September #3 - Alabama Association of Nurse Anesthetists

ALANA A Publication of the Alabama Association of Nurse Anesthetists News Bulletin advancing quality anesthesia care, serving our members, promoting the nurse anesthesia profession ALANA Elections 2011/12 In these days of uncertainty, leadership has never been more important. The ALANA needs quality leaders to guide the organiza tion. Our members depend on these leaders to set goals and objectives to keep ALANA relevant, involved and advocating for all CRNAs. One of the most valuable things any of us can do is to give back to the profession. One way of giving back is to volunteer to serve our professional association. Service is fun and a very rewarding experience. This year, we have twelve CRNAs who are willing to give of their time, resources and energy to make ALANA a stronger, more effective advocate for all nurse anesthetists. Tom Dryden chaired the ALANA Nominating Committee this year and did yeoman's work in putting together a tremendous slate of potential leaders for ALANA. The slate of candidates was approved by the membership at the ALANA Annual Spring Business Meeting in Destin. On behalf of the ALANA leadership, our thanks to Tom for the excellent job in assembling this slate of candi dates. In addition, our thanks to each of the candidates for their willingness to serve the Alabama Association of Nurse Anesthetists. Service on the Board of Directors is an enjoyable and rewarding way to give back to the profession and to shape the future of nurse anesthesia in Alabama and beyond. Each candidate was given an opportunity to prepare a brief biographical sketch, a position state ment, and submit a photo to be included in this issue of the ALANA NewsBulletin. Please read through the position statements that begin on page 4 as you prepare to vote in the election. Volume 29, Number 3, 2011 Jim Henderson, Editor In This Issue President’s Address Heather J. Rankin, MSN, CRNA 2 Calendar of Events 3 Candidate Position Statements 4 Introduce Yourself Willie Furr, CNRA 18 Anesthesia Abstracts 21 Fall Meeting Information 24 The ballots will be mailed to each active member of the ALANA on record as obtained from the most recent mailing list of active members from the AANA. Head Teller for this year is David Fort, CRNA of Birmingham, Alabama. Should you not receive a ballot or need a duplicate ballot, Mr. Fort can be reached at davidfort8@aol.com. Mr. Fort will be assisted by Mary Stover, CRNA and David Sanford, CRNA. Ballots must be returned in the envelope provided and received by the tellers no later than October 14. The results of the election will be announced at the ALANA Annual Fall Business Meeting at the Wynfrey on October 29, 2011 at 12:00 noon. Newly elected members will be inducted at that time. All active members of the ALANA are welcome to attend and participate in the business meeting, even if not regis tered for the educational sessions. ALANA 2011/12 Candidates President Elect Phillip Kendrick Bruce Von Hagel Vice President/Secretary Heather Fields Carol Johnson Nominating Committee Chair Pennie Nichols (unopposed) Board of Directors South Chris Caldwell or David Gay Central Phillip Fikes, Patrick Hubbard or Seth Richardson North Albert Herrington or Brian Koonce September 2011 Volume 29, Number 3 H920'4):& /012131!/44#5'1*'#6!#7!89&4:!/6:4*):*'4*4 !"#$%&'(%)*+,(%#*%&'(% ALANA President THANKS As I write this last president’s address, I think about the past year. It has been my honor to serve the CRNAs of Alabama in this capacity. It has been a very busy year, starting off with a Board Retreat and not slowing down. I have had the opportunity to speak on the safe, quality, and cost effective care that Alabama nurse anesthetists bring to the great citizens of our state in Montogmery and Washington, D.C., as well as represent our state at multiple meetings nationwide. It is obvious at these meetings that our state has earned respect across the nation, thanks to the hard work of many before us. This year, meetings have occurred with BCBS as we continue to work towards direct reimbursement for CRNAs. The PR committee has done outstanding work during CRNA week, and will soon have an Alabama CRNA video for your viewing. Look for more information on that soon! H#4*!O7P5:!D#Q!+R,STS!.!U#6*(#3:&%;!/012131!XL-+R XXR=+L,=SIS, D#1&@!#7!]'&:5*#&4 President Y:1*):&!>16Z'6 +T-T!O1Z!B:17!"'&50: D:44:3:&;!/B!XT,++ +,T=+RI=,LT,!E5:00M )[)&16Z'6\%1)##=5#3 Director "%6@'!D144 --K!/4)7#&@!"'&50: D'&3'6()13;!/B!!XT+R+ +,T=XK-=,LLK!E5:00M 5%6@'2144\2:004#9*)=6:* PresidentElect ]1?'@!Y132&'()* +-+T!^10214)!]&'?: U#6*(#3:&%;!/B!XL--L XXR=K-I=,RII!E5:00M 7)132&'()*\)#*31'0=5#3 Director U'5)1:0!Y932:& -S,T!F6'?:&4'*%!D0?@;!GYHD!RKI D'&3'6()13;!/B!!XT+IR +,T=III=STRR!E5:00M 3)932:&\912=:@9 VicePresident/Secretary H)'00'$!_:6@&'5Z -S,T!F6'?=!D0?@;!GYHD!RTR D'&3'6()13;!/B!!XT+IR +T-=TTR=+K+,!E5:00M 5$Z\912=:@9 Director D01'&!H:&Z'64 RX,!>#66%!B16: G$&'6(?'00:;!/B!!XT-RL +,T=TLX=RXXR!E5:00M 201'&$:&Z'64\C'6@4*&:13=6:* Treasurer `:66'7:&!O?:&*#6 RTRT!"&#C6!H#'6*!B16: U*=!O0'?:;!/B!XT--S +,T=TX-=RRLI!E5:00M [:66'7:&=#?:&*#6\(31'0=5#3 Director _%0:!b16@:&7#&@ +IX!Y'()!>'@(:!]&'?: H:0)13;!/B!!XT-+R +,T=+LL=KI-+!E5:00M :1(0:Z'5Z+I\(31'0=5#3 Senior Director Y:1*):&!a':0@4 +XX,!>'@(:!>#1@ O$:0'Z1;!/B!!XLK,R XXR=S+K=X,X,!E5:00M )0?-&6\1#0=5#3 Nominating Committee Chair A)#314!]&%@:6 -,-K!^1&&'6(*#6!"'&50: D'&3'6()13;!/B!!XT+R+ +,T=I,S=RRIR *40::$:&,-\1#0=5#3 Senior Director /02:&*!Y:&&'6(*#6 X,-+!D1&5#@%!>#1@!GV Y96*4?'00:;!/B!!XTK,+ +TL=LT-=KKIX!E5:00M 102:&*):&&'6(*#6-,-\ 5#3514*=6:* UAB Student Representative 8'5Z!D:&&% +XLI!Y15Z2:&&%!B16: Y##?:&;!/B!!XT++L +,T=RS,=RIX,!E5:00M 62:&&%\912=:@9 Senior Director /6@&:C!U#&&'4 L+-L!_:4*&10!b':C!>#1@ A&944?'00:;!/B!!XT-SX +,T=L,+=,-IK!E5:00M 416@316+,T\(31'0=5#3 Samford Student Representative Justin Carroll +LX,!D:?:&0%!]&'?: D'&3'6()13;!/B!!XT++X +,T=TR+=RTKS [51&&#0-\4137#&@=:@9 VQ:59*'?:!G*177 Executive Director Larry A. Vinson c&#9$!U161(:3:6*!G:&?'5:4 H#4*!O7P5:!D#Q!+R,STS U#6*(#3:&%;!/B!!XL-+R XXR=+L,=SIS,!E#7P5:M 01&&%\(3410=5#3 General Counsel T. Joe Knight _&:44!D9'0@'6(;!G9'*:!T,, 301 19th Street N D'&3'6()13;!/B!XT+,X +,T=TX-=T-TS!E5:00M `#:\*[#:Z6'()*01C=5#3 Government Relations Specialist Susan Hansen a&16Z0'6!>:4#9&5:4!c&#9$ R-+,!^100!G*&::* U#6*(#3:&%;!/B!!XL-,L XXR=+RR=+-KS!E#7P5:M XXR=X+,=STXI!E5:00M )164:6\7&16Z0'6&(=5#3 G$:5'10!G:&?'5:4 Federal Political Director /3%!8:'3Z'6 XLK!^##@C1&@!"#9&* D'&3'6()13;!/B!!XT+R+ +,T=+RX=KXK+!E5:00M 16:'3Z'6\1#0=5#3 State Peer Assistance Advisor John Morris -KL!>'5Z%!B16: H:00!"'*%;!/B!!XT-+K +,T=T+S=XTTL!E5:00M -T,S3#&&'4\5:6*9&%*:0=6:* Editor `'3!Y:6@:&4#6 -,L!V32:&!^1% B1c&16(:;!c/!X,+R, S,L=KK+=TLTK!E:?:6'6(4M 416@316X\5)1&*:&=6:* AANA Foundation Advocate H1*&'5Z!Y9221&@ +-IL!>#44!/?:69: Y##?:&;!/B!!XT++L +,T=TX-=K+,L!E5:00M $1*&'5Z)9221&@\3:=5#3 ALANA NewsBulletin! "#$%&'()*! +,--! .!/012131!/44#5'1*'#6! #7! 89&4:! /6:4*):*'4*4;!<65=!.!/00!>'()*4!>:4:&?:@= A):!/B/8/!8:C4D900:*'6!EFGHG!,-IJKLIM!'4!$920'4):@!N91&*:&0%!2%!*):! /012131!/44#5'1*'#6!#7!89&4:!/6:4*):*'4*4;!<65;!H#4*!O7P5:!D#Q!+R,STS;! U#6*(#3:&%;!/012131=! HOGAU/GAV>W!G:6@!1@@&:44!5)16(:4!*#!/B/8/!8:C4D900:*'6;! H#4*!O7P5:!D#Q!+R,STS;!U#6*(#3:&%;!/B!!XL-+R= 2 Heather J. Rankin, MSN, CRNA CHANGE As the summer days continue to blast us with heat, I look forward to the change of the seasons and for fall weather and football. Many other changes will be taking place in healthcare over the next few years, and although I have no idea what the end result will be, I think we as a profession can continue to strengthen our role in healthcare. We know we are quality, cost effective providers, and need to continue to show this to those around us. We need to continue to make our voices heard in Montgomery and in Washing !"#$%&'('%)#*%+,-!%*./0.)1.1%2#%3.*2/)0.%0.245601.4.#!%)#*%72!8.% 8 funding. Change is also occurring in our national organization. The 50 State Service Strategy brought forth by President San toro and the AANA Board of Directors is a forward thinking plan with the end result strengthening the state associations. This will increase the overall strength of the AANA as our national and state organizations together navigate the changes in healthcare and other issues facing our profession. I hope you have noticed a few changes on the ALANA website, including a new name –www.alabamac rna.org. Soon the website will be getting a redesign, so check back to see the changes. This year I have also been able to meet and talk with many of you either in person at meetings, or by phone or email. Seeing the dedication you provide to your patients and passion for our Association make me proud to say that I have served on this Board. I would like to thank everyone who has been a part of this year’s Board. You are a very talented group of individuals, and I am grateful that I had the opportunity to serve with you. We have had a very busy year, and your hard work and dedication was much appreciated. Thank you to those of you who have helped mentor me. I have learned a lot over the past years as I have served on the Board, and I hope to use this information to continue to learn and to serve our great pro fession. Thank you especially to my family. To my dad and mom, herself a CRNA, thank you for your encouragement and love throughout life. Thank you most to my husband and boys – for putting up with me, even when I told you I had a last minute conference call or meeting out of town – you’re the best! I look forward to seeing you all at the Fall Meeting, and as always, please do not hesitate to contact me if I can be of service to you. VOTE Speaking of change, I encourage everyone to vote in the upcom ing ALANA elections. The Nominating Committee put together a slate full of talented CRNAs for the upcoming Board. This is your chance to let your voice be heard. Remember, every vote makes a difference, and if you don’t vote, you can’t complain! CONGRATULATIONS