loisane

Good idea, classic. I did ask my insurance agent, but they said they didn't know of any such policy. I will ask about a rider, that might be an option the agent didn't think of. I agree with you about loopholes, that is why I am trying to find some individual coverage. Thanks! loisane

To the those of you already teaching in a classroom/academic setting: Do you carry liability insurance? I'm not talking about traditional liability insurance that many of us have for clinical practice (that would cover a nurse involved in the care of a patient who subsequently files a lawsuit claiming negligence). I am hearing more and more about college and graduate students filing lawsuits related to their education. These students claim they were treated unfairly, usually related to an evaluation or a grade. Many times they have been unable to successfully complete their program, or have not been allowed to continue due to their poor performance. So they sue to try and force their way back into the program. I am wondering if there are liability insurance policies available for educators to protect themselves from this type of risk. Does anyone know of any company or agency offering such a policy? I have been told that I might be able to obtain such coverage through a professional organization. What professional organizations exist for nursing educators? The only educational professional organizations I have found are for grades 1-12 teachers. Yes, I know my employer's insurance would cover me if a lawsuit was filed. But I am still exploring options to obtain my own, personal coverage. Any thoughts? loisane

Concerned, Why do you think our dues are excessive? Have you compared them to other professional organizations? They are completely in line with other comparable professions. And most of those professions don't have near the mean salary we do. When you take that into account, our dues are a bargain! Candidates for the certification exam pay fees that I am sure cover the costs of their result notification. I very much doubt that the membership "picks up the bill". The councils are autonomous, so I would imagine they have budgets separate from the AANA. By your own admission you are not well aware of the inner workings of the AANA. Why is that? Are you active in your state association? Have you attended any national meetings? You would have far more insight into the questions you raise if you became active and saw the working of the our association for yourself by being an active participant. Mid year assembly is in a couple of months. I encourage you to go see your association in action. Every CRNA I have known who has expressed views similar to your post, comes back from MYA with a different attitude. In fact, I have heard it said more than once, that we are getting MORE than could be expected for our dues dollars, not less! Additionally, even if you did in fact find that these things need drastic change, how would you propose to accomplish that? The way to change things is from within. I guarantee there is a committee in your state association that could use your help this very minute. All it would take is a phone call, and you can start work toward positive change. Run for office, make the budget analysis, come up with a different plan, implement it and see if it helps. Complaining gets nothing accomplished. Good, hard, honest work makes our organization better and stronger. What are you going to do to help that happen? loisane crna

Amen, amen, amen, AMEN! Did I say AMEN? loisane crna

CAMC School of Nurse Anesthesia in Charleston WV grants a Masters in Health care administration in conjuction with its nurse anesthesia program. I beleiveveRush University's nurse anesthesia program has a strong business focus as well. You may find others in addition to these. There is quite a bit of cross interest with business among the nurse anesthesia community. loisane crna

Accreditation standards require that all graduates administer spinals, epidurals and peripheral blocks. These standards have been in place for several years, I believe. Like you, I graduated with very little hands on regional in school. People like you and me have to find learning opportunites through employment and/or workshops. It can be done, if you haven't found a way yet, you just need to keep looking and it will come together for you eventually. loisane crna

