Published Nov 11, 2003
I am interested in hearing from the anesthesia students (and any others) what legal issues most interest them as students. Those issues can include student concerns and those related to being a CRNA. This is for a project.
i'll chime in. there are a few issues for me, some more important than others, some just based on current issues.
of course instructors always emphasize worst case scenarios.
1. awareness under anesth. just because there is alot of emphasis on it in the media.
2. just being part of the anesthesia team when something goes wrong and anesthesia is known to have deep pockets.
3. spinals / epidurals and associated risks.
4. complications from difficult airways.
5. having responsibility for positioning, then having the surgeons alter patient position during procedure or prior to case and something happen that the CRNA would not be immediately aware of.
i'm sure there are more after i do more clinicals.
My 2 cents
The issue of Anesthesia Assistants in general and specifically how AA programs may endanger clinical sites for CRNA education
The ASA and AANA conflict.....seems while we're busy fighting Washington has an easier time reducing Medicare reimbursment.
The attrition of SRNAs of during the first semester of clinicals; which is next semester for my class. We're all a little concerned about it; sort of a fear of the unknown, if you will.
Some of our big discussions recently have included:
1. DNR in the OR
2. Definitely awareness under anesthesia
3. Providing analgesia to peds under anesthesia (the practice of not providing, is it really out there?)
4. Anesthesia responsibilty regarding consents and patient wishes (pt consented for "x" procedure, but while operating, surgeon sees need for "y" procedure, etc...)
the whole supervison thing is still a little fuzzy to me. does there have to be and anesthesiologist or can I work under the surgeon or has that all changed
Legally, no state requires you to be supervised by an anesthesiologist. However, most but certainly not all, have policies requireing medical direction by the MD staff. There are plenty of locations that CRNAs practice without the direction os MDAs, this occurs in many rural hospitals, the VA and others. The opt out issue is for medicare reimbursement but not a legal. All states as far as I know allow you to practice what you are trained to do, so get the best training you can find!!
19 more clinical days!
The issue I fear most is the litigiousness of patients in this current era of healthcare. With malpractice insurers discontinuing or modifying coverage to CRNAs, how will we be adequately covered in (God forbid) a patient injury or frivolous lawsuit? How can we defend claims of anesthetic awareness and/or nerve injury?
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