Congratulations to Samford student, Katherine Martin, recipient of the ALANA Scholarship. This $1,000 scholarship is awarded an nually to a student at an Alabama nurse anesthesia program by the AANA Foundation. FALL MEETING Once again, the Program Committee has an outstanding agenda for the Fall Meeting, October 2830. Friday offers a cardiovascular seminar with the opportunity for ACLS and PALS, followed by a special session Friday evening focusing on the Business of Anesthe sia, led by Daniel J. McNeff. Saturday will include the Funderburg Lectureship Series speaker, Mark Welliver, PhD, an AANA update by John McFadden, our Region 7 Director, and ALANA update and the ALANA Business Meeting, which I have the privilege to give and where the incoming Board members will be announced. Sun day will include lectures from John McFadden and our state school faculty. This meeting offers 22 CEs and 7 pharmacology hours for a great price! Calendar of Events October 28, 2011 ALANA Board of Directors Meeting Wynfrey Hotel, Birmingham October 28 30, 2011 ALANA Fall Meeting Wynfrey Hotel, Birmingham, AL October 30, 2011 ALANA Board of Directors Meeting Wynfrey Hotel, Birmingham November 19 20, 2011 ALANA Board of Directors Retreat Marriott Hotel, Birmingham, AL February 7, 2012 Alabama Legislature Regular Session Opens Montgomery, AL April 27 29, 2012 Spring Meeting 2012 Hilton Sandestin, Destin, FL May 21, 2012 Alabama Legislature Closes Montgomery, AL continued on page 3 ALANA NewsBulletin www.alacrna.org 3 PresidentElect PresidentElect Phillip Kendrick Bruce Von Hagel Phillip Kendrick, CRNA, Ph.D. Hoover, Alabama Callahan Eye Foundation, Birmingham, AL Staff Nurse Anesthetist Bruce Von Hagel, MSN, CRNA Birmingham, Alabama UAB Hospital, Birmingham, AL Chief CRNA Education: University of South Alabama, BSN, 1978 School of Anesthesia for Nurses Located at USA Medical Ctr, 1981 University of South Alabama, MS, 1991 University of South Alabama, Ph.D., 1997 Education: UAB School of Nursing, BSN, 1984 UAB Nurse Anesthesia Program, 1994 Samuel Merritt Uni versity, MSN, 2009 UAB School of Health Professions, (.0!2+/)!.%2#%;.)8!-/)0.%3)#),.4.#!$%/600.#!%=9>%?@./6 tive MSHA Program, current Service: ALANA Board of Directors, 19992001 ALANA VicePresident, 20102011 AANA Communications Technology Committee, 2001 AANA JOURNAL Reviewer, 2003Present AANA Committee on Professional Development, 2004 AANA Foundation Scholarship Committee, 2004Present Alabama State Board of Nursing Nominating Committee, 2009Present NBCRNA Professional Practice Analysis Task Force, 2010Present Position Statement: After a cursory survey of the healthcare landscape, it appears that the profession of nurse anesthesia is in its best posi tion that I can ever recall. Finally, proponents (other than ourselves) are espousing the virtues of CRNAs. Creditable sources are providing documentation of what we have been saying all along: CRNAs provide quality, safe anesthesia at reasonable prices. In essence, we appear to be the solution to the anesthesia delivery system and not the problem. The highly respected Institute of Medicine (IOM) echoes this sentiment. A recent report was issued by the Committee of the Robert Wood Johnson Foundation Initiative on the Future of Nursing at the IOM titled, The Future of Nursing: Lead 2#,%(-)#,.$%9*:)#/2#,%;.)8!-'%%7-.%+01!%0./"44.#*)!2"#%5<% the committee is to remove the scopeofpractice barriers that exist for advanced practice nurses. This prestigious commit tee headed by Donna Shalala goes on to state that advanced practice nurses should be able to practice to the full extent of their education and training. An article published in the August, 2010 edition of Health Affairs compared anesthesia outcomes of Medicare patients in opt out states without MD supervision and states with MD su pervision. An analysis of six years of Medicare data found no evidence that opting out resulted in increased inpatient deaths or complications. This study proved that CRNAs are safe R practitioners working alone or under supervision. The authors even recommended that the Center for Medicare/Medicaid Ser vices allow CRNAs in every state to work without supervision of a surgeon or anesthesiologist. Hogan et al reported on a cost effectiveness analysis of anes thesia providers in the June, 2010 issue of Nursing Economics. In this article, the authors concluded that CRNAs acting inde pendently provide anesthesia services at the lowest economic cost. In addition, CRNAs can be educated at onesixth the cost of an anesthesiologist. It was concluded that as the demand for health care increases, a key to containing costs while maintain ing quality will be to allow increasing numbers of CRNAs to A0)/!2/.%2#%!-.%4"1!%.B+/2.#!%*.82:.0<%4"*.8' And now for the bad news. It is a travesty that the largest A0":2*.0%"B%-.)8!-/)0.%5.#.+!1%2#%!-.%1!)!.%"B%98)5)4)%0.B61.1% to recognize the services of independent CRNAs in Alabama. Blue Cross and Blue Shield (BCBS) of Alabama administers health and dental programs to 2.2 million Alabamians. I would suspect that a large number of these BCBS customers reside in one of the eighteen counties in Alabama in which CRNAs are the sole providers of anesthesia services. For at least the past twenty years, our state association has con tinuously maintained an open, honest dialogue with BCBS of Alabama to address the reimbursement issue. Our past efforts have gotten us nowhere. Performing the same actions over and over again expecting different results is a sign of insanity. It is time to try new strategies with new techniques in dealing with BCBS. Resolving this issue will not only affect the independent prac titioners, but it will affect every member of our association in a positive way. Being appropriately recognized by the largest -.)8!-/)0.%5.#.+!1%A0":2*.0%2#%!-.%1!)!.%D288%.8.:)!.%"60%1!)!61% as healthcare professionals substantially. Therefore, resolving this reimbursement issue should be our number one priority and the issue where we expend the majority of our energies and expenses. ALANA NewsBulletin Service: ALANA BOD 20002001 ALANA Programs CoDirector 2001 Position Statement: Over the years, our association has addressed many attempts to change the course of our practice. We have encountered legislative, regulatory, practice, and reimbursement chal lenges. In every instance, one quality has been crucial to the ALANA’s ability to hoist its sails unscathed or without regres sion experienced leadership at the helm. As you consider who will guide our association out of the next wave of chal lenges and reform, experienced leadership will continue to be essential to the prosperity and longevity of the ALANA and "60%A0"B.112"#%2#%98)5)4)'%%C%)4%/"#+*.#!%!-)!%C$%)8"#,%D2!-% the talented ALANA board directors, posses this necessary quality. I have volunteered my time and service to the ALANA for over a decade. Since 2000, I have served on the board of di rectors, program committee, codirected our state association meetings, and coordinated meeting operations, vendors, and fundraisers. As a result, I have had the pleasure of working with countless leaders in the ALANA and the AANA. My service to our association has given me the opportunity to stay involved with the vital issues facing our state and nation, as well as the current strategies being implemented to resolve these issues. As your ALANA President, I will leverage this experience to move our association forward. As Chief CRNA in one of the largest medical centers in Alabama, I bring a solid foundation in organizational and operational leadership, business acumen, and practice related issues. I have also been deeply involved in the strategic planning associated with the coming healthcare reform. Healthcare is changing. In the near future, the way we prac tice, the issues we face, and the method used to reimburse healthcare services will not likely be similar to today. The www.alacrna.org leadership of the ALANA must ensure our profession and be an active participant and well positioned in this epic era of /-)#,.'%%9#%.@A.02.#/.*%8.)*.0%D-"%-)1%)%+04%,0)1A%"B%!-.1.% changes and its impact on our profession will be necessary to steer our association through the transformation in our indus try. As your ALANA President, I will work tirelessly to navi gate our association to the forefront of each wave of healthcare reform and seize every opportunity to advance our profession as a result. While the ALANA positions our profession for the future vi sion of healthcare, I will not retire the decades long work of the past. There have been tremendous accomplishments made by A0.:2"61%8.)*.01$%)#*%D.%461!%D"0E%!"%502#,%+#)8%0.1"86!2"#%!"