ALANA
A Publication of the Alabama Association of Nurse Anesthetists
News Bulletin
advancing quality anesthesia care, serving our members, promoting the nurse anesthesia profession
If you missed Legislative Day, you missed a great opportunity to promote our profession! Although the Alabama State Nurses Association Nurses Day at the Capitol rally was rescheduled due to the weather, the ALANA decided to brave the storm and host our Legislative Day. We were able to make several important connections with Legislators, which made it worth the drive in the rain! Representative Jim McClendon was presented the Healthcare Leadership Award for his service by President Heather Rankin. Representative McClendon is serving his 3rd term and is Chair of the House Health Committee. He remind­
ed us that if we do not educate the legislators about what we do then our opposition, whether right or wrong, will educate them. We were glad to have the freshmen class from Samford and UAB nurse anesthetist programs in attendance. The stu­
dents were educated and entertained by President Rankin, Joe Knight, CRNA, JD, and Susan Hansen, Government Relations Specialist on several topics including civics, professionalism, involvement, and practice rights protection. We thank the students and the faculty from both of these schools for being a part of our Legislative Day activities. The ALANA also sponsored lunch for the Democratic Representatives and the Republican Representatives and Republican Senators. We were able to meet and greet as the Legislators entered the lunch. Governor Bentley also attended and was greeted by our group of CRNAs. We were able to share with the groups who we are and what we !"#$%&'$()*'+,"",$-(.$/00'!$-1*&$1,!121!3(0$21.1*.$*"$4'51.0(*"+.#$6.$7"3$8(,$.''$)+"9$*&'$:18*3+'.;$-'$-'+'$(<0'$*"$
make several important contacts. If you missed it this year, you should join us next year for a day that is crucial to promoting our profession and establishing relationships that can affect our practice! Thank you to everyone that attended and helped make this a successful endeavor! In This Issue
President’s Address Heather Rankin, MSN, CRMA
Nurse Anethesia Week
Program News
Outstanding Preceptors
Call for Nominations
Legislative Day Highlights
Anesthesia Abstracts
Spring Meeting
2
4
8
10
15
16
19
22
Pat Smith, Heather Rankin, Amy Neimkin, Tom Dryden and Michael Humber pose with Governor Bentley
March 2011
Volume 28, Number 1
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2
Heather J. Rankin, MSN, CRNA
The year 2010 ended on a sad note for our state as the ALANA said goodbye to a well known nurse anesthetist and our friend, Dr. Ingrid Oakley. Dr. Oakley was a faculty member at UAB’s Nurse Anesthesia Program and was instrumental in teaching many stu­
dents over the years, who are now practicing nurse anesthetists all around our country. She will be missed greatly. Our thoughts and prayers go out to all of her friends and family. Swearing In
The ALANA Board of Directors has been busy already in 2011, continuing to implement the strategic action items we planned at the Board retreat held in the fall. Starting off the year, Federal ="01*18(0$>1+'8*"+;$697$?'19@1,$(,!$A$B'-$*"$C(.&1,5*",$>D$)"+$
the swearing in ceremonies of the House of Representatives. What an experience to be in our Nation’s capital while these ceremonies -'+'$&(::',1,5#$$C&10'$*&'+';$-'$21.1*'!$(00$*&'$0'51.0(*12'$")/8'.$
and attended a reception for the entire Alabama delegation. What an experience! CRNA Week
The end of January brought the 12th annual CRNA week, held Jan­
uary 23­29. The ALANA worked hard to promote our profession throughout the week. A number of radio stations broadcast a public service announcement about nurse anesthetists. I represented our association on two different news programs: WBRC’s Good Day Alabama in Birmingham and WSFA’s midday show in Montgom­
ery. I also met with Governor Bentley and was presented with a proclamation for CRNA week. An editorial went out during this week and was featured in several newspapers as well as the Robert Woods Johnson Digest. It was an action packed week! Great job by the Public Relations Committee to help with these events! If you did something for CRNA week at your hospital, please share with the Board of Directors; we’d love to hear what you did. Legislative Day
Legislative Day was held March 9th and was an action packed day. We started off with breakfast and an educational session for the stu­
dents in attendance. Susan Handson, Joe Knight, and I discussed advocacy, PAC, and legislation 101. Representative Jim McClen­
don was presented with the 2011 ALANA HealthCare Leadership Award. To all of those who helped plan, especially the GRC com­
mittee, and to all of those who attended, especially the CRNAs who took the day from work to be in Montgomery, many thanks! ALANA NewsBulletin
MidYear Assembly
MidYear Assembly will be held April 10­13 in Washington DC at the Crystal Gate Marriott hotel. This is a great meeting for anyone who is interested in learning about the legislative and regulatory side of anesthesia. Spring Meeting What a wild weather year we are having already! Couple the snow with the beautiful days with temperatures in the 60s, and I already have spring fever. What better cure for spring fever than the beach??? The ALANA Spring Meeting held at the Sandestin Hilton is just around the corner. Please register and reserve your room early for this fantastic educational meeting as the hotel sells out of rooms each year. This year’s meeting will be May 6­8 and will offer 21 CE credits. The Program Committee has done a fabulous job lining up top­notch faculty from across the nation. As always, please do not hesitate to contact me at any time. I look forward to seeing all of you at the beach!
In Memorium...
Dr. Ingrid Oakley, anesthetist, veterinarian, and educator passed away on December 9, 2010. Dr. E(@0'7$+'8'12'!$&'+$F#G#?#$(,!$8'+*1/8(*'$1,$
Nurse Anesthesia from the University of Alabama at Birmingham and later attended Auburn Univer­
sity College of Veterinary Medicine to receive her D.V.M. She joined the UAB Nurse Anesthesia Program Faculty in 2005 as an Assistant Professor and served as the Program’s Director of Admis­
sions since 2008. In addition to a heavy teaching load in the NAP, her recent scholarly activity included an AANA Journal publication titled “Anesthetic Implica­
tions of Osteogenesis Imperfecta” and coordina­
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oxygen therapy for patients post airway proce­
dures. Given her dual­profession background Dr. Oakley has investigated multiple correlates between veterinary anesthesia with human anes­
thesia delivery. In addition, Dr. Oakley devoted a great deal of time to developing a cultural competency curriculum for the NAP and School of Health Professions. She served on the board of the Greater Birmingham Humane Society and functioned as an active member of the Jefferson State Community College Institutional Animal Care and Use Committee. Ingrid and was an avid runner completing several marathons, including the Boston Marathon. Dr. Oakley and the passion she brought to the education of nurse anesthetists will be sadly missed. CCC=101J5&61=#&(
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Nurse Anesthesia Week Highlights
Andrew H. Morris, CRNA, MSNA -(./#"%0/"(,&#"1%2'3/"$3.1%45464%789:/,%;(:3&/#.<%2#$$/&&((
As CRNAs, we are all familiar with the following scenario:
“Good Morning. My name is Andy Morris and I am a nurse anesthetist. I will be administering your anesthesia today.”
