Beyond The Mask: Innovation & Opportunities For CRNAs

The nurse anesthesia profession hasn’t traditionally been a field known for its diversity but that’s something leaders are trying to change. At the forefront is Dr. Courtney Brown at Wake Forest. She joins the show to discuss the importance of recruiting people from all backgrounds to nurse anesthesia and what’s being done to make that happen. Show Notes: https://beyondthemaskpodcast.com/?p=2150 Today's Rundown: 2:16 – Welcome in our guest, Dr. Courtney Brown 3:23 – Dr. Brown has made many efforts to improve diversity and inclusion at Wake Forest and that will be our focus today. 3:46 – Why is this topic of diversity so important for our field? 4:35 – We’re behind many other health professions 6:00 – Explain diversity and inclusion and what they mean. 6:28 – An example of a recent graduate that almost didn’t apply to the program because of the marketing materials. 8:26 – Is there a negative perception of nurse anesthesia due to the lack of diversity? 10:26 – Why do people associate promoting diversity with Affirmative Action? 13:37 – Now that things are on the radar, is progress being made? 16:58 – How does recruitment work and what do you look for? 19:01 – Dr. Brown shares the updated statistics from her program. 20:23 – Explaining pipeline programming and how it works. 23:04 – The balance of male versus female in the profession. 24:49 – What can faculty at other programs do to improve diversity and inclusion? 27:20 – Where can the average CRNA start? 31:52 – What should be a part of the national agenda to assist in diversifying our profession? 27:17 – Final thoughts from Dr. Brown.

Happy Thanksgiving! To celebrate this wonderful day of gratitude, we welcome on AANA CEO Randy Moore and AANA Senior Director of Federal Government Affairs Ralph Kohl to help us give thanks for an organization that does so much for the CRNA profession every year. Full show notes: https://beyondthemaskpodcast.com/?p=2172 On this episode: 1:37 – Thanksgiving morning! 2:00 – We’re thankful for our guests today, Randy Moore, CEO of the AANA, and Ralph Kohl, the Senior Director of Federal Government Affairs for the AANA. 2:35 – This podcast will focus on giving thanks for the AANA. 3:12 – Ralph explains what he’s thankful for. 4:15 – What this organization means to Randy. 6:31 – What mentors – past or current – are you thankful for knowing? Randy first. 8:13 – Ralph on his mentors. 10:23 – What does success look like for the AANA from Randy’s perspective? 11:49 – Ralph’s idea of success. 12:39 – What should every CRNA be thankful for? 14:49 – How would you explain your enthusiasm for the AANA? 18:43 – How do you want to be remembered if you move on, Ralph? 20:55 – What about Sharon, what are you thankful for from the AANA? 22:00 – Jeremy shares what he’s thankful for.

Dan Simonson and Jack Hitchens are long-time CRNAs that identified a need in the profession to be able to easily track and manage data. That’s why they created the Open-Source Anesthesia Electronic Medical Record, which they believe provides great value – at no charge – to CRNAs around the world. Find out everything you need to know about OSAEMR and its future. Full show notes: https://beyondthemaskpodcast.com/?p=2163 Today's rundown: 1:55 – Welcome in our two guests, Dan Simonson and Jack Hitchens. 3:55 – Today’s topic is OSAEMR or Open-Source Anesthesia Electronic Medical Record. Here’s some background on what it is. 4:46 – Why is this important for our profession? 5:32 – This even allows you to track your data as a student. 6:26 – This is a project Dan and Jack have worked on for five years. Here’s how it all started. 8:54 – A labor of love for Dan and Jack. 10:21 – It’s been a way for both guys to contribute to the profession and more than 400 CRNAs are using it now around the world. 11:44 – How does this interface with other systems already in place? 13:10 – Have these EMRs been helpful in the development in OSAEMR 15:02 – Is there a reason people wouldn’t want this data out there? 16:14 – What is OSAEMR’s motto relative to data? 17:28 – There’s no data being captured in plastics work but this can change. 20:04 – Pain management procedures are going to be a part of the data collection. 21:09 – Here’s what CRNAs can do to help OSAEMR continue to move forward and grow. 23:04 – There are three versions of the product currently. 25:56 – What are the near-term goals for the product? 26:51 – Final thoughts from Dan.