% many longstanding issues. As your ALANA President, I will work with the ALANA di rectors to implement a strategy to bring resolution to: F% BCBSAL reimbursement inequities F% Attempts to limit our scope of practice through regulatory and legislative efforts F% Student training and workforce issues F% Member involvement F% Association communication with its members. Our profession is entering an exciting time. At no other time in history has our profession been better positioned to capitalize on the sea of change occurring in healthcare. For the ALANA to safely navigate these rapid transformations, our associa tion will need a proven, experienced leadership. I encourage each of you to participate in the selection of our association’s leadership. Your vote is important. I am fully prepared to help guide our association on this tremendous and exciting voyage. I respectfully request your support. T Vice President/Secretary Board of Directors ~ South Heather Fields or Carol Johnson Chris Caldwell or David Gay Heather Fields, MBA, MSN, CRNA Opelika, Alabama Lanier Memorial Hospital, Valley, AL Partner, Riverview Anesthesia Associ ates, Inc. Education: Southern Union State Community Col lege, ASN, 1995 Auburn University, BSN, 1998 Auburn University, MBA with concentration in MIS & Healthcare Administration, 2000 Samford University, MSN with concentration in Anesthesia, 2007 Service: ALANA Board of Directors October 2009 present, GRC Chair 20102011, GRC Cochair 20092010, Participant in Introduce Yourself campaign for the ALANA. Position Statement: As a member of the ALANA Board of Directors, I have had many opportunities to represent you! While serving on the board, many of our practice rights have been challenged. I have been able to assist in defending these rights. By speaking with people about what nurse anesthetists are and what they do, I helped to spread the word about our wonderful profession. By educating state legislators about our role in healthcare, I helped them understand how crucial nurse anesthetists are for providing cost effective, high quality care. All of these were eyeopening experiences that made me want to continue to give to the profession that I love! That is why I am running for Vice President. We have to continue to defend our profession against attacks. We have to continue to educate the public about our profession and the services that we provide. We have to make sure that legislators know the value that nurse anesthetists have in healthcare. We have to continue defending our practice rights to ensure that our livelihood is protected. Without these actions, we risk losing what makes the nurse anesthetist profes sion so great. This includes the right to practice as we do now. I am committed to putting in the time and effort required to do these things and to represent you! If elected, I promise to serve you to the best of my ability. Together, we can make a differ ence. Your vote will be greatly appreciated. Heather Fields, MBA, MSN, CRNA 2330 Ridge Road Opelika, Alabama 36804 (334) 749.3031 (home) (334) 728.3030 (cell) hlv1rn@aol.com 6 Carol Johnson, CRNA, MNA, MBA Birmingham, Alabama Children’s of Alabama, Birmingham, AL Senior CRNA: Anesthesia Information Management System and Performance Improvement Coordinator Christopher S. Caldwell, MSN, CRNA Auburn, AL East Alabama Medical Center, Opelika, AL Partner/Anesthetist – Guardian Anesthesia Services Education: Auburn University, Bachelor of Chemi cal Engineering, 1994 Auburn University, Bachelor of Science in Nursing, 1995 UAB Nurse Anesthesia Program, Master of Nurse Anesthesia, 1999 Auburn University, Master of Business Administration, 2010 Service: Alabama Association of Nurse Anesthetists, Board of Direc tors, 20062008, Hoover Athletic Association, Board of Directors, 20062008 Position Statement: It is an honor to run for Vice President of our Alabama As sociation of Nurse Anesthetists. I am grateful to be a member of a professional organization of anesthetists that are dedicat ed to excellence and advocacy in providing unparalleled care to our patients. Each year, our profession faces new challeng es from professional practice issues, environmental issues, hospital policy changes, reimbursement, healthcare reform, the state of the economy, regulatory compliance, and stringent federal mandates to name a few. We must actively address each of these issues and lead the way in not only adapting to but shaping our changing environment and the future of our profession. The successes we have achieved are well earned. We demonstrate critical thinking skills, compassion, and leadership ability each day. These qualities have afforded our profession great success thus far and as we continue to work together, we will achieve even greater success as a profession through serving our patients and our communities. We are all leaders and I encourage each of you to use your leadership skills not only in the surgical environment but also in your local communities and your professional organiza tions. Volunteer your time and leadership abilities in your communities. We touch the lives of our patients each day. Many of the residents of the State of Alabama have either been cared for or had a friend or family member cared for by a nurse anesthetist at one time or another. Our community has experienced our professionalism and our dedication to excellence. Education: University of South Alabama, BSN, 1998 University of TennesseeKnoxville, MSNNurse Anesthesia Concentration, 2002 Position Statement: It is most certainly a privilege and honor to be nominated for the ALANA Board of Directors, and for that I am very thank ful. As a partner in a nurse anesthesia practice, and as a self employed contractor and practice management consultant, I have personally experienced many of the challenges, changes, and barriers that we all face as nurse anesthetists. The advance ment of nurse anesthesia practice through research, education, )#*%8.,218)!2"#%D288%*.+#.%"60%A"12!2"#%2#%!-.%B6!60.%"B%-.)8!- care. C!%21%4"1!%24A"0!)#!%!-)!%D.%/"#!2#6.%!"%5.%G.@258.%)#*%*282,.#!% in our roles as caregivers, educators, and facilitators. We cur rently face ongoing and evolving challenges which include a reversing supply/demand mismatch, government and com mercial insurance funding and reimbursement changes, and national healthcare reform. We must advocate for and clarify our position in order to facilitate our presence in this evolving healthcare marketplace. The art and science of nurse anesthesia practice have been extremely generous to me both professionally and personally. I am committed to fostering the growth and evolution of our craft, and I am very appreciative of the opportunity to play a broader role in our vocational development. I will strive to serve our membership, their opinions, concerns, and needs, and I sincerely appreciate your consideration of my candidacy. Contact Information: Christopher Caldwell, MSN, CRNA 1257 Walker Circle Auburn, AL 36830 (334) 8214466(h) (334) 6632419(m) cscaldwell7@gmail.com David B. Gay, MSN, MNA, CRNA Mobile, Alabama Anesthesia Solutions of Mobile Providence Hospital Staff Anesthetist Education: University of Mobile, BSN, 1997 University of Mobile, MSN, Family Nurse Practitioner, 2001 University of Alabama at Birmingham, MNA, 2004 Position Statement: As nurse anesthetists, we are the front line providers of qual ity, safe, costeffective anesthesia in our communities. I am proud to be a CRNA in my community and I am honored to be nominated by my peers as a candidate for the ALANA Board of Directors. As your ALANA Board Member, I pledge to assiduously defend the rights and traditions my predecessors have estab lished and to add to the integrity, leadership, and vision our association relishes. The ALANA is a strong, healthy, organization; nevertheless, our state association must continue to move us boldly forward. I will work with your ALANA leadership to: F% F% F% F% F% H.1"8:.%!-.%*21/0242#)!"0<%2116.1%D2!-%/"44.0/2)8%% reimbursement in Alabama &.B.#*%8.,218)!2:.%)#*%0.,68)!"0<%!-0.)!1%!"%"60%1/"A.%% of practice C4A0":.%!-.%2#!.0)/!2"#%)#*%A)0!2/2A)!2"#%"B%!-.%% ALANA leadership with the membership =#2B<%"60%:"2/.%D2!-%82E.I42#*.*%-.)8!-/)0.%)11"/2)% tions ?:)86)!.%!-.%24A)/!%"B%#)!2"#)8%-.)8!-/)0.%0.B"04%"#%% the Alabama market I vow to listen to the membership, learn from the leadership of past, and lead with unrivaled fervor. I will proudly serve our association to protect and propagate the dynamically changing and rewarding profession of nurse anesthesia. Contact Information: David Gay, MSN, MNA, CRNA 6615 Lubarrett Way Mobile, AL 36695 (251) 8952880 DavidBrianGay@aol.com continued on page 14 ALANA NewsBulletin www.alacrna.org S Board of Directors ~ Central Board of Directors ~ Central Phillip Fikes or Patrick Hubbard or Seth Richardson Philip B. Fikes, MNA, CRNA Tuscaloosa, Alabama Huntsville Hospital, Huntsville, Alabama Staff Anesthetist Education: Shelton State Community College, ADN, 1993 The University of Alabama, BSN, 1998 UAB Nurse Anesthesia Program, MNA, 2001 Position Statement: The Nurse Anesthesia Profession has been successful for many reasons. We owe our present and former leaders for their dedication and hard work in keeping the nurse anesthesia profession strong. I am committed to working hard for our as sociation and its members in order to make our profession even stronger. Our current healthcare model is under constant debate and scrutiny. It is our responsibility as Nurse Anesthetists to make 160.%!-)!%D.%)0.%E#"D#%B"0%!-.%M6)82!<%)#*%/"1!%.B+/2.#!%/)0.% we provide. We must strive to maintain and improve our posi tion in healthcare. Patrick A. Hubbard, MSN, CRNA Birmingham, Alabama Brookwood Medical Center Staff Anesthetist, Nurse Anesthesia Student Manager Seth A. Richardson, MNA, CRNA Birmingham, Alabama University of Alabama at Birmingham Hospital, Birmingham, Alabama Staff Anesthetist, Nurse Anesthesia Resident Manager Education: UAB, BSN, 2003 Samford University, MSN, 2007 Education: UAB, BSN, 1997 UAB Nurse Anesthesia Program, MNA, 2004 Position Statement: If you are like me, you carry a great sense of pride in being a CRNA and a trusted healthcare provider. In my opinion, Nurse Anesthesia is arguably one of the best professions in the workplace today. I would like to give back to this profession as it has given so much to me. On the same note, I would like to carry on the strong work and dedication of those before us who have maintained the prestige of Nurse Anesthesia. I am eager to learn more about the functions of the ALANA and am more than willing to serve as a strong advocate for our patients and our practice. I am truly honored to receive a nomination for a position on the ALANA Board of Directors. I feel very B"0!6#)!.%!"%-):.%16/-%)%0.D)0*2#,%)#*%B68+882#,%/)0..0%)1%)% CRNA. Just as I care greatly for my patients, I care greatly for my fellow CRNAs and the future of our profession. If given the opportunity, I will devote extra time and hard work to serv ing the members of the Nurse Anesthesia community to the best of my ability. Position Statement: Uncertainty is ever present in today’s dynamic healthcare environment. From recently passed healthcare reform to looming cuts in Medicare reimbursement, there are many questions regarding the direction of our healthcare system. J2!