Beyond The Mask: Innovation & Opportunities For CRNAs – Détails, épisodes et analyse

The Provider Non-Discrimination law from the Affordable Care Act, which prohibits commercial payers from discrimi-nating against providers based on their licensure, has been in effect for more than a decade now. In 2020, Congress re-quired the federal government to issue rules and enforcement policies that would prevent commercial payers from dis-criminating against providers. But enforcement isn’t happening, and deadlines keep getting missed. This has led to two big commercial payers to institute policies paying CRNAs 15% less than physician anesthesiologists for the exact same services, which has created a discriminatory environment.

On September 27, 2024, the AANA took action to protect patients' access to care and prevent further discrimination on its members by filing a writ of mandamus against the Biden administration for failure to do more to enforce this law. Why did AANA feel compelled to bring this lawsuit? What does this mean for CRNAs and the facilities where they work? And ultimately, what does this mean for the patients they serve?

Today, we're going to get the latest and learn the details from AANA CEO Bill Bruce, AANA President Janet Setnor, MSN, CRNA, Col. (Ret), ASAFR, NC, and AANA President-elect Jeff Molter, MBA, MSN, CRNA. This could be a huge moment in time for the profession and we’re going to fill you in on everything the AANA hopes to accomplish.

Here’s some of what we discuss in this episode:

• Why now for the lawsuit and what exactly does the writ of mandamus mean?
• The cost shift that will happen and what it means for billing.
• Are CRNAs able to recoup financial damages?
• Can AANA members get involved?
• What is the AANA doing to further prevent Anthem’s policy or stopping Cigna’s policy?
• What is the timeline for everything moving forward?

Visit us online: https://beyondthemaskpodcast.com/

The 1099 CRNA Institute: https://aana.com/1099

***Use coupon code BEYOND1999 to get 20% off through November 2024

Get the CE Certificate here: https://beyondthemaskpodcast.com/wp-content/uploads/2020/04/Beyond-the-Mask-CE-Cert-FILLABLE.pdf

Help us grow by leaving a review: https://podcasts.apple.com/us/podcast/beyond-the-mask-innovation-opportunities-for-crnas/id1440309246

Donate to Our Heart Your Hands here: https://www.ourheartsyourhands.org/donate 

We’ve seen and heard a lot of questions about the new Maintaining Anesthesia Certification (MAC) Program from the NBCRNA so we’re going to tackle as many of those as we can head-on with incoming president Garry Brydges, PhD, DNP, MBA, CRNA, ACNP-BC, FAAN. This innovative four-year program is designed to streamline credentialing and reflect CRNA's commitment to continuous improvement in safe, quality patient care, and we’ll discuss all of the details today.

Here’s some of what we discuss in this episode:

The history of the CPC program and all of the dialogue surrounding it at the beginning.

What is the role of the Board of Nursing compared to the NBCRNA?

Why do the modules go away?

What can you expect from the questions and how are they evaluating scores?

Why do they want to know how confident you are in answers?

About the MAC program: https://www.nbcrna.com/certification-programs/mac 

Visit us online: https://beyondthemaskpodcast.com/

The 1099 CRNA Institute: https://aana.com/1099

***Use coupon code BEYOND1999 to get 20% off through November 2024

Get the CE Certificate here: https://beyondthemaskpodcast.com/wp-content/uploads/2020/04/Beyond-the-Mask-CE-Cert-FILLABLE.pdf

Help us grow by leaving a review: https://podcasts.apple.com/us/podcast/beyond-the-mask-innovation-opportunities-for-crnas/id1440309246

Donate to Our Heart Your Hands here: https://www.ourheartsyourhands.org/donate 

Support Team Emma Kate: https://grouprev.com/haloswalk2024-shannon-shannon-brekken

As science improves, we’re learning more and more about brain health and how to maintain our youth even as we age. Today we’re joined by Ryan Sullivan, CFP®, CRPC®, RCC™ of Hartford Funds to share the valuable knowledge he’s gained from a partnership with the MIT Age Lab and explore how simple lifestyle changes can significantly impact our brain health and, consequently, our financial future.