We were on location at the North Carolina Association of Nurse Anesthetists and wanted to get a historical perspective on CRNAs. With the help of past AANA presidents Sandy Ouellette and Nancy Maree, we take a look back at the important battles fought and won by nurse anesthetists through the years that help shape the way our industry operates today. Full show notes: https://beyondthemaskpodcast.com/?p=2167 On today's show: 1:37 – We’re recording live from the North Carolina Association of Nurse Anesthetists meeting. 1:51 – Two popular guests, Nancy Marie and Sandy Ouellette, join the show. 2:37 – Sandy highlights some of the past challenges that will help CRNA’s unite and fight future issues. 3:12 – Background on Frank vs South and why that decision is still important today. 5:04 – The next important case involved Dagmar Nelson in the 1930s. 6:34 – The road to reimbursement was a 7-year process in the 1980s. 7:50 – How the ANA helped turn around the industry when it began dying out in late 80s. 9:25 – The ongoing issue of federal supervision of nurse anesthetists in Medicare. Why we need to remove it and what role states are playing. 13:31 – ANA threw their support behind antitrust cases. 18:06 – Antitrust fights still go on today. 19:24 – Nancy explains the antitrust and fraud case against Twin City Hospitals in 2004 and what came from it. 23:42 – What role has the ASA played in all of the challenges and crises the industry has faced? 26:30 – The recent Anesthesia Care Team statement and why many believe it’s restrictive. 29:13 – What can ANA members do today to help the association succeed and remain strong moving forward? 30:36 – Why membership is so important for ANA. 32:24 – New students and new graduates seem to be the biggest hole in membership. 36:20 – Can the ANA be listening to members better? Here are issues they have spoken out on. 40:24 – Jeremy’s perspective as an outside on the membership issue. 44:11 – Final thoughts from Sandy on why it’s such a great time to be a CRNA.

Accepting a new job is such a rewarding feeling that motivates you to get to work and continue growing your career, but understanding your employment contract first is vital. Mark Silberman, legal counsel for the AANA, will break down the specifics of a contract, what you need to know, and how to protect yourself. Plus, he’ll help us understand the different types of employment statuses and which is better for CRNAs. ***CE CREDIT ALERT: Did you know you can get continuing education credit from the AANA for listening to this episode? Go to https://knowledgenetwork.aana.com/home to get the details and get your credit today! And see a list of other episodes that qualify for CE credit here: https://beyondthemaskpodcast.com/series-ce-credit Show Notes: https://beyondthemaskpodcast.com/?p=2142 Today's rundown: 2:29 – Welcoming on our guest today, Mark Silberman, who is legal counsel for the AANA 3:05 – What we’re talking about on this show and why it’s important. 4:17 – Mark breaks down the parts of a contract and what you need to know about one. 5:45 – A real-life example from a CRNA of a contract that didn’t get put in writing. 6:47 – Let’s define the differences between an employee and an independent contractor. 9:08 – Mark explains independent contractors even further. 10:20 – Trying to understand why some independent contractors are classified that way when they appear to be an employee. 12:02 – It all comes down to what is the intention. 13:16 – You have to remember that employers will almost always have leverage because they hold the commodity: the job. 13:57 – Define ‘employee at will’ and how many states have that status. 15:48 – What’s the difference between job description and employee contract? 16:59 – Job descriptions are not enforceable. The contract specifics are. 18:02 – Does every CRNA need a contract? 20:06 – The biggest mistake people make when they’re looking at a contract. 21:44 – What are the most important things CRNAs should pay attention to in a contract? 20:07 – Can you re-negotiate your contract? 24:31 – Let’s talk non-competes. Every state has its own interpretations of these. 27:46 – How do we find out if these non-competes are enforceable? 29:12 – What happens when a new employer takes over? 31:39 – Should Independent contractor CRNAs incorporate for protection? 33:11 – Final words of wisdom for CRNAs entering a contract.