-%)%8"#,%!0)/E%0./"0*%"B%1)B.$%)BB"0*)58.%/)0.$%(HK9L1%)0.%2#%)%B):"0)58.%A"12!2"#%!"%2#G6.#/.%-.)8!-/)0.%8.,218)!2"#%)1%D.88% as ensure access to high quality anesthesia services to the patient populations we serve. In order to achieve these goals there are steps we must take. First, CRNA’s must be informed and active in the political process. We simply cannot sit idly by and allow our practice to be shaped by others. We must take ownership and do all that we can to ensure the continued progress of our craft. Second, we need to increase public awareness of the nurse anesthesia profession. As public awareness grows of the safety, skill, )BB"0*)5282!<%)#*%M6)82!<%"B%)#.1!-.12)%!-)!%(HK9L1%A0":2*.$%D.%/)#%5.%160.%!-)!%)D)0.#.11%)4"#,%.8./!.*%"B+/2)81%D288%,0"D%)1% D.88$%!-61%2#G6.#/2#,%A"82/<' I am grateful to be considered for the ALANA Board of Directors. If elected I will work in whatever capacity necessary to ensure the continued growth of our great profession. If elected as a board member to the ALANA, I will serve self lessly to make sure that our profession continues to be a leader in the medical community. I will serve the members of our profession with my time, energy, and ideas. I am honored to be Thank you. nominated and committed to serving our profession. Patrick A. Hubbard Philip B. Fikes, MNA, CRNA 2196 Ross Ave 14131 Highway 82East Hoover, AL 35226 Duncanville, AL 35456 (205) 5318206 (mobile) Home : (205) 7503604 patrickhubbard@me.com Cell: (205) 8867397 ib4ua13@yahoo.com 8 Contact Information: Seth A. Richardson, MNA, CRNA 1908 Guthrie Dr. Bessemer, AL 35023 (205) 4979521 (H) (205) 5418783 (C) Adamsteel@aol.com ALANA NewsBulletin www.alacrna.org 9 Board of Directors ~ North Nominating Committee Chair Albert Herrington or Brian Koonce Pennie Nichols Albert Herrington, MSN, CRNA Huntsville, AL Huntsville Hospital: Staff Anesthetist Education: University of Mobile, ADN, 1997, Mobile, AL University of South Alabama, BSN, 1999, Mobile, AL Old Dominion University, MSN, 2004, Norfolk, VA Position Statement: It is an honor to be a nominee on the ALANA ballot this year. I have had the opportunity to serve as your north region direc tor on the ALANA board for the past two years. In that time, I have served as cochair of the programs committee, and co chair and then chair of the ALACRNA PAC. We as CRNAs bring affordable quality anesthesia to our patients and com munities. This is not always recognized by our state or federal government. Our voice must continue to be heard, not only in Montgomery, but in Washington, DC, as well. That voice must be heard if we as CRNAs are to practice to the fullest extent of our abilities and receive full reimbursement for our service. In regard to Alabama’s anesthesia programs, I believe our student anesthetists must remain a priority. If we do not properly train and prepare them for their clinical duties, we do them, our patients, and our profession a great disservice. I was originally driven to serve as a way to give back to a profession and organization that has been very good to me in my career as a student and an anesthetist. I now wish to continue that work for another term. I want the opportunity to continue to be a productive member of the ALANA board of directors. I want the opportunity to be a voice for your opinions and concerns. I would now ask for your vote to allow me this honor and op portunity. Albert Herrington, MSN, CRNA 3012 Barcody Rd. SE Huntsville, AL 35802 (256) 6518893 albertherrington101@comcast.net (unopposed) Brian T. Koonce, MSN, CRNA Huntsville, Alabama Decatur General Hospital, Decatur, AL Director, Anesthesia Services/PACU Pennie Nichols, MSN, CRNA Staff CRNA Anesthesia Services Division University Hospital Birmingham, Alabama Education: Southeast Missouri State University, BSN, 1989 The Uniformed Services University of the Health Sciences, MSN, 1999 Education: Masters of Science in Nurse Anesthesia, May 2010 Ida V. Moffett School of Nursing, Samford University, Birmingham, Alabama Bachelors of Science in Nursing, May 2005 The University of West Georgia, Carrollton, Georgia Service: Member, AANA Scope & Standards Task Force Former Member, AANA Federal Services Ad Hoc Committee Position Statement: My name is probably not familiar to many of you but please don’t let that scare you off. Just last year I settled in Hunts ville following retirement from the U.S. Air Force. It was a humbling experience to provide anesthesia care for the men & D"4.#%D-"%+,-!%B"0%"60%B0..*"4'%%C%#"D%/"6#!%2!%)%A02:28.,.% to provide anesthesia care for patients in the Northern Ala bama region, both in times of peace & tranquility and during disasters. With frequent military moves and deployments, it has never been possible for me to serve in a State anesthesia organiza tion. It is an absolute honor to be nominated to serve on the board of directors for the Alabama Association of Nurse Anesthetists. Service: Welcoming Committee Chair 2011 Student Representative for Samford’s Nurse Anesthesia Class of 2010 Position Statement: The opportunity I had to serve as a student representative on the ALANA Board was one of the most valuable learning experi ences for me as a student. It proved a direct correlation between active involvement in our professional organization and the impact that we can have on the way the public perceives our profession. As Chairman of the Nominating committee, I will seek members from all areas of the state dedicated to the vision of advancing our profession and educating those we serve. I would appreciate you allowing me the opportunity to continue to serve you. Thank you. Contact Information: Pennie Nichols, MSN, CRNA 2708 Lakeland Trail Birmingham, Alabama 35243 (205) 746.4448 sixcents24@gmail.com Throughout my anesthesia career, my goal has been to pro vide safe anesthesia care and to advance our specialty. I can’t tell you how many times I’ve been introduced as the patient’s anesthesiologist or a patient has said, “Thanks Doc” after an encounter! If you know me at all, you’ll know that education is my passion…and I fully recognize that it extends far beyond the classroom. I think you’d agree that the general public doesn’t know who we are. I want to be a driving force behind changing the public’s perception; I want them to know that we exist! I hope that you’ll join me by telling patients that a CRNA will be with them throughout their procedure while the anesthesiologist (if you work with one) is there periodically. Through education, I want to pave the way for the citizens of the “Cotton State” to speak out against the lack of direct reimbursement for nurse anesthesia care. After all we have continued on page 14 10 ALANA NewsBulletin www.alacrna.org 11 In the News... Faster...the New Fast Dr. John McFadden, CRNA, Region 7 Director Board of Nursing Update -./0-1%0(,("&2+,3&2#4 K>(HK9%0.A"0!.*%0./.0!2+/)!2"#%*20./!8<%!"%!-.%98)5)4)%>")0*%"B%K6012#,%*602#,%%9A028% NO68<%PQRR%B"0%STU%(HK91%D2!-%98)5)4)%4)282#,%)**0.11%2#%K>(HK9%+8.1'%%9>K%%2116.*% a new CRNA wallet card, effective with RN license expiration date, 12.31.2012. Records for 36 CRNAs failed the electronic import process because the First and Last Name from NBCRNA did not match Alabama Board of Nursing records. As of Friday, July 29, eleven (HK91%2#%98)5)4)%-)*%#"!%0.A"0!.*%0./.0!2+/)!2"#%!-0"6,-%PQRV'%%9AA0":)8%B"0%(HK9% A0)/!2/.%2#%98)5)4)%8)A1.1%D2!-%B)2860.%!"%0.A"0!%0./.0!2+/)!2"#'% Working as a CRNA without current approval by the Alabama Board of Nursing subjects your RN license to disciplinary action by Alabama Board of Nursing. Employers and agen /2.1%)0.%165W./!%!"%+#)#/2)8%A.#)8!2.1%)#*%0.A)<4.#!%"B%1.0:2/.1%5288.*%B"0%)%(HK9%D-"% does not hold current ABN approval. 9X9K9$%2#%PQQU$%B)/282!)!.*%!-.%1!)0!I6A%B"0%.8./!0"#2/%!0)#1B.0%"B%(HK9Y%H./.0!2+/) !2"#%*)!)%B0"4%K>(HK9%!"%!-.%98)5)4)%>")0*%"B%K6012#,'%%7-.%H./.0!2+/)!2"#%1!)BB%)!% NBCRNA and the Advanced Practice staff at the Alabama Board of Nursing work closely to ensure accurate and timely updates for CRNAs who qualify for ongoing approval to practice in Alabama, at no expense to the CRNA. License renewal fees for Alabama RN and CRNA must be paid between September 1 and December 31, 2012. You must report at least 6 credits in pharmacology plus 18 credits for total of 24 contact hours, earned between January 1, 2011 and December 31, 2012. Tally your credits today at www.abn.alabama.gov | Continuing Education | Access Individual CE Record. Charlene B. Cotton, MSN, RN Alabama Board of Nursing Dues NonDeductibility Notice In addition to the amount of your member dues determined by the American Association of Nurse Anesthetists, Inc. as not tax deductible due to lobbying activities on the Federal level, the Alabama Association of Nurse Anesthetists, Inc. reasonably estimates that $57.00 of your dues is attributable to lobbying activities on the State Level and is, therefore, not tax deductible. 12 ALANA NewsBulletin Z[%N%C%)*42!%2!\%7-.0.%)0.%1"%4)#<%.4)281$%!.@!%4.11),.1$%)#*%:"2/.4)281%G<2#,%!"D)0*%4.% !-)!%C%-):.%)%*2B+/68!%!24.%E..A2#,%6A'%]"4.%*)<1$%C%5./"4.%A)0)8<^.*%B0"4%1.#1"0<%":.08")*'% C%5./"4.%B061!0)!.*%D-.#%1"4."#.%)/!6)88<%D)8E1%2#!"%4<%"B+/.%!"%!)8E%_,)1A\`$%.1A./2)88<% D-.#%C%)4%!0<2#,%!"%0.1A"#*%!"%.4)281'%C%+#*%4<1.8B%D"#*.02#,%2B%!-.%,.#.0)!2"#%5.B"0.%4.