“Ohhh, so you’re the anesthesiologist?”
Let’s face it. In our line of work, it’s hard to make a lasting impression on patients. Between limited time with the patient, production pres­
sure, or midazolam, it’s easy to understand why nurse anesthetists have an image problem (or lack thereof) with the general public. That’s why the ALANA Public Relations committee saw National Nurse Anesthe­
tists Week from January 24th ­ 28th as a great time to continue to edu­
cate patients, lawmakers, and the general public on nurse anesthesia. The committee worked to accomplish this goal on several fronts.
First, the ALANA ran an editorial piece in the Montgomery Adver­
45464%7"(</=(.&%>(3&'("%;3.?/.%;(,(/@(<%7"#,:3$3&/#.% tiser reaching lawmakers. This same article was also published in the from Governor Bentley
Robert Wood Johnson Foundation’s News Digest. This news digest is a national publication which “highlights key articles from major news­
papers and journals”. With this effort we received recognition from the AANA! The full text of this piece can be found at the end of this article. Furthermore, to help further awareness of CRNAs in the general public, the ALANA aired two public service announcements during the week on several central Alabama radio stations including WZZK 104.7, WBPT 106.9 “The Eagle”, WNCB 97.3 “The Buck”, WENN AM 1320 & FM 102.1, WBHK 98.7 “Kiss FM”, WAGG AM 610, and WBHJ “95.7 Jamz”. These stations spread our message to a huge reach from Tuscaloosa, to north of Cullman, east to Anniston, and south of Clanton. Then on Thursday, January 27th, President Rankin spent the day personally representing the ALANA. That morning, she ap­
peared on Fox 6 in Birmingham’s Good Morning Alabama. Later that day, she appeared on a midday show in Montgomery. Dur­
ing both interviews President Rankin solidly represented Alabama CRNAs. %&(*$()*'+,"",;$.&'$*&',$-',*$*"$*&'$H"2'+,"+I.$")/8'$*"$&(2'$($:+"80(9(*1",$.15,'!$<7$H"2'+,"+$J"<'+*$F',*0'7$!'80(+1,5$K(,3­
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of this article.
The CRNAs of Alabama can be proud that their association is working hard to “spread the word” about what an asset and value nurse anesthetists are! In closing, you may be asking yourself how can I give back to a profession that has given me so much? The answer? Continue to educate your patients everyday! Want to take it one step further? Get Active! Participate in our annual Legislative Day, volunteer )"+$8"991**''$!3*1'.;$+3,$)"+$")/8'S$%&'+'$1.$."$938&$7"3$8(,$!"$*"$9(@'$.3+'$'2'+7",'$@,"-.$-&(*$($,3+.'$(,'.*&'*1.*$!"'.S
Thank you for your dedication to your profession as Alabama nurse anesthetists!
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ALANA NewsBulletin
OFFICE OF THE GOVERNOR
ROBERT BENTLEY
January 25, 2011 D'+*1/'!$J'51.*'+'!$?3+.'$6,'.*&'*1.*.$C''@
PROCLAMATION By the Governor of Alabama
Whereas;$60(<(9($1.$)"+*3,(*'$*"$<'$&"9'$*"$9"+'$*&(,$T;MUU$D'+*1/'!$J'51.*'+'!$?3+.'$
Anesthetists who live and work all across our state; and Whereas, Alabama’s CRNAs, and thousands more across the nation, increase public understanding about the work they do, the rigor of our education and training, the numbers of patients they serve, and the uncompromising skill and proven safety with which they serve them; and Whereas, Governor Robert Bentley, who is a physician, acknowledged the importance of their work saying “Across the state, CRNAs work closely with our doctors to ensure that every patient in need gets the safe, compassionate anesthesia care they deserve. Alabamians are grateful to our nurse anesthetists for their dedication, hard work, and commitment to patient safety;” and Whereas, Each CRNA is a highly trained healthcare professional trained to serve in every setting where anesthesia is delivered – from treating patients in traditional hospital surgery and obstetrical delivery rooms to caring for injured soldiers on the front lines at war time. Nurse anesthetists care for patients of all ages, from newborn babies to great grandparents; and
Whereas, In addition to having earned a Bachelor of Science degree in nursing, or other appropriate undergraduate degree, any CRNA will have practiced for at least one year as a registered nurse in an intensive care setting, graduated from an accredited nurse anesthesia educational program, which normally requires another thirty months of study, completed their clinical training, and passed the ,(*1",(0$8'+*1/8(*1",$'R(9#$DJ?6.$(0."$93.*$"<*(1,$(*$0'(.*$MU$&"3+.$")$(::+"2'!$8",*1,31,5$'!38(*1",$
every two years; and
Whereas, CRNAs are the sole providers of much­needed anesthesia care in many rural counties and access to CRNAs in these medically underserved areas of our state allows local healthcare facilities to serve their communities with obstetrical, surgical and trauma stabilization care, when they otherwise might not be able to. Now, Therefore, I, Robert Bentley, Governor of Alabama, do hereby do proclaim January 23­29 (.$60(<(9(I.$D'+*1/'!$J'51.*'+'!$?3+.'$6,'.*&'*1.*.$C''@
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of Montgomery on the 25th day of January 2011.
