Hospitals with NO nurse anesthetists

[pnurseuwm]

If there are any Wisconsin CRNAs here, or other CRNAs in other states that can shed some light on this situation... I need an explanation! :uhoh21:

I'm soon to be a nursing student in Milwaukee this fall. I called Aurora Sinai Hospital for shadowing experiences of a CRNA. The lady I talked to said that Sinai no longer "uses" nurse anesthetists, nor does St. Francis and another Aurora hospital in the area!

I'm confused, how can THREE hospitals in one city NOT "use" nurse anesthetists? Has anyone else experienced this? Could I have NOT fully understand what the lady was saying? The only thing I could think of is that they don't do surgeries or use some other type of anesthesia provider (AAs or something).

What do you all think?

[user69]

can a crna practice without any md involved? specifically doing something like pain management on a private basis, or do they always have to work in cooperation with some licensed physician?

[movinsouth]

Thank you for the responses and encouragement guys! I will continue to research the world of nurse anesthesia. This forum is a valuable resource

pnurseuwm-

I work in a Madison hospital, and there are many CRNAs praciticing here, I have shaddowed several of them. They are highly utilized in the Madison area.

[loisane]

can a crna practice without any md involved? specifically doing something like pain management on a private basis, or do they always have to work in cooperation with some licensed physician?

it depends entirely upon your individual state nurse practice act. there are some where this would be illegal, and others where it would be perfectly ok.

loisane crna

[badgernurse]

If there are any Wisconsin CRNAs here, or other CRNAs in other states that can shed some light on this situation... I need an explanation! :uhoh21:

I'm soon to be a nursing student in Milwaukee this fall. I called Aurora Sinai Hospital for shadowing experiences of a CRNA. The lady I talked to said that Sinai no longer "uses" nurse anesthetists, nor does St. Francis and another Aurora hospital in the area!

I'm confused, how can THREE hospitals in one city NOT "use" nurse anesthetists? Has anyone else experienced this? Could I have NOT fully understand what the lady was saying? The only thing I could think of is that they don't do surgeries or use some other type of anesthesia provider (AAs or something).

What do you all think?

I am an RN in Milwaukee working on a career path towards becoming a CRNA. The Aurora hospitals (St. Lukes, Sinai, West Allis and others in the area) do not employ CRNAs. They used to and it is generally thought that they "phased out" CRNAs for political reasons. To understand those reasons, please visit various discussions on this board re: MDAs vs CRNAs. Other hospitals in Milwaukee do employ CRNAs but on a very limited basis such as OB/GYN roles and IV resources (I'm not joking). There are a group of us who plan to become CRNAs and understand that we will not be practicing in Milwaukee for those very reasons. If you want to shadow a CRNA, visit a hospital in Madison such as University of Wisconsin or even in Chicago where CRNAs are employed at the capacity they were intended to. If you have other questions regarding the hospitals, feel free to pm me.

[Sheri257]

this is from a legal brief from the aana web page:

"medicare does not require these (reference to asa statement) as a standard of care. medicare has no requirement of anesthesiologist supervision and will reimburse crnas who are not supervised by any physician if they meet the appropriate requirements."

i also found this:

the laws of every state permit crnas to work directly with a physician or other authorized health care professional without being supervised by an anesthesiologist. the joint commission on accreditation of healthcare organizations (jcaho) does not require anesthesiologist supervision of crnas nor does medicare.

so what is the opt-out issue really about? if you read this article, it's somewhat confusing.

http://www.canainc.org/news/2004archive/pdfs/012904nurseanesthetistwintrust.pdf

[deepz]

So what is the opt-out issue really about?.........

Confusion arises when unfounded presuppositions get in the way.

'Physician direction or collaboration' does not mean 'anesthesiologist supervision.' Any physician will do. The A$A generally wishes to imply that CRNAs cannot safely function without an MDA lounge lizard to oversee their work. And many folks wrongly assume this is the question in the opt-out issue. Not so.

CRNAs do not function in a vacuum. CRNAs work as part of a team, usually in collaboration with a surgeon. But when surgeons are told repeatedly by the A$A that they (the surgeons) are Captains of the Ship, always liable for the acts or omissions of a CRNA -- even though a patent falsehood, long ago discredited -- surgeons become uncomfortable and less likely to utilize CRNAs. Opt-Out States simply clarify and remove this misapprehension.

No state, nor Medicare, now or in the past has ever required CRNAs to be 'supervised' by an anesthesiologist. Never.

The Opt-Out is merely a technical clarification of reimbursement rules under Part A of Medicare, as it applies to HOSPITALS' Conditions of Participation. If the hospitals don't comply with 'supervision' language in facility bylaws in those States that have not Opted-out, those hospitals won't get their Part A Medicare dollars.

Abstruse stuff.

deepz

[Sheri257]

Abstruse stuff.

Yeah, no kidding. Thanks for the explanation deepz.