% somehow had it easier. All they had were phone messages written on a piece of paper. They say ignorance is bliss – there may be something to that. My brain understands this is our new reality: information is slamming towards each of us at a rapid pace – and there is no chance of it slowing down. The good news is, we “know” things faster. The bad news is, we know things faster. We no longer debate if reading in the O.R. is safe. It’s almost become a nonissue since our smartphones provide us with brief alerts and tweets quicker than words can be put on paper. Who wants to wait for the print media? We live in a high velocity world and, as Jim Carroll so eloquently elucidated in his book, Ready, Set, Done, faster is the new fast. The question is, how to keep up? How do we, the AANA members – as the essential element of our profession – stay intune with our industry’s rapidly changing circumstances AND respond with a solution (“innovate”) to the challenges we encounter? Whether it is adopting a new anesthetic agent, evaluating a new piece of technology, or contributing to a reengineered process, agility and adaptability are key attributes to our profession’s survival. If we don’t 0.1A"#*%!"%!-.%0)A2*I+0.%2116.1%!-)!%.06A!%)0"6#*%61$%)%/"4A.!2#,%,0"6A%160.8<%D288'% Nor is our Association immune to the impact of highvelocity change. Although there is a sense of security in the status qou (keeping things the same is SO much easier), we cannot allow our discomfort with change to keep us mired in yesterday’s way of doing things. AANA is destined to evolve. We are not the same association we were 10 years ago – nor should we be. And respecting our history does not permit stagnation. Our internal structure and processes will need to change. Our meetings and agendas will need to be transformed. And the AANA of the future will hopefully morph into an alliance of dynamic colleagues who choose to con #./!%5./)61.%!-.<%+#*%:)86.%2#%.)/-%"!-.0'% 91%)6!64#%)AA0")/-.1$%!)E.%)%4"4.#!%!"%0.G./!%"#%-"D%<"6%4)#),.%468!2A8.%4"*.1%"B% communication. Are you taking in the information and using it to change your practice and profession? Do you need to master some strategies for controlling the unending stream of data? Are you frustrated at the way things are changing? The staff and Board of the AANA are generating novel approaches to help us navigate through the knowledge ecosystem that we are all a part of. Be on the lookout for a redesigned website, blogs and forums for posting, and innovative ways of interacting with your colleagues – in person and virtually. If you have some ideas for how we can better meet your professional needs, drop me a note or call. Who knows, you may be on to the next Google. Or at the very least, your idea might help all of us keep pace with the everincreasing velocity of new anesthesia knowledge. www.alacrna.org 13 Nurse Anesthesia Program News ALANA Student Representative Justin Carroll, SRNA Samford University Dr. Laura Wright, PhDc, MNA, CRNA Interim Program Director Dr. Phillip Kendrick left the Nurse Anesthesia Program May 31st. We would like thank Dr. Ken drick for his leadership these past 5 years. He led with humor and compassion, and kept our pro gram strong. Not only was he instrumental in the success of our recent accreditation process, he was an excellent teacher and dedicated to the education of our students. He will be missed by all. I have been named the Interim Program Director, while a national search for a Program Director is being conducted. I vow to keep the program strong as progression to a doctoral program begins. I have been with the program for 10 years and will complete my PhD in the fall. I look forward to the challenges of taking on this role and moving the program forward. Michael Humber has been accepted into the UAB School of Nursing DNP program. We are ex cited for his endeavors and will support him through his education. We are proud of Dr. Epps who was part of a team to win “Research Article of the Year” by the editorial board of the International Nursing Association for Clinical Simulation and Learning (INACSL). Dr. Epps, along with some faculty in the UAB School of Nursing, wrote the article, “Video Facilitated Feedback to Improve Student Performance Following HighFidelity Simula tion,” for the international peerreviewed journal Clinical Simulation in Nursing. The students are busy. We congratulate the class of 2011 as they prepare for graduation this fall. J.%0./",#2^.%!-.%-)0*%D"0E%A6!%B"0!-%5<%!-.%/8)11%"B%PQRP%)1%!-.<%+#21-%6A%!-.20%+01!%/82#2/)8%0"!) tion and we look forward to the class of 2013 which began on August 15th. Continued from page 6, Carol Johnson Continued from page 10, Brian Koonce I encourage you to seek volunteer opportunities in your local government, civic organizations, and professional organizations and donate your time, critical thinking skills and leadership abilities in your communities as well. Creating positive com munity relationships will provide new opportunities to further our profession. I ask for your vote for Vice President and will work diligently in addressing the issues our profession faces today and those we will face tomorrow. I look forward to the opportunity to work tirelessly at the local, state, and national levels for you and our profession. been shown to be just as safe and more cost effective! I hope you’d agree that we provide the most compassionate /)0.%)1%D.88'%%C%5.82.:.%)#%2#2!2)!2:.%!"%+,-!%B"0%"60%02,-!B68% reimbursement must begin with the customer …the public at large! Contact Information: Carol Johnson, CRNA, MNA, MBA 2731 Cherokee Drive Mountain Brook, AL 35216 (205) 4416219 cj2731@gmail.com Contact Information: Brian Koonce, MSN, CRNA 203 Morningwalk Lane Huntsville, AL 35824 2565293292 (cell) bkcrna@mac.com -R C%)4%"#%+0.%B"0%"60%1A./2)8!<$%)#*%4<%B.0:"0%D288%#"!%D2!-.0% away if elected! Thank you, ALANA members, for the opportunity to serve you, this great organization, and our beautiful State. Please allow me to take this opportunity to introduce myself. My name is Justin Carroll, Samford University’s student representative on the Board of Directors of the ALANA. I graduated with my Baccalaureate in the Science of Nursing from the University of Alabama and am currently in my second year of Samford’s Nurse Anesthesia Program. It has long been a goal of mine to one *)<%A0)/!2/.%)#.1!-.12)%)1%)%(.0!2+.*%H.,21!.0.*%K601.%9#.1!-.!21!%)#*%5./"4.%)%4.45.0%"B%!-21% exceptional profession that is everevolving in order to meet the demands of the changing world of health care. I am honored to begin my anesthesia journey by serving the ALANA in this role. From a student’s perspective, I would like to discuss a couple of ways in which nurse anesthesia education is evolving in order to ensure that the profession will continue to rise to the challenge of providing superior anesthesia care in the midst of a changing health care climate. The two sub jects that I will talk about are the simulation experiences utilized by many nurse anesthesia pro grams and the future requirement for a doctoral degree for entry into nurse anesthesia practice. ]2#/.%!-.%2#!0"*6/!2"#%"B%!-.%+01!%)#.1!-.12)%12468)!"0%2#%RTaQ$%#601.%)#.1!-.12)%A0",0)41%)0"6#*% the country have increasingly adopted this handson approach to anesthesia training. Student Registered Nurse Anesthetists (SRNAs) routinely use many simulator modalities, ranging from 5)12/%4)#2E2#%!)1EI!0)2#.01%!"%!-.%16A.0I!./-#2/)8$%-2,-%+*.82!<%"A.0)!2#,%0""4%12468)!"0'%7-.% AANA Journal published an article in 2008 which reported that 96% of the 52 program directors surveyed utilized some form of simulation experience in their curriculum. A question on many minds may be: “Is simulation effective?” In 2002, the AANA journal featured an article explor ing SRNAs’ opinions of simulation. The article reported that SRNAs felt that simulation allowed the development of critical thinking/decisionmaking skills, management of rare or unusual events, and viewed the simulator experience as “a vital part of their education”. Personally, I feel that simulation provided me invaluable advantages while preparing for clinical. By strengthen ing skills and allowing the physical application of the science of anesthesia, I believe simulation contributes to the advancement of anesthesia education and future practice. 7-.%-21!"02/)8%/"601.%"B%#601.%)#.1!-.12)%.*6/)!2"#%21%B)1/2#)!2#,%2#%!-)!%2!%21%0.G./!2:.%"B%!-.%/"0 responding changes and expansion of health care needs. When duty calls, the profession of nurse anesthesia consistently answers, and rises above, for that matter. Nurse anesthesia educational A0",0)41%-):.%4":.*%B0"4%-"1A2!)8I5)1.*%/.0!2+/)!.%A0",0)41%!"%!-.%A0.1.#!I*)<$%6#2:.012!<I based programs. On the forefront of change is the decision made by the AANA and Council on Accreditation of Nurse Anesthesia Educational Programs (COA) which states that nurse anesthe sia programs must offer doctoral degrees to students who enter the program on January 1, 2022 to facilitate the requirement of a practiceoriented doctoral degree for entry into practice by 2025. Clinical doctorate degrees like the Doctor of Nurse Anesthesia (DNAP) and the Doctor of Nurs ing Practice (DNP) differ from the PhD in that the DNAP/DNP coursework is clinically focused versus researchbased. This move will allow CRNAs to “remain leaders in anesthesia care” ac cording to Wanda Wilson, 2007 AANA President. The use of simulation and the requirement of a clinical doctorate for entry into practice are just two of the countless ways in which our profession stays ahead of the game. Our state and nation al association work tirelessly to protect nurse anesthesia practice and ensure that CRNAs remain the safest, highest quality providers of anesthesia. Again, it is an honor to pursue my anesthesia education and to serve as your student representative. ALANA NewsBulletin www.alacrna.org -T Nurse Anesthesia Program News Mary C. Karlet, PhD., CRNA, Chair Department of Nurse Anesthesia Alumni, students and faculty enjoyed the warm gulf breezes in Destin, Florida at the May 2011 Samford Alumni Reception. Over 30 participants enjoyed reconnecting with friends in an absolutely beautiful setting. Hoping that those who could not attend this year are able to come by in 2012! The Samford Program thanks the ALANA Board of Directors for providing lodging in Destin for our students! It is so appreciated! Eight Samford nurse anesthesia students attended the AANA National Meeting in Boston August 610, 2011. The students 5.#.+!!.*%B0"4%4)#<%1!6*.