Bill Would Ensure Quality Care Response:
On behalf of the TN Association of Nurse Anesthetists and over 1800 Certified Registered Nurse Anesthetists CRNA's) represented in the state of TN, it is evident that there is an inherent lack of knowledge in regards to the scope of practice for nurse anesthetists. First, every CRNA is required to receive training in pain management including both didactic and hands-on experience as per the requirements set forth by the Council of Accreditation (COA) and for those who specialize in Pain Management; a post graduate fellowship in Pain Management is usually completed. Second, each CRNA must pass a national Board Certification Exam in Nurse Anesthesia in order to practice. Third, CRNAs have been providing anesthesia and pain management services safely in TN for more than 100 years.
In response to the data referenced by Dr. McCarley’s in his opinion letter, the following should also be noted as well: In the year 2008, CRNAs, NPs, and PAs performed only 5,813 facet injections (13%) while TN physicians performed 38,877 facet injections (87%). In 2009, CRNAs, NPs, and PAs performed 7,599 injections (16%) while Physicians performed 39,402 facet injections (84%), and in 2010 CRNAs, NPs, PAs performed only 6,126 (14%) facet injections while Physicians performed 37,051 facet injections (86%). Clearly CRNAs, NPs, and PAs are only performing a small fraction of the Pain Injections within TN. It should also be noted that research into why physicians are performing such a disproportionate number of injections has not been evaluated.
After analyzing HB1896/SB1935, the public should be informed that CRNAs have an unblemished safety record with NO complaints recorded with the Board of Nursing or Department of Health in regards to care by CRNAs providing Interventional Pain Management Services. Recently the Federal Trade Commission (FTC) commented on this bill stating, “We are unaware of evidence that the licensed physicians and APNs subject to new limits under the Bill – acting within their respective scopes of practice – increase the risk of harm to patients. Nor have we seen evidence of systematic failure in the current supervision and collaboration arrangements between physicians and APNs.” In conclusion the FTC made the final statement in regards to HB1896, “Absent evidence of specific safety issues, however, staff recommends that the Bill be rejected, because it is likely to raise costs and limit access to health care.” The Tennessee Association of Nurse Anesthetists agrees with the FTC in their summation of the current proposed legislation.
The reason that Tennesseans need to vote NO to HB1896/SB1935 is that this bill will significantly reduce access to care as CRNAs are the only anesthesia provider in 39 of the 95 counties within TN. The TANA will continue to be an advocate for Tennesseans.
Mark J. Haffey CRNA, MSN, APN
TN Association of Nurse Anesthetists(TANA) Public Relation Committee Chair