Nurses have all the right attributes to be successful in politics but there are so few in office around the country. We want to help change that by empowering nurses to feel confident and comfortable running for office. We’ll spend this episode discussing why it’s an important topic and we’ll learn more a new campaign school that Sharon Pearce and Kimberly Gordon are working to launch in 2020. On this episode: 1:52 – Introducing our topic and our guest Kimberly Gordon. 2:19 – Sharon talks about what her and Kimberly have done together in the past. 3:45 – Why is this topic so important? 4:57 – Only two nurses serve in office at the Federal level right now. 5:21 – Why aren’t there more nurses in office? 7:01 – North Carolina has three nurses in state legislature, including Gale Adcock. 8:10 – Who are the two nurses on the national level? 8:52 – Neither of those are advanced practice nurses, which we’ve never had at the Federal level. 10:01 – Let’s talk about the breaking down barriers project Sharon and Kimberly are working on at Yale. 12:37 – We’ve met nurses from all over the country and they feel like this is very important. 13:40 – We as nurses are really late to this game. Physicians have been training people for politics since the 70s. 14:34 – Is it intimidating for nurses to consider running for office? 15:35 – Occupation-specific schools have become popular for a reason. 16:29 – A huge barrier is we don’t like to ask for money or help and that’s an issue. 18:41 – We’re not asking people to run for governor. We want to build a pipeline that starts in county commissions, school board, places like that. 19:32 – Maybe one day we’ll have a nurse as president. 19:55 – What kind of timeline are we talking about for this project? 20:34 – Yale has provided so much acceptance and assistance through this process. 21:39 – “If you’re not at the table, you’re on the menu.” 22:51 – Applications open on January 1, 2020. Get the full show notes and additional resources here: https://beyondthemaskpodcast.com/?p=2135

Retirement means many different things but one of the most important is transitioning to a new healthcare plan. For many people, Medicare becomes the best option but it can be difficult to sort through and understand. Who is eligible? What are my options? How much are premiums? We brought on Medicare guru Joanne Giardini-Russell to clear up a lot of questions for us. On this episode: 1:51 - Today we're talking about Medicare decisions for the retiring or retired CRNAs. 2:48 - Our guest today is a Medicare expert, Joanne Giardini-Russell 3:29 - Joanne gives us her background in the industry. 5:47 – Let’s start with the basics: what is Medicare? 7:09 – Who is eligible for Medicare and is it mandatory? 8:22 – If I’m still working at 65, does that effect anything? 9:44 – You don’t have to take Medicare at 65. It’s important to know that everyone’s situation is different. 11:14 – Understanding how the Health Savings Account plays into your decision. 11:54 – A lot of people don’t understand that premiums are income-related. 13:09 – When you start talking about retirement, planning needs to begin as soon as possible to work through options like these. 13:43 – Your HSA contributions get taxed and many people don’t know that. 14:40 – What does the acronym IRMA mean? 17:51 – Client story about a couple found out they were paying more than they needed to for premiums. 19:35 – Are there other costs for Medicare beyond the premium? 21:11 – You have two choices to handle the 20% beyond Medicare’s coverage. 23:02 – What are the pros and cons of the Medicare Advantage plan? 25:27 – What else does a CRNA need to know after they enroll? Let’s talk basics. 27:22 – If you’re over 65 and you’ve enrolled in Medicare, can you make changes or are you stuck? 28:44 – Pre-existing conditions do come back into play with Medicare. 29:33 – It’s very important to know that people with pre-existing conditions have one shot to get into Medicare. Here’s what you need to know. 30:23 – How much flexibility do you have in picking an insurance carrier? 32:29 – What are my annual requirements with Medicare coverage? 35:19 – Final thoughts from Joanne Show notes and additional resources: https://beyondthemaskpodcast.com/?p=2123