Governor Robert Bentley
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to Skillful, Safe Anesthesia Care By Heather Rankin, MSN, CRNA
ALABAMA IS FORTUNATE to be home to more *&(,$T;MUU$D'+*1/'!$
Registered Nurse Anesthetists who live and work all across our state. Despite our numbers and the fact that CRNAs have been caring for patients in America for nearly 150 years, few people outside the healthcare industry know much about the formidable role nurse anesthetists play in our medical community or the proven, quality care we give to Alabama patients every day. That is one reason why Alabama’s CRNAs, and thousands of our colleagues from across the nation, are celebrat­
ing National Nurse Anesthetist Week Janu­
ary 23­29 and using the week­long event to increase public un­
derstanding about the work we do, the rigor of our education and training, the numbers 6
of patients we serve, and the uncompromis­
ing skill and proven safety with which we serve them. gral to the healthcare process as evidenced by the fact that these advanced practice nurses administer ap­
proximately 32 million Governor Robert Bent­ anesthetics each year. ley, who is a physician, Each CRNA is a highly acknowledged our trained healthcare national celebration professional trained to and the importance of serve in every setting our work with a proc­
where anesthesia is de­
lamation recognizing livered – from treating the dedicated service patients in traditional and quality care nurse hospital surgery and anesthetists provide obstetrical delivery for patients throughout rooms to caring for Alabama. “Across the injured soldiers on the state, CRNAs work front lines at war time. closely with our doc­
Nurse anesthetists care tors to ensure that ev­
for patients of all ages, ery patient in need gets from newborn babies the safe, compassionate to great grandparents. anesthesia care they deserve,” Bentley said Since many forms of in issuing the procla­
anesthesia are admin­
mation. “Alabamians istered by both nurse are grateful to our anesthetists and anes­
nurse anesthetists for thesiologists, it is im­
their dedication, hard portant for patients to work, and commitment know that regardless of to patient safety.” whether we are trained as nurses or physi­
In Alabama and across cians, all anesthesia the nation, nurse professionals undergo anesthetists are inte­
extensive anesthesia education and patient care is a top priority. In addition to hav­
ing earned a Bachelor of Science degree in nursing, or other ap­
propriate undergradu­
ate degree, any CRNA who cares for you or a member of your family will have practiced for at least one year as a registered nurse in an intensive care set­
ting, graduated from an accredited nurse anesthesia educational program, which nor­
mally requires another thirty months of study, completed their clinical training, and passed *&'$,(*1",(0$8'+*1/8(­
tion exam. During the course of our careers, CRNAs also must obtain at least 40 hours of approved continuing education every two years.
It is no doubt a result of our dedication and extensive training in anesthetic management ALANA NewsBulletin
that Alabama’s CRNAs have achieved the “high­
est standards in patient safety,” according to the Alabama Board of Nurs­
ing. In addition to our proven track record for safety and uncompromising quality care, CRNAs are the sole providers of much­needed anesthesia care in many rural counties in Alabama. Access to CRNAs in these medically underserved areas of our state, allows local healthcare facilities to serve their communities with obstetrical, surgical and trauma stabilization care, when they otherwise might not be able to. If they haven’t already, chances are good that a nurse anesthetist will one day be called upon to care for you or someone in your family. Before that day comes, please take time to learn about anesthesia safety, know the questions to ask prior to undergoing an anes­
thetic, and understand *&'$<','/*.$")$+'8'121,5$
anesthesia from a nurse anesthetist. That informa­
tion and more is available online from the American Association of Nurse Anesthetists at www.aana.
com and the Alabama As­
sociation of Nurse Anes­
thetists at www.ala­crna.
org.
No matter where you call home in Alabama, there are many dedicated D'+*1/'!$J'51.*'+'!$?3+.'$
Anesthetists who live and work in or near your community. If you know a CRNA, please thank them for their hard work and for their commitment to safe, compassionate, qual­
ity patient care.
This Editorial was submit­
ted to papers all across Alabama for printing during National Nurse Anesthetist Week.
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with a personalized approach to your -(0(+%0&*3&0((%()*),0&1
ANDY EASTERLING, CPA/PFS, CFP® CERTIFIED FINANCIAL PLANNER™ Two Perimeter Park South, Suite 310­E
Birmingham, AL 35243
Phone: 205.262.1120 Cell: 205.563.0115
(,!7\5+(,!21'-/,(,81(05+"3:#8"9
Securities and investment advisory services are offered through Multi­Financial Securities Corporation, member FINRA/SIPC H+(,!Y1'-$Z1,(,81(0$H+"3:;$44D$1.$,"*$()/01(*'!$-1*&$ Multi­Financial Securities Corp.
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Nurse Anesthesia
Program News
Michael W. Humber, MNA, CRNA
Assistant Professor and Director of Clinical Education
Best of wishes to the UAB Nurse Anesthesia Class of 2010. The class was honored at a luncheon in November sponsored by the UAB Nurse Anesthesia Alumni Chapter and commencement was held on December 18, 2010. We look forward to the good work this class will do.
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ored for her 42­year service to the University at a retirement reception in January. Mrs. Hawkins came to UAB in 1969 and became an integral part of the developing nurse anes­
thesia program in 1974. In her retirement Mrs. Hawkins is enjoying more time with her family but will be deeply missed by UAB faculty, staff, and students.
The Council on Accreditation of Nurse Anesthesia Educa­
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continued accreditation was granted effective October 2010. The Program achieved the maximum accreditation of ten years with no citations or weaknesses noted in the site report. The UAB Nurse Anesthesia Program was awarded the Inter­
national Federation of Nurse Anesthetists (IFNA) recognition )"+$/2'$7'(+.#$V6F$1.$*&'$/+.*$:+"5+(9$*"$")/81(007$+'8'12'$
the IFNA Recognition, having completed all requirements of the Anesthesia Program Approval Process. The recognition is valid until May 2016.
The UAB Nurse Anesthesia Program has added an early decision application cycle. This is designed for appli­
cants that have completed all admission requirements with exception of ICU experience. Applicants with a desire to attend the UAB Nurse Anesthesia Program should submit the application with all required materials by June 1st for matriculation in Fall of the following year. The screening process for early decision is more stringent and only a few will be chosen. However, applications not chosen for early decision will automatically roll over to the regular admission cycle in September without penalty. More information and application instructions can be found at www.uab.edu/mna.
The UAB Nurse Anesthesia Alumni Chapter held its second annual Continuing Education Event March 11­12 at the Renaissance Ross Bride Golf Resort and Spa. The event provided 8 CEUs with 4 hours of pharmacol­
ogy and concluded with a golf scramble on Saturday afternoon. Anyone interested in joining the Alumni Chap­
ter should visit www.uab.edu, click the “Alumni” tab then choose “Join the NAS.” When prompted to join an Alumni Chapter, “Nurse Anesthesia” should be chosen. Anyone needing more information may contact Michael Humber at 205­934­5977 or email mhumber@uab.edu. 8
ALANA NewsBulletin
Nurse Anesthesia
Program News
Mary C. Karlet, PhD., CRNA, Chair
Department of Nurse Anesthesia
The Samford Nurse Anesthesia Program welcomed 24 students into the class of 2013 in January 2011. This outstanding group of students is distinguished by their intellect, experience, and enthusiastic spirit. They come from all areas of the coun­
try including Florida, Mississippi, Georgia, Oregon, Arkansas, and Tennessee. Class of 2013, welcome to Birmingham, to Samford, and to our great profession.