#!IB"/61.*%.*6 cational activities. As a program, we were proud when Nina McLain, CRNA, PhD ex pertly represented Samford on the “CRNA Challenge Team” at the AANA College Bowl. Thank you to the many Samford alumni who contributed to the Nurse An esthesia Education Fund, which supported student participation at this worthwhile educational and professional event. Four exceptional Samford Nurse Anesthesia graduates were recognized with Ida V. Moffett School of Nursing awards. Brittany Denson, class of 2011 received the Baptist Health System Academic Achievement Award for the highest grade point average of any graduate student in the School of Nursing. Katie Schneider, class of 2011 received the ?82^)5.!-%()8-"6#%9D)0*%)1%)%1!6*.#!%D-"%.@.4A82+.*%!-.%-2,-.1!%A0"B.112"#)8%M6)82 ties and a commitment to nursing. Brandon Woods, class of 2011 received the Agatha Hodgins Award as the most outstanding nurse anesthesia graduate. Lauren Foster, class of 2011, received the Theresa Culpepper Award for her commitment to nurse anesthesia professionalism. Congratulations to these outstanding graduates! Samford nurse anesthesia students continue to put Samford’s core values into action. Danielle Wilson, class of 2012, demonstrated “service to God, to one another, and to the community” on her recent volunteer trip to Belize. Danielle had the incredible oppor !6#2!<%!"%1.0:.%A)!2.#!1%2#%#..*%D-28.%A.01"#)88<%5.#.+!!2#,%B0"4%)%6#2M6.%)#.1!-.12)% training experience. See photo below. Congratulations to Samford faculty member Dr. Nina McLain on the acceptance of her article, “Anesthesia Clinical Performance Outcomes: Does Teaching Methodology Make a Difference?” for publication in the AANA Journal. Twentyfour students graduated this year from the class of 2011. In addition to the students who accepted positions in Ala bama, these outstanding graduates spread out across the country and accepted jobs in Texas, Georgia, Mississippi, Florida, Kansas, and California. Graduates, welcome to our great profession. Ken Taylor, CRNA, class of 2011 and his mother Karen Taylor, DNP were featured in an article about Samford Ida V. Moffett School of Nursing graduates in the May 13, 2011 edition of the Birmingham News. 16 ALANA NewsBulletin www.alacrna.org -S introduce yourself An Interview with Willie Furr, CRNA What is the most rewarding aspect of your career as a CRNA? The most rewarding aspect of being a CRNA would have to be providing safe anesthesia to the people of Covington county while adhering to professional peer reviewed widely accepted practices. Knowing that as a CRNA I am charged with the awesome responsibility of making a difference in peoples lives, and carrying them through what is often an apprehensive time. Every time I discharge a comfortable, smiling relieved patient from the recovery room, or a new mother delivered a healthy baby comfortably in her home town, I can not help but smile. I feel blessed to do what I love everyday. Most Frustrating? Being the sole Anesthesia provider as a member of an all CRNA group in a very busy prac tice setting brings about some unique challenges. Even though Nurse Anesthetists are one of the oldest nursing professions in the country, and have blazed a record of well documented safe care, it is my belief that we are the end the CRNA and the physician can almost always mutually agree on a safe plan of action. Technology and techniques are constantly changing allowing for cost effective, less invasive procedures with faster recovery times. One thing remains constant; the responsibility to the patient. Talk to them and really listen. Sit with them, educate them, reassure them, and carry them through. Take the time and be what they need you to be. Biggest Surprise? “Rural Hospitals are Busy,” and the fact that I can still recite chapters from clinical anes thesia texts. But really, about seven years ago when I came to this community from Erlanger Hospital, a level 1Trauma Center, I received an education that can not be taught. While more seasoned CRNA’s who had been practicing for many years helped me settle in and offered assistance, there was just a feeling that is hard to explain when its midnight and you have a couple of trauma patients and a stat CSection to manage and you’re the only one in the building. As the years go by one grows and hones their practice. There is a still water effect that comes from deep within. One learns to prioritize, take the cases one at a time, remain calm, take a deep breath, eat when you can and ask for help when needed. How did you get interested in a career as a CRNA? I was exposed to the world of Nurse Anesthetists while working as a scrub tech in the United States Navy, and while working as a surgical tech while attending college. Do you recommend this career to others? Absolutely! Ambition is key for someone aspiring to become a CRNA. I would encourage one to shadow a nurse anes thetist for several weeks to really get a feel for what we do everyday. It takes a certain personality to live in the world of anesthesia. Graduate schools do a great job of screening those that are up for the task. GRE scores are 24A"0!)#!%56!%!-)!%2#!.0:2.D%21%)#%.M6)8%A8)<2#,%+.8*'% Are you driven? Are you a hard worker? Can you really -)#*8.%)%/"#G2/!%D-28.%4)2#!)2#2#,%<"60%/"4A"160.%)#*% uplifting your profession? And, can you be a person that others would like to emulate? My name is Willie Furr widely appreciated and accepted as part of the team, but face struggles pertaining to equality. Reimbursement from insurance companies continues to be an issue. To remain a valuable provider to rural hospitals and others in an ever budget tightening environment, we must be compensated equally for providing equal, competent care as our counterparts. Most Challenging?%3)#<%!-2#,1%/"4.%!"%42#*'%%91%D2!-%4"1!%A0":2*.01%!-.0.%21%)%/"#1!)#!%A0.1160.%!"%5.%.B+/2.#!% while keeping turnover time and delays at a minimum. Over the years, I have learned to show up early, work hard and work smart. Develop a relationship with the surgeons, operating team, and administration. Continue to educate others about anesthetic practice. And above all, be able to defend your decisions pertaining to a particular case. In 18 ALANA NewsBulletin What do you hope to accomplish that you have not already accomplished? I would like to earn a clinical *"/!"0)!.%&Kb%!-)!%21%)#.1!-.12)%1A./2+/'%C%)4%A0"6*%!"% be a Nurse Anesthetist. When not practicing anesthesia, what do you enjoy the most? Spending time with my wife of 11 years and my !-0..%5.)6!2B68%,2081'%%Z-$%C%82E.%!"%+1-%!""' How do you introduce yourself to your patients? Hello my name is Willie and I am a Nurse Anesthetist. I will be providing your anesthesia today. www.alacrna.org Why did you choose to work in this specialty? I watched, I listened, I asked questions. I wanted 4"0.'%C%)4%*.+#2!.8<%)%!<A.%9%A.01"#)82!<'%C%8":.*%!-.% autonomy. I believed in myself, but more importantly others believed in me. Someone once said, “no one gets to where they are alone.” Most memorable CRNA moment? Why are you ac tive in ALANA? It happened this last year when I was asked to speak at the Medical Board of Examiners meeting in Montgomery. Prior to this I was like many of you. I loved what I do and I worked to live. This day I was taught a valuable lesson, and asked myself a question. Do you live to work? I learned a thing or two from Heather Rankin, ALANA President, and many others that day about passion. I learned that what we do is a privilege and an awesome responsibil ity that remains possible because we believe in the right to practice. Often times our right to practice is challenged for various reasons. Without the ALANA there would be no local voice. Can you imagine a ruling that would limit a practice you have been performing safely for many years. So many representatives of the ALANA and associates really opened my eyes that day. Yes it is easy to go to work everyday and just be a great anesthesia provider, 56!%W61!%E#"D%!-)!%"!-.01%)0.%+,-!2#,%B"0%<"60%02,-!%!"% practice. So if you are called upon to be active in the ALANA please know that it is because you matter. I can tell you that as a rural anesthesia provider, and other rural anesthesia providers in south Alabama and across the state along with the ALANA made a differ ence that day. Different Career? That’s a tough question. I would probably be a farmer or a NASA scientist. What a contradiction but kind of true. Who was your role model? Dale Shepherd, CRNA. I was just out of the military. Very young and work ing as a scrub technician in a rural hospital. I was just starting junior college and was lost. I came from a meager background and no one in my family had at tended college. I thought she had the coolest job in the world, even though what she did all those years ago was frightening to me (as a nonanesthesia person) at times, I loved what she was allowed to do everyday. She, more than anyone, took me under her wing. She helped me with my class schedule. Put me in touch D2!-%/"6#1.8"01$%.:.#%,):.%4.%"**%W"51%B"0%+#)#/2)8% help. When I graduated junior college and went for my BSN she was there. Always present and encourag 2#,'%]-.%D)1%!-.%+01!%A.01"#%C%!"8*%D-.#%C%D)1%)//.A! ed into Anesthesia school. She was so proud. Even then she helped me, always checking on me, making 19 sure I was maintaining the course. When I graduated from Anesthesia school, there she was in the front row. I do not know where I would be today without her. Thank you Dale! If you could change one thing about anesthesia, what would it be? The relationship between Anesthesiologists and Nurse Anesthetists. Over the years I have worked in different practice settings, care teams and solo practice. At the end of the day we have the same goal; Patient care and safety. I personally have not ever been threatened by the presence of an MDA while work ing together. Over the years I have begun to understand that most of the battlegrounds are politi /)8%)#*%+#)#/2)8%!