Jessie Bozelka: Proposed anesthesia staffing changes won’t help patients
Sun., Jan. 15, 2023
By Jessie Bozelka
Whether you are having surgery or getting an epidural in a birthing suite, you are usually in a room with at least one highly trained medical professional to ensure you are safe and receiving the best possible care. One of those professionals is likely a certified registered nurse anesthetist. CRNAs focus on the planning of your anesthesia, the administration of medications before, during and after surgery to ensure your comfort and keep you safe during your procedure. Our state’s health care system is complex, and it works best when it puts patients first. Whenever I hear about ideas to change the system, I try to think about whether the patients we care for in Spokane will benefit from the proposed change.
There is currently a staffing crisis in health care, and our elected leaders in Olympia are fielding several ideas on how to address this crisis so that more patients have better access to quality care. There are many types of medical professionals that staff hospitals, but I will focus on anesthesia care because that is what I know best. CRNAs like myself are board certified and licensed in our state to provide anesthesia care for patients independent of physician supervision. This means we are able to offer quality anesthesia care in places where there are not physician anesthesiologists – in fact, CRNAs work in 93% of all rural hospitals in Washington and are the only provider of anesthesia in 72% of these hospitals in smaller communities. We are also the primary provider of anesthesia for those serving in our nation’s military. CRNAs are qualified to provide care independently due to strict requirements for our education and clinical training – we have an average of four and half years of clinical experience in ICUs before starting our doctorate degree, more than 12,000 hours of clinical care experience by the time we graduate and study from the same textbooks and courses that are required for physician anesthesiologists during their education. The current staffing crisis means that more than ever, I am proud that I have the ability to serve patients independently if needed and assist in increasing access to care.
Unfortunately, there is one controversial proposal under consideration in Olympia that not only does not make sense in Washington but would cost patients money and does nothing to alleviate the staffing crisis. This proposal, HB 1038, will be heard by the House Committee on Health Care and Wellness on Friday – it also has a Senate version, SB 5184. Some would like our state to allow for anesthesiologist assistants, a type of care provider that does not have the training or authorization to provide anesthesia without direct supervision by a physician anesthesiologist.
First, the proposal does not make sense for rural communities where physician anesthesiologists are not providing care. Second, in larger urban hospitals, it would just mean more anesthesia providers required to serve the same number of patients. That does nothing to help with the staffing shortage, but it will make care more expensive for patients. Some larger hospitals may find those extra profits appealing, but I do not think this in the interest of patients and families seeking care. Fortunately, there are some more effective proposals for increasing access to care, such as investing more in higher education and encouraging greater collaboration between hospitals and our state’s universities to make the clinical training pipeline for CRNAs more efficient.
Like many of my neighbors, I ended up in Spokane after seeking a community with access to the beautiful outdoors. I gravitated toward a career in nursing following in my mother and grandmother’s footsteps, both of whom were registered nurses. After working in a cardiac ICU and a neonatal ICU for six years, I completed my doctorate in anesthesia, which gave me the training and education to become a CRNA so I could provide quality anesthesia care to the residents of places like Spokane independently without the increased cost to the patient of physician supervision. In these past few years of our staffing crisis, I am certain that CRNAs have helped patients seeking care because of our skillset and practice independence.
I know our state can work together to make progress on the health care staffing crisis. We must invest in the strengths that Washington has already established so that more people can make the same decision I did when I saw Spokane as an attractive place to live and raise a family. If we all put the interest of patient care first, I am confident we can make a difference.
Jessie Bozelka, DNP, CRNA, ARNP is a board certified registered nurse anesthetist who lives in Spokane. She loves the great outdoors and currently provides anesthesia care at Sacred Heart, Holy Family and the Ketamine Clinic of Spokane.
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