Ryan is the Vice President and Managing Director of Applied Insights with Hartford Funds. They have a partnership with the MIT Age Lab to better grasp how we make decisions and what motivates us as we age. Understanding these insights and how they tie into our finances can help us improve our long-term outlook.   

Here’s some of what we discuss in this episode:

• Some of the factors that keep your brain from aging at the same rate as your body.
• How can you get a sense of what your brain age is?
• Our brain creates trash that needs to be removed from our bodies or else it will accumulate with enough sleep.
• The costs that are associated with cognitive health decline and how we incorporate that into retirement planning.
• Our diet is connected to our brain health.

Check out ‘The Age-Proof Brain’: https://a.co/d/9XV4j46

About our guest: https://www.hartfordfunds.com/practice-management/applied-insights-team/john-diehl-bio.html

Visit us online: https://beyondthemaskpodcast.com/

The 1099 CRNA Institute: https://aana.com/1099

***Use coupon code BEYOND1999 to get 20% off through November 2024

Get the CE Certificate here: https://beyondthemaskpodcast.com/wp-content/uploads/2020/04/Beyond-the-Mask-CE-Cert-FILLABLE.pdf

Help us grow by leaving a review: https://podcasts.apple.com/us/podcast/beyond-the-mask-innovation-opportunities-for-crnas/id1440309246

Donate to Our Heart Your Hands here: https://www.ourheartsyourhands.org/donate 

Support Team Emma Kate: https://grouprev.com/haloswalk2024-shannon-shannon-brekken

Jeremy and Sharon were up in Hershey for the PANA Spring Symposium and hosted a live taping of the podcast with Brett Fadgen, MSN, CFRN, CRNA. If you haven’t heard Brett’s story, it’s a remarkable one about perseverance and never giving up in the face of life’s challenges. Join us to hear all about his journey and how he became the only one-armed nurse anesthetist.  

Here are some of the things you’ll learn on this show:

• Brett’s childhood and growing up with a congenital defect. 3:21
• The journey from being a paramedic to RN to anesthesia school.  9:05
• The challenges he faced in anesthesia school. 13:47
• The contact he has with other people with limitations that are interested in anesthesia. 23:55
• What questions do patients ask? 26:15
• The final message Brett has for people. 32:00

About our guest: https://www.panaforqualitycare.com/single-post/2019/01/23/crna-inspires-by-defying-stereotypes-exceeding-expectations

Visit us online: http://beyondthemaskpodcast.com 

Get the CE certificate here: https://beyondthemaskpodcast.com/wp-content/uploads/2020/04/Beyond-the-Mask-CE-Cert-FILLABLE.pdf

We had a chance to spend some time with the new AANA Deputy Chief Advocacy Officer Ingrida Lusis during our time at the mid-year assembly to learn more about her background in government affairs and how she plans to strengthen advocacy by bringing state and federal affairs all under one umbrella. Join Sharon and guest host Tracy Castleman, CRNA, as we go on the offensive with our newest advocacy leader.

Here are some of the things you’ll learn on this show:

• Ingrida’s background in government affairs and her goals for the new position. 3:03
• Why she feels CRNAs need to go on the offensive. 7:46
• Her thoughts and views on full practice authority. 9:52
• What other ways we can look at to give CRNAs more power besides just running for office? 18:15
• Why supporting the ASAPAC is very important. 22:36
• The perception of the AANA vs the reality when she arrived. 29:01
• What would she say to get people involved that hate politics? 33:24

About our guest: https://www.prnewswire.com/news-releases/aana-appoints-ingrida-lusis-as-deputy-chief-advocacy-officer-301703396.html 

Visit us online: http://beyondthemaskpodcast.com 

Get the CE certificate here: https://beyondthemaskpodcast.com/wp-content/uploads/2020/04/Beyond-the-Mask-CE-Cert-FILLABLE.pdf

Cannabis has several medicinal uses and is legal in several states. More and more patients are using cannabis as a medication for anxiety, pain management, and for recreational use.

