NBCRNA and the AANA... WOW!

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Got this in my email.. since I am not a member of the AANA I do not know where this is coming from.

Is the AANA's panties in a wad over the recertification plan? I think the recert plan is karma for the assenine DNP push. If this works out, CRNA's will have a choice of the certifying bodies they can choose there... Yup.. that will not cause ANY problems..

Quote

Dear CRNA:

We want to draw your attention to an issue that should concern all nurse anesthetists. An amendment to the AANA bylaws has been proposed that would withdraw the explicit recognition of the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA) as the certifying body for nurse anesthetists and the Council on Accreditation (COA) as the accrediting body for nurse anesthesia education. It instead requires that the AANA "shall recognize" independent entities which serve a certification or accreditation function. The amendment language suggests that this is simply a change in nomenclature, is intended to make the bylaws less restrictive and is in the best interest of the AANA. In actuality, the amendment changes a longstanding relationship and distances the AANA, NBCRNA and COA from one another. Neither the AANA, the NBCRNA, nor the COA had a part in initiating this bylaw change. The AANA, NBCRNA and COA have recognized each other as the sole professional, certification and accreditation organizations and worked as partners for many decades. Each organization has its own mission, but each is led by CRNAs who recognize each other as colleagues and partners in the field of nurse anesthesia. The proposed bylaw change opens the door to fracturing these relationships creating uncertainty about the future of our profession and will force the AANA, NBCRNA and COA to deal with this uncertainty when our time, energy and resources are better spent addressing the many significant challenges facing our profession. We are urging fellow AANA members to oppose the proposed amendment.

Why this amendment is bad for the profession:

  • The mandate in Article XXI of the amendment which requires the AANA to create guidelines for certifying bodies is in direct conflict with organizations that accredit the NBCRNA which require that certifying bodies be separate and autonomous from the membership organization. This directly jeopardizes the CRNA credential.
  • The loss of a direct membership voice in the selection of their accrediting and certifying agencies. This decision will be within the sole purview of the AANA Board of Directors without a requirement for member input.
  • There will likely be pressure placed on the AANA Board of Directors by the sponsors of the amendment to form or find an additional certification agency. The authors indicated they have developed a template for this action and the AANA Board has been contacted by an outside certification organization inquiring about the need for their services.
  • The AANA and NBCRNA boards would be distracted from the important work they perform on behalf of the profession by efforts to establish a second credentialing body. Such an effort will consume time and money better spent on combating external attacks on the profession.
  • Confusion could arise among the public (consumers, boards of nursing, advocacy organizations) if two certifying bodies for nurse anesthetists existed, and this could be used as a weapon by organized medicine groups which seek to restrain nurse anesthetist scope of practice.
  • Employers or state licensing boards may refuse to recognize two tiers of credentials.
  • A less demanding credentialing process may create a concern over less qualified practitioners.
  • Perceived erosion in dedication to the highest standards of practice may undermine the ability of nurse anesthetists to practice independently.
  • Nurse anesthetists could lose the support of regulatory and advocacy groups who have been pushing for greater opportunities for nurse anesthetists.

A certifying body is required to ensure the integrity of the certification process to protect patient safety, and to work with the professional association while maintaining the required autonomy. This is precisely what the NBCRNA does. We are comprised solely of volunteers; most of whom are practicing CRNAs who are members of the AANA. We consistently work with the AANA and take the concerns they express into consideration in our efforts to protect and improve the credentialing practices in nurse anesthesia. We urge you to contact your State Association President and Region Director and let them know you oppose the proposed amendment to the AANA bylaws. And do not forget to cast your vote of opposition at the 2013 AANA Meeting.

Sincerely,

The NBCRNA Board of Directors

On the PLUS side.. This is such an esoteric subject it might be possible only CRNA's will post in a CRNA forum..

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Specializes in Anesthesia.

This has nothing to do with DNP/DNAP, but the way NBCRNA forced the new recertification plan on CRNAs and the AANA. I don't know if it will pass, but it is going to be voted on at the Las Vegas meeting.

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I'm not saying it is a reaction to the DNP feces.. I'm saying there might possibly be karmic justice after all.

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A CRNA who is not a member of the AANA pays the equivalent of AANA annual dues to re-certify. With the recognition of other certification organizations, I can see a bidding war and people re-certifying with the least expensive entity. The AANA is acting and it even affects me... interesting.

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Specializes in Anesthesia, Pain, Emergency Medicine.

DNP and recert are two totally different issues. Not sure how you can make the leap, karma?

Nothing wrong with 2 certifying bodies. NPs have that option and it is no big deal. Competition is good.

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Specializes in Anesthesia.

This is from the NBCRNA not the AANA. This is an interesting problem. CRNAs are the most autonomous group of APNs there are, and we are the most unified and we have the most powerful organization of all APNs.

IMHO anything that takes away from the unity of our group is probably going to hurt CRNAs in the long run.

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Specializes in critcal care, CRNA.

So if there are 2 certifying bodies, will one have less standards? Will one be looked down upon? Will both be accepted throughout the country?

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Specializes in Anesthesia, Pain, Emergency Medicine.

