Brother Norman Hipps: CRNAs deserve official designation in Pa.

This letter was published on TribLIVE on July 31, 2019

Pennsylvania is home to hundreds of student nurse anesthetists, yet Pennsylvania is one of just two states that fail to officially recognize CRNAs in some form. Because there is no “certified registered nurse anesthetist” title under the state’s Professional Nursing Law, CRNAs are recognized only as registered nurses, not as CRNAs.

This is the second consecutive legislative session that the measure passed the Senate, and the third time the full Senate has approved it. The House will have the opportunity to do the same when it returns to session this fall.

Certified registered nurse anesthetists are critical members of the health care team for everyone who faces the need for surgery. They provide an expert and assuring presence to patients in the moments before surgery begins and are the first to greet them when they awake.

Without formal designation, CRNAs have significant challenges.

Pennsylvania CRNAs who serve in the military must secure designation in another state to provide anesthesia in the armed services because we do not officially recognize CRNAs here. They cannot assist on rapid response teams in states affected by natural disasters because they lack formal credentials.

With 13 nurse anesthetist programs here, Pennsylvania ranks among the top draws nationally for CRNA students. But that could be at risk. Without an official CRNA designation, many graduating students wait as long as six months to get credentialed in out-of-state facilities, as state boards must verify that the students meet the requirements necessary to be classified appropriately there.

CRNAs are the hands-on providers of anesthesia care, operating safely in every setting where anesthesia is administered, including hospital operating and delivery rooms; ambulatory surgical centers; the offices of dentists, podiatrists, ophthalmologists and plastic surgeons; pain management centers and more.

In Pennsylvania, education and clinical training for nurse anesthetists is extensive and requires national board certification. At the Excela Health School of Anesthesia, in partnership with Saint Vincent College in Latrobe, we ensure our graduates are eligible to sit for the national certification examination administered by the National Board on Certification and Recertification of Nurse Anesthetists .

We also provide mentoring and quality experiences that enhance the learning experience through clinical hours as well as simulation experiences that help students grow professionally. Our college currently has more than 20 clinical affiliation sites in the tristate area. We focus on providing students the knowledge and skills they need to develop as competent and safe quality anesthesia practitioners.

The nurse anesthetists we graduate are respected in the field as professionals who are well-prepared and ready to meet the challenges of modern health care.

Professional designation in Pennsylvania would help us achieve our shared mission of keeping patients safe, ensuring access to quality care. It is time to recognize CRNAs for the skills they have and the value they bring to our commonwealth.

Senate Unanimously Approves CRNA Designation Bill; Legislation Sent to House for Consideration

FOR IMMEDIATE RELEASE

CONTACT: Kurt Knaus, 717-724-2866

Senate Unanimously Approves CRNA Designation Bill;

Legislation Sent to House for Consideration

HARRISBURG (June 24, 2019) --- In the final days of legislative session before the General Assembly adjourns for summer, the state Senate today unanimously approved a measure (S.B. 325) that would formally recognize certified registered nurse anesthetists as “CRNAs” under Pennsylvania statute.

Pennsylvania remains one of just two states (New York is the other) that do not recognize CRNAs in some fashion. Under the state’s Professional Nursing Law, there is no official definition for “certified registered nurse anesthetist,” meaning these professionals are recognized only as registered nurses.

The measure, which is sponsored by state Sen. John R. Gordner (R-Columbia), now goes to the House, where Rep. Tarah Toohil is sponsoring a companion measure (H.B. 1064).

“We are so grateful to these legislative champions for all the work they are doing to advance the profession of nurse anesthetists and ensure these advanced practice nurses finally get the recognition they deserve,” said Derek Reckard, president of the Pennsylvania Association of Nurse Anesthetists, which represents more than 3,700 CRNAs and students in Pennsylvania.

These professional designation bills are simple, non-controversial title recognition measures, which is why similar measures have passed in previous legislative sessions. This is the second consecutive legislative session that Gordner’s measure passed the Senate, and the third time the full Senate has approved the measure. The Senate Consumer Protection and Professional Licensure Committee approved the bill June 12.

CRNAs operate safely in every setting where anesthesia is administered, including: hospital operating and delivery rooms; ambulatory surgical centers; the offices of dentists, podiatrists, ophthalmologists, and plastic surgeons; pain management centers and more.

The lack of professional designation brings logistical and financial challenges for CRNAs.