Our Simulation Center efforts continue to expand, allowing all of our students to practice and improve clinical skills in a controlled, but realistic non­patient envi­
ronment. We are pleased that many of our clinical preceptors have remarked about *&'$&15&'+$.@100$0'2'0$(,!$.*3!',*$8",/!',8'$*&(*$.1930(*1",$:+"9"*'.#$
The spirit of giving was profoundly demonstrated in December by the Samford faculty members and students. Katie Schneider, class of 2011, organized a department effort to provide needed supplies and gifts for the occupants of Hanna House and Kings Ranch. On September 17, 2010, the Samford University Ida V. Moffett School of Nursing recognized distinguished alumni of the Birmingham Baptist Hospital and Ida V. Moffett School of Nursing. The “Courage to Care” awards honor alumni who have made a difference through their professional prac­
tice. This year, two distinguished CRNAs and Birmingham Baptist Hospital graduates were honored. Wanda Marquardt, CRNA and Kerry Gossett, CRNA were recognized for their distinguished careers. We can never say it enough…our program appreciates the dedication of our clinical sites and our CRNA preceptors. Samford students are indebted *"$(00$")$"3+$801,18(0$:+'8':*"+.#$%&1.$7'(+;$/2'$'R8':*1",(0$DJ?6.$-'+'$
voted as Outstanding Preceptors in the Samford program: Mike Harper – Gadsden Regional Hospital, Gadsden; David Neal – Children’s Hospital of Birmingham; David Sanford – St. Vincents Medical Center, Birmingham; Rick Warren – Gadsden Regional Hospital, Gadsden; Jason Wilson – Princeton Baptist Medical Center, Birmingham
Congratulations Outstanding Preceptors and thank you. You are truly making a difference in a future CRNA’s life!
PLEASE MARK YOUR CALENDARS! The Samford Nurse Anesthesia Program will be hosting an Alumni Reception in Destin, Florida at the ALANA state meeting on Friday May 6, 2011. Alumni, students and clinical faculty please plan to attend!
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9
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One of the highlights of the ALANA observance of National Nurse Anesthesia Week has been the announcement of the Outstanding Clinical Preceptor Awards. These awards were developed to recognize those individuals who consistently provide our nurse anesthesia students with excellent clinical experiences and create an environment that is conducive to learning the science and art that is nurse anesthesia. Based upon recommendations from .*3!',*.$(,!$)(830*7;$'(8&$,3+.'$(,'.*&'.1($:+"5+(9$8(,$,(9'$3:$*"$/2'$1,!121!3(0$+'81:1',*.#
%&'$+'81:1',*.$(+'$(-(+!'!$($D'+*1/8(*'$")$6::+'81(*1",$(,!$512',$($_TUU$*31*1",$5+(,*$*"$(**',!$(,$646?6$
Educational Meeting. Recipients are honored at the Business Meeting of the ALANA Annual Spring Meeting in Sandestin, to be held May 6 ­8, 2011. On behalf of the students and members of the ALANA, it gives us great pleasure to announce this year’s Outstanding Clinical Preceptor recipients:
Eric Bern, VA Medical Center, Birmingham, AL
Jonathan Duke, Sacred Heart Hospital, Pensacola, FL
Doyle Graham, Athens­Limestone Hospital, Athens, AL
Mike Harper, Gadsden Regional Hospital, Gadsden, AL
David Neal, Children’s Hospital of Birmingham, AL
Frank Pollara, Springhill Medical Center, Mobile, AL
David Sanford, St. Vincents Medical Center, Birmingham, AL
Rick Warren, Gadsden Regional Hospital, Gadsden, AL
Jason Wilson, Princeton Baptist Medical Center, Birmingham, AL
Jeff Wooden, Baptist South Medical Center, Montgomery, AL
Alicia Thompson, SRNA and Frank Pollara, CRNA
Tyler Coggin and Rick Warren
Jason Wilson, Lindsey Doss and Chad Cochran
10
ALANA NewsBulletin
Jeff Wooden, CRNA (L) and Brandon Shaver, SRNA
Mike Harper and Stacey Pepper
Michael Humber (L) and Eric Bern
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Jonathan Duke, CRNA (L) and Timothy Hale, SRNA
David Sanford, Lauren Foster and Emily Whitcomb
David Neal and Brittany Denson
11
AANA and ALANA Hard at Work for YOU in DC
IJ#8%$8<&%9(,#$(%&'(%,'3.G(%K#8%C3.&%&#%<((LM Mahatma Gandhi
Amy Neimkin, DNP, MBA, CRNA
Every day in our practice, our patient care is affected by social, economic, and health policies. Delivering anesthesia care, especially in a care team setting, requires politically astute thinking and action. Nurses, especially CRNAs, have always been seen as patient advocates. Our advocacy role extends out in con­
centric circles and includes collaboration with other health care professionals, institutions such as hospi­
tals, the community, and state and national entities, in an effort to protect the health, safety and rights of our patients. Every day, we are advocates for our patients and our profession.
The leadership of the ALANA and AANA have become “experts” in health policy as it relates to anes­
thesia care. This expertise is driven by the empathy felt for those who are voiceless or powerless in our health care system and is a deeply political act. After all, health and disease are political – resources, education and care are not distributed equally! And CRNAs meet this challenge every day by being the sole providers of anesthesia care in the vast majority of rural America. Our Federal Government Affairs staff in Washington is a preeminent group of recognized health policy experts. They have authored chap­
ters in textbooks and have lectured to health policy students. We are fortunate to have such a talented and capable staff advocating for us!
As committed members of the ALANA, I encourage you to take your patient advocacy one step further – take action when you receive advocacy alerts from the ALANA or AANA and please support your CRNA PAC and your ALA­CRNA PAC. “Never doubt that a small group of committed citizens can change the world… indeed, it is the only thing that ever has” ­ Margaret Mead.
Swearing­In of the 112th Congress
President Heather Rankin and I travelled to Washington, DC in January for the swearing­in of Represen­
tative Terri Sewell to the 112th Congress. We were invited to attend by Rep. Sewell (D­7th District), the /+.*$6)+18(,N69'+18(,$-"9(,$'0'8*'!$*"$D",5+'..$)+"9$*&'$G*(*'$")$60(<(9(#$$6$,(*12'$")$G'09(;$.&'$1.$
($5+(!3(*'$")$=+1,8'*",$V,12'+.1*7;$X(+2(+!$4(-$G8&""0$(,!$ER)"+!$V,12'+.1*7;$(,!$1.$($:3<018$/,(,8'$
attorney. The celebration and viewing of this historic event took place in the Mumford Room in the Madi­
son building of the Library of Congress. Rep. Sewell addressed her family, friends and supporters before and after her swearing­in and shared her favorite quote by Shirley Chisholm ­ “Service is the rent we pay for the privilege of living on this earth.”