-)!%-)AA.#%"6!12*.%"B%!-.%"A.0)!2#,%0""4'%X.!1%),0..%!"%0.1A./!%.)/-%"!-.0% and appreciate each other, knowing that we both provide safe anesthesia. There does not always have to be a tug of war. They are needed and we are needed. The future of health care is uncer tain. Lets all make sure that we continue to provide the best anesthesia in the world. One might say naive, but I say faith. PRACTICE GUIDELINES FOR PREOPERATIVE FASTING AND THE USE OF PHARMACOLOGIC AGENTS TO REDUCE THE RISK OF PULMONARY ASPIRATION: APPLICATION TO HEALTHY PATIENTS UNDER GOING ELECTIVE PROCEDURES Anesthesiology 2011;114:495511 American Society of Anesthesiologists Committee Abstract 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 Purpose The purpose of this article was to describe the latest recommendations for practice regarding pulmo nary aspiration risk reduction. >)/E,0"6#*% % % c.#.0)8%)#.1!-.12)%24A)201%6AA.0%)20D)<%A0"!./!2:.%0.G.@.1$%A6!!2#,%A)!2.#!1%)!%021E%B"0%A684"#)0<%)1I% piration. Preoperative assessment and preparation includes management of factors contributing to aspiration in order to reduce the risk of its occurrence. Management strategies aimed to reduce the risk of aspiration include requiring patients to fast prior to anesthesia, and the administration of medi /)!2"#1%!-)!%2#G6.#/.%,)1!02/%:"864.%)#*%)/2*2!<' Methodology Practice guidelines regarding pulmonary aspiration were originally developed by a Task Force of the American Society of Anesthesiologists (ASA) in 1999, and are periodically evaluated and revised. Synthesis and analysis of current literature, expert opinion, open forum commentary, and clinical feasibility data were used to formulate the guidelines. % % % % (600.#!%0./"44.#*)!2"#1%)0.%5)1.*%6A"#%)#%6A*)!.%"B%1/2.#!2+/%.:2*.#/.%)#*%.@A.0!%"A2#2"#'%X2!.0)I% ture published since the previous guidelines were evaluated for robustness of article type (metaanal ysis of multiple trials, single randomized controlled trial, etc.) and strength of support for the conclu 12"#1%_16AA"0!2:.$%16,,.1!2:.$%42@.*%0.168!1$%"0%.:2*.#/.%2#16B+/2.#!%!"%*0)D%/"#/8612"#`'%K.D%160I% veys were conducted to describe practitioner opinions. Result % % While little literature evidence was found evaluating the effectiveness of preoperative assessment, !-.0.%D)1%1!0"#,%.@A.0!%"A2#2"#%!-)!%2*.#!2+/)!2"#%"B%)1A20)!2"#%021E%B)/!"01%)#*%:.02+/)!2"#%"B%)AA0"I% priate fasting were important steps to be taken with every patient. % Strong literature evidence and expert opinion were cited to support fasting from clear liquids for 2 hours before anesthesia in both adults and children. Metaanalysis results demonstrated that gastric volume was smaller and pH higher in patients who had been allowed clear liquids up to 2 hours be fore anesthesia, compared to those who were required to fast longer. Literature regarding breast milk, 2#B)#!%B"0468)$%#"#-64)#%428E$%"0%)%82,-!%50.)EB)1!%D)1%4"1!8<%.M62:"/)8%)#*d"0%2#16B+/2.#!'%7-.0.%% were two exceptions. Studies in children given nonhuman milk less than 4 hours before anesthesia demonstrated higher gastric volumes. Also, hypoglycemia was associated with fasting times longer than 8 hours in children. No literature evidence was cited regarding the intake of fried or fatty food. Expert opinions for fasting times were: breast milk 4 hours infant formula 6 hours nonhuman milk 6 hours light breakfast 6 hours fried or fatty food 8 hours The effectiveness of metoclopramide to reduce gastric volume was supported by the litera ture, but no 20 ALANA NewsBulletin % www.alacrna.org 21 undergoing an elective anesthetic. There is no rted reduced gastric volume and recommendation that they be applied to patients who use of cimetidine, ranitidine, are not receiving anesthesia for their surgery or prazole, and lansoprazole. Studies of procedure. They are not meant to be applied to nd magnesium trisilicate creased gastric pH with equivocal women in labor or emergent anesthetics. Many cosupport was found regarding gastric acidity reduction. Literature supported reduced gastric volume and acidity with the use of cimetidine, ranitidine, famotidine, omeprazole, and lansoprazole. Studies of existing health conditions delay gastric emptying, volume. The effect of droperidol sodium citrate and magnesium trisilicate demonstrated increased gastric pH with equivocal results on making patients at increased risk for aspiration. Such to reduce nausea and vomiting was gastric volume. The effect of droperidol and ondansetron to reduce nausea and vomiting was con patients will probably need additional management )./,'%0,1%'2)34/('#!')5"%),-')'55'!,6)"5) % % +04.*%5<%!-.%82!.0)!60.'%?:2*.#/.%B"0%!-.%.BB./!1%"B%)#!2/-"82#.0,2/1%!"%0.*6/.%,)1!02/%:"864.%"0%)/2*2!<%% strategies in order to be anesthetized safely. o reduce gastric % volume or% acidity D)1%.M62:"/)8'%C#16B+/2.#!%82!.0)!60.%D)1%B"6#*%!"%4)E.%)#<%/"#/8612"#%0.,)0*2#,%!-.%.BB./!%"B%)#<%"B%% % % !-.1.%*06,1%!"%2#G6.#/.%!-.%"//600.#/.%"B%A684"#)0<%)1A20)!2"#'%7-.0.%D)1%#"%.@A.0!%"A2#2"#%16AA"0!%% #615$!/'#,)./,'%0,1%')706)5"1#(),") Those additional strategies we might choose for sion regarding the effect of any of for the routine administration of any of these medications prior to anesthesia. ;1'#!'),-')"!!1%%'#!')"5 )<1.&"#0%+) Conclusion e was no expert opinion support for patients at increased risk include medication Recommendations for fasting times are summarized in the following table. administration. All the medications reviewed for this update were found to be effective, but evidence was nistration of any of these r to anesthesia. in table 1. Adults Infant and children Clear liquids 2 hours 2 hours Breast milk -- 4 hours -- 6 hours uidelines provide us with tools to Infant formula Nonhuman milk 6 hours 6 hours ased decisions regarding prevention Light breakfast 6 hours 6 hours Fried or fatty food 8 hours ACTS IS A PUBLICATION OF LIFELONG LEARNING, LLC © COPYRIGHT 2011 " Comment % % % % T hese guidelines remain essentially unchanged from the previous ones issued in 1999. And yet, many of us practice in departments that still maintain the traditional “NPO after midnight” standard. The rea 1"#1%B"0%4)2#!)2#2#,%!0)*2!2"#)8%1!)#*)0*1%)0.%4)#<%)#*%:)02.*'%7-.%/"#121!.#/<%"B%)%"#.I12^.I+!1I)88% standard facilitates patient compliance. “NPO after midnight” is ingrained in our health care culture, not only among providers but among consumers as well. T hese guidelines are not standards to be adopted verbatim. Instead, they provide us important infor mation that we can use in the evaluation and revision of our departmental policies and in our clinical A0)/!2/.%*./212"#1%D-2/-%2#/"0A"0)!.%5"!-%0.1.)0/-%+#*2#,1%)#*%A)!2.#!%1A./2+/%2#*2:2*6)82^)!2"#' Important Information About -./0-156%/#4&247#78%9"#*(882#43:%/("&2+,3&2#4%9"#;"3$ 8 hours ISSN Number: 1938-7172 PThese practice guidelines provide us with tools to make evidence based decisions regarding preven AGE 14" !2"#%"B%A684"#)0<%)1A20)!2"#'%7-.1.%0./"44.#*)!2"#1%D.0.%2116.*%)1%A0)/!2/.%,62*.82#.1'%]/2.#!2+/%% review supports these management practices, but the evidence is not strong enough for them to be issued as professional standards. While standards are generally accepted principles that should be fol 8"D.*%6#*.0%4"1!%/20/641!)#/.1$%,62*.82#.1%4)<%5.%4"*2+.*%"0%0.W./!.*%)1%*.!.042#.*%5<%2#*2:2*6)8%% clinical need. % % C!%21%24A"0!)#!%!"%0.4.45.0%!-)!%!-.1.%,62*.82#.1%)0.%*.12,#.*%B"0%!-.%1A./2+/%1.!!2#,%"B%)%-.)8!-<%A)I% tient undergoing an elective anesthetic. There is no recommendation that they be applied to patients who are not receiving anesthesia for their surgery or procedure. They are not meant to be applied to women in labor or emergent anesthetics. Many coexisting health conditions delay gastric emptying, making patients at increased risk for aspiration. Such patients will probably need additional manage ment strategies in order to be anesthetized safely. % % Those additional strategies we might choose for patients at increased risk include medication admin istration. All the medications reviewed for this update were found to be effective, but evidence was not 16B+/2.#!%!"%/"#/86*.%)#<%"B%!-.4%1-"68*%5.%0"6!2#.8<%,2:.#%!"%-.)8!-<%A)!2.#!1%D2!-"6!%.8.:)!.*%021E%% for aspiration. While these guidelines don’t tell us we have to choose any of them, the evidence is there that these medications do what they are supposed to do. When we decide that the situation is appropriate for inclusion of these medications, due to our assessment of an individual patient’s risk for aspiration, the evidence supports that medication decision. % % % % % % While published research was reviewed for this update, expert opinion was also incorporated into !-.1.%,62*.82#.1'%C!%D"68*%1..4%!-)!%"A2#2"#%-)*%)%12,#2+/)#!%2#G6.#/.%"#%!-.%.#*%0.168!1'%&.1A2!.%% equivocal literature evidence regarding milk and solids, these recommendations included limits sup A"0!.*%5<%.@A.0!%:2.DA"2#!1'%7-21%*./212"#%0.G./!.*%)#%)AA0"A02)!.%)AA82/)!2"#%"B%!-.%A02#/2A8.1%"B%% evidence based practice. While research evidence is the foundation for practice decisions, there isn’t empiric evidence about everything and we should not disregard our clinical expertise in any given situation. Even though studies do not clearly demonstrate the increased risk of allowing milk or solids before anesthesia, our practitioner common sense helps us determine the risk is too great to allow it. 7-.%021EI5.#.+!%/"4A)021"#%21%1"4.D-)!%*2BB.0.#!%D2!-%0.1A./!%!"%/8.)0%82M62*1'%7-.%82!.0)!60.%1!0"#,8<%% supports the safety of clear liquid intake up to 2 hours before anesthesia. Additionally, there is clear e vidence of the harm of a longer fast from clear liquids. Fast times longer than 2 hours were associated with increased gastric volume and acidity, which could paradoxically increase the risk 22 Cassandra Taylor, DNP, DMP, CRNA, CNE www.AnesthesiaAbstracts.com ANESTHESIA ABSTRACTS IS A PUBLICATION OF LIFELONG LEARNING, LLC © COPYRIGHT 2011 Provided as a service to the ALANA by Aneshesia Abstracts, www.AnesthesiaAbstracts.com. Table 1: Recommended fasting times for adults and children Recommendations for fasting times of aspiration. ALANA NewsBulletin 9!