!!!! I realize this issue is very important and I do believe that this is unneccessary legislation however......You can make your point without attacking other members. You would have much more credibility. All you have done is show that you are very very stresed and currently undstable which supports your opposition on this issue. Just wanted to make you aware of the impression your leaving.[/quote']
Thank you.