We then took the opportunity to visit all of *&'$")/8'.$")$"3+$J':+'.',*(*12'.$(,!$G',(­
*"+.$)+"9$60(<(9(#$%&'$")/8'.$-'+'$1,$8'0­
ebration mode and we were privileged to meet the friends and family of our Members of Congress as well as their staff. We were invited to a reception that evening for the new members of the Alabama Delegation, hosted by Rep. Spencer Bachus. We took advantage of every opportunity to share with everyone we met what CRNAs do every day for the citizens of Alabama.
12
ALANA NewsBulletin
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Funding
The U.S. House of Representatives was slated the week ")$Z'<#$TM$*"$8",.1!'+$($<100$*&(*$83*.$($*"*(0$_TUU$<1001",$
in annualized spending from the federal budget, including (<"3*$",'N/)*&$")$&'(0*&$:+")'..1",.$(,!$,3+.1,5$'!38(­
*1",(0$)3,!1,5$1,$*&'$83++',*$/.8(0$7'(+#$$6*$*&'$!1+'8*1",$
of the AANA Board of Directors, the AANA has joined The Nursing Community in writing the House to spare nurse workforce programs from the axe.
With the federal government running on “continuing res­
olution” (CR) funding through March 4, 2011, Congress must enact legislation extending available funds past that date or the government will shut down. The Republican­
majority House is promoting major spending cuts, while the Democratic­majority Senate is more inclined to sup­
port level­funding of government programs. Ultimately, both chambers of Congress must agree on a package of budget extensions to present to President Obama for his signature into law for federal services to continue uninter­
rupted.
e$
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A$ 9:+"21,5$*+(,.1*1",$")$8(+'$)+"9$",'$.'**1,5$*"$(,­
other (e.g.; Early discharge following ambulatory surgery, reduced hospital readmission or emergency room visits due to reduction in postoperative pain or nausea)
A$ 9:+"21,5$ 8""+!1,(*1",$ ")$ 8(+'$ ]'#5#f$ W'!18(*1",$
reconciliation; coordination of care between OR and ICU)
J
$ '!381,5$ *&'$ 1,81!',8'$ ")$ &".:1*(0N(8a31+'!$ 8",!1­
tions (e.g.; manifestations of poor glycemic control, surgical site infections following CABG, orthopedic procedures, or bariatric surgery)
=
$ +'2',*1,5$&".:1*(0$+'(!91..1",.$]'#5#f$+'!38'$&".:1­
tal readmission or ER visits due to reduction in post­
operative pain or nausea)
This information will be shared with the Center for Medi­
care and Medicaid Innovation (CMMI), which at a recent meeting had urged the AANA to provide such examples of innovative care models. Created under Section of 3021 of the Affordable Care Act, the CMMI is charged to de­
velop, deploy, evaluate and scale up healthcare payment models and delivery care models that ultimately reduce costs and improve quality of care. The AANA seeks to be part of this very important conversation in the healthcare reform landscape, and your information can help make this happen. The House package would reduce many programs to FY 2008 levels, and would cut Title 7 health professions and %1*0'$O$,3+.'$-"+@)"+8'$)3,!1,5$<7$_TM`#T$91001",$1,$*&'$
current FY 2011, compared with the President’s FY 2011 <3!5'*$+'a3'.*$")$_bOc#T$91001",#$$?3+.'$(,'.*&'.1($'!3­
cational programs apply to Title 8 nurse workforce devel­
opment grant programs to help support program establish­ You are encouraged to submit your projects regardless ment and expansions and nurse anesthetist traineeships.
of size and scope, so that the AANA can promote to the Medicare agency the contributions of AANA members in President Obama’s 2012 budget proposal issued Feb. 14 advancing continuous improvement of patient care. Ev­
*"*(0.$_b#d$*+1001",;$1,803!1,5$($!'/81*$")$_T#c$*+1001",;$:+"­ ery small step toward this end contributes to a positive vides two years’ relief from huge Medicare Part B pay­ future for our patients, our communities and our country. ment cuts to CRNA and physician payment, and offers Please send your information to info@aanadc.com with a modest boost to Title 8 nurse workforce development the subject line “CMMI Innovative Models of Care.”
programs important to CRNA educational institutions.
Nurse anesthesia educational program directors should MARK YOUR CALENDARS for the 2011 Mid Year stay tuned for opportunities to write members of the U.S. Assembly! House of Representatives and urge that nurse workforce The 2011 Mid Year Assembly will be held April 10­13, development programs be preserved. 2011, at the Crystal Gateway Marriott, in Arlington, VA. Make plans now to join other CRNAs as we take the mes­
4464% -((?<% BO3$H:(<% #*% 2;64<A% P..#@3&/@(% 7"3,­ sage of nurse anesthesia directly to Capitol Hill! Please &/,(%Q#=(:<
email me if you plan to attend @amyneimkin@mac.com. The AANA Federal Government Affairs Department in Please follow me on Facebook and Twitter for the latest Washington DC seeks your help in identifying innovative advocacy updates!!!
models of care where CRNAs have participated in change Twitter@ALANAFPD
processes that have proven to reduce costs and improve Facebook: Federal Political Director~Alabama Associa­
quality. Your involvement may have ranged from partici­ tion of Nurse Anesthetists
pant to lead investigator. They are looking for examples that address:
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-X
Cadence Ad
-R
ALANA NewsBulletin
Call for Nominations
Tom Dryden, CRNA, Nominating Committee Chair
A
re you interested in how new healthcare policies will affect you as a CRNA? Do you have opinions about how your state association can be more effective in promoting and advancing the nurse anesthe­
sia profession? Do you have special talents that could be put to good use?
There has never been a better time to get involved in your professional association. To be effective, ALANA must have CRNAs who are willing to volunteer their time, knowledge and talents. Step up, get involved and volunteer to serve! Service in the ALANA is one of the most rewarding aspects of a career as a CRNA.
The Nominating Committee is looking for CRNAs who want to serve. In 2011 we will elect a President­Elect, Vice President/Secretary, three Board of Director positions and a Chair for the 2012 Nominating Committee. As the sitting Nominating Committee Chair, please contact me or any member of the ALANA Board of Directors to discuss the rewards and duties of service. Hurry ~ the members will vote to approve the slate of candidates at the ALANA Spring Meeting, with the election to follow in the fall. I look forward to hearing for you!
Tom Dryden, CRNA
ALANA Nominating Committee Chair
tsleeper01@aol.com.