What does the next 5, 10, 20 years look like for the healthcare industry? That’s a question everyone would love an answer for, but there are many opinions out there. We sat down with Steve Mund to pick his brain on everything from insurance to costs to payments and more. On this episode: 1:59 – Introducing our guest on this episode, Steve Mund. 2:29 – Sharon shares some background on Steve. 4:24 – It’s an interesting time in healthcare and there’s no way to predict how it will change in the years to come. 6:57 – How to be a problem-solver for your department. 7:58 – The three payment models healthcare needs to engage in for the future. 10:14 – What about the accountability on the patient side? 11:19 – The providers get penalized but what about the payer? 12:57 – Jeremy shares a recent discussion he had with an insurance executive about drug costs. 14:01 – Let’s talk about mergers. Are their benefits to these large mergers? 14:59 – One prediction projected operating margin to be -16%. 15:55 – The length of stay can be an area of improvement potentially. 16:47 – Hospitals only operate on a 2.5-4% margin. 17:41 – Where is all the money going? 20:04 – What factors are driving the utilization of healthcare? 22:03 – What does Steve see as the future of healthcare payers? 23:36 – The best way to stay informed is Becker’s Review. 25:29 – How do you determine value in healthcare these days? 26:58 – So how can providers show their value to their organizations? 27:42 – How can we help cut down on waste in financial, clinical and personnel areas? 29:16 - The waste isn’t always about money, it’s also about time. 30:40 - Some final thoughts from Steve. Show notes: https://beyondthemaskpodcast.com/ep-#43:-the-future-of-healthcare-with-steve-mund/2115/

Nurse practitioners play such an important role in healthcare so let’s learn more about the profession. The CEO and president of the American Association of Nurse Practitioners join us on this episode to share their accomplishments, challenges, and goals to improve the industry and empower their nurses. Did you know the CEO of the Nurse Practitioners used to work for the AANA? Come join us for a great conversation. Here's what we have on this episode: 1:46 – Welcome in our guests Sophia Thomas and David Hebert 3:06 – What is a nurse practitioner? 4:44 – Tell us more about your organization, AANP 5:47 – Sophia explains how the AANP is structured. 6:44 – David talks about his role at AANP and a little about the role of nurse practitioners. 8:41 – Why lobbying is so important in this line of work. 9:27 – The AANP has really increased their PR and media efforts in recent years. 11:31 – What are the challenges facing nurse practitioners today? 12:29 – David explains why nurse practitioners should be able to work independently. 14:23 – 28 states still require some sort of collaborations and that makes it difficult on NPs. 17:15 – It’s important for everyone in the profession to understand the issues and then get involved politically. 20:02 – Sharon talks about her goals to get nurses involved in the formulation side of the profession. 22:57 – We want to empower nurses to do more than just work and go home. 23:46 – Quality and cost of healthcare is important to consumers, but so is convenience. These are things that nurse practitioners can provide. 27:01 – A unified voice in the profession is very important and that’s the goal of the AANP. 28:26 – How does your credentialing work? 30:40 – What is David most proud of in his role at the AANP? 31:51 – David shares his history with AANA and what he remembers about that role. 34:18 – Some final thoughts from Sophia on the history of the profession. To get the full show notes and additional resources from Beyond the Mask, click here: https://beyondthemaskpodcast.com/?p=2108

We always talk about the importance of community within the CRNA profession so let’s take it a step further by discussing how and why you should get involved. There are varying levels of involvement, as we’ll get into, but Joe Rodriguez will help us understand what your participation means to the industry. ***CE CREDIT ALERT: Did you know you can get continuing education credit from the AANA for listening to this episode? Go to https://knowledgenetwork.aana.com/home to get the details and get your credit today! And see a list of other episodes that qualify for CE credit here: https://beyondthemaskpodcast.com/series-ce-credit Show Notes: https://beyondthemaskpodcast.com/the-importance-of-getting-involved-with-joe-rodriguez-crna/2079/ Today's rundown: 2:20 – Introducing our guest today, Joe Rodriguez. 3:08 – His topic today is ‘getting involved.’ Here’s why it’s important. 4:07 – Participating in community at work versus neighborhood is a little different for Joe. 5:09 – Have you always been like this or did you develop this interest in getting involved? 7:25 – Should everyone be as engaged as Joe? What’s the happy medium? 9:18 – How many CRNAs total compared to AANA members? 11:16 – What is the average CRNA career worth? 12:17 – Do you remember MI 68? Their story shows why it’s important to be engaged. 13:00 – Sometimes people just need to be asked. 14:23 – Why Joe is so passionate about all these regulatory issues. 15:37 – How do you overcome an opponent that’s better funded? 19:12 – Highlighting the progress that Joe has seen through the years. 21:27 – How do you balance your time to get so much accomplished? 23:43 – If he wasn’t a CRNA, Joe would be a lawyer. 26:30 – What advice would you give people to get them involved? And specifically for people at different stages of their career – early, middle, late.