Pennsylvania CRNAs who serve in the military must secure designation in another state to serve as an armed forces anesthesia provider because the commonwealth does not recognize CRNAs. Pennsylvania-based military CRNAs pay more traveling out of state to obtain credits or meet other legal requirements to stay licensed and credentialed. They also pay more out-of-pocket expenses renewing multiple licenses.

Pennsylvania CRNAs also cannot assist on rapid response teams in states affected by natural disasters because they lack the formal credentials.

Moreover, with 13 nurse anesthetist programs here, Pennsylvania ranks among the top draws nationally for CRNA students. But that leadership position in education and training is at risk once students realize they face hurdles to getting credentialed after graduation.

After receiving training in Pennsylvania, many CRNAs relocate to states where they are fully recognized and credentialed for clinical practice, contributing to “brain drain.”

“The time is now to finally get this bill over the finish line,” Reckard said. “Every CRNA in Pennsylvania is committed to working with members of the House of Representatives to help them understand how important this bill is to keeping patients safe, ensuring access to quality care and reigning in rising health-care costs.”

Learn more about CRNAs in Pennsylvania at www.PANAforQualityCare.com. Additional details are available via Twitter at @PANACRNA and on Facebook at www.facebook.com/PANACRNA.

Pa. CRNA among Prestigious Fellows at Penn

Ji Su (Jenny) Kim graduated May 20 from the University of Pennsylvania’s Doctorate of Nursing Practice Program after serving her final year as a fellow of the prestigious Barry & Marie Lipman Family Prize. Only 16 students receive a fellowship each year.

The prize celebrates leadership and innovation in the social sector with an emphasis on impact and transferability of practices, and in finding ways to resource and connect change-makers to bring innovative ideas to new places and solve problems around the world.

Kim came to the United States from South Korea when she was just a kid. After high school in Georgia, she went to Penn and received a bachelor’s degree in nursing. Soon after, she left for California to serve as a Level 1 trauma center pediatric intensive care unit (ICU) nurse.

Kim came back to Penn in 2016 to finish her doctorate and, for now, plans on sticking around. She will work as a certified registered nurse anesthetist (CRNA) at a large academic hospital in Philadelphia after graduation.

With so much health education, medical training and real-world clinical experience, it only made sense that as a fellow Kim would study … economic development?

“I chose that discipline because it was the one I knew about the least and I wanted to learn more about it,” Kim says. The other fields were health, social justice and education. The 16 fellows are divided into four groups of four to study each discipline.

Students interested in the fellowship submit an application with short-answer essays and must complete an in-person interview. Kim’s fellowship ran from August 2018 through graduation.

Her team’s work involved looking deeply into nonprofit organizations --- financial statements, tax filings, board structures, etc. --- and determining what impact they have on a community and the potential for transformative experiences by those who seek or utilize the services.

More than 100 nonprofits apply for the review and chance to win. Kim’s team collectively narrowed the field to 40 organizations, and then to 12. The students present the slimmed down selection to the prize committee. Kim presented on a homeless organization that provides mobile hygiene services. It began in San Francisco but has since expanded to other cities.

“We had personal leadership coaches counsel us through our leadership goals for the year as well as a public speaking coach to give us feedback on our presentation styles and delivery,” Kim said. “These two things were invaluable in fostering confidence, ownership, and realization of being the subject matter expert.”

After all the presentations, the prize committee, which includes faculty and the Lipmans, picks three winners. The overall winner receives $250,000 but all three get access to Penn staff and faculty to share information and best practices to advance their cause.

That her fellowship discipline had nothing to do with anesthesiology made no difference. The minds around her influenced her and inspired her, and the whole experience will help her as a CRNA.

“It really opened my eyes to where we fit into this larger system,” she said. “The rest of the world really doesn’t operate in silos. In the real world, everyone really kind of works together. This experience showed me how to work collaboratively. We all need each other and we need to use each other’s strengths to elevate the whole.”

Kim may be staying in Philadelphia for now, but don’t expect her to stay put for long.

Her father passed when she was in high school, so she watched her mom raise three children. Her family benefited from a community that supported them, which is why she is committed to finding a way to give back for all that she received.

Her ultimate goal is to go on medical mission trips --- short term at first to gain experience, and then longer term to help as many and as much as she can. That is also among the reasons she became a CRNA. You can go anywhere in the world where there is surgery or pain and suffering, and you can be a part of relieving it, she said.

“If I do my job right, you’ll never know I was here,” Kim says in a video about the fellowship. “It’s such a great privilege to be able to have that hand print in someone’s life without needing the glory that comes with it afterwards. And really, it’s the invisible hands in the world that really are the drivers and the movers part of us making us wholly connected at the same time.”