North Carolina HB503 is officially dead

kmchugh · Sep 7, 2005

Gotta get that political indoctrination in early.

jwk

You know, perhaps this attitude has something to do with why AA's face such an uphill battle with the CRNA community. There is much all of us in the anesthesia community can do to better work together. However, your reduction of the history of the history of nurse anesthesia practice to political indoctrination effectively drives us further apart. Attitudes like yours are why we as CRNA's fight so hard to protect that which is rightfully ours. Ours by history, ours by present practice, and ours by fiat of the courts.

Nurses were the first full time providers of anesthesia. Nurses are still the ones actually at the head of the table for the majority of anesthetics delivered in the US today. Statistically, CRNA's provide safe, reliable anesthesia. Knowing these facts does not constitute indoctrination. It is simple knowledge of the history and present practices of one's own profession. And you belittling these facts does not in any way alter them.

Yes, I am the same person who wrote the thread about the need for the ASA and the AANA to get along. But also know that I know where the friction between the two organizations starts. It starts when, after 100 years of practicing safe, independent anesthesia, CRNA's are told by the ASA that we must now practice only under the supervision of an anesthesiologist. And why is that? Given the track record of safe anesthetics, it certainly cannot be that we have suddenly become unsafe. Ah, but there is the billing issue. An untapped gold mine.

Perhaps you could be a bit less offensive, and try to learn something here.

Kevin McHugh, CRNA

BigDave · Sep 7, 2005

In class today our instructor (and recent past president of NCANA) said that the MDs spent $500k on lobbying/padding campaigns for this bill and the CRNAs all of $40k or so. Hurray for the little guys! Next year is a "short" session (May-Aug?) and unless something will help someone in the Fall elections, it will be a tight fit to reintroduce this bill.

jwk · Sep 8, 2005

jwk
You know, perhaps this attitude has something to do with why AA's face such an uphill battle with the CRNA community. There is much all of us in the anesthesia community can do to better work together. However, your reduction of the history of the history of nurse anesthesia practice to political indoctrination effectively drives us further apart. Attitudes like yours are why we as CRNA's fight so hard to protect that which is rightfully ours. Ours by history, ours by present practice, and ours by fiat of the courts.
Nurses were the first full time providers of anesthesia. Nurses are still the ones actually at the head of the table for the majority of anesthetics delivered in the US today. Statistically, CRNA's provide safe, reliable anesthesia. Knowing these facts does not constitute indoctrination. It is simple knowledge of the history and present practices of one's own profession. And you belittling these facts does not in any way alter them.
Yes, I am the same person who wrote the thread about the need for the ASA and the AANA to get along. But also know that I know where the friction between the two organizations starts. It starts when, after 100 years of practicing safe, independent anesthesia, CRNA's are told by the ASA that we must now practice only under the supervision of an anesthesiologist. And why is that? Given the track record of safe anesthetics, it certainly cannot be that we have suddenly become unsafe. Ah, but there is the billing issue. An untapped gold mine.
Perhaps you could be a bit less offensive, and try to learn something here.
Kevin McHugh, CRNA

Read virtually any post by deepz and some of the LANA'ers regarding anesthesiologists or AA's and then let's rethink this "offensive" concept.

History of anesthesia is one thing (and as I recall, it didn't start with nurses). I didn't belittle that. Political indoctrination is another matter altogether. They're two entirely separate concepts.

I have never demanded or put forth the argument that CRNA's don't have the right to practice. Yet thousands of CRNA's claim that AA's should not have that same right for any number of bogus reasons that always boil down to a turf battle and nothing more. That viewpoint starts with SRNA's who, until they started their program (unless they live in Georgia or Ohio), have probably never heard of an AA, much less worked with one. It also comes straight from the top, and has for many years. I listened to a past president of the AANA state during an educational meeting more that 20 years ago (NWAS perhaps) who stated that CRNA's everywhere should "...watch out for these people...we thought they disappeared, but now they've gotten approved by Medicare...".

Do I want to take away your practice rights? Nope. Do CRNA's, both on an individual basis by and large and certainly as state and national organizations want to take away my practice rights? Absolutely, without a doubt. Do I want to restrict your scope of practice with regards to regional anesthesia, invasive monitoring, or any other procedure? Nope. Do CRNA's, individually and as an organization, want to restrict my scope of practice? Absolutely, without a doubt.

