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Commentary: This rule change would improve care at veterans hospitals

Commentary: This rule change would improve care at veterans hospitals

Published in the Albany Times Union, November 11, 2024
By Andrew Burns, CRNA and U.S. Navy Veteran

 

New York veterans deserve the best, most timely health care through the Veterans Administration, without long waits and red tape. 



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Interview With Jake Forrester, CRNA

Happy PRIDE month from NYSANA DEI Committee! Through the month of June, we are engaging in important conversations about the healthcare our CRNAs provide to our LGBTQ+ community!
 
We are kicking it off with one of our very own, Jake Forrester, MS, CRNA - Chair of the Liberty District which includes the areas of Bronx, Kings, NYC, Queens, and Richmond!
Please reach out to the DEI committee with ideas for other CRNA spotlights. 

Interview with  for Jake Forrester, CRNA

Why did you decide to become a CRNA?

  • In undergrad, I was taking the elevator during clinicals and a CRNA jumped in the same elevator. She asked me what my plans were for after school and immediately followed by telling me about her profession as a nurse anesthetist.
  • Since that encounter, every CRNA I met said they loved their job and wouldn’t  want to do anything else.
How was your process of working towards becoming a CRNA? Did you have support and mentors?
  • I worked 2.5 years in the ICU before starting CRNA school. I didn’t have any mentors, so I used online outlets such as nurse and CRNA blogs.
  • Imposter syndrome was very real and I truly wasn't sure if I was able to do it. But, someone once told me: “nothing good comes easy. And the road to become a CRNA is no different” - this really kept me going and pushing myself towards my goal
How has your experience and background helped you care for minority patients of the LGBTQ+ community?
  • It is very important to understand the culture within this community. For example, knowing that transgender patients are the most marginalized patients in this community, or that care for the LGBTQ+ community is overall subpar.
  • As an openly gay man myself,  many of my patients feel more comfortable confiding and sharing personal information that is common in the LGBT community with someone who understands this lifestyle. This ultimately leads to safer anesthesia and better patient outcomes.

What do you think we can improve on as CRNAs who provide care for the LGBTQ+ patient population?

  • Check your own biases and opinions before you even interact with patients, and be aware of your own limitations. Being open to learning from patients is crucial. In the end, regardless of our beliefs, we’re there to make sure our patients are safe and receive equal care. We can start by ensuring judgement free zones when we interview our patients in pre-op. Another great way to improve your knowledge is to team up with CRNAs that are part of the LGBTQ+ community. Be willing to ask questions and learn from them.
  • There are many hospitals across the country that provide gender-affirming surgeries (GAS). When patients come in for GAS procedures, there is a “GAS team” that includes providers trained to care for these patients and able to prioritize their specific needs. Every hospital should have a team that is comfortable and dedicated to these patients.

  • Something as little as a Pride pin on your badge can have a great impact. This allows patients to know that I am not there to judge them, from the moment I walk in the door. Patients are therefore more open to share information about their background and lifestyle behaviors.
Are there current policies in the facilities you work in tailored to awareness and support of LGBTQ+ patients?
  • At my current hospital, there is a hospital liaison that represents and guides the patient through the medical process. The liaison is present in preop, PACU, and during the rest of admission. Their role is to support the patient during their hospitalization.
  • What can we do to diversify our profession and support young residents who are part of this community?
  • Ideally, any CRNA that is part of this community should be proud and willing to share their story. Becoming more visible in this aspect will encourage other nurses to join the profession because they see themselves represented. 
  • Another outlet could be by recruiting at nursing schools and other LGBTQ+ nursing associations to spread awareness about our profession.
  • Sponsoring events is also a great way to get our face out there. NYSANA could help sponsor the Pride parade and have a float where the general public and healthcare professionals see our support. Maybe setting an STI testing at a bar while having a CRNA run it, could also show support to our patient population. 
  • And lastly, having a CRNA as part of the GAS team and becoming comfortable with providing care for these patients during their gender-affirming surgeries.
Are you working on any current projects that you would like to share with us?
  • I’m attending the AANA’s annual Congress this summer in San Diego, and will be speaking on "Anesthesia considerations for patients on PrEP for HIV prevention".
  • Numerous hospitals across the country are creating an anesthesia registry for transgender patients during gender affirming and non gender affirming surgeries. My Chief CRNA asked me if I was interested, so I am currently helping my hospital gather and organize this data. 

Times Union Letter to the Editor

Legislature could improve rural health care with nurse anesthetist bill

Letter to the editor of the Times Union regarding Officials say updates N.Y. Health infrastructure in Danger, Dec 5, 2023

Mark Blazey, Rochester

For healthcare to remain viable in rural New York, lawmakers must address outdated healthcare delivery models and Medicaid reimbursement in anesthesia. 