Spartan, there is not quick simple answer to your question. In order to answer it, you have to look at layers of regulation associated with CRNA practice. CRNAs are educated and trained in all aspects of anesthesia care. This is referred to as "scope of practice". Layer one-education, professional standards of care and certification-all allow for a full scope of practice. Layer two-state nurse practice acts. This of course varies from state to state. Some states require physician supervision of CRNAs, some do not. No state requires that the supervision be provided by an anesthesiologist. States that require supervision may vary in just what type of provider can provide that supervison. For instance, there are some state in which a CRNA could provide anesthesia for a dentist, and some where they could not. Every CRNA must be knowledgeable about their particular state nurse practice act. Layer three-institutional policies. Even though all state nurse practice acts allow for full scope of practice for CRNAs, some institutions choose to limit the tasks they allow CRNAs to perform. Every CRNA must be knowledgeable about the institutional policies and the associated credentialling process that will specify what they are allowed. Sometimes they have a full scope of practice, other times not. For instance, some places do not allow CRNAs to insert lines or perform regionals. Even though those activities are legal, they are not allowed by institutional policy. Layer four-liability insurance. You have to know what your coverage allows, or does not allow. I have heard that some insurance companies will not cover new graduates for out of hospital cases until they get several years experience. Some insurance decisions are completely arbitrary. I once had trouble finding coverage because I performed anesthesia for liposuction. Layer five-reimbursement. This is where the opt outs that badger refers to come in. This issue is the most complex of all, and I don't know how much you really want to know, but here goes. Medicare is in two parts. Part B pays providers. CRNAs have full billing rights equal to anesthesiologists under Part B. Medicare part A pays the hospital. In order for a hospital to get paid, it must abide by the "Condition for participation". One of the conditions for participation is that CRNAs be supervised by a physician. Since that is not a consistent legal requirement in all states, this is an unfair requirement. Hospitals in states in which physician supervision is not required in their nurse practice acts, were having to provide that supervison in order to get paid by Medicare. There was a long, ugly fight about getting it changed. The end result was a compromise in which the states in which physician supervision is not required in their state code, may petition Medicare to "opt-out" of this part of the conditions for participation. To summarize, CRNAs can perform all of the same tasks that an anesthesiologist can, related to anesthesia. I believe that it is likely that you could find a CRNA practicing at full scope in each and every one of the 50 states. It is also quite likely that you could find a CRNA functioning in a restricted capacity in each of the states. The reason for that restriction will vary for each situtation. Each practicing CRNA needs to be knowledegable about their options, and make the best decison for themselves about their individual practice environment. Hope this helps. loisane crna

Have to disagree with you , platon. It is a well accepted comparison in nursing, that nurse anesthesia is in many ways an extension of critical care nursing skills. CRNAs do in fact manage vent settings, but I would not choose that particular aspect of critical care as the best exemplar of the specialty. Critical care by its nature involves the care of complex patients who are either unstable, or at risk of becoming unstable. Surgery deliberately induces patient instability. The number one job in anesthesia is to maintain that balance, and provide the patient with stability. Yes, our job also involves providing an environment of analgesia, amnesia and immobility. But the priority is always patient stability-safety first. And we are charged with maintaining that stability regardless of what happens. The patient may already be near death, with multiple systems involved-we have to manage all of them and do our best to restore health. Or the patient may be 100% healthy to begin with. One might think that patient safety is easier in this setting, and sometimes it is. But the nature of surgery and anesthesia is that anything can happen to any patient at any time. It is often the unexpected emergency, that occurs in a routine case, involving a well patient that is the most challenging to manage, and where anesthesia really proves their value, and earns their money (see, I actually made a connection to the original thread!). Most definitely, there is a connection between critical care nursing and anesthesia. Critical care nursing is a great background to become a nurse anesthetist. It is not the only path to nurse anesthesia, and it is possible to become a great nurse anesthetist having a different background. But nurses who do not like critical care, and/or are not good at it, are very likely not suited for anesthesia. loisane crna

I know of ZERO CRNAs who feel like they are stuck in a job forever that they do not like. No CRNA ever wants to give up anesthesia. It just doesn't happen. Of course, there are ways to build on your career, and advance in your profession. You can become active in your state association, run for office, become state president. You can develop your management skills, and become chief of your department. You can become an entrepreneur and start your own business. You can teach nurse anesthesia students, clinically in the operating room, or as a didactic classroom instructor. You can participate in research activities. You can advance your education by earning a doctorate degree. If you think nurse anesthesia is a dead end job, you do not have a realistic picture of it. Wait until you get there, to see what you really think. I entered nurse anesthesia because I was tired of the same old thing, and I wanted new challenges. That was several decades ago, and I still feel just as excited and stimulated by my work as I did when I started. With all these opportunities, why would I even consider changing paths to enter medicine? If I wanted that, I would have done it in the first place. loisane crna

