Why doesn't Canada use nurse anesthetists?

fergus51 · Feb 15, 2005

Because docs are better at protecting their territory in Canada:) I would love to see more roles for advanced practice nurses, but it's not easy to do. We'd need programs to train them, tests to certify them, nursing boards to monitor them, laws that regulate them, etc....

Missa · Feb 15, 2005

Because docs are better at protecting their territory in Canada:)

I should have known. :chuckle

Even though I think you're right and that it wouldn't be easy to do, I think it would be very worthwhile and beneficial to everyone. The government and the health care system are doing a great disservice to themselves and the population by underestimating the potential of nurses.

fergus51 · Feb 15, 2005

I'm definitely with you Missa. The other area I see it in is midwifery. There are many certified nurse midwives in the US, but I don't know any such programs in Canada. BC only started regulating midwifery as a recognized profession in the late 90s (and they are not nurse-midwives). A CNM costs a lot less than an OB and studies have shown they are just as safe or safer for low risk women, so they could save us just as much as CRNAs.

NorthER,RN · Feb 15, 2005

"The government and the health care system are doing a great disservice to themselves and the population by underestimating the potential of nurses." - Missa

Hi Missa - isn't that the truth!!! The docs in our small ER want an expanded practice role for us - sort of like the government nurses that work alone in the nursing clinics, however it is such a problem to increase our scope of practice. We're very fortunate to have great doctors and enough of them to rotate through ER so that we are always covered, however most small towns are not so fortunate - and our GPs are the ones that do the anaethetist's work in surgery. - Just as with the Advanced Practice RN's - which BC is just starting to work towards, it will take a long time before we move into the expanded practice role. Why not contact your college of nursing in your province and see if they have an answer to your excellent question?

paulacath · Feb 15, 2005

With regards to the comment that Doctors are better at protecting their territory in Canada...I read an article in last few weeks saying that the Cdn Medical Assoc. is pro-nurse anesthetist. So that isn't the holdup...I'm guessing it is more the logistics.

With move towards advance practice roles for nurses I think that nurse-anesthetists and other advanced practice roles are definitely on the horizon. The question of When? still remains....

Fiona59 · Feb 15, 2005

BCTV did a segment on this on one of their newscasts a couple of weeks back. Basically male dr. said something along the lines of I want a dr. looking after my patients not a NURSE with extra courses.

Don't flame me, not my opinion. It just seems that there are a lot of turf wars in Canadian healthcare. Dr's don't want RN's encroaching their turf, RN's don't want LPN's encroaching their turf.

Something has to give, the healthcare dollar will only spread so far..

fergus51 · Feb 16, 2005

I think it's important to note that although the US uses more advanced practice nurses, it hasn't resulted in a cheaper system. They still spend about twice as much as we do on health care per person.

paulacath · Feb 16, 2005

I guess there will always be problems between individual doctors and nurses. Its only natural for people to feel territorial. Takes a very confident person not to. i'm happy hear that some doctors are for it. That's a start...

lalaxton · Feb 21, 2005

Actually U of Toronto was thinking of making anethesia one of the ACNP specialties in their program. In other words one way of using and existing program (ACNP) to get nurses into anethesia. Not sure if they ever decided to go ahead with this.

I agree it's probably logistics that is holding this up, just look how long it's taken for NP's to get going in many provinces. Even in Ontario practice is still quite restricted and held up at every turn by the OMA (Ontario Medical Association).

TEAMACNP · Mar 6, 2005

Missa;

I am not sure if u r in Canada or USA, but my husband is a Canadian transplant in the US who completed both ACNP (CV Surgery/Pulmonary Medicine/ICU) and Nurse Anesthesia Programs. He would love to go back 2 canada to practice but there r numerous issues. Yes, CMA and Provincial Medical Assoc. have too much governmental influence & they stick together. This is in contrast to nrsg (Canadian Nurses don't even agree on APN's Role which is the first hurdle-Canadian RN's must achieve by stick together as one group supporting one another's subspecialties and use this power innumbers as a huge political influence). As for MD's practicing anesthesia (GP's), this is very dangerous practice that most CDN MD's ironically support. After all the training my husband has completed and many MD's (Surgeons, Anesthesiologists, etc) go to him for support and advice. His training was more intense than many medical schools and medical resident programs as proven by one his nursing collegues that attended medical school during my husbands training. My husband ACNP/CRNA actually tutored his medical resident friend for oral board examinations. Just trying to demonstrate how strong most NURSE anesthetists are in the US. Yes, 65% of anesthesia is delivered by CRNA's & the politics are rediculous in the US between the 2 grps. Anesthesiologist report that critical events occur when the CRNA is practicing independently which is foolish. U might hear of 1-3 critical events involving CRNA's (1-3 events of 65% of all US anesthetics is less than a 0.5% problem overall, unlike MD's a 1-3 critical event in the remaining 15% overall is a huge problem....somewhere around 25-30% critical incident when an MD provides anesthesia solely). By and large the best results are when the 2 groups work together and this is what the CDN HealthCare Delivery system needs to focus on. 1 anesthesiologist to 2-4 CRNA's would reduce a lot of the burden Canada experiences currently.

There r a lot of CDN CRNA's working in the USA that would welcome training CDN nurses to practice anesthesia but again CDN Nurses and NRSG programs need to come together to provide the politcal pressure to make this happen. They must overcome the great medical association influence in the political arena and work as a team. These 2 di-poles r not good for the CDN public. Let's face it, the only people suffering r the CDN people. This is in 2 stages, first the quality of health care and the rediculous amount of tax dollars being wasted which is coming from all CDN's wallets. Shame on the gov't for not pursuing these options. Of any country that needs to strengthen APN's is canada.

I could go on and on and on but no time and space. CRNA's could be a reality in CDN, but continuous studies just delay things even more. The stats r south of the border, the AANA for US CRNA's r more than willing to help CDN Nurses get on board, develop education programs, clinical requirements, etc. CDN NRS and NRSG Prgm just need to initiate and attack with force to make it happen. Hope CDN Nrg PRGMs read this e-mail too and really understand the impact CRNA's could make. My husband says the CRNA prgms r very hard but u (and pt's) only benefit from the 32 months of extreme stress u experience during training. He struggled the entire time but ended up scoring in the 100percentile on the national exam, according to his faculty he did not miss a single question on the exam. He teaches in the CRNA progams on a volunteer basis, manages a CRNA group, ...bla bla bla...and he is CDN. So Canada has no reason to say where would u get instructors from becz there r many CDN CRNA in the US just waiting to go home... They won't start anything frm the US becz they r compensated very well frm the US, hence CDN would need to initiate prgms and then extend offers to these high grade people. Or CDN nurses could just say why bother.....the shortage is just as bad in the US, there r greater opportunities in the US for nurses in all aspects of healthcare and u'r living stnds sig'ly impoved compare to CDN. Nurses in USA can develop enormous amounts of autonomy compared to CDN. This is something CDN nurses and CDN gov'ts need to consider in order to keep and attract RN's back to CDN.......Sorry for any errors I am not proofing this at all

lalaxton · Mar 7, 2005

Well said TeamACNP,

The Canadain Nurses Association is trying to bring together the different provincial NP initiatives and even develop a national NP certification exam. You can go to their website and look under the "Canadian Nurse Practitioner Initiative" (CNPI) for more information about it.