Certified Registered Nurse Anesthetists (CRNAs) are anesthesia specialists who administer approximately 65% of the 26 million anesthetics given to patients each year in the United States. CRNAs are the sole anesthesia providers in approximately 50% of all hospitals and nearly 70% of the rural hospitals in the United States (Foster, Jordan, 1994).
CRNAs provide anesthetics to patients in collaboration with surgeons, anesthesiologists, dentists, podiatrists and other qualified healthcare professionals. When anesthesia is administered by a nurse anesthetist, it is recognized as the practice of nursing; when administered by an anesthesiologist, it is recognized as the practice of medicine (Council on Accreditation of Nurse Anesthesia Educational Programs, 1994).
Recently, the American Society for Anesthesiologists Political Action Committee ran an extensive campaign regarding the independent practice of CRNAs and the quality and safety of care provided to Medicare patients. They were attacking a decision that was made this summer by Governor Jeanne Shaheen to protect local access to healthcare and avoid disruption in services available in rural New Hampshire communities. It's been framed by some as a turf war and an issue of safety, but the real issue is preserving access to local healthcare. Healthcare professionals from hospitals around the State continue to support the Governor's decision, which was to opt-out of federal regulations surrounding physician supervision of Certified Registered Nurse Anesthetists (CRNAs) (Waugaman, Foster, Rigor, 2002).
Managed care plans recognize CRNAs for providing high-quality anesthesia care with reduced expense to patients and insurance companies. The cost-efficiency of CRNAs helps keep escalating medical costs down. Legislation passed by Congress in 1986 made nurse anesthetists the first nursing specialty to be accorded direct reimbursement rights under the Medicare program. A total of 45% of the nation's 28,000 CRNAs are men, versus approximately 5% in the nursing profession as a whole (Seneman, 1993).
Nurse....
