Ep 93: CRNA Supervision & Direction – Its History and Relevance Today

The issue of supervision and direction within our industry has come to the forefront during the COVID pandemic, but it’s anything but a new conversation. We’ve asked Sandy Ouellette, CRNA, to give us another history lesson on the subject. It’s something she’s actively been involved with for over multiple decades. Join us as we define supervision and direction, explain how this has evolved over time, and why it’s just as relevant today.

Click the timestamps below to help you navigate through the many topics we discussed.

On This Episode:

Very few people can tell you more about the history of our profession than Sandy Ouellette, CRNA. The former AANA president has been an active member of the profession for many years and taken part in many key decisions through the years.

On this episode of Beyond the Mask, we want to add another chapter to our historical series by discussing supervision and direction. Ouellette has spent her lifetime and career trying to bring attention to these issues. She’s pushed policy makers through the years and ultimately hopes we get to a point of true collaboration. That’s why she’s a perfect guest to bring us all up to speed on how supervision and direction has evolved for CRNAs over time.

Many people would assume that supervision appears to be more in important and controlling but that’s not the case here. By definition, the word supervision means the action or process or occupation of supervising, critical watching and directing. But direction is defined more by guidance or assistance.

This has impacted both reimbursement and liability, which is why it’s always been a hot-button issue. It’s become even more so in 2020 as states have temporarily opted out and allowed nurse anesthetists to work independently. Will these restrictions be lifted permanently? That’s a legitimate question taht people are asking right now.

But Ouellette believes the future is bright for CRNAs and the profession as long as members continue to stay active and make their voices heard.

This episodes should be particularly helpful to the younger professionals but everyone will find value listening to Ouellette share the knowledge she’s gained throughout her career.

A look at some of the additional topics we cover on the show:

  • Legal cases that impacted nurses
  • The definition of these terms
  • How supervision and direction evolved through the years
  • Why reimbursement plays a big part.
  • The AANA’s position statement on this
  • Surgeon liability when working with nurse anesthetists
  • Why the future is bright for CRNAs
  • How COVID impacts this

Check it out at the top of the page and use the timestamps to help you navigate through the many topics we discussed.

[2:36] – Sandy Ouellette joins us in the studio.

[4:05] – Why we’re talking about supervision and direction.

[5:35] – Why is this topic important in 2020? 

[8:19] – When this concept began. 

[10:57] – Changes in 1960s and 1980s

[14:16] – Reimbursement for supervision

[17:36] – AANA position statement on supervision vs direction

[21:11] – Prescriptive authority for nurses

[24:32] – Care vs Cure

[27:03] – Liability

[33:55] – Where are we today on this issue?  

[38:41] – Best time to be a CRNA

[40:52] – COVID’s impact on this  

[45:05] – States opting out temporarily

 


“This supervision and direction that has been with us since the very beginning, since ANA was formed, is used often as a lethal weapon against nurse anesthesia practice and used in one way or the other to restrict practice.”

-Sandy Ouellette, CRNA

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