gasgodess said:
The New York State Health Department writes regulations to regulate hospitals in the state. One such regulation is the New State Hospital Code. Section 405 of the Code deals with anesthesia services provided in hospitals.
In the Code is the only place where the practice of nurse anesthetists is described. Provisions authorizing CRNA practice are the following.
405.13 Anesthesia Services (a)(1)"
. Anesthesia shall be administered in accordance with their credentials by the following:
(iv) certified registered nurse anesthetists (CRNAs) under the supervision of an anesthesiologist who is immediately available as needed or under the supervision of the operating physician who has been found qualified by the governing body of the medical staff to supervise the administration of anesthetics and who has accepted responsibility for the supervision of the CRNA; "
According to a February 1, 1989 letter from Dr. David Axelrod (then the NYS Commissioner of Health) to all hospital administrators in New York, the regulation does not require that supervisory physicians be able to perform the specific activities they supervise. Further, it was the Commissioner's opinion, the regulation does not affect the respective legal liabilities of operating physicians and CRNAs.
Very good point mw, but it is also followed by this, for office based care anway. With all of these rugualtions. Although not explicitly stated, the only physician's who really do this in the real world are anesthesiologists, practically anyway. It is possible that other docs get CME training, but not very plausible.
Would've have been better to just PM me, but since you want to copy and paste webpages onto this site here it goes. This was as of 1997.
Anesthesia should be administered only by a licensed, qualified and competent practitioner. Registered professional nurses (RNs) who administer anesthesia as part of a medical, dental or podiatric procedure (including but not limited to CRNAs) should have training and experience appropriate to the level of anesthesia administered, and function in accordance with their scope of practice. Supervision of the anesthesia component of the medical, dental or podiatric procedure should be provided by a physician, dentist or podiatrist who is physically present,
who is qualified by law, regulation or hospital appointment to perform and supervise the administration of the anesthesia and who has accepted responsibility for supervision. The physician, dentist or podiatrist providing supervision should: 1. perform a preanesthetic examination and evaluation; 2. prescribe the anesthesia; 3. assure that qualified practitioners participate; 4. remain physically present during the entire perioperative period and immediately available for diagnosis, treatment and management of anesthesia- related complications or emergencies; and
5. assure the provision of indicated postanesthesia care.
This has caused controversary as of late and have been the reason for the lawsuits, because it implies that an anesthesthesiologist be on site as well.
Anyway, all of this is says nothing anyway. Truth is anesthesiologists will need CRNAs just like CRNAs need anesthesiologists. Anesthesia related topics are becoming more prevalant in the media and in the end the public will decide. I believe that the layman will actively choose to seek out an anesthesiologist for their care based on fear of their outcome given the increased coverage. So in the end I don't this debate really matters. The CRNA's field won't die and neither will anesthesiology. There is more than enough room for both of us.