thezman

Addiction are chronic progressive often fatal if untreated brain diseases that originate in a complex inferface between the addicts genome and their exposures. Other that "maybe" their first exposure there is nothing akin to free will involved. There is OVERWHELMING neuroscience that demonstates how actual morphology (dendritic sprouting ) occurs with addictive drug exposure. First PRIMITIVE reward pathways in the midbarin are subverted and the actual wiring to the orbitofrontal cortex changes and decision making becomes globally impaired around drug craving and seeking. You only need to step back from the emotionality and judgements and look at the behavior squarely to recognize that the decision making of the addicted brain is irrational and often frankly insane at least by Einstein's defintion of insanity. All of these studies are freely available from the NIDA website at http://www.nida.nih.gov/nidahome.html As health care professionals we have a unwavering responsibility to look at the science and not in the myths and stigma that keep our colleagues from recovery. We owe them at least as much compassion and support with their struggles with these horrendously malignant diseases as we do our patients! If you truly want definitive references on the current science feel free to visit the AANA' Peer Assistance and Wellness Webpages at: AANA - Peer Assistance Homepage Best regards, Art Zwerling

BTW, Art Zwerling is an unpaid volunteer Peer Assistance Advisor as are all of the Peer Assistance Advisors. A great deal of the work of the AANA is done by unpaid volunteer SRNA/CRNA members. As others have so clearly demonstrated our dues are truly a minuscule amount of $ compared to the benefits we get as AANA members! Best, Art

The AANA is already one of the most cost effective professional organizations I know of. I certainly know of no other member driven organization that has done as much to protect the scope of practice of APNs and advocate for professional development of it's membership. I would suggest that you attend the Mid Year Assemby in April In Washington and get a copy of the Treasurer's Report Mid-Year Assembly Monday, April 20, 2009 Registration | Sunday | Tuesday | Wednesday Morning Session 0 CE Credits 7:00 a.m. - 5:00 p.m. Registration 7:00 a.m. - 8:00 a.m. Meet the Candidates "Early Bird" Coffee Coffee 8:00 a.m. - 8:30 a.m.AANA President's Report Jackie S. Rowles, CRNA, MBA, MA, FAAPM 8:30 a.m.- 8:40 a.m. AANA Treasurer's Report Lawrence R. Stump, CRNA, MEd 8:40 a.m.- 8:45 a.m. Introduction of 2009 Slate of Candidates 8:45 a.m. - 9:45 a.m. Board of Director Candidates Position Statements 9:45 a.m. - 10:15 a.m. Meet the Candidates You may then want to introdruce a resolution at the Annual Business Meeting that suggest more cost saving fiscal policies. I am sure the AANA Leadership including Mr Stump would be most interested in hearing your concerns. Best regards, Art Zwerling

For those who have doubts about the cost- effectiveness of AANA membership, please take a look at your tax returns and benefits packages. Given the intense battles raging on with organized medicine around territoriality, scope of practice of APNs, and our future place as the anesthesia providers of choice, I find my AANA dues the biggest bargain imaginable. There are many reasons we run over a 90% participation rate in our professional organization, a huge one is the relative bang for our bucks! My dues for the ANA, ENA, and AACN, have never provided the depth and breadth of return that my very reasonable AANA dues have. Best regards, Art Zwerling

The science behind the use of NMDA receptor blockers is that LTP (long term potentiation) of pain transmission at the dorsal horn is predominately mediated by glutamate activity. There is some compelling evidence that acute pain states that persist can induce neuroplasticity (actually new dendritic/synapses sprouting in this case) that sets up a chronic pain state. Best, Art Zwerling

All, Just to clarify a few issues: 1.HB 1256 is very much alive in PA, please stay tuned to the PANA Wesite at http://www.pana.org/top.asp There will soon be a white paper released that will clarify the history and issues that PANA faces in moving this legislation forward. 2.Please don't be fooled by the political rhetoric of the PSA/ASA the conflict is purely about control of anesthesia maketplace revenues. 3. I really do believe bringing the issue of my being in recovery is a pretty detestable cheap shot, particularly given the incidence of chemical dependency in anesthesia. 4. Regardless of my staunch opposition to the ASA/PSA assaults on CRNA practice in PA the PANA will continue to advocate for all CRNAs in PA. I have elected to remove myself from the equation so that we can all focus on principles rather than personalities. 5.Each and every time a nursing organization/group comes under fire and begins acting like a repressed group by circling the wagons and shooting inwards we do ourselfs a grave disservice. While the group is busy being in chaos and dissarray, the opposition gains tremendous power to subvert the mission of the organization which is to advocate for all of it's members. 6. For those who want to find out the reality and be part of the solution, please get involved with PANA and support the efforts of the BODs to get our 12 educational programs actively participating in the organization. 7. I hope to see all of you SRNA types involved in your professional organization rather than flaming each other in cyberspace. We need your committment and passion to move forward. Best, Art Z.

There are two fully qualified anesthesia provider types accross the entire spectrum of clinical anesthesia delivery, CRNAs and Anesthesiologists. AAs by design and legislative mandates are fully dependent on anesthesiologist supervision. In many areas of the US CRNAs are autonomous providers that work in cooperation with their sugeon colleagues without anesthesiologist involvement of any sort. This includes full service pain services including interventional and implantables. Contary to the propagana espoused by many in organized medicine there is no federal standard of care that requires anesthesiologist supervision of CRNAs. All there is a CMS regulation pertaining to billing Medicare! To date I believe 12 or so states have opted out of this requirement. Hopefully the remaining 38 will follow. Best, Art

As a CRNA Program, I couldn't agree more. MS nursing has a completely different culture and priority list than Critical Care/Anesthesia. For any new GN with a decent GPA (particularly in the sciences) and decent GREs I heartily recommend you apply directly to a critical care unit ASAP! Best, Art

I'm sure Dr. Kossick had excellent reasons to move to Union University!! He is one of the most ethical and superb anesthesia educators around. you guys really lost a winner! Best, Art

The Program Director is Dr. Mark Kossisk. He is an incredible educator and super guy! Best, Art

You do get what you pay for! The resourses are incredible! Art

Maggie, Yes this is the transition of the Pennsylvania Hospital School of Nurse Anesthesia into Unniversity of Pennsylvania with a May admission and 24 month MSN. Art

Colleagues, The University of Pennsylvania School of Nursing is admitting students to it's Nurse Anesthetist MSN and MSN/PhD programs. Classes begin 5-04. Anyone interested can contact their admissions coordinator, Kari Szensky at [email protected] Best Regards, Art