This is a copy of a post I put on the Facebook page for CRNAs and SRNAs. It was in response to a member who questioned why an anesthesiologist would sit on the NBCRNA Board. I think it is an interesting and timely discussion, and so I thought I would provide an additional copy on my blog.
I am in favor of having an anesthesiologist and a surgeon on the NBCRNA board, as well as a public member and a hospital administrator member. The job of the NBCRNA is to take the scope and standards developed by the specialty society (that would be us, the AANA) and turn them into a certification/re-certification program that fairly measures and certifies that individuals meet those standards and can practice with that scope.
Since 100% of CRNAs work with surgeons, and over 60% of CRNAs work with anesthesiologists, it makes good sense to me that a surgeon, an anesthesiologist, and a hospital administrator, representing the “community of interest” that employs and works with CRNAs, be represented on the Board. They will have a point of view that will augment and broaden that of the CRNAs on the Board, which of course are in the majority.
What I find more troubling and more the problem, is that the AANA does not have designated members on the Board- such as the head of the AANA Continuing Ed. Committee, for example. The NBCRNA is charged by the ABSNC, the accrediting body that accredits them, with maintaining a collaborative relationship with the specialty society, and in my opinion, the NBCRNA has manifestly failed in meeting that standard. I have every respect for the members of the NBCRNA- but things have gone too far in their quest for a false “autonomy” that instead of providing them independent and unbiased judgment, has instead cut them off from the very source of their raison d’être: the AANA. Without the AANA, there would be no need for the NBCRNA. Certification and re-certification does not happen in a vacuum. It happens (or should happen) in sync with the advances in practice.
No specialty, and in particular our specialty, is static. But the NBCRNA does not dream up the advances in care – the practitioners do. As Kathy Apple, CEO of the National Council of State Boards of Nursing, told me, “practice always leads regulation”, and so it must be with certification and re-certification as well. We practitioners determine, through our many unique situations, what CRNAs can and should do. We give that information to our specialty society, the AANA, via various methods. And then, the way it is supposed to work, is that the AANA passes on those new advances to the NBCRNA and the COA, who then craft a program to teach and then certify that these particular and specific advances are brought to the service of the public in general in a manner consistent with fairness to the individual CRNAs and safety and quality for the public.