In this episode, Jeremy and Sass discuss the pharmacodynamics of cannabis and focus on the systemic effects of this medication. You won’t want to miss their discussion highlighting the anesthetic considerations of patients who takes cannabis.

Here are some of the things you’ll learn on this show:

• Adapting to cannabis becoming more acceptable recreationally and for care with patients. 2:29
• The pharmacokinetics related to cannabis. 4:32
• Reviewing an AANA Journal article on cannabis. 7:54
• The respiratory effects you might find from cannabis.  9:25
• The anesthetic implications for a cannabis user. 11:58
• Does cannabis help with pain management? 15:01

Resources:

1. Teitel A, Bozimowski G. A Review of the Pharmacology and Anesthetic Implications of Cannabis. AANA J. 2020 Jun;88(3):237-244. PMID: 32442102.

About our hosts: https://www.kpsan.org/school/people/

Visit us online: http://beyondthemaskpodcast.com 

Get the CE certificate here: https://beyondthemaskpodcast.com/wp-content/uploads/2020/04/Beyond-the-Mask-CE-Cert-FILLABLE.pdf

Voting started this week for the next round of AANA Board of Directors elections, and we want to help you get to know your candidates a little better. Thanks to our friends at the American Association of Nurse Anesthetists, we will share the opening statements from the Board of Director Candidates’ Forum during the Mid-Year Assembly so you can hear first-hand from each of the talented CRNAs running for office.

Remember that you can cast your vote now so visit the AANA Election Center and get all of the information you need.

Here’s who you’ll hear from on this show:

• Candidate for Director: Mike MacKinnon, DNP, FNP-C, CRNA 2:04
• Candidate for Director: Jodie Szlachta, PhD, RN, CRNA 4:05
• Candidate for Director: Andrea Roberts, DNAP, CRNA, APRN 6:06
• Candidate for Director: Howie Goodwin, DNAP, CRNA 8:07
• Candidate for Director: Susan Newell, MSN, CRNA 10:10
• Candidate for Director: Daniel King, DNP, CRNA, CPPS 12:12
• Candidate for Director: Stacy Yancey, CRNA 14:21
• Candidate for Treasurer: Eric Rauch, DNP, CRNA 16:21
• Candidate for Treasurer: Kristie Hoch, DNP, CRNA 19:33
• Candidate for Vice President: Jeffrey Molter, MSN, MBA, CRNA 22:30
• Candidate for President-Elect: Janet Setnor, MSN, CRNA, Col (ret) 25:32

Visit us online: http://beyondthemaskpodcast.com 

Get the CE certificate here: https://beyondthemaskpodcast.com/wp-content/uploads/2020/04/Beyond-the-Mask-CE-Cert-FILLABLE.pdf

The issue of reimbursement is one that we’ve covered from many different perspectives on this show but now it’s time to take the problem into our own hands. Rebecca Love, RN, MSN, FIEL is leading a commission along with Sharon Pearce, DNP, CRNA, FAANA for nurse reimbursement to tackle this broken financial model once and for all. Today we’ll tell you all about the commission’s plan and why we think this will transform the healthcare system and help end the terrible nursing crisis our country is facing.

Here are some of the things you’ll learn on this show:

• History of the current financial model and why it’s a problem. 4:00
• Why is this perpetuating the nursing shortage? 9:21
• Where is the money going right now if it’s not going to nurses? 14:30
• This next generation is much more in tune with the financial realities of the world.  19:55
• The problem with nurses that are being brought in from overseas. 26:59
• Details on the commission, who is involved, and what you can do to help. 32:06
• Thoughts on why this is so critical for nursing moving forward. 36:27

About the Commission: https://commissionfornursereimbursement.com/

Visit us online: http://beyondthemaskpodcast.com 

Get the CE certificate here: https://beyondthemaskpodcast.com/wp-content/uploads/2020/04/Beyond-the-Mask-CE-Cert-FILLABLE.pdf

Emergency cricothyrotomy is a rare, but incredibly important procedure that can be lifesaving. A primary step when performing a cricothyrotomy is correct identification of the cricothyroid membrane (CTM). 

