February 22, 2010

Letter: Nurse anesthetists say their record is excellent

To the Editor:

Despite the abundance of information and commentary in the Racine media about Wheaton-Franciscan’s recent decisions involving its anesthesia department, several critical pieces of information about nurse anesthesia somehow continue to elude coverage. All of these facts are easily confirmed through any number of sources, including the Federal Register, Wisconsin state law, published research, and more.
  • In 2005, Wisconsin became the 14th state since 2001 to “opt out” of the federal physician supervision requirement for Certified Registered Nurse Anesthetists (CRNAs). What this means is that in Wisconsin, for nearly five years now, nurse anesthetists do not need to be supervised by a physician while providing anesthesia care to patients. A state’s right to opt-out of this unnecessary requirement was approved in 2001 by the Bush Administration following exhaustive analysis of the issue by the Centers for Medicare & Medicaid Services (CMS), including a thorough examination of existing anesthesia safety studies. CMS concluded that the studies show there is no difference in the quality of care provided by CRNAs and anesthesiologists.
  • Many facilities in Wisconsin, particularly in the state’s vast rural areas, do not require physician supervision of the nurse anesthetists who typically are the only anesthesia professionals working there. CRNAs enable these facilities to provide surgical, obstetrical, and trauma stabilization services, otherwise citizens in these communities would have to travel great distances for necessary healthcare. Why don’t anesthesiologists work in these medically underserved outposts? Because the big bucks are to be made in urban/suburban centers such as Milwaukee and Racine.
  • There is no federal requirement that nurse anesthetists must be supervised by an anesthesiologist, nor is there any such requirement in Wisconsin state law.
  • Nurse anesthetists are the hands-on providers of more than 32 million anesthetics each year in the United States, and according to the Institute of Medicine, anesthesia is nearly 50 times safer than it was in the 1980s.
  • Nurse anesthetists work collaboratively with physicians of all kinds on a daily basis, including surgeons, dentists, podiatrists, and anesthesiologists. For that matter, so do anesthesiologists. Anesthesia isn’t provided in a vacuum, it is provided for a reason—surgery and other procedures, delivery of a baby, trauma stabilization. There are always physician specialists involved in these scenarios.
Individual facilities such as Wheaton-Franciscan have a choice of going beyond the CMS rules and requiring physician or even anesthesiologist supervision of nurse anesthetists. However, such a requirement does not mean greater patient safety, just greater costs. The facts speak for themselves.

Wanda Wilson, CRNA, PhD
Executive Director, American Association of Nurse Anesthetists

17 comments:

  1. My parents had a saying for the above commentary....

    "Self praise is no recommendation"

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  2. So they say their record is excellent. Big surprise there! What the hell else are they supposed to say?

    Breaking news: When asked about safety, Toyota says their record is excellent.

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  3. "I'm an excellent driver."

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  4. Uh, Wanda....you do realize that we know you are a paid spokesperson of your organization right? Your job is PR, not objective thought and therefore you cannot be trusted to tell us the truth when it is not in your organization's self interest.

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  5. Pete and Dustin - why not find out how many malpratice suits have been awarded or are pending against these nurses. A good place to start is the Wisconsin Department of Licensing and Regulation site under complaints.

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  6. The people that built the Titanic said it was unsinkable too.

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  7. Wheaton has a full-time PR machine working. That is a clear sign that they know they are in trouble. Full page ads telling us how good they are along with manufactured news are all signs of an organization in spin mode.

    Mt Pleasant is the same way over the village hall. They have to shine up their bad actions that will end up costing us over $25 million to relace the village complex.

    I mention Mt Pleasant because both organizations are in full spin mode behaving very much the same related to having to be in full-time PR mode to cover their tracks.

    I hope the Post stays on both organizations to make sure the truth gets out.

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  8. I'm glad that the people that will financially benefit and be employed by this move have endorsed it as a great idea. I feel relieved! Thanks for clearing that up!

    No worries here...those doctors that were concerned didn't know what they were talking about because they weren't the nurses that were going to be hired.

    I hate to admit it, but I almost started thinking for myself! I'm glad the Wheaton PR machine stopped me in time!

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  9. This almost put me to sleep.

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  10. "Nurse anesthetists are the hands-on providers of more than 32 million anesthetics each year in the United States, and according to the Institute of Medicine, anesthesia is nearly 50 times safer than it was in the 1980s."

    Did you catch that one people? 50 times safer than it was in the 80's. That should make you feel really confident about their skill. What is 50 times better than really, really, really, really bad anyway?

    And here is another truth gem:

    "There is no federal requirement that nurse anesthetists must be supervised by an anesthesiologist, nor is there any such requirement in Wisconsin state law."

    In other words, the only way we're getting away with this is that the State government hasn't regulated it yet.

    And then there is this!

    "CMS concluded that the studies show there is no difference in the quality of care provided by CRNAs and anesthesiologists."

    There you have it folks. We don't need MD anesthesiologists. The profession is essentially a waste of time. What they can do the nurses can do just as well if not better. How do we know this? A survey. AND! The fact that rural communities get by with what they have. It isn't that the rural communities would prefer and MD anesthiologist, but can't get one - no way!

    Thanks for the letter but if you don't mind, please take this turd somewhere else. It defies common sense.

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  11. OK, if you are using this quote to win us over, then I suggest trying again.

    "requirement was approved in 2001 by the Bush Administration"

    Now I really don't trust it.

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  12. 1:05 - well put. And if anyone can do it, why do anesthesiologists pay some of the highest malpractice premiums.

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  13. It's fun reading the negative comments from all the "anonymous" posters. Guessing most of them are doctors...

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  14. 5:56 - guessing "NOT".

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  15. "Many facilities in Wisconsin, particularly in the state’s vast rural areas, do not require physician supervision of the nurse anesthetists"

    I wonder why? Could it be THAT THERE AREN'T MANY ANESTHESIOLOGISTS IN RURAL AREAS? Maybe because, I don't know....they're RURAL.

    If the State made a law that required supervision of nurses by an anethesiologists, then what would happen in rural areas that don't have one? Do you think we are that stupid?

    The reason there is no rule doesn't equate to nurses are awesome, it was just a matter of practicality.

    I think the person who wrote this is clinically insane.

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  16. If the nurses are so good why do we need doctors to do the anesthesia? Maybe we should have nurse surgeons too? In fact maybe the entire health system at All Saints can be replaced with nurses because I am sure someone has done a study to show that the care is no worse when nurses are looking after you.

    My personal opinion is that nurses are good at following a set of instructions but totally incapable of independent thought. Works great in most situations but when s#$t hits the fan I want a doctor with a brain and not a nurse with a cookbook.

    Going back to high school, I do not remember if anyone in the top 10% of my class wanted to become a nurse. I have done some research and found that 90% of all doctors graduated in the top 10% of their class. Totally reverse for nurses. 90% of nurses graduated in the middle of their high school class. Go figure! I know who I would want doing my anesthesia!! I betcha Wheatons are laughing all the way to the bank!!!!

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  17. Hey where's the Dr.? Oh, he's out having a cigarette - not to worry we have a nurse - maybe we should just fire the Dr.

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