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RN or Anesthesia responsibility?

CRNA   (2,743 Views | 6 Replies)
by bsunbeam bsunbeam (New) New

847 Profile Views; 9 Posts

I recently started a new job at a small hospital with a 3 bed OR. The personnel is great, very knowledgeable, great to help. The anesthesioligist

on the other hand is a different story. He does know his job but he or any of the other CRNAs every interview the patient except for a brief minute or

two prior going to the OR. It if left up to the OR nurses for the complete

interview. I feel this is wrong. Please let me know if this is acceptable practice.

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SuperSGirl has 19 years experience and specializes in O.R., Endo, Med-Surge, Mgtmt., Psyche.

53 Posts; 2,505 Profile Views

I am a little unclear about what the interview entails but if it directly relates to the care they are giving or if it is their paperwork, I say it is unacceptable.

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178 Posts; 3,103 Profile Views

You may want to post this question to the nurse anesthetist forum.

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314 Posts; 4,085 Profile Views

Sunbeam, we had this problem with one particular md. She never did a pre op interview and ran into so many problems you wouldent believe it. As a team we discussed this problem and decided that for us to interview the patient could have the worst results as our training ect would not cover us. It also seemed wrong to let this lazy person just get away with it. We documented several incidents then went to the persons boss. with the "evidence" we had he had to act and that person retired to the relief of all of us. Its a bad situation.

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394 Posts; 6,020 Profile Views

Pre-op interview, anesthesia consent including risks, benefits, alternatives is standard of care.

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BigDave has 14 years experience.

198 Posts; 2,885 Profile Views

When JCAHO came to our hospital in Feb, I had to go fetch the chief of anesthesia to explain why the anesthesia pre-op checklist/interview wasn't done in a person's chart. He initially tried to tap dance, but in the end, he just had to say "I'm sorry." I don't think the RN is allowed to make the ASA classification or other determinations. Of course, some of this could be done prior to immediately pre-op.

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jwk has 32 years experience.

1,102 Posts; 8,702 Profile Views

If they're not personally doing the anesthesia evaluation, they could be guilty of fraud, an especially nasty problem if dealing with Medicare. If the anesthesiologist is doing the case or if they are providing medical direction to the CRNA's, it is a Medicare requirement that they PERSONALLY perform a pre-operative evaluation. They must certify that they did so both on the evaluation form and/or anesthesia record, as well as the bill they send to Medicare. This is worth pointing out to hospital management, as they would be complicit in Medicare fraud if they knew this was going on and did nothing to stop it.

I can tell you that except in the direst of emergencies, it is not possible to perform a pre-operative anesthesia evaluation in 1-2 minutes. You've got some major-league lazy and unsafe anesthesia staff at your hospital. And although you might think he "knows his job" from a technical skills standpoint, he does NOT truly know his job if he is passing the buck to the OR nurses.

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