Nurse Practitioners of Utah, Once again this year the Legislature has introduced a bill, HB 109, Anesthesiologist Assistant Amendments, which creates Anesthesia Assistants (AAs). AAs, if allowed to practice in Utah, will be providing anesthesia in many of our operating rooms. They will begin their practice with less education and experience than our Certified Registered Nurse Anesthetist (CRNA) colleagues and one anesthesiologist will be able to supervise four ORs with AAs providing anesthesia at the same time. I believe this will decrease patient safety and is unnecessary as there are already CRNA's available to provide this care.
I'm requesting that you contact your legislators by telephone or e-mail if they are on the House Health and Human Services Committee.
Committee members include:
Rep. Paul Ray Chair
Rep. LaVar Christensen Vice Chair
Rep. Dr. Stuart Barlow
Rep. Dr. Edward Redd
Rep. Dr. Michael Kennedy
Rep. Rebecca Chavez-Houck
Rep. Tim Cosgrove
Rebecca Lockhart, RN and Speaker of the House informed us that this is likely to pass this year! The legislators are only hearing from anesthesiologists and other physicians who are in favor of the bill. They need to hear from nurses, who have no monetary gain, about the risks associated with this potential practice. It is crucial to state in your first sentence that you are a CONSTITUENT of the legislator and that you VOTE.
Some talking points, Stay positive and focus on patient safety issues:
- Qualifications for the AA education include a Bachelor's degree in any discipline and there are no practice requirements prior to starting the degree program. (For example a student with a finance Bachelor's degree could apply and be accepted: this really happened). CRNA education requires a Bachelor’s degree in nursing or an advanced degree in one of several fields as well as significant experience as an RN)
- There are limited science coursework and/or healthcare practice pre-requisites. CRNA requires significant strong science background as well as one to two years experience as a critical care nurse prior to admission to a 2-3 year CRNA program.
- Proposed ratio of 1:4 -- anesthesiologist to AA personnel. This means four anesthesia assistants are giving anesthesia to four patients in different rooms at the same time. How does this equate to direct supervision? What happens in an emergent situation? - What if there are two case complications at the same time? How does the assistant manage this when the one anesthesiologist is tied up with another deteriorating patient?
- Is there an impact on the surgeon? Does he or she have to accept responsibility for administration of the anesthesia during a procedure or during an emergency in the OR?
- Who would the legislator want to administer anesthesia to his or her loved ones? (In an emergency admission situation such as trauma, there is no choice; whoever is on duty gives the anesthesia.)
- If any of you have family or friends who have had surgical experiences and/or who have concerns about anesthesia effects, PLEASE share this information with these people. They can direct their concerns to members of the Health & Human Services Committee who will be meeting early next week on this bill.
I hope you will each reach out to your legislator and discuss this issue.
PS: Note that the bill has had an amendment to require that patients be informed of the level of education of personnel giving anesthesia and also have DOPL review qualifications of all groups who are doing this. This is a good amendment (by Rep. Chavez-Houck) but this all should be done before the bill passes. I encourage you each to read the bill and amendment. A thorough investigation during the interim session would be better than passing this bill now.
To learn more or to find out who your legislators are, please see the following site: http://le.utah.gov/ Join me in action! Please contact me with any questions. Thank you.
Lee Moss, NP
UNP Legislative Committee