%!-.%99K9L1%9##6)8%3..!2#,%2#%>"1!"#$%!-.%K>(HK9%2#!0"*6/.*%!-.%1!)0!%"B%!-.20%("#!2#6"61%b0"B.112"#)8%(.0!2+/)!2"#% Program. There has been much discussion about this recent news. The ALANA would like to keep everyone as up to date as pos sible, so please know that as we learn new information, we will pass it along to you. Please check the NBCRNA website, www. NBCRNA.com, as well as the ALANA website, www.alabamaCRNA.org, for updates. We will also be sending out emails and updating the ALANA facebook page with new information. Neither the AANA nor the ALANA was involved with the creation or development of this program, as the NBCRNA is an autonomous entity. Despite this, the ALANA Board of Directors is always available to help answer questions and hear your concerns. Listed below is the information we currently have. Key points are to look out for are 1) Frequently Asked Questions during the week of August 21st, 2) the NBCRNA encourages feedback on this 2116.$%)#*%V`%A8.)1.%A)0!2/2A)!.%2#%!-.%b0"B.112"#)8%b0)/!2/.%9#)8<121%160:.<%B"0%/"#!.#!%:)82*2!<%"#%!-.%K)!2"#)8%(.0!2+/)!2"#%?@ amination.. The comment period is September 6th through November 14th. Please make your comments to them at this time. Here is the information NBCRNA has provided to date. CPC Program 1. The CPC Program is announced on the NBCRNA homepage (www.nbcrna.com) with a link to the onepage description of the components. P'%%%%%%%988%M6.1!2"#1%1-"68*%5.%*20./!.*%!"%0./.0!2+/)!2"#e#5/0#)'/"4%.4)28%)**0.11' 3. The Frequently Asked Questions (FAQs) are posted on the NBCRNA website. 4. The link to the CPC Program survey will go live September 6th and extend through November 14th 2011. S'%%%%%%%7-.%K>(HK9%D288%*.:.8"A%)%f(b(%]!)!.%7""8%[2!g%)B!.0%!-.%(b(%A0",0)4%/"4A"#.#!1%)0.%+#)82^.*%B"88"D2#,%!-.%O)#6)0<% NBCRNA 2012 Board of Directors meeting NBCRNA Needs Participation in the Professional Practice Analysis Survey The NBCRNA needs your feedback in order to compile information regarding current CRNA practices. The following are a few points regarding this vital survey. Professional Practice Analysis R'%%%%%%7-.%K>(HK9%21%/"#*6/!2#,%)%b0"B.112"#)8%b0)/!2/.%9#)8<121%160:.<%B"0%/"#!.#!%:)82*2!<%"#%!-.%K)!2"#)8%(.0!2+/)!2"#%?@)42 nation. P'%%%%%%7-21%160:.<%D288%*.+#.%!-.%B0)4.D"0E%B"0%!-.%K)!2"#)8%(.0!2+/)!2"#%?@)42#)!2"#%_K(?`%B"0%1.:.0)8%<.)01%!"%/"4.%)#*%.#160.% the currency and relevance of the examination. 3. The survey invitation was sent this week. 4. The PPA Survey is open for participation until September 12th, 2011. 5. A link is available on the NBCRNA homepage (www.nbcrna.com) to request to participate in this important survey. The ALANA values your membership in our association and continues to work hard for you each day. While this is an issue that affects our members, in addition to your continued dialogue with the Board of Directors on this issue, please do not hesitate to *20./!%)#<%M6.1!2"#1%)#*%/"44.#!1%!"%0./.0!2+/)!2"#e#5/0#)'/"4%"0%("88..#%9-.)0#%)!%_Uaa`%UThIVTQU' Sincerely, Heather J. Rankin, CRNA, MSN www.alacrna.org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egislative Spotlight Senator Greg Reed What do you do for a living? Vice President of a business for diagnostic imaging with a large international ultrasound systems manufacturer. How did you get interested in politics? It started in high school and continued as a student at the University of Alabama with my House colleague, John Merrill. I also served as Vice President of the Republican Party for 8 years. Who was/is your role model/mentor in the legislative arena? Mr. Edgar Weldon <'3&%$3=(%>#7%"74%*#"%#*+,(? I wanted to make a difference. I have been interested for a long time and wanted to serve. Biggest surprise once you were elected? !"#$%&&#'%()#$*#+,#-)$./$)"#$./0-#$/*.&$/(&%12$(3'$/*%#3'+4$$5$'%'36)$#7,#-)$)"()4 What is the most rewarding aspect of serving in the Alabama Legislature? A feeling of real accomplishment when I can help pass legislation such as the sanctity of life bill. Most frustrating? Staying up all night Most challenging? The speed we are operating at – reading bills and staying up to date on issues. Would you recommend public service to others? Yes, everyone should be involved. What is your most Memorable Moment from your campaign or public service thus far? Election night –the 18 months of hard work yielding the opportunity I wanted to be able to serve. If you could have any @#:2&2,3:%#*+,(A%B'3&%B#7:=%2&%C(? The one I have now. What advise would you give those ,#4&($@:3&24;%3%"74%*#"%@7C:2,%#*+,(? Make sure you understand all the pros and cons to winning and losing. When not working or serving constitu ents, what do you enjoy the most? Time with my wife Mitsy and our three sons, Andrew, James and John Michael. Michael Humber, Pat Smith, Seth Richardson and Amy Neimkin visit with Senator Greg Reed (center). +R ALANA NewsBulletin www.alacrna.org +T THE WYNFREY ALANA FALL MEETING October 28 – 30, 2011 Make your reservations now for the ALANA Fall Meeting O nce again, the ALANA Program Committee has delivered an outstanding line up for our Fall Meeting. We will open on Friday with an allday offering on Adult and Pediatric Emergency Cardiac Care and Pharmacol ogy Forum. At the conclusion of the Forum, ACLS and PALS testing will be made available. The Friday evening seminar features a special presentation entitled “Understanding the Business / Legal Tools of Anesthesia Practice,” sponsored by “Legally Mine.” The focus of “Legally Mine” is and always has been the education of professionals on the best tools available in the U.S. for the purpose of asset protection. O n Saturday we open early with the annual Funderburg Lectureship sponsored by the Samford University Nurse Anesthesia Program and its distinguished alumni. This year’s Funderburg lecturer will be Mark D. Welliver, CRNA, DNP, ARNP. Dr. Welliver is an Associate Professor of Professional Practice at Texas Christian University School of Nurse Anesthesia, in Fort Worth, TX. Dr. Welliver also maintains a clinical practice as a trauma call team member at UF & Shands Jacksonville, a level I trauma center. Saturday’s meetings conclude with the State of the State report by ALANA President Heather Rankin and the annual business meeting. S unday morning opens with presentations by John McFadden, Ph.D., CRNA. Dr. McFadden is the AANA Region 7 Director. Dr. McFadden is a practicing CRNA who joined Barry University’s Master of Science Program in Anesthesiology full time in 2001. Dr. McFadden is Associate Dean in the College of Health Sciences and the Administrator of the Master of Science Program in Anesthesiology. The morning concludes with presentations by /600.#!%=9>%)#*%])4B"0*%B)/68!<%)#*%)864#2%2#%/600.#!%)#*%0.8.:)#!%1/2.#!2+/%!"A2/1' Scott Karr Medical Education Associates of Alabama Birmingham John McFadden, PhD Associate Dean in the College of Health Science and the Administrator of the Master of Science Program in Anesthesiology Barry University On Friday, we are pleased to offer Adult and Pediatric Emergency Cardiac Care and Pharmacology Forum. At the conclusion of the Forum, ACLS and PALS testing will be offered. These sessions will have limited enrollment so early preregistration is highly recommended. ACLS/PALS books are available for purchase. Pickup your book at the registration desk. Name Address City State Zip “The Handbook of Emergency Cardiovascular Care for Healthcare Providers” We have a Special Session Friday night on Understanding the Business / Legal Tools of Anesthesia Practice. Select the Special Sessions and Regular Sessions you wish to attend. Home Phone Email address ! CEUs 22 Fee $450. Adult Cardiovascular & ACLS (Friday AM) ! 4 $100. Pediatric Cardiovascular & PALS (Friday PM) ! 4 $100. Understanding the Business / Legal Tools of Anesthesia Practice ! 3 $75. All Regular Sessions (Sat & Sun) ! 11 $275. Preregistration deadline October 15, 2011 All Sessions, Cardiac Care, Legally Mine alacart AANA Number Daniel McNeff (-2.B%?@./6!2:.%ZB+/.0 Legally Mine Orem, UT Heather Rankin, MSN, CRNA ALANA President Helena, Alabama Do you plan to stay at the Wynfrey? !Yes !No Saturday Only ! 6 $150. Method of Payment: Sunday Only ! 5 $125. !Checks payable to: ALANA Student “$0” if Preregistered ! !Credit Card: !MasterCard !Visa ALACRNA PAC Contribution ! ACLS/PALS Book (Pickup at Registration) ! $20. SponsorAStudent Contribution ! $25. Card Number: 2011 Funderburg Lectureship Sponsored by: Alumni of Samford/Baptist NAP !AE Expiration: Signature: $0. Total (enter total CEUs and fees) See web site for late registration and onsite registration fees Mark D. Welliver, CRNA, DNP, ARNP Associate Professor of Professional Practice, Texas Christian University School of Nurse Anesthesia Fort Worth, TX 26 1-800-WYNFREY Place of Employment FACULTY David Fort Instructor Nurse Anesthesia Program Ida V Moffett School of Nursing Reservations should be made directly with the Wynfrey Hotel to insure you get the group rate. Rooms blocked for ALANA are at a discounted group rate of $146 per night single/double. Cutoff date for hotel reservations is September 28, 2011. Please use our Reservation Code 1BA2OX when making reservations at the Wynfrey Hotel. Refund Policy: Refunds on tuition will be honored upon receipt of a written request prior to October 15, 2011, subject to a $50.00 cancellation fee. ALANA NewsBulletin www.alacrna.org Send completed registration form and payment to: ALANA 9#8&%)*+,(%.#D%EFGHIH J#4&;#$(">A%1K%%LMNEF For those with special needs or questions about the 4..!2#,$%/"#!)/!%!-.%9X9K9%ZB+/.%"0%>06/.%i"#%;),.8% at 2059029600 or Email at bvonhagel@uabmc.edu. +S /012131!/44#5'1*'#6!#7!89&4:!/6:4*):*'4*4;!<65= H#4*!O7P5:!D#Q!+R,STS U#6*(#3:&%;!/012131!!XL-+R!!!!!!!!!

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