Commentary by Jay Horowitz (author of the bylaw changes as they pertain to the NBCRNA) in response to the recent email blast from the NBCRNA asking you to vote against the proposed bylaw changes. PLEASE READ THE TRUTH!!!! By now I hope you have had a chance to digest the blast e-mail dated 7/30/13 from NBCRNA. In my 25 years as a CRNA I have never seen such an unprofessional, ethically challenged, tone-deaf, irresponsible, cynical, immature, bullying, and inaccurate communiqué. I am equally embarrassed for, and ashamed of, the CRNAs on the NBCRNA Board who allowed their signatures to be attached to the e-mail. Whoever wrote this up in barely veiled lawyer-speak, must think CRNAs are so disengaged and ignorant that we can’t determine facts (of which there were practically none) from obfuscation, scare tactics and word games. And remember, they blasted this to every CRNA using a database they took with them when they abruptly, and without notice, left the AANA offices, using funding derived primarily from all CRNAs who pay for NBCRNAs services. As the author of the proposed bylaw changes, I can only count on the grassroots efforts of the small number of CRNAs I can reach, to forward this to your state presidents and ask to have them blast an e-mail to all their membership. So let’s break down the nonsense in the NBCRNA e-mail: NBCRNA said: We want to draw your attention to an issue that should concern all nurse anesthetists. An amendment to the AANA bylaws has been proposed that would withdraw the explicit recognition of the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA) as the certifying body for nurse anesthetists and the Council on Accreditation (COA) as the accrediting body for nurse anesthesia education. The Truth: No it doesn’t. Recognition is established through the recognition agreements not through the Bylaws. NBCRNA said: It instead requires that the AANA "shall recognize" independent entities which serve a certification or accreditation function. The amendment language suggests that this is simply a change in nomenclature, is intended to make the bylaws less restrictive and is in the best interest of the AANA. The Truth: That is correct. They got one thing right. NBCRNA said: In actuality, the amendment changes a longstanding relationship and distances the AANA, NBCRNA and COA from one another…The proposed bylaw change opens the door to fracturing these relationships creating uncertainty about the future of our profession and will force the AANA, NBCRNA and COA to deal with this uncertainty when our time, energy and resources are better spent addressing the many significant challenges facing our profession. We are urging fellow AANA members to oppose the proposed amendment. The Truth: The relationship between AANA and NBCRNA has been strained for some time. The fractures already exist. Furthermore, the "recognition" of the NBCRNA and its "work as partners" with the AANA has not spanned many decades. NBCRNA separately incorporated from the AANA around 2007. It is important to make a distinction between this recently incorporated entity and its predecessors; The Councils on Certification and Recertification as they previously existed within the AANA bylaws structure. It is hoped that passage of the bylaws will once again strengthen these relationships. NBCRNA egregiously said: Why this amendment is bad for the profession: • The mandate in Article XXI of the amendment which requires the AANA to create guidelines for certifying bodies is in direct conflict with organizations that accredit the NBCRNA which require that certifying bodies be separate and autonomous from the membership organization. This directly jeopardizes the CRNA credential. The Truth: Nothing could be farther from the truth and the language of the amendment is clear. “Any entity fulfilling such a function shall meet the guidelines established by the Board of Directors to qualify for such recognition.” This has nothing to do with guidelines for certification or recertification. Those are clearly the domains of the credentialing entity. This language only allows the AANA to choose who performs these functions, not the functions themselves. Your credential is safe. This is clearly misleading and a blatant attempt to needlessly scare A NBCRNA said: • The loss of a direct membership voice in the selection of their accrediting and certifying agencies. This decision will be within the sole purview of the AANA Board of Directors without a requirement for member input. The Truth: This proposed amendment is designed to give the AANA Board the flexibility to act as the voice of, and in the best interests of the members, and is consistent with other significant areas of Board governance. The membership has no voice other than through our elected AANA Board since NBCRNA "leadership" self-selects, self-elects and is increasingly self-serving. NBCRNA said: • There will likely be pressure placed on the AANA Board of Directors by the sponsors of the amendment to form or find an additional certification agency. The authors indicated they have developed a template for this action and the AANA Board has been contacted by an outside certification organization inquiring about the need for their services. The Truth: This again is simply untrue. The sponsors have never discussed such actions or developed any templates that I am aware of. More obfuscation and scare tactics. NBCRNA said: • The AANA and NBCRNA boards would be distracted from the important work they perform on behalf of the profession by efforts to establish a second credentialing body. Such an effort will consume time and money better spent on combating external attacks on the profession. The Truth: There has already been enough distraction and waste of time, energy, money and other resources. Passage of the bylaw proposals will stop these distractions. NBCRNA said: • Confusion could arise among the public (consumers, boards of nursing, advocacy organizations) if two certifying bodies for nurse anesthetists existed, and this could be used as a weapon by organized medicine groups which seek to restrain nurse anesthetist scope of practice. The Truth: There is only one certifying body now and no suggestion or desire to have this change. There is zero evidence to support any of these contentions. However, as a frame of reference, there are numerous professions with multiple credentialing entities that do just fine. If more than one body is certifying, as long as the respective certifying entity meets the state board requirements, there is no issue. NBCRNA said: • Employers or state licensing boards may refuse to recognize two tiers of credentials. The Truth: There is only one “tier” now and no other “tier” is being suggested by passage of these bylaw proposals. This is a stale argument from the CPC debate and is completely without relevance. NBCRNA said: • A less demanding credentialing process may create a concern over less qualified practitioners. The Truth: These bylaw proposals have nothing to do with the credentialing process whatsoever. This is a diversion tactic. Ironically few, if any of the cosigners are likely to be affected by the CPC. Though many members are very upset about CPC, the genesis of these proposals has nothing whatsoever to do with its content. NBCRNA said: • Perceived erosion in dedication to the highest standards of practice may undermine the ability of nurse anesthetists to practice independently. The Truth: Again, there is nothing in the proposals that calls practice standards into question or has anything to do with practice standards. NBCRNA said: • Nurse anesthetists could lose the support of regulatory and advocacy groups who have been pushing for greater opportunities for nurse anesthetists. The Truth: Simply untrue. Another distraction since the proposals have nothing to do with regulators or other stakeholders. NBCRNA said: A certifying body is required to ensure the integrity of the certification process to protect patient safety, and to work with the professional association while maintaining the required autonomy. The Truth: Protecting the safety of patients is not the job of the certifying entity nor is there consensus that it can even do so. Assuring patient safety is the job of the AANA via practice standards, and state regulatory boards. There has been concern expressed by NBCRNA about unintended consequences and “red flags” hoisted, which could jeopardize NBCRNA with their accreditors; NCCA and ABSNC. According to NCCA, separate incorporation is the foundation of autonomy. ABSNC requires evidence of collaboration. While the intent and actual language of the bylaw proposals is no threat whatsoever to the autonomy of the NBCRNA, their own e-mail to CRNAs is enough for AANA or individual CRNAs to file a complaint with NCCA or ABSNC. Talk about a red flag! NBCRNAs words and actions only serve to reinforce the need to pass the bylaw proposals. Passage by the members may be the only way to salvage the dysfunctional relationship that currently exists and allow the parties to step back and reevaluate for future success on behalf of CRNAs. Jay
Posted on: Thu, 01 Aug 2013 02:04:50 +0000
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