The primary providers of anesthesia in rural hospitals are Certified Registered Nurse Anesthetists (CRNAs). Though highly trained, advanced practice providers, we face unnecessary barriers to practice. A CRNA’s scope of practice is not formally written into New York State law. New York is the only state to not formally recognize CRNAs, leading to staffing and financial shortages. Nearly a third of CRNAs trained in New York between 2018 and 2023 have left to practice in other states.

Some1500 CRNAs provide essential care to rural Medicaid patients yet lack of recognition in state law. As a result, hospitals may not be reimbursed for services provided to Medicaid beneficiaries --ruinous for New York’s rural healthcare system. 

Additional barriers to practice, such as physician supervision of CRNAs, comes with an unnecessarily high price tag for patients and medical facilities; study after study prove this redundancy does not increase patient safety or improve outcomes. CRNAs have the skills, the education and expertise to provide rural patients with anesthesia care and pain management services and ensure access to care for populations that would otherwise have to travel long distances from their homes for treatment.

The legislature must pass S769-A/A6958-A, which would move the state toward innovative, evidence-based health care, increasing access to care in rural New York.

The writer is the president of the New York State Association of Nurse Anesthetists
Published December 25, 2023

Mark Blazey's Testimony on the Healthcare Workforce Shortage

TESTIMONY OF MARK BLAZEY, PRESIDENT OF THE NEW YORK STATE ASSOCIATION OF NURSE ANESTHETISTS (NYSANA) BEFORE THE ASSEMBLY STANDING COMMITTEES ON HEALTH, MENTAL HEALTH, PEOPLE WITH DISABILITIES, HIGHER EDUCATION AND LABOR ON EXAMINING THE STATUS OF THE HEALTH CARE WORKFORCE IN NEW YORK STATE December 19, 2023

Assembly Health Committee Chair Paulin, Assembly Mental Health Chair Gunther, Assembly Committee on People with Disabilities Chair Seawright, Assembly Higher Education Committee Chair Fahy, Assembly Labor Committee Chair Joyner and members of the respective committees, I thank you for this opportunity to submit written testimony for your consideration as you look at the status of the health care workforce in New York State.

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Summer Newsletter

The August newsletter covers the following topics:

 

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June 2023 Newsletter

Stay up-to-date on the latest NYSANA news.

June's newsletter covers the following topics:

  • President’s Message 
  • Legislative Update: end of session 2023
  • Spectrum News Story
  • Invitation to join a NYSANA Committee
  • Peer Wellness
  • NYSANA Election Update
  • Fall Meeting with Twin Oaks Workshop
  • Liberty District Meeting

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Spectrum News Covers NYSANA Fight for Title

Spectrum News featured Sean McGarry and Jeremy Lombardoni in a 3-minute long story which aired Saturday June 3. The story underscores the meaning and importance of title recognition to our profession and healthcare in New York state.

Sean highlights our essential role in providing access to critical anesthesia services in rural and underserved areas. He explains how the passing of legislation would recognize CRNAs formally in state education law to increase both the quality and access to the anesthesia and surgical services across the state.

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Improving healthcare for LGBTQIA+ Community

June is national LGBTQIA+ pride month. The meaning of Pride month is just as varied and multifaceted as the individuals that make up this unique and diverse community. Pride month is a time to reflect on what it means to live in one's most genuine and authentic truth and to express that truth in a way that is unabashed. Pride is also a time to reflect on the progress that the LGBTQIA+ community has made when it comes to rights and civil liberties while also highlighting further opportunities to close gaps in equity. During pride month the community comes together in the form of parades and celebrations to openly show support for each other and for those that are not yet comfortable living in their truth so that they feel less isolated.

The intersections of the queer community and healthcare highlight a history of disparity based on gender expression and sexual orientation that has been rooted in implicit bias, institutional barriers, and a lack of training in regard to specific community needs. This disparity manifests as decreased access to healthcare, increased prevalence of preventable medical conditions, and increased morbidity and mortality related to mental health when compared to the general population. This disparity becomes even more profound when compounded with belonging to other traditionally underserved communities. We as a society have made great strides in improving these conditions but there is still much work to be done.

