Nurse Anesthesia Practice

A Historical Review of its Legal Preservation

Daniel Rohrer, RN, BSN, SRNAYork College of Pennsylvania/WellSpan Health Nurse

Anesthetist Program

It is essential…

Ira P. Gunn, MLN, CRNA, FAAN

OBJECTIVES Identify the key historical legal cases that contributed

to the definition and preservation of nurse anesthesia practice.

Describe the significant persons, dynamics, and outcomes of each case

  Discuss the impact of the historical cases on the

practicing CRNA 

Discuss the role of the CRNA in practice preservation and interdisciplinary partnership. 

Brief History…

Lakeside Hospital

Dr. George W. Crile

Dr. George Crile and staffThe Lakeside UnitJanuary 13, 1915

Agatha Hodgins

Founder of AANA

1877-1945

THE FIRST CHALLENGE

VS

Dr. Francis H. McMechan

Fit for Duty?

Agatha Hodgins Neuilly-sur-Seine, France

World War I

IMPACT First anti-nurse anesthesia activity

Medicine, Licensure, & Supervision

Precedent for challenge

Frank Vs. South KY House Bill

214

Dentist Supervision

Education & Training

Good Point!

Chalmers-Francis Vs. Nelson

Dagmar Nelson, CRNA Dr. Verne Hunt

Impact Tested and Preserved Nurse

Anesthesia Practice *first nursing specialty

Medicine vs. Nursing

First NANA (AANA) advocacy

Bahn Vs. NME, Inc.Antitrust Cases

Vinod Bhan, CRNA (center) with attorneys

ImpactNurse & Physician Providers

Right to bring suit Protection from monopoly

*other cases

Brave Advocates……

Discuss the issues…

“We must provide them (future providers) with the opportunity to develop, live up to, and contribute to the same proud professional identity and high quality service ethic that has brought us (CRNAs) so far and which will sustain our presence into the future.” - Ira P. Gunn

Our role… Professionalism

Healthcare Policy

AANA & PAC

What else…?

References Bankert, M. (1989). Watchful Care: History of America's Nurse Anesthetists. New York, New York : The Continuum Publishing Company.Becker, K. (1998). A Brief History of Nurse Anesthesia Practice. Seminars in Perioperative Nursing, 7 (1), 80-85. Blumenreich, G., & Markham, J. (1985, December ). Bhan vs. NME Hospitals, Inc. Antitrust Standing of CRNAs Sustained . Journal of American Association of Nurse Anesthetists, 526-527.Gunn, I. P. (1999). Issues and Perspectives Affecting CRNA Practice: Professional Identity and Historical Roots. CRNA: The Clinical Forum For Nurse Anesthetists, 10 (1), 41-47.Keeling, A. A Brief History of Advanced Practice Nursing in the United States . In A. Hamric, J. Spross, & C. Hanson, Advanced Practice nursing: An Integrative Approach (4th ed.). St. Louis , Missouri : Saunders Elsevier.Kentucky State Medical Association . (1917, February 1). Frank Vs. South . Kentucky Medical Journal.Koch, B. E. (2010). Nurse Anesthesia: A History of Challenge . In J. Nagelhout, & K. Plaus, Nurse Anesthesia (4th ed.). St. Louis, Missouri : Saunders Elsevier.Matsusaki, T., & Sakai, T. (2011). The Role of Certified Registered Nurse Ansthestists in the United States . Journal of Anesthesia, 25, 734-740. doi: 10.1007/s00540-001-1193-5McAuliffe, M., & Koch, K. (2011). Imagining in Time: Ira P. Gunn Educator, Advocate, Legend. Journal of American Association of Nurse Anesthetists, 79 (6), 459-463.Meeusen, V., Zundert, A., Knape, H., & Gatt, S. (2012). History of non-medical professionals in anaesthesia . The Journal of Perioperative Nursing in Australia, 25 (1), 48-52.Motenko, N. P. (2000, August). One More Battle In Competetive Struggle. Journal of American Association of Nurse Anesthetists, 68 (4), 291-294.Mund, A. R. (2012). Policy, Practice, and Education . The Journal of American Association of Nurse Anesthetists, 80 (6), 423-426.Pennsylvania Association of Nurse Anesthetists. (n.d.). Position Statement From the Pennsylvania Association of Nurse Anesthetists on HB 1256. Retrieved February 16, 2013, from PANA.org URL: www.pana.org/manuscripts/pana%20white%20paper %2010-2007.pdfThatcher, V. S. (1953). History of Anesthesia: With Emphasis on the Nurse Specialist. Philadelphia, Pennsylvania: J.B. Lippincott Company.Van Nest, R. L. (2006). The Life and Trial of Dagmar Nelson Part 2. The Journal of American Association of Nurse Anesthetists, 74 (4), 261-265.Van Nest, R. L. (2006). The Life and Trial of Dagmar Nelson Part I. The Journal of American Association of Nurse Anesthetists, 74 (3), 183-187.Wilson, W. O. (2012). Nurse Anesthesia: A Past, Present, and Future Perspective. Nursing Clinics of North America , 72 (2), 215-223.

doi: 10.1016/j.cnur.2012.02.010