Scope of Practice

platon20 · Feb 8, 2008

I hear what your saying pal, but I applaud the AANA for stepping in and making any effort to stop AA practice. The same way that the Nursing assoc. should have stepped in to stop PA practice in it's infancy. Unfortunately for NPs they were asleep behind the wheel. Well the AANA is not!!!!! We will not allow the AMA or A$A to back door in another profession to maintain there strangle hold on health care.
Smiley

thats all fine and good. But lets quit playing games and call a spade a spade. The CRNAs are just as greedy as the MDAs are, and these turf battles have absolutely NOTHING to do with patient safety and EVERYTHING to do with fear and $$$$

As long as you are willing to admit that, then I agree with your post 100%

Qwiigley, BSN, MSN, DNP, RN, CRNA · Feb 8, 2008

JWK and PainDoc, Why are you trying to stir the pot on a nursing website?

It would be better to learn from each other and not antagonize the other.

You may be amazed at what other practicing professionals have to offer.

There are so many jobs out there, don't worry about yours going away anytime soon.

When the babyboomers start needing their new hips, we'll all be busier than we can stand.

ready4crna? · Feb 8, 2008

Nowhere in this country are CNM's allowed to do c-sections and that won't change anytime soon.
The Louisiana decision is a major blow. It's not one judge. It went all the way to the Louisiana Supreme Court and they decided that pain management is medicine. If CRNA's want to legally do pain management, they have to change the practice acts. That's like saying CNM's just need to convince the state legislatures to let them do c-sections. Don't hold your breath.

Please provide a citation for the LA supreme court decision. The only decision I am aware of is the district court ruling-http://www.asipp.org/documents/CRNA-Judgment.pdf

Again, a single judges ruling, currently in appeals process unless you have some info on the process completion.

n_g · Feb 8, 2008

Plaintiffs argued that nursing boards circumvented the legislature in order to expand nurse anesthetist scope of practice by adopting “statements.” Additionally, plaintiffs argued that the “statements” were invalid because the documents were not adopted in accordance with administrative procedures. A Louisiana Court of Appeal recently reversed a trial court’s order by ruling that the nursing board’s “statement” constituted a rule that required compliance with the procedural requirements of the Louisiana Administrative Procedures Act (LAPA).
In response to a petition by an individual nurse anesthetist for an advisory opinion on nurse anesthetist scope of practice, the Louisiana State Board of Nursing adopted the following statement....

http://www.asahq.org/Newsletters/2007/02-07/stateBeat02_07.html

n_g · Feb 8, 2008

A Louisiana court recently held that the Louisiana State Board of Nursing’s advisory opinion substantively expanded the scope of practice of a nurse anesthetist into an area where they have not traditionally practiced (i.e. - chronic or interventional pain management). The advisory opinion was issued in 2005 in response to a nurse anesthetist’s request for clarification on this issue. Subsequently, Spine Diagnostics Center of Baton Rouge, Inc brought a lawsuit against the nursing board that, among other things, sought an injunction to prevent the nurse anesthetist who requested the opinion from continuing to perform pain management procedures....

In its entirety:

http://www.asahq.org/news/news011508.htm

n_g · Feb 8, 2008

http://www.lanacrna.com/Modules/PracticeUpdates/PracticeUpdates.aspx

As all know there has been an ongoing lawsuit against the LSBN by Spine Diagnostics Center of Baton Rouge Inc. relative to the LSBN affirming CRNA practice to include interventional and chronic pain management services. This lawsuit is considered by all in nurse anesthesia who work to protect our practice rights as a potentially precedent-setting case that would have far-reaching implications.

I think you were right. This was not the Supreme Court of Louisiana decision. If this decision stands, it will have nationwide impact no doubt. CRNA's are on shaky ground trying to argue that pain is part of their scope and they know it.

Qwiigley, BSN, MSN, DNP, RN, CRNA · Feb 8, 2008

...and they know it...
No, WE know that WE need to fight to keep our current practice. This is a NURSING website, not a MDA website.
I personally do not do pain management nor am I trained to do so. But I can assure you that if I were to decide to get into this, I would take more than a "weekend course."
I welcome your questions and thoughts on this subject, but please be respectful. This is not a website to bash advance practice nurses.
In anesthesia, there is no diagnosing. The surgeon orders the need for anesthesia. He/She relies on the anesthesia provider to manipulate the patient's mind and body to keep them without pain and stable while the surgeon himself does things to the patient that could very well kill him.
Diagnosis is in the "practicing medicine" realm.

allnurses Guide · Feb 8, 2008

...and they know it...
No, WE know that WE Diagnosis is in the "practicing medicine" realm.

Unfortunately, it is not quite that simple because APNs make diagnoses all the time and it is still not considered in the realm of medicine.

For the non-nurses on here it would be nice if you posted your basic background when you start posting on a thread that way everyone knows from the beginning where your educational background comes from and motivation.

Maybe the administration could add a spot under the personal profile to include a few more titles instead of just "other" when you don't have a nursing degree..?

JWK is a pretty familiar figure and we know that he is an AA and PainDoc if I remember right is an MDA that switched to being a pain specialist. N G I have no I idea what your background is, but your posts sounds like a lot of the posts from the SDN....so are you possibly a med student/pre-med student?

n_g · Feb 8, 2008

I guess if people don't tow the line then we shouldn't post our opinions. Honestly, none of our opinions matter. It's in the hands of the courts and legislatures. If I were a betting man, you can guess where I would put my money. The bigger question is how this will impact CRNA's nationwide. I'm just sitting on the sidelines.

allnurses Guide · Feb 8, 2008

I guess if people don't tow the line then we shouldn't post our opinions. Honestly, none of our opinions matter. It's in the hands of the courts and legislatures. If I were a betting man, you can guess where I would my money. The bigger question is how this will impact nationwide. I'm just sitting on the sidelines honestly.

It is usually the more populated states that set precedents, but you never know even a smaller state like La could be the turning point. AANA/AMA/ASA all have powerful lobbying groups so there is no telling where all this will end up, but in the end it will probably be comprises in all the states based on how powerful the lobbying groups are in each of those states. Personally, I am have picked out the most CRNA friendly states that I would eventually like to practice in when I retire from the military, but to each their own.

Now, N G do you care to enlighten us to your educational background?

n_g · Feb 8, 2008

State size has nothing to do with it. It's about precedence. The law and courts follow precedence. They don't want to reinvent the wheel with each case.

allnurses Guide · Feb 9, 2008

State size has nothing to do with it. It's about precedence. The law and courts follow precedence. They don't want to reinvent the wheel with each case.

I would agree with you if this was a federal case, but this is based on state laws not federal. If all the appeals fail in La then it will be a precedent for that state that the ASA will try to use in other states, but it won't have near the impact of say the same thing happening in California or New York.

Now....Would you care to quit "sidestepping" the question and answer what your educational background is?