Shinseki Resigns. VA CRNAs Dreams of Independence Dashed

[Consigliere]

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Woohoo!

 

[deleted126335]

don't count your chickens. There was a setback in Minnesota this week.

 

[DermViser]

Woohoo!

http://www.asahq.org/For-Members/Ad...ress-Regarding-Nursing-Handbook-while-VA.aspx

Wow, absolutely disgusting on Shinseki's part.

 

[BuzzPhreed]

Don't shed any tears for Shinseki. This is what happens when you let a four-star career general with no medical background try to run the largest governmental healthcare agency. People are getting a firsthand sight of what a single-payor government run system will look like.

I love the idealists who think that you just provide healthcare to everyone and suddenly the population is going to be healthy and everyone will be happy and run to their doctors. It's a f**king fairy tale. They obviously know nothing about human nature, nothing about human health, and nothing about the saying "you can lead a horse to water but you can't make him drink." I hope people are paying attention and taking notes on this. This is ultimately what Obama wanted for the whole country.

In the meantime all the do-gooder idealists are going to be sitting around scratching their heads and saying it was obviously not an inherent problem with the system just the people running it. But for any of you who ever worked in a VA hospital (myself included) none of you were surprised by any of these so-called "revelations" were you? This ****'s been going on for decades. Fact is when you pay people peanuts and give them no incentive not to be lazy, guess what happens? This! Welcome to socialized medicine. The VA is the paradigm.

 

[Consigliere]

don't count your chickens. There was a setback in Minnesota this week.

What was that setback? Independent CRNA practice? Whatevs.....all 50 states soon.

 

[deleted126335]

What was that setback? Independent CRNA practice? Whatevs.....all 50 states soon.

"On May 13, Minnesota Senate file 511 became law (Chapter 235) removing existing requirements for Advanced Practice Registered Nurses (APRNs) to practice within the relationship of a physician. Under the language, collaborative management will no longer be required of nurse anesthetists providing anesthesia care.

The Minnesota Society of Anesthesiologists (MSA) fought the measure from its inception with a coalition of physician groups including the state medical society, family physicians, pain physicians, and others. The political dynamics of the legislature, weighed heavily by the state’s rural geography and a vocal state school of nursing, eventually prevailed and patient safety was substituted with an “access to care” law"

 

[Baller MD]

"On May 13, Minnesota Senate file 511 became law (Chapter 235) removing existing requirements for Advanced Practice Registered Nurses (APRNs) to practice within the relationship of a physician. Under the language, collaborative management will no longer be required of nurse anesthetists providing anesthesia care.

The Minnesota Society of Anesthesiologists (MSA) fought the measure from its inception with a coalition of physician groups including the state medical society, family physicians, pain physicians, and others. The political dynamics of the legislature, weighed heavily by the state’s rural geography and a vocal state school of nursing, eventually prevailed and patient safety was substituted with an “access to care” law"

Terrible...

 

[aneftp]

"On May 13, Minnesota Senate file 511 became law (Chapter 235) removing existing requirements for Advanced Practice Registered Nurses (APRNs) to practice within the relationship of a physician. Under the language, collaborative management will no longer be required of nurse anesthetists providing anesthesia care.

The Minnesota Society of Anesthesiologists (MSA) fought the measure from its inception with a coalition of physician groups including the state medical society, family physicians, pain physicians, and others. The political dynamics of the legislature, weighed heavily by the state’s rural geography and a vocal state school of nursing, eventually prevailed and patient safety was substituted with an “access to care” law"

Does this even matter in anesthesia? Didn't Minnesota opt out a long time ago?

And the collaborative management is a farce if you think a surgeon is "directing anesthesia or collaborating" with independent Crna anyways in many rural areas.

 

[deleted126335]

Does this even matter in anesthesia? Didn't Minnesota opt out a long time ago?

And the collaborative management is a farce if you think a surgeon is "directing anesthesia or collaborating" with independent Crna anyways in many rural areas.

Every little bit helps. The collaborative management requirement is one liability hook for the surgeon that is no longer there. Every little bit helps.

 

[aneftp]

Every little bit helps. The collaborative management requirement is one liability hook for the surgeon that is no longer there. Every little bit helps.

I understand.

However, until the ASA can prove the CRNAs (especially the much younger ones with much less experience than the younger anesthesiologist). Until the ASA can prove to the public CRNAs are a liability in higher risk cases, the AANA will keep chipping away.

What does this involve? It's easy. Anesthesiologist at major tertiary hospitals must demand that transfers from rural hospitals state on their transfer form they aren't equipped to handle complex cases. We aren't refusing care. We want acknowledgement they aren't willing to handle the complex cases.

This makes it easy to sell to the public. That rural CRNA only practices can't handle complex cases. That they can hide their quality data by punting the higher risk cases away and cherry pick. The public will understand that more.

 

[deleted480308]

...or you get surgeons to hire only docs for gas as their surgery centers and work with hospital management to require doc supervision too...legal permission doesn't mean anything if no one will hire you.

the more nuclear option is to get all the anesthesiology docs together and refuse to supervise nurses or simply leave the state in protest...with no one around to do the complicated cases, they'll be forced to reconsider. The trick is that you would all have to do it, if only most of you do...all that you ensure is the scabs get rich