As CRNAs, we don’t have a lot of experience dealing with the media or being in front of the camera. We’re used to working behind closed doors and out of the spotlight. But there are times whem we’re called upon to be a spokesperson for a place or an event. That’s why we brought on a public relations specialist to give us tips and techniques that make us feel like the experts we are. Today's rundown: 1:38 – Chris Bettin is our guest today. 2:21 – Some background on Chris 2:48 – Chris about to head off on a new endeavor in PR. 3:27 – Why we’re talking about spokesperson training today. 4:23 – How do you deal with the media and why it’s so important for CRNAs. 5:07 – Every CRNA is a candidate to be interviewed. 6:05 – Scenarios where CRNAs might be called on to be interviewed. 7:21 – What you need to understand about reporters. 8:18 – The biggest fears we have in an interview. 10:15 – Things that Sharon has learned from Chris. 11:35 – The message you’re trying to deliver is critical so don’t wing it. 13:47 – Have a built-in answer ready to give you time to gather yourself. 15:47 – Three techniques for navigating an interview: flagging, hooking and bridging. 20:47 – How can you control your nerves in front of the media? 21:39 – Do’s and Don’ts of spokesperson training. 23:20 – Any other techniques you want to share with us? 24:28 – More on Chris’ new company, Crossdot Communications. Get the show notes and additional resources here: http://beyondthemaskpodcast.com

Lynn Macksey, CRNA, has been an expert witness on more than 50 cases and she’s bringing that knowledge to the show to help us understand the legal side to the profession. She’ll share what she’s learned through the years that will help you protect yourself and keep your name out of a case. Today's rundown: 1:47 – Lynn Macksey is here with us today to talk medical legal implications in anesthesia. 2:18 – Some background on Lynn. 2:32 – How she decided to make the transition into anesthesia after 20+ years in ICU. 4:43 – Why this topic today is so important. 5:29 – Keeping yourself from being named in a case is so important. 5:59 – What are closed claims? 8:14 – Lawsuits now include everyone that has control. 10:08 – What are the reasons for surgical or anesthesia related lawsuits? 13:07 – The four elements of a medical malpractice case that must be present for negligence. 14:54 – What specific cases have you been involved in that might have changed your practice? 18:13 – A story about a former Saturday Night Live cast member. 21:02 – We learn so much from our mistakes. 23:37 – What range of money is involved in these types of cases? 25:48 – Final thoughts from Lynn on this topic. Get the full show notes and additional resources by clicking here.

Our first installment of the presidential leadership series begins with a conversation with former AANA president Terry Wicks. His decorated career includes this year leading the organization in 2006-07, and we’ll go back with him to discuss the highlights, the challenges, and what he still remembers about the experience. You’ll enjoy some great stories along the way. The rundown for today's episode: 1:53 – Welcoming Terry Wicks to the show. 2:19 – Introducing the Presidential Leadership Series we’ll be doing. 3:26 – Sharon has a story about Terry she wants to share first. 5:02 – Terry talks about the new endeavor he’s taking on at UNC-Greensboro. 6:14 – Highlights from his year as president of the AANA from 2006-07 8:52 – There were some challenges as well. 10:28 – We want to do this series to teach people about the history of the industry and those that have impacted CRNAs. 11:45 – The accessibility of leaders has been so rewarding. 13:17 – What Terry enjoyed best about being the AANA president. 14:40 – What the travel is really like for an AANA president. 16:32 – Another unforgettable story that Terry will always remember. 18:14 – What advice would you give an incoming AANA president? 20:20 – What ways did your experiences shape your participation in the AANA after you left office? 22:30 – Helping people deal with substance abuse has become a passion. 23:46 – What advice would you share with new CRNAs? 25:09 – Is there another profession you’d like to be a part of if you had your choice? 26:50 – Some parting words from Terry. Get the full show notes and additional resources by clicking here.