Medical Business Management Leading CRNA Billing Service in Alabama Supporting ALANA for 17 Years Vendor at Biannual Meetings Reimbursement Advisor MBM
MBM Specialties:
Anesthesia Cash Flow Establish Independent CRNA Practices Project Fee­for­Service Collections Bill/Collect for Hospital Anesthesia Departments Bill/Collect for Independent CRNA’s Joe Gribbin 205­979­5882 1025 Montgomery Hwy, #100 Birmingham, AL 35216 jgribbin@mbmps.com www.mbmps.com
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-T
Highlights from ALANA Legislative Day Heather Fields, MSN, CRNA, Senior Director and Chair of the Government Relations Committee
I
f you missed Legislative Day, you missed a great opportunity to promote our profession! Although the Alabama State Nurses Association Nurses Day at the Capitol rally was rescheduled due to the weather, the ALANA de­
cided to brave the storm and host our Legislative Day. We were able to make several important connections with Legislators, which made it worth the drive in the rain! Representative Jim McClendon was presented the Healthcare Leadership Award for his service by President Heather Rankin. Representative McClendon is serving his 3rd term and is Chair of the House Health Committee. He reminded us that if we do not educate the legislators about what we do then our opposition, whether right or wrong, will educate them. We were glad to have the freshmen class from Samford and UAB nurse anesthetist programs in attendance. The students were educated and entertained by President Rankin, Joe Knight, CRNA, JD, and Susan Hansen, Govern­
ment Relations Specialist on several topics including civics, professionalism, involvement, and practice rights protection. We thank the students and the faculty from both of these schools for being a part of our Legislative Day activities. The ALANA also spon­
sored lunch for the Demo­
cratic Representatives and the Republican Represen­
tatives and Republican Senators. We were able to meet and greet as the Leg­
islators entered the lunch. Governor Bentley also attended and was greeted by our group of CRNAs. We were able to share with the groups who we are and what we do. The afternoon -(.$/00'!$-1*&$1,!121!3(0$
visits to Legislators. As you can see from the pictures, we were able to make several important contacts. If you missed it this year, you should join us next year for a day that is crucial to promoting our profession and establish­
ing relationships that can affect our practice! Thank you to everyone that at­
tended and helped make this a successful endeavor! 16
ALANA President Heather Rankin presents Healthcare Leadership Award to House Health Committee Chairman Jim McClendon
ALANA President­Elect David Hambright addresses House and Senate Republican Caucus Luncheon
ALANA Government Relations Chair Heather Fields visits with House Speaker Mike Hubbard
Bruce Von Hagel greets Governor Bentley as Pat Smith looks on.
ALANA NewsBulletin
CRNAs Working For You! Tom Dryden, Seth Richardson, Bruce Von Hagel, Nick Berry, Kyle Vanderford and Blair Perkiins visit with Senate Majority leader Jabo Waggoner (Center)
Pat Smith, Michael Humber, Amy Neimkin and Seth Richardson visit with Senator Slade Blackwell (Center)
ALANA Lobbyist Johnny Crawford, GRC Chair Heather Fields and Senator Gerald Dial share a moment.
Michael Humber, Pat Smith, Seth Richardson and Amy Neimkin vists with Senate Health Committee Chairman Senator Greg Reed (Center)
ALANA Lobbyist Susan Hansen, President Rankin and President­Elect Hambright visit with Chairman McClendon
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-S
ALANA Student Representative
Sara Crowe, BSN, RN, SRNA
A
.$97$*19'$(.$($,3+.'$(,'.*&'.1($.*3!',*$1.$!+(-1,5$*"$(,$',!;$A$/,!$97.'0)$+'B'8*1,5$<(8@$
to when I curiously considered nurse anesthesia as my profession. What was it about being a CRNA that really drew me in? After much soul searching and countless brain­draining &"3+.$")$.*3!71,5;$AI2'$!'81!'!$1*$(00$8"9'.$!"-,$*"$<'1,5$)30/00'!$(*$*&'$',!$")$*&'$!(7#$C&10'$
this answer made me feel good about myself for a short time, I had to ask myself another question, “What does that really mean???” Does that mean that I will never intubate another esophagus or that I will never miss another IV? Probably not, unfortunately. What I did decide is I want to feel com­
mitted not only to my patients but also to the profession. As acting Samford student representative to the ALANA, I have gained a new perspective on the profession of nurse anesthesia. From the countless emails, conference calls and meetings, I have been awoken to the daily battle to move our profession forward amidst an ever­changing healthcare .7.*'9#$60.";$9"+'$*&(,$'2'+$A$)''0$*&'$/+'$*"$'9:"-'+$DJ?6I.$(,!$:+"2'$*&(*$-'$(+'$.()';$8".*$')­
fective and accessible anesthesia providers. Of course, there is always a catch and that is the, “How.” X"-$!"$-'$5'*$*&'$-"+!$"3*g$X"-$!"$-'$*'(8&$:"01*181(,.$(,!$:(*1',*.$(01@'$(<"3*$8'+*1/'!$+'51.­
tered nurse anesthetists? Get Involved! It’s that simple! I know we have all heard the saying, “A chain is only as strong as its weakest link.” Well, this is true now more than ever and we need all ALANA members on board, including students! What can you do to help you ask? It can be something as small as writing a letter in support of an issue or becoming a key contact if you or someone you know has contacts to a local political representative. Last, but certainly not least, you can donate to the ALA­CRNA PAC! Now I know reaching out to students for money is like dropping a bucket in a dry well, but it’s really not as bad as you may think! You can do a one­time donation of ANY amount you can manage, opt for the monthly credit card draft program or join the Buck­A­Day Program. By joining Buck­A­Day you can give back to the pro­
fession for less than a gallon of gas or a small Starbucks coffee­­ not that nurse anesthetist students drink coffee, right?!
G"$,"-;$(.$A$.*':$"))$97$."(:$<"R$(,!$<1!$7"3$(00$)(+'-'00;$A$(.@$7"3$*"$+'B'8*$<(8@$",$7"3+$:(*&$*"$
<'8"91,5$($DJ?6#$J'9'9<'+$*&(*$/+';$*&(*$!'*'+91,(*1",$(,!$*&".'$8"3,*0'..$&"3+.$")$.*3!71,5$
that brought you to this profession? Be proud, be vigilant and shout it from the roof tops that you are a CRNA!
Best,
Sara Crowe, BSN, RN, SRNA
Samford University
18
ALANA NewsBulletin
7'3"$3,#:#GK
The effect of additional propofol on intubating conditions
J Clin Anesth 2010;22:603­607
Kwon MA, Kim SK, Jeon DG, Song JK, Kim WI
49<&"3,&
Purpose: The purpose of this study was to evaluate the effects of divided doses of propofol prior to intubation on intubating conditions and hemodynamics.
N3,?G"#8.=R Propofol improves intubating conditions in a dose dependent manner. Propofol does not potentiate non­depolar­
izing neuromuscular blockade and the mechanism by which it causes relaxation of laryngeal muscles is unclear. While larger induction doses of propofol produce better intubating conditions, they also result in hypotension and, at times, reduced heart rate as well. These hemodynamic effects delay the transit of non­depolarizing muscle relax­
ants to the neuromuscular junction, slowing the onset of paralysis.
