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Old 07-20-2012, 09:19 PM
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Default Colorado Court: Nurses Can Provide Anesthesia

DENVER (AP) — "The Colorado Court of Appeals ruled Thursday that advanced-practice nurses can administer anesthesia without a doctor’s supervision, a ruling the prompted a warning by doctors that patients could suffer serious medical complications and receive inadequate care.
The court ruling came in response to a lawsuit filed by the Colorado Society of Anesthesiologists and the Colorado Medical Society seeking to stop the change".

"Hospitals said the move was necessary because there aren’t enough doctors, and the crisis will only get worse as the country adapts to new health care laws that open the doors to millions of new patients".

“This definitely affects patient care,” Clark said. “There is a danger of cardiac arrest and neurological injury while using anesthesia. We should focus on the patients rather than lowering the standard of care by taking physicians out of the equation.”

"Hospitals say the ruling will not jeopardize patient care, and cutting costs will help patients. The practice has been approved by state officials. The lawsuit came after the Colorado Medical Board and Colorado Board of Nursing recommended the state opt out of a provision of the Social Security Act that required surgical centers, hospitals and other facilities to provide doctor supervision for certified registered nurse anesthetists".

Federal law allows states to opt out by sending a letter to the Centers for Medicare and Medicaid Services signed by the governor in consultation with regulators attesting that the new policy is in the best interest of citizens and consistent with state law".

"Fran Ricker, executive director of the Colorado Nurses Association, which represents 1,400 of the 50,000 nurses across the state, said the ruling will improve patient care, especially in rural areas where anesthesiologists are in short supply and specially trained nurses can fill the void".

“It’s impossible to comply with the current law because some hospitals have no anesthesiologist in the first place,” she said.
"Doctors say Colorado law has long held the surgeon to be the “captain of the ship” in the operating room and responsible for supervising everyone, including a nurse anesthetist when an anesthesiologist is not available. Doctors say they will now be held responsible for the actions of practitioners they do not control".

"Kari Hershey, attorney for the Colorado Medical Society with 7,000 members statewide, said the ruling doesn’t make sense because surgery can’t begin without a surgeon"
.
“We work best in partnership with our nursing colleagues. It needs to be a team environment,” Hershey said".

Colorado Court: Nurses Can Provide Anesthesia ? CBS Denver
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Old 07-20-2012, 09:23 PM
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I absolutely would not do any sort of anesthesia as an advanced practice nurse. I think the idea is craziness.
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Old 07-21-2012, 04:42 AM
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What patient would let an advanced practice nurse put them to sleep with out a Dr present? Heck to the no I think that opens up law suit city and loss of the APN's license. Stoopid ruling if you ask me!
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Old 07-21-2012, 06:59 AM
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Maybe I'm making an incorrect assumption in re: what they are referring to when they say APN in the article....I took that to mean a CRNA who has received training in the field, and are willingly taking the risk associated with administering anesthesia. I did not take it to mean just any random APN would be putting people to sleep now.

That being the case, I don't see it as such a big deal....CRNAs can and do do this every single day, and their outcomes have been shown to be no worse than an anesthesiologist. it releases the CRNAs from the requirment of having a supervising anesthesiologist on site....and I'm not sure how it goes in other areas, but here in IL that collaborative practice agreement is more about money & power......probably because the AMA is based in Chicago.

All politics aside, this has the potential to improve access to care and reduce expenses, and, as already stated, will have no effect on patient safety.......I'm not understanding how that is a bad thing, assuming we are talking about appropriately trained individuals.

If I'm way off on the gist of the article....let me know. Maybe I need more ....
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Old 07-21-2012, 07:13 AM
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You are correct Dria they are talking about CRNAs who are trained in administering anesthesia.
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Old 07-21-2012, 08:33 AM
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I have had a CRNA administer my anesthisia before (just the person who got assigned to me...told me in pre-op day of).

I actually had no problems
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Old 07-21-2012, 09:41 AM
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My last surgery I had a CRNA no problems.
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Old 07-21-2012, 03:45 PM
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Everyone who is anyone in nursing these days wants to be a CRNA. The game is going to change for them though. They are really going to earn their pay if others follow suit with this ruling.

A lot of nurses are going the CRNA route for the earning potential (not starting a calling vs. its a job debate, but this is a fact) and because its considered prestigious.

Its no secret most healthcare facilities consider every penny they put towards nursing care a waste, a debt with no return on the investment. Hence the deliberate short staffing, constant nipping away at benefits and adding responsibilities to already overworked staff.

They don't want to cut the pay of the CRNAs so, instead, they play a "wolf in sheep's clothing" game with them and make them more vulnerable to being accountable when something goes wrong. They'll insist they are giving nurses more "autonomy" and respect their ability to practice without "physician supervision". But, in the end, the only thing it means is.........if something goes wrong, they can throw the nurse under the bus without sacrificing the "supervising physician" along with them.

Its been this way for clinical nurses for a long time now. The day and age in which going to court with a "I did what the doctor ordered" defense is acceptable are long gone. Now it will be for the CRNAs too.

Its just more double talk and two faced maneuvers by the politicians/healthcare administration. They will in one breath say nurses are overpaid techs who need to learn to smile while changing bedpans.......and in the very next breath support a ruling such as this one that states they can perform very complicated procedures (which used to be reserved for physicians alone) without supervision.
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Old 07-22-2012, 12:13 PM
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My Godmother made a career out of it... back then it was only one more year of training over the Diploma RN. Everyone keeps trying to talk me into going this route, but I'm just not sure.... I just know I don't want to be a floor nurse for the rest of my career, and I don't want to run a unit either....
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Old 07-22-2012, 02:44 PM
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Im just gonna say (a little off topic) The OR is different from the floor your patients are asleep mostly and one patient at a time. Plus no familys to deal with. It is a 6 month orientation for the OR because there is lots of things you need to learn that is not taught in school unless you take a perioperative course. I like when I get a chance to scrub in even if it is only to hold retractors. Although one time I had to first assist a c section until the 1st assistant got there. That was interesting and kinda scary carrying a wet slippery baby to the bassinet. I walked like an old women and I have held/carried newborns in the past but its different right out of mama. I love the OR but have no desire to become a CRNA way too much responsibility for me. I work with a lot of good CRNAs that could do it on their own sometimes better than some MDAs.

Dont forget the OR as a choice kylee it might be your niche.
Lisa
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