As I've stated before - the hypocrisy and lack of objectivity is striking. Do you not see that CRNA's trying to limit AA practice is absolutely no different than MD's that seek to limit CRNA's? "There is much all of us in the anesthesia community can do to better work together" rings awfully hollow to my group when I can't practice in states like North Carolina, where despite there being 5 CRNA schools, there is still a shortage of anesthesia providers, not just in rural areas, but in urban ones as well.

kmchugh · Sep 8, 2005

Your arguments about the scope of the AA's practice would be more compelling if the scope of practice of AA's was controlled by CRNA's. In fact, it is not. It is controlled by the same group who conceived the very idea of AA's, specifically, anesthesiologists. AA's were conceived to essentially be anesthesia PAs, with the same kinds of practice standards and limitations as the PA. Your chief proponents, the ASA, are the ones who limited your scope of practice, and required you to work under the direct supervision of anesthesiologists. Accordingly, your education prepared you for that type of practice. If CRNA's are involved at all, it is simply to ensure that you practice under the guidelines already set up for you. Just as we do.

As to the issue of where AA's can practice, see it from another viewpoint. CRNA's were not as pliable as the ASA hoped, and did not knuckle under to pressure. Worse, our position was backed up by the courts. At about the same time as the failed legal challenges, anesthesiologists conceived of the idea of AA's. You connect the dots. The ASA has tried to legislate us under their control and has tried to force us under their control through the courts. In every case they have failed. Now, it is blatantly apparent that if they can't bring us under their umbrella (and thereby increase their billing potential), they will try to elbow us out by other means. Forgive us if we don't bow to the inevitable.

Kevin McHugh

Edited to add: Read more carefully. I didn't say that we started the practice of anesthesia. I said we were the first full time practitioners of anesthesia, and the first research done and published on safe administration of anesthesia was done by a nurse anesthetist. I can go on, but I hope you get the point.

VickyRN, MSN, DNP, RN · Sep 8, 2005

In class today our instructor (and recent past president of NCANA) said that the MDs spent $500k on lobbying/padding campaigns for this bill and the CRNAs all of $40k or so. Hurray for the little guys! Next year is a "short" session (May-Aug?) and unless something will help someone in the Fall elections, it will be a tight fit to reintroduce this bill.

I am very happy for our victory, but watch out for dirty politicking in NC. We thought the horrific medication aide bill was dead in the water also, but it was later "snuck in" as a rider on the very popular Appropriations Act. https://allnurses.com/forums/showthread.php?t=115152

apaisRN, RN, CRNA · Sep 9, 2005

JWK, that was a nasty response to a simple comment I made. CRNAs would not be in existence today were it not for the AANA - therefore I support that AANA because it gave me the opportunity to enter this profession. It has nothing to do with anesthesia assistants. I HAVE worked with AAs, although not closely, and the ones I've met seemed professional and skilled. I don't have strong feelings about them, although it seems like it wasn't all that necessary to develop a new category of anesthesia professionals when the CRNA system had been working well for a long time. But hey, they're here, and we might as well work together.

jwk · Sep 9, 2005

JWK, that was a nasty response to a simple comment I made. CRNAs would not be in existence today were it not for the AANA - therefore I support that AANA because it gave me the opportunity to enter this profession. It has nothing to do with anesthesia assistants. I HAVE worked with AAs, although not closely, and the ones I've met seemed professional and skilled. I don't have strong feelings about them, although it seems like it wasn't all that necessary to develop a new category of anesthesia professionals when the CRNA system had been working well for a long time. But hey, they're here, and we might as well work together.

It wasn't nasty - it was to make a point, which I explained further in the post that followed.

surgpa · Sep 9, 2005

JWK, that was a nasty response to a simple comment I made. CRNAs would not be in existence today were it not for the AANA - therefore I support that AANA because it gave me the opportunity to enter this profession. It has nothing to do with anesthesia assistants. I HAVE worked with AAs, although not closely, and the ones I've met seemed professional and skilled. I don't have strong feelings about them, although it seems like it wasn't all that necessary to develop a new category of anesthesia professionals when the CRNA system had been working well for a long time. But hey, they're here, and we might as well work together.

As I read this bill, there are TWO distinct portions. One, it allows AAs to work as such in NC. Two, it MANDATES CRNAs to work under the "supervision" of MDAs. This is the true crux of the argument and the friction between the two (three?) groups. If it were in fact two different proposed laws it would have been better received for the first and more honest on its face for the second. Why in the world would you combine the practice law of allowing AAs to work while limiting CRNAs in the same law? Makes no sense to me except for the obvious agendas mentioned elsewhere.

Mike

VickyRN, MSN, DNP, RN · Sep 23, 2005

Just got back from the NCBON meeting today... North Carolina HB 503 is NOT dead (as many had presumed), but has been referred out of the Health Committee to the Finance Committee, with the real chance of being resurrected next session.

Please learn from our bitter experience with the Medication Aide legislation (which we mistakenly thought was "dead" also: https://allnurses.com/forums/showthread.php?t=115152 ) Secretive, underhanded politics can be the norm down here. Don't let this one slip by you! Too much at stake to lose.