As the director of the Certified Registered Nurse Anesthetist, (CRNA), program at the University of North Florida, I have been charged with graduating as many doctorally prepared advanced practice nurses as I can in response to the continual anesthesia provider shortage problem.
But it is so disheartening to watch graduates cross that stage at commencement, walk out of the auditorium, get in their car, and drive across state lines to exercise their practice and full potential elsewhere.
For the sake of the millions of Floridians who deserve the highest quality of medical care during the most critical moments of their lives, this needs to be the year that our state joins 44 others in allowing thousands of highly qualified and trained CRNAs to perform their critical work without antiquated bureaucratic obstacles.
House Bill 375 and Senate Bill 462, sponsored by Representative Mike Giallombardo, and Senator Ana Maria Rodriguez, will remove those obstacles and allow each medical professional to put their full focus on successful patient outcomes.
More than 6,400 CRNAs work throughout Florida, each with eight to ten years of healthcare and anesthesia education, more than 12,000 hours of clinical training, and national board certification.
Their work in surgical settings is never alone. At a minimum, three other healthcare professionals work literally side by side during surgery.
Before a procedure, each CRNA closely studies each detail about the patient, poring over the slightest details of medical history, lab results, current medications, recent vitals, and more. During surgery, a CRNA is laser-focused on the patient, making tiny adjustments as needed to ensure a safe and successful outcome.
In this setting, CRNAs collaborate with physicians and surgeons and other medical professionals with the ability to prevent surgery from beginning if they have concerns and make critical and immediate adjustments.
There is no bureaucracy during surgery. Each person is finely attuned to the needs of that patient.
Unfortunately, state law has not kept up. Florida is one of only six states where CRNAs are required to obtain permission from a physician before performing a procedure; even if that physician isn’t in the same room, hospital or county.
This not only increases delays and complications, but it also worsens an already critical shortage of healthcare professionals especially in rural areas.
All members of the healthcare team collaborate and work together to achieve the optimal outcome for the patient. No legislation would ever change that important aspect of teamwork with the patient as the center of our focus.
But every facility utilizing a supervision model must find surgeons and proceduralists that are willing to sign the protocol. That is much easier said than done and can come with increased costs for the facilities.
I am aware of surgery centers that have or will be closing their doors because they don’t have the money to pay for a CRNA and physician anesthesiologist, nor can they consistently find surgeons willing to sign the protocol.
The camaraderie and focus before, during and after a procedure are truly the most selfless and transcendent moment of my life. To paraphrase President Reagan, it is amazing what we can achieve when we don’t care who gets the credit.
Let’s live up to that ideal and end arbitrary barriers that don’t help patients and continue to make sure Florida remains the best state in the country for people to live and work.
Dr. Ryan Shores, DNP, CRNA, APRN, is the Director of the University of North Florida Nurse Anesthesiology Program and serves as president of the Florida Association of Nurse Anesthesiology (FANA).