Sorry WTB, I have to disagree with you. NP organizations are much more powerful. AANP alone has 36,000 members. That is only one of the NP organizations. There are quite a few more.

As I'm a member of both AANP and AANA, it is easy for me to compare.

On the autonomous issue, that is a toss up. If you look at just autonomy, CRNA wins easily because even in the states where you are "supervised", in reality you practice independently because the surgeon is doing the "supervising".

If we are talking about legal statute for independent practice, I'm not sure on that point. 20 states + DC allow total independent practice for NPs.

Having two credentialing organizations will not hurt. Most likely it will help as we all know, competition is a good thing.

FNPs have two credentialing organizations to choose from. Works great.

Different tests but both are accepted and nobody cares what credentialing body you used.

wtbcrna said:
This is from the NBCRNA not the AANA. This is an interesting problem. CRNAs are the most autonomous group of APNs there are, and we are the most unified and we have the most powerful organization of all APNs.

IMHO anything that takes away from the unity of our group is probably going to hurt CRNAs in the long run.

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Specializes in Anesthesia.
nomadcrna said:
Sorry WTB, I have to disagree with you. NP organizations are much more powerful. AANP alone has 36,000 members. That is only one of the NP organizations. There are quite a few more.

As I'm a member of both AANP and AANA, it is easy for me to compare.

On the autonomous issue, that is a toss up. If you look at just autonomy, CRNA wins easily because even in the states where you are "supervised", in reality you practice independently because the surgeon is doing the "supervising".

If we are talking about legal statute for independent practice, I'm not sure on that point. 20 states + DC allow total independent practice for NPs.

Having two credentialing organizations will not hurt. Most likely it will help as we all know, competition is a good thing.

FNPs have two credentialing organizations to choose from. Works great.

Different tests but both are accepted and nobody cares what credentialing body you used.

Everyone is entitled to their opinion. I still hold to mine though, but from what I was reading the new bylaw passed and opened up the possibility for a new accrediting agency. Who knows the next accrediting agency could be better or just a way for the ASA to get a hold of more of our profession.

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Yup, that email was from the NBCRNA and COA not the AANA. I have not seen where the AANA has issued a statement or a response to this e-mail yet. From what I can gather...and I may be way off base here...the AANA felt the heat from its membership to do something in response to the recert changes that the NBCRNA and COA slammed down our throats. The whole "period of discussion" where the vast majority of CRNAs wrote in against having to retake the exam was a sham at best from what I can tell. They had their sweet idea of implementing this new standard, and no amount of well written, logical letters was going to change their minds. Simply put, having to retake the exam does nothing...NOTHING...to strengthen the skills and improve the care that is currently being given by CRNAs throughout this country. All it does is drum up a ton of money for the NBCRNA and the COA and for all the test administration and prep-course entities associated with this certification process. Some argue that it is a way to bring our standards in line or parallel to those of the MDAs, but that is a weak reason for implementing their new set of standards. I work autonomously alongside three anesthesiologists. One is great and takes the time to tweak his anesthetic delivery to meet his goal of providing better service as time advances. One is great, but he is going to do what he's done since the 80's regardless of any evidence that better practices exist. One is terrible and basically gets patients through with total disregard to anything other than keeping them alive till he hands them off to the PACU nurses. Their model of recertification has no effect on their clinical delivery of anesthesia, and I'm sure that the same will hold true for CRNAs. The only valid reasons that exists to add burden and cost to maintaining certification is if that added burden and cost will produce significant improvement of clinical skills and knowledge across the board that significantly enhances the delivery of the care that we provide...or if the added burden and cost will help advance our status as providers within the healthcare system as a whole. The recent changes do neither of these, and the AANA membership is calling BS. The NBCRNA and the COA should make and enforce policy according to the wishes and educated opinion of its constituency, and if they fail to do so and implement self-benefiting policy that ignores the opinion of the majority of the CRNAs that support it's existence, they should be held accountable. Look no further than Washington to see what happens when governing bodies are allowed to do what they choose without the fear of repercussions. Competition and choice is always a good thing. I just hope that whatever evolves from this is founded on accountability, simplicity, and common sense.

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Well. I just read that on the AANA site and came over here to say that I was obiviously mistaken. Too bad. If what they are claiming is and has been true this entire time, why the defensive e-mail from the NBCRNA and COA in the first place? What are the details behind the "frayed relationship" that they are mending? We can speculate till the cows come home, but does anybody know the facts behind all this friction and weirdness between them?

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Specializes in Anesthesia.

I am well aware of the credentialing issue that is coming up for an AANA bylaw change. This change is appropriate and is needed so that the CRNA credential stays an integral part of the profession. That can only be done by input from the profession--the AANA. Currently, NBCRNA can and has snubbed their collective noses at the AANA and CRNAs and nothing can be done about it. With the Bylaw fix, the AANA BOD can recognize other groups for accreditation and certification. We elect the BOD and have a say at the ballot box.

One more very important thought--NBCRNA has no business sending emails to AANA members regarding OUR bylaw changes. They are two separately incorporated groups and it is inappropriate for them to try to interfere with our (AANA) business.

If you are going to be at the business meeting, consider voting for the bylaw change.

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