The International Federation of Nurse Anesthetists is celebrating 30 years as an organization in 2019 and we had the chance to spend some time with four current board members and one past president. During this episode, we had the chance to talk about the IFNA’s history, its mission, where it hopes to go in the future, and much more. Check out the full show notes by clicking here.----more---- Today's rundown: 1:54 – Introducing today’s topic on the International Federation of Nurse Anesthetists 2:09 – Welcome in our IFNA guests to the show. 2:28 – Some history on IFNA and how it formed from Sandy Oullette 5:15 – President Jackie Rowles introduces today’s panel: 1st VP Ingrid Andersson, Treasurer Zorica Kardos, and Executive Committee member Gye Seon Jeong 5:58 – Andersson shares the value of IFNA to her Swedish national organization. 7:16 – Similar practices between US and Sweden. 9:15 – Gye Seon Jeong on her experience with IFNA in Korea 14:10 – How many nurse anesthetists in Korea? 15:40 – Zorica Kardis from Slovenia joins the show to share her experiences. 16:40 – The challenges of being the treasurer of an international organization. 18:43 – The number of CRNAs in Slovenia and how their practice compares to the US. 20:05 – How the IFNA supports the growth within individual countries. 21:15 – 107 countries reported nurses provide nurse anesthesia and we have 43 country members. 21:48 – What IFNA is doing to grow and expand the organization. 22:55 – What are the greatest accomplishments of the IFNA? 26:33 – Where is the focus for the IFNA in the future? 28:49 – Each guests shares their best memory of IFNA 43:54 – Sandy Oullette shares a funny story. 46:27 – Jacky shares some closing comments on IFNA.

Whether you’re looking for that first CRNA job or you're a veteran in the industry, the interview process can be stressful. It’s easy to question yourself and your preparation. That’s why we wanted to bring on a guest from one of the country’s top medical centers to give you an inside look at the interview process and share tips to help you land your next job. Visit the Beyond The Mask Podcast website... ----more---- Show Notes: 2:17 – Introducing our guest Laura Ardizzone 5:46 – What we’re talking about today: CRNA job interviews 7:10 – What are some of the skills and strategies of the interviewer? 9:16 – Be confident that your future employer has seen your social media posts. 10:00 – Some companies/hospitals utilize software to cull social media feeds. 11:28 – Social media works both ways and employers are often reviewed by candidates. 12:52 – CRNAs are in high demand right now. 13:46 – Resources that can help you prepare for an interview. 15:00 – What types of questions are off-limits? 15:50 – Jeremy shares a funny interview story. 17:02 – A surprising thing that candidates have told Laura. 18:58 – How long does a typical interview last? 19:42 – A question that Laura commonly likes to ask to gauge the interview direction. 20:32 – Should CRNA’s ask about time off during an interview? 21:45 – How should you dress for an interview? 22:36 – How and when should a candidate follow up after an interview? 24:30 – What if you haven’t heard back for a while? 25:40 – Have you ever hired someone that turned out to be completely different than expected? 26:25 – Final words of wisdom from Laura.

There’s some concern in educational circles that the history of nurse anesthesia has lost importance during the evolution of the profession. We want to dive into that topic today and explore the history, accomplishments, and milestones with two experts on the subject. Sandra Ouellette and Evan Koch will provide historical insight and some wonderful information on this episode. Check out the full show notes by clicking here.----more---- Today's rundown: 1:38 – Introducing Sandra Ouellette, one of our guests today. 3:50 – A little background on Ouellette’s career and recent honor. 5:16 – Introducing our second guest Evan Koch and his background. 6:16 – Our main topic today: relevance of nurse anesthesia history in evolution of profession. 6:46 – What are some of the common themes found throughout history? 9:05 – Surgeons can be a CRNA’s greatest asset. 9:26 – Surgeon Evarts Graham’s impact on the history of the industry. 11:18 – Humbug in anesthesia at the outset of discovery. 12:47 – Ouellette on some of the history that’s been edited through the years. 14:01 – Where you can find a lot of great information on anesthesia history. 14:47 – The role that educators have played in our history. 15:54 – Helen Lamb’s impact. 17:00 – Educators have faced various threats and obstacles through the years. 19:30 – Contributions that CRNA’s have made on anesthesia. 22:19 – Has the discussion of professional identity been around for a while? The debate surrounding the title Nurse Anesthesiologist. 28:23 – It’s important to know and understand the history of nurse anesthesia. 30:51 – What’s the difference between DNPs vs PhD? 34:38 – When did history get taken out of the nurse anesthesia curriculum? 39:17 – History of the CRNA journal and other achievements. 42:13 – Closing thoughts from both guests.