Opportunities for improvement include but aren't limited to:

- Inclusive sexual health education
- Increased funding to public health resources
- Intentional health screening for queer patients that highlights disease prevention and mental health while maintaining a nonjudgmental atmosphere
- Improved employer benefits for same-sex partners
- Healthcare benefits that include access to gender-affirming care
- Legislation that makes discrimination based on gender expression and sexual orientation illegal on a federal level
- Inclusive and intentional education for healthcare providers about the history of disparity and the specific health needs of the LGBTQIA+ community
- Active recruitment of healthcare providers from the LGBTQIA+ community to help identify and bridge gaps in care that can lead to disparity

As this Pride month begins, now is the time to engage in conversations with our colleagues, teams, departments, and employers about what policies are in place to protect and serve members of the LGBTQIA+ community who are seeking care as well as those who are providing care. Together we can help to make our places of healing to be open and equitable to everyone under the rainbow. 
 

CBS News Coverage of Advocacy Day 2023

Watch Advocacy Day New Coverage on CBS

NYSANA in New York Daily News

Rural Healthcare Op-Ed by NYSANA members

Thank you to Elyse Gallo, CRNA, Michael Thamsen, CRNA and Sean McGarry, CRNA, for submitting this opinion piece to the New York Daily News, discussing CRNAs practicing at the top of their license as a viable solution to New York's rural healthcare crisis. See Page 6.

Buffalo News Op Ed

Another Voice: Supervision of CRNAs is unnecessary and impedes care

Read President Sean McGarry's op-ed in the Buffalo News.

"Removing unnecessary supervision requirements increases access to care for all New Yorkers. This must be the priority. Right now, New York is the only state in the country that has not formally recognized the title and scope of practice of a CRNA. No more waiting! New York needs to come through for its CRNAs."

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April Newsletter

Stay up-to-date on the latest NYSANA news.

In this month's newsletter, NYSANA President, Sean McGarry celebrates the profession of CRNAs.

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February 2023 Newsletter

Stay up-to-date on the latest NYSANA news.

In this month's newsletter, NYSANA President, Sean McGarry discusses the legislative agenda 

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Spectrum News Coverage of Sim Day

Simulation day at the Capital was a great success! We were pleased that news coverage featured NYSANA President Sean McGarry and the testimony of patient Michael Boots. You can watch it here.

Our next meeting at the state capital will be Tuesday, May 9, 2023. This is NYSANA's annual Advocacy Day where we will meet with legislators and push for our legislation. We will show strength through our numbers! Please plan to represent the profession. Registration will close on Friday, April 7 to allow time for the GRC committee to set up meetings for you with your State Senators and Assemblymembers. We hope you will join us!!

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AMC Residents win Goldie Brangman Award for 2022

Chris Erlichman, BSN, RN and Yanet Segura, BSN, RN receive the 2022 Goldie Brangman Award

Goldie Brangman, CRNA, MEd, MBA was an accomplished CRNA and exceptional mentor. Goldie served as the first and only African American President of the American Association of Nurse Anesthesiology and President of NYSANA from 1960 - 1961. She famously treated Dr. Martin Luther King Jr., after a near-fatal assassination attempt in 1958.

Every year at the Annual Fall Meeting the Goldie Brangman Award winner is announced. This year, two nurse anesthesia residents were named for their outstanding research and demonstrated work.

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President's address, September 2022

Stay up to date on the latest NYSANA news.

In this month's newsletter, NYSANA President, Giovanna Mahar, recaps her year and welcomes new President Sean McGarry

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NYSANA urges the U.S. Department of Veterans Affairs to create national standards of practice that will allow Certified Registered Nurse Anesthetists (CRNAs) to practice at the full extent of their training, education, and licensure.

As we take the time this month to honor the more than 892,000 veterans who live in New York State, it is important to remember that we owe America’s veterans far more than words of gratitude. They have earned the best, most timely healthcare—without long waits and red tape—through the Veterans Administration (VA). As President of the New York State Association of Nurse Anesthetists I urge the U.S. Department of Veterans Affairs to create national standards of practice that will allow Certified Registered Nurse Anesthetists (CRNAs) to practice at the full extent of their training, education, and licensure. Removing barriers so that advanced practice providers, including CRNAs, can practice to the top of the education and licensure is the right policy and honors those who have served our country.

This move will not only expand access to care for veterans but decrease wait times so that care can be delivered when they need it most, while decreasing the cost of that care for the VA.  In addition, it would allow the VA needed flexibility with rural facilities and providers working across state lines.

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CRNAs provide critical service to the military and veterans

CRNAs are the primary providers of anesthesia care to U.S military personnel and our nation’s veterans. We thank these CRNAs for their critical service.

Nurses first provided anesthesia on the battlefields of the American Civil War. During World War I, nurse anesthetists became the predominant providers of anesthesia care to wounded soldiers on the front lines. Today, CRNAs have full practice authority in every branch of the military and are the primary providers of anesthesia care to U.S. military personnel on front lines, navy ships, and aircraft evacuation teams around the globe.

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