Methodology: This prospective, randomized, double­blind study included 102 ASA physical status I and II patients, 18 years to 70 years old, scheduled for elective procedures. Exclusion criteria included an abnormal airway, severe cardiovascular disease, and a systolic blood pressure greater than 180 mmHg. Patients were not premedicated. General anesthesia was standardized, except for the dose and timing of propofol administration. Patients were randomly assigned to one of three groups. The propofol 1.5 group received a single dose of 1.5 mg/kg propofol. The propofol 1.5+0.5 mg/kg group received an induction dose of 1.5 mg/kg propofol followed by an additional 0.5 mg/kg propofol 45 seconds before intubation. The propofol 2.0 group received a single dose of 2.0 mg/kg propofol for induction. All patients received 1.5 µg/kg fentanyl prior to induction of gen­
eral anesthesia. In addition to standard monitoring, BP was monitored invasively. Following induction of general (,'.*&'.1(;$+"83+",139$U#c$95h@5$-(.$(!91,1.*'+'!;$)"00"-'!$<7$1,&(0(*1",$")$TUUi$"R75',$(,!$ci$.'2"B3+(,'#$
In the propofol 1.5+0.5 group, the second dose of propofol was administered 45 seconds after rocuronium. In the other two groups, an equal volume of normal saline was administered in lieu of the second dose of propofol. Sy­
ringes were covered with an opaque material to prevent the anesthetist from knowing whether propofol or saline had been administered.
Intubating conditions were categorized as excellent, good, poor, or impossible. “Excellent” conditions included a relaxed jaw, vocal cords that were abducted and immobile, and no diaphragm movement. “Good: intubating condi­
tions allowed for some diaphragm movement. “Poor” intubating conditions included movement of the vocal cords and coughing or bucking. “Impossible” intubating conditions were present when the jaw was not relaxed and the vocal cords were closed.
Plasma and effect site concentrations of propofol at intubation were estimated. Statistical analysis was appropriate.
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19
Result:
The median time from administration of the in­
duction dose of propofol to loss of conscious­
ness was 24 seconds in the propofol 1.5 group, 29 seconds in the propofol 1.5+0.5 group, and 18 seconds in the propofol 2.0 group (P < 0.004 pro­
pofol 2.0 group versus other groups). The MAC ")$ .'2"B3+(,'$ -(.$ .1910(+$ 1,$ '(8&$ 5+"3:$ !3+­
ing intubation. Estimated plasma concentrations of propofol at intubation were 6.7 µg/mL in the propofol 1.5+0.5 group compared with only 2.6 µg/mL in the propofol 1.0 group and 2.7 µg/mL in the propofol 2.0 group (P < 0.001). Estimated effect site concentrations at intubation were 4.7 µg/mL in the propofol 1.5 group, 6.1 µg/mL in the propofol 1.5+0.5 group, and 5.7 µg/mL in the propofol 2.0 group (P < 0.001).
The number of patients with excellent or good 1,*3<(*1,5$8",!1*1",.$-(.$.15,1/8(,*07$&15&'+$1,$
the propofol 1.5+0.5 group compared to either the propofol 1.5 or the propofol 2.0 group (P < 0.004). Of the 34 patients in each group, 31 in the propofol 1.5+0.5 group had excellent intubating conditions, compared to only 10 patients in the propofol 2.0 group and 8 patients in the propofol 1.5 group. Good intubating conditions occurred at about the same rate in each group. Poor intu­
bating conditions occurred in only 3 patients in the propofol 1.5+0.5 group compared to 14 and 13 patients respectfully in the propofol 2.0 group and propofol 1.5 group.
%&'+'$-'+'$,"$.15,1/8(,*$!1))'+',8'.$1,$&'9"!7­
namics in any of the groups at baseline. However, 2 patients in groups propofol 1.5 and propofol 2.0 had an MAP less than 60 mmHg that required treatment. One patient in the propofol 1.5 group and 3 patients in the propofol 2.0 group also had a heart rate less than 50 bpm.
2#.,:8</#.R Inducing general anesthesia with 1.5 mg/kg of propofol followed by an additional 0.5 mg/kg 20
propofol before intubation resulted in better in­
tubating conditions and higher estimated plasma and effect site concentrations of propofol than administering either 1.5 or 2.0 mg/kg of propofol alone for induction of general anesthesia. Divid­
ing the induction dose of propofol in this manner does not result in undesirable hemodynamic ef­
fects but does reduce the incidence of hypoten­
sion requiring treatment.
Comment:
Early in my career I worked with an exception­
ally skilled anesthetist whose motto was “neater, sweeter, slicker, quicker.” John’s goal was not only to provide a quality anesthetic, but to work so smoothly that it looked like a performance. He would’ve loved this article.
6$.3:'+/81(0$0""@$(*$*&1.$(+*180'$0'(2'.$7"3$*&1,@­
ing, “what’s the difference whether I give all the propofol at once or save some of it to give a few seconds later just before I intubate?” But there are two aspects of this study which deserve closer attention. First, we have to think about the effects of a normal intubating dose of propofol on blood pressure and cardiac output. We know from other studies that administering something that increases cardiac output (e.g. ephedrine) at the same time that we give a non­depolarizing muscle relaxant speeds the onset of paralysis. Quite simply, increasing cardiac output gets the non­depolarizer to the site of action more quickly. It stands to reason, then, that reducing blood pres­
sure and cardiac output with a full intubating dose of propofol may slow the onset of neuromuscular blockade because the non­depolarizer gets to the neuromuscular junction more slowly. Adminis­
tering propofol in divided doses was shown in this study to reduce the incidence of hypotension and bradycardia, thus preserving cardiac output and allowing the rocuronium to reach the neuro­
muscular junction more quickly. Secondly, we’d like to give as large a dose of propofol as pos­
sible because larger doses provide better intubat­
ing conditions and prevent sympathetic responses ALANA NewsBulletin
to laryngoscopy and intubation. But doing so often results in undesirable decreases in blood pressure. This study showed that administering the propofol in two partial doses resulted in higher estimated plasma levels of propofol at the time of intubation while at the same time attenuating any decreases in blood pressure and heart rate. A win win; better intubating conditions, better hemodynamics.
We can all go to the OR tomorrow and induce general anesthesia with propofol the same way we always have. But if we want to do the job just a little bit better we should heed what this article has to teach us. Doing so will take a perfectly good anesthetic and make it into something more like a performance; something “neater, sweeter, slicker, quicker.”