I know this post is a little old, but I had to comment. I am a CRNA, and am more familiar with that allnurses forum, but I was just browsing through this area today. The use of sniffing an alcohol pad has been researched, and the results published. It was found to be as effective for PONV (post op n/v) as a dose of anti-emetic drug. Sorry I don't have the reference. It was probably in the AANA journal. This is a low cost, low risk alternative to medication. It is catching on, since there is at least some evidence based practice behind it. Probably needs replicated with larger studies, but I am sure we will see more of this. loisane crna

None of the 50 states require a MSN to practice as a CRNA. Many require a masters, but it does not have to be in nursing. West Virginia and Puerto Rico require a MSN to be an advanced practice nurse. WV CRNAs do not have to meet this qualification to practice as a CRNA. All states have requirements regarding prescriptive authority for nurses. Prescriptive authority is not a part of usual nurse anesthesia practice. A prescription is given to a patient for a third party to dispense the medication. CRNAs do not usually do this, except for those involved in pain clinics or writing their own pre or post op medication orders, for the patient to have filled at a pharmacy. Those CRNAs would need prescriptive authority. To give anesthesia in an OR, where the CRNA admisters the medication themselves, does not require prescriptive authority. There has been alot posted on both these subjects through the years here. A search would give you lots of information. Or better yet, ask an experienced, working CRNA. loisane crna

[quote=ICUMindy 'Advanced practice nurse' means a registered nurse with a Master's degree or higher in a nursing specialty and national specialty certification as a nurse practitioner, nurse anesthetist, nurse midwife, or clinical nurse specialist." (bold face per AANA)..... Info obtained from AANA website :State Legislative and Regulatory Requirement This is a common misconception, which is why I feel compelled to continue to address this until it is very clear. "A Master's degree or higher in a nursing specialty" does not require that the degree be a MSN. There are several other degrees that will qualify. I repeat, a current graduate of any accredited nurse anesthesia program is qualified to obtain a license and practice as a nurse anesthetist in any of the 50 states (assuming meeting certification requirements). If the national AANA website is less than clear to those of you who need this information, I suggest you contact someone from the state association where you are interested to practice. They will have direct knowledge of how their state operates. I live in a state which, on superficial reading, many assume requires a MSN. I can assure you that is not the case, and new graduates who hold other degrees will have no trouble working here as a CRNA. loisane crna

This is a little misleading. CRNAs who graduate from an accredited program are able to practice in any of the 50 states. It does not matter what your master's is in. About half the programs grant a nursing degree, the other half in another area. Please visit aana.com for the most up to date information on state practice regulations. loisane crna

This thread saddens me. In my day the CRNAs brought food in for the students. I remember many a call night when the team ordered out and refused my offer to pay. Everyone knew students were on limited income and there was a feeling that helping them was a professional courtesy. What a shame things have reversed. My current clinical site doesn't have students. But you can bet that if I get a chance in the future, I'll do what I can to reverse this trend and restore the "good old days". Maybe some of you soon-to-be CRNAs will consider doing the same. loisane crna

It is possible to be a failure at 90 questions. The essential element is the difficulty of the questions at the end of the test. If they were getting harder, that meant you were answering right and getting progressively more difficult questions, and will probably pass. OTOH, if the questions were pretty easy, that means you are answering incorrectly and the computer is giving less difficult questions to establish where your score should be, and it leans more toward a failing score. (BTW, I completely agree that you sounded well prepared, and don't mean to imply I think you failed. Just sharing what I know about the test). I know people who swear this is true, and that it worked for them. I have read posts here from those who say it did not work for them. Seems like worth a try to me, although I think you are right, it will only make a difference of a day or two. loisane crna