In this episode Jeremy and Sass discuss the anatomy related to the CTM. They talk about palpation methods for finding the CTM, discuss current evidence for the use of ultrasound identification, and break down the ultrasound techniques that are useful in clinical practice. This is the podcast that will excite you to use POCUS for identification of the CTM!

Here are some of the things you’ll learn on this show:

• Understanding and identifying the anatomy. 2:21
• The two most effective ways to find the cricothyroid membrane. 8:32
• A couple of relevant studies that provide good information. 12:45
• The ultrasound procedure to help identify it. 17:19
• The educational resources that Jeremy recommends. 21:48
• The String of Pearls technique. 22:40

Show Notes & Resources:

1. Kristensen MS, Teoh WH, Rudolph SS. Ultrasonographic identification of the cricothyroid membrane: best evidence, techniques, and clinical impact. Br J Anaesth. 2016 Sep;117 Suppl 1:i39-i48. doi: 10.1093/bja/aew176. Epub 2016 Jul 17. PMID: 27432055.
2. Rai Y, You-Ten E, Zasso F, De Castro C, Ye XY, Siddiqui N. The role of ultrasound in front-of-neck access for cricothyroid membrane identification: A systematic review. J Crit Care. 2020 Dec;60:161-168. doi: 10.1016/j.jcrc.2020.07.030. Epub 2020 Aug 13. PMID: 32836091. Journal of Anaesthesia, Volume 117, Issue suppl_1, September 2016, Pages i39–i48, https://doi.org/10.1093/bja/aew176
3. Hung KC, Chen IW, Lin CM, Sun CK. Comparison between ultrasound-guided and digital palpation techniques for identification of the cricothyroid membrane: a meta-analysis. Br J Anaesth. 2021 Jan;126(1):e9-e11. doi: 10.1016/j.bja.2020.08.012. Epub 2020 Sep 28. PMID: 32896429.
4. Kristensen MS, Teoh WH. Ultrasound identification of the cricothyroid membrane: the new standard in preparing for front-of-neck airway access. Br J Anaesth. 2021 Jan;126(1):22-27. doi: 10.1016/j.bja.2020.10.004. Epub 2020 Oct 31. PMID: 33131758.
5. Siddiqui N, Arzola C, Friedman Z, Guerina L, You-Ten KE. Ultrasound Improves Cricothyrotomy Success in Cadavers with Poorly Defined Neck Anatomy: A Randomized Control Trial. Anesthesiology. 2015 Nov;123(5):1033-41. doi: 10.1097/ALN.0000000000000848. PMID: 26352376.
6. Airway Management for Anaesthesiologists. Ultrasound guided marking of the cricothyroid membrane using:
   1. Transverse TACA Technique: https://airwaymanagement.dk/ultrasound_needle_cricothyrotomy
   2. Longitudinal “String of Pearls” Technique: airwaymanagement.dk/pearls

About our hosts: https://www.kpsan.org/school/people/

Visit us online: http://beyondthemaskpodcast.com 

Get the CE certificate here: https://beyondthemaskpodcast.com/wp-content/uploads/2020/04/Beyond-the-Mask-CE-Cert-FILLABLE.pdf

One of the things you find out about CRNAs as they approach retirement is that their bank account might be ready for retirement but they might not be. Many people don’t consider the consequences of walking away from that daily routine of being at the hospital and interacting with colleagues, and not being prepared for that can leave you with a lack of fulfillment in retirement. Today we’ll discuss the importance of not only planning financially for retirement but also preparing emotionally and mentally for this significant life change.

Here are some of the things you’ll learn on this show:

• Most CRNAs fall in one of two camps when they retire. 5:50
• Has COVID caused more burnout among CRNAs? 7:41
• Why it’s so important to develop a plan for the next stage of life. 11:29
• You have to be prepared for a retirement that could last for 40 years. 18:09
• What is the sweet spot for retirement? 24:28
• The important takeaways from this discussion. 31:35

Visit us online: http://beyondthemaskpodcast.com 

Get the CE certificate here: https://beyondthemaskpodcast.com/wp-content/uploads/2020/04/Beyond-the-Mask-CE-Cert-FILLABLE.pdf