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AVANA NEWSLETTERS & ARCHIVES

President's Report - Fall 2011

First and foremost, I would like to thank all of our members for their continued support of AVANA. Through your support and encouragement, the Board of Directors has made, and will continue to make strides in making CRNA’s presence in the Veterans Affairs Health Care System more visible, lobby for pay and practice changes and establish a strong working relationship with AANA and NOVA.

Many AVANA members attended the AANA Annual Meeting in Boston in August. During the AVANA Luncheon on August 9th, Roberta Reedy, Deputy Director of National Anesthesia Service, gave a brief update on the status of several issues affecting CRNA’s. The implementation of regulations eliminating the pay cap (raising it to $155,000) that was mandated by Public Law 111-163 is still pending. Raising the aggregate limit to $230,700, while passed, still has not been fully worked out in many places. For those who are in the process of interviewing and hiring new staff, the qualification standards have removed the Nurse I level. Entry is now Nurse II as of August, 2010. The full qualifications standards are covered in VA Handbook 5005, Part II, Appendix G7. Issues that are currently being explored and updated are Moderate Sedation/Deep Sedation Protocol, Out of Department anesthesia coverage and an anesthesia IMED consent.
Several members on the Board of Directors are on national boards or committees that allow AVANA to have input into policies or rules that will impact us individually and as an organization. These CRNA’s are on a joint NOVA/AVANA Legislative Roundtable, Federal Government Advisory Committee and AANA Educational Committees.

Please take a look at our greatly improved, user friendly and colorful website. We now have a website that is up-to-date and 21st century reflective of our professional organization. I must single out two members who have worked tirelessly on this improvement. Garrett Peterson and Melanie Clemens have dedicated many , many hours in formatting and testing this website to get the best possible site for all of us. You are bow able to pay your dues, contact your regional director and go to other VA or Anesthesia sites without ever leaving our website! Please take a moment and let us know what you think of the site, how it could meet your needs and be made better.

As we enter the fall and winter, remember AVANA always welcomes everybody to be “part of the action.”. Now is the time to consider running for an office, helping on a committee or getting new members. Our strength is membership. The more members, the stronger our voice.

Dave Polner CRNA
AVANA President
Phoenix VA, Phoenix, AZ

Eastern Regional Update - Fall 2011

Once again this year, the Eastern Region is delighted to welcome a number of new members to AVANA. With the continued efforts of our membership drive, we are slowly, but surely increasing our numbers. It is our mission to recruit as many new members as we can. To date the VA employs around 700 CRNAs, so the greater representation we can achieve, the better poised we are to make our voices heard.

Despite fears that nurse anesthesia programs are turning out too many new nurse anesthetists, a quick job search on CRNAjobs.com shows that the job market in the Eastern Region is still robust. This means that we need to continue to be competitive in order to recruit and retain the most qualified nurse anesthetists for the VA System. It was recently brought to my attention that new graduates in the New York Metropolitan area are starting at salaries that are above the VA salary cap. With this in mind, we need to maintain and bolster our efforts in Washington. We need to be diligent in researching the market in our area and provide solid documentation to our representatives in Washington. The passage of S 1963 was a huge achievement for us, but our mission is not yet complete.

On a positive note, it has been an exciting year for us, yet again. Following an extremely successful annual meeting, the Board of Directors has been working on several new projects. If you have visited our website lately you will notice that it has been completely revamped. If you haven’t, please check it out at www.vacrna.org. The publications committee has been working hard to bring you up to date features and information including electronic payment capabilities for your annual dues and scholarship donations, photo slide shows from past meetings, and a forum for communicating between members. We are also on facebook as AVANA. In addition to our AVANA scholarships, we have also added an AANA Foundation Scholarship in Maureen Reilly’s name. If you are involved with teaching student nurse anesthetists, encourage them to check out our website to see what funding may be available for them.

As chairperson of the nominating committee, I am on a quest to identify and recommend the most qualified individuals for the next election. It has been exciting to welcome a number of fresh faces to the Board of Directors and I hope we continue to bring new wisdom and ideas to our organization. If you are interested in joining the AVANA Board of Directors, please let me know. Stay tuned to the website for updates.

Again, for those new members, welcome, and thank you for joining us on our mission. For those tenured members, thank you for your continued support. It was great to meet so many of you at the annual meeting in St. Petersburg, FL. I hope you all enjoyed yourselves and will continue to spread the word about AVANA at your stations. I look forward to seeing you at the annual meeting next year.

Melanie Clemens, CRNA, MSN
AVANA Eastern Regional Director
Brooklyn VAMC, Brooklyn, NY

Western Region Update - Fall 2011

Greetings from the Western Region, where a majority of AVANA members work to support the Veterans! We are happy to support the organization’s leadership as well, sending our President ,Dave Polner(Phoenix), our President-Elect, Sherry Swearngin, (Boise), our treasurer, Cyndi Holgate ( Phoenix), and our Secretary, Stephanie Corbett ( San Diego), all from the Western Region.

Currently the Automated Record Keeping systems are becoming parts of our practices, with varying application. While Fresno’s, San Francisco’s and Palo Alto’s CRNAs have been using automation successfully for some time, other facilities are still waiting. Those in Phoenix have been given a partial application, while those in Portland, Roseburg, Boise, West Los Angeles have only heard rumors of installation. Financing is reportedly an issue in some instances. The move to automation is making a few consider early retirement, while those who have used ARK for some time are convinced of its value. At least one CRNA ( San Francisco) is providing formal input to her VISN for refining the PICIS format.

Hiring CRNAs continues to be variable from one area to the next. In Los Angeles, funding for hiring new CRNAs, who rotated through as SRNAs, is slowing the process, a concept familiar to AANA leadership. Ways to offer supportive guidance to HR has been a popular topic among those who lose great candidates because the paperwork weighs down the process. However, in Phoenix two additional CRNAs have been hired and more slots have been granted, though funding for these slots remains open-ended.

At San Francisco’s VA, Linda Fuhrman, CRNA, who was sponsored in the VA/DOD Nurse Anesthesia Training Program and who rotated there as a student, is now serving on the selection committee with Roberta Reedy, CRNA, for the next year’s students. All over the Western Region, SRNAs report that these rotations give them valuable exposure to regional anesthesia as well as ASA Class III, IV and V patients.

In San Francisco, the thirteen fulltime and two part time CRNAs are ‘traveling’ throughout the facility delivering anesthesia support to the GI Suite as well as the Cath Lab and Interventional Radiology, for which formal block times are now incorporated into the surgical schedule. Fresno reports similar growth in the GI and Cardiology block times, increasing the total of CRNAs committed to outside-the-operating room assignments.

More than likely, a number of VA CRNAs from all over the country are donating their time off to serve the underserved in countries all over the globe. I am aware that Fresno, San Francisco, and Portland have representatives in this type of volunteerism working in Guatemala, the Philippine Islands, and Ethiopia. Our membership would enjoy knowing of more, so please let us know!

Finally, Boise CRNAs are proud to support one of their own, AVANA member Kit Dubois, CRNA, who has been deployed to Iraq until January 2012. We join Boise in thanking Kit, who is also President of the Idaho Association of Nurse Anesthetists, for his service and looking forward to his safe return.

Rita Silen
AVANA Western Regional Director
Portland VA, Portland, OR