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Calendar of Events
April 10­13, 2011 AANA Mid­Year Assembly Crystal Gateway Marriott
Arlington, VA
May 6­8, 2011 ALANA Spring Meeting Hilton Sandestin Beach Resort
Sandestin, FL
August 6­10, 2011 October 28­30, 2011 78th Annual AANA Meeting Hynes Convention Center
Boston, MA
ALANA Fall Meeting The Wynfrey Hotel
Birmingham, AL CCC=101J5&61=#&(
21
ALANA Spring Meeting
Information & Registration
SANDESTIN HILTON MAY 6–8, 2011
AGENDA
Friday May 6, 2011 (8 CEUs – 2.75 Pharm)
11:15AM AANA Update Paul Santoro, MS, CRNA & Wanda Wilson, PhD, CRNA
12:15PM Lunch Buffet
12:30PM C
ost Effectiveness / Quality / Healthcare Reform Panel Paul Santoro / Wanda Wilson / Janice Izlar / Heather Rankin
13:30PM A
LANA President’s Address & Business Meeting Heather Rankin, MSN, CRNA ALANA President
ALANA Beach Party
06:30AM Registration & Continental Breakfast
07:00AM uman Factors and Patient Safety – Creating a H
Culture of Safety Janice Izlar, DNAP, CRNA
08:00AM In Just a Flash: Reducing the Risk of OR Fires Janice Izlar, DNAP, CRNA 09:00AM Exhibits & Refreshments 09:15AM Pain and Immune Function During Prostatectomy* Stephen Yermal, PhD, CRNA
10:15AM A Look at Critical Thinking Phil Kendrick, PhD, CRNA
15:00PM 11:15AM Melatonin as a Preop Sedative*** Phil Kendrick, PhD, CRNA
Sunday May 8, 2011 (6 CEUs – 3.25 Pharm)
12:15PM Lunch Buffet
12:45PM Inhaled Anesthetic Pharmacology Review: Kinetics of Inhaled Anesthetics*** Derek Sakata, MD (SPONSORED by: Sagent Pharmaceuticals)
13:45PM Reversing Inhaled Anesthetics: Returning Patients Quickly to Baseline** Derek Sakata, MD (SPONSORED by: Sagent Pharmaceuticals) 14:45PM Wellness Elective (Session 1)
Saturday May 7, 2011 (7 CEUs – 1 Pharm)
06:00AM Registration & Continental Breakfast
06:00AM Early Bird Wellness Elective (Session 2) 07:00AM Combat Anesthesia** Captain Peter Strube, MSNA, CRNA
08:00AM What is Appropriate Patient Selection Criteria for the Ambulatory Surgery Center? Janice Izlar, DNAP, CRNA
09:00AM Exhibits & Refreshments 09:15AM NPO Status and Aspiration Pneumonitis** Wanda Wilson, PhD, CRNA
10:15AM Anesthesia Entrepreneurship Paul Santoro, MS, CRNA
22
06:00AM Registration & Continental Breakfast
06:00AM Early Bird Wellness Elective (Session 3) 07:00AM Old Drugs ­ Forgotten Uses*** Peter Strube, CRNA
08:00AM New Drugs: What’s on the Horizon*** Peter Strube, CRNA
09:00AM Finance Peter Strube, CRNA
10:00AM Break (Check out)
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$ /+9'2j$=+'N'9:*12'$6,(05'.1($h$6,*1:7+'.1.kkk Stephen Yermal, PhD, CRNA
11:30AM C
ancer Surgery and Recurrence: Implications for CRNAs* Stephen Yermal, PhD, CRNA
12:30PM ADJOURN
* ** *** .25 Pharm Credits .50 Pharm Credits 1 Pharm Credits
ALANA NewsBulletin
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Room reservations should be made directly with the Hilton Sandestin by calling 1.850.267.9500 or by visiting them online at www.hiltonsandes­
tinbeach.com. Use our ALANA Group Code of ANS to secure the special rate. Rooms blocked for the ALANA are at a discounted group rate ")$_LTl$:'+$,15&*;$'R803!1,5$*(R$(,!$)''.#$%&'$
deadline for receiving rooms at this special pric­
ing is April 5, 2011. Reserve your room early, as the hotel always sells out! Check in time is 4PM and checkout is 11AM.
Meeting Fees
AANA Members Full Registration: F')"+'$6:+10$LU*&$ _MUU#UU
6)*'+$6:+10$LU*&$
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Non­AANA Members Full Registration: F')"+'$6:+10$LU*&$ _`UU#UU$
6)*'+$6:+10$LU*&$$ _``U#UU
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Sponsor–A–Student Program
This year the ALANA is offering each of you an opportunity to show your support for the future of our profession by sponsoring a student to attend the Spring Meeting. The ALANA charges a nominal fee for attendance by students from in­state schools, so your contributions will be used to help offset their expenses. A ribbon will be added to your nametag designating you as a Sponsor­A­Student Donor. Wear it proudly!
Featuring AANA Leadership
Registration
Name: __________________________________________
Address: ________________________________________
City/State/Zip: ___________________________________
Place of Employment: _____________________________
E-mail Address: __________________________________
Home Phone: ____________________________________
AANA Member: ! Yes ! No
AANA Number: _____________________
! Full Meeting – Wellness Sessions Included.
AANA Member $400/ Non-member $500
! Friday only.
AANA Member $175/ Non-member $225
! Saturday only.
AANA Member $150/ Non-member $200
! Sunday only.
AANA Member $125/ Non-member $175
! Student.
In-State $25/ Out-of-State $100
! I want to Sponsor-A-Student ($25 Minimum)
! Optional ALA-CRNA PAC contribution
! My check to ALANA is enclosed
! Charge to my credit card:
! MC ! VISA ! AE
______
______
______
______
______
______
______
______
______
Card Number: ____________________________________
Expiration Date/Billing Zip Code: _____________________
Name as appears on card: ____________________________
Send completed registration form and method of payment to:
ALANA Office
Post Office Box 240757
Montgomery, AL 36124
Fax 334.272.7128
Questions? Call 334.260.7970
AANA President Paul Santoro, MS, CRNA CCC=101J5&61=#&(
AANA Executive Director
Wanda Wilson, PhD, CRNA
For those with special needs or questions about the meeting,
contact Bruce Von Hagel at 205.902.9600 or the ALANA Office
at 334.260.7970. Refunds on tuition will be honored upon receipt
of a written request prior to April 20, 2011, subject to a $50.00
cancellation fee. Refunds will not be honored after April 20th.
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Finally, a cure for spring fever!
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ALANA Spring Meeting
Sandestin, Florida
May 6­8, 2011
For more information call
(334) 260.7970 or visit www.AlabamaCRNA.org