Peripheral nerve blocks are a growing type of regional anesthesia and there’s an app out there that serves as a reference guide for CRNAs. We brought on Block Buddy co-founders Scott Urigel and Jeff Molter to find out how the idea was developed and how it’s benefiting the industry. Check out the full show notes for this episode by clicking here. ----more---- Today's rundown: 1:38 – To Block or Not to Block: That is the question 2:00 – Introducing our guests: Scott Urigel and Jeff Molter. 2:26 – Who are our guests today? 4:05 – How difficult was it to develop the Block Buddy app? 6:39 – How long did the process take? 8:57 – The app has evolved quite a bit since it was first published. 9:37 – How are CRNAs utilizing blocks now? 10:30 – What we’ve been seeing from large anesthesia companies in Ohio. 12:12 – There’s always a learning curve and peripheral nerve blocks are no different. 13:53 – When we first started doing it, we thought it was the worst idea. 15:18 – Some locations nationwide have limitations on blocks in our practice. 17:03 – Block Buddy is hosting its own conferences and programs now. 20:30 – Is there a financial opportunity for CRNAs? 22:08 – How can a CRNA that learns this skill go out and benefit from it? 24:38 – Congratulating Scott for a great award he just won. 25:17 – Jeff won Ohio CRNA of the Year.

Protecting yourself should be a priority for every CRNA and often times it’s easy to think that you’re already covered. But there are many options to consider with malpractice insurance, from the policy type to the company that you purchase the policy through. John Fetcho, Director of AANA Insurance Services, joins us to these differences and clear up any misconceptions we might have. See the full show notes on our website here.----more---- Take a look at the rundown for this episode: 1:40 – Welcome John Fetcho – Director of AANA Insurance Services 2:47 – Why is this topic of malpractice insurance so important? 4:50 – You want to understand who is insuring you and what coverage you have. 7:16 – Occurrence coverage vs claims made 10:45 – The two types of insurance companies: Admitted and Non-Admitted 14:30 – When CRNA is involved in a claim, 100% of the time there are legal expenses. 15:28 – How can you find ratings for insurance companies? 17:51 – Insurance policies aren’t created equally. There are significant differences. 20:39 – Are moonlighting policies still available? 21:42 – A real-life story about a how a supplemental policy could have made a huge difference. 24:26 – How the policy premiums different state to state. 30:00 – AANA is there as a resource for members. 31:11 – AANA premiums for CRNAs have gone down 33% since they began.

This week, we have the pleasure of speaking with Tom Baribeault, Chief CRNA at Lexington Surgery Center and Founder of the Society for Opioid Free Anesthesia (SOFA). He discusses his personal experiences with eliminating opioids in his own practice, and the challenges of breaking away from standard anesthesia practices. Tune in to find out what kind of opoid replacements are being used, as well as how you can begin to implement non-opioid strategies with your patients.

The Tax Cuts and Jobs Act, which went into effect at the beginning of this year, created a lot of changes that will heavily affect the taxes that CRNAs pay over the next several years. Jeremy will walk you step-by-step through some new options that you should consider taking advantage of, as well as some hazards that could trip you up if you're not in the know.

We turn the spotlight now to Helen Lamb, who spearheaded the efforts to standardize education across nurse anesthesia programs nationwide. Her vision for the future of nurse anesthesia education led to certification and accreditation and resulted in the very first standard curriculum for CRNAs.

This week, we'll continue our Historical Series with a look into the life and career of Alice Magaw. With a keen attention to detail and an unprecedented record of safety, she gained recognition around the world as a leader, teacher, published author and innovator in her field, and ultimately became known as the mother of anesthesia.

Caroline Killmon and Ashley Fedan are back, and this time they're teaming up to discuss the CRNA and SRNA presence on social media, and the bullying that has begun to pervade various platforms. We'll explore important issues such as the expectations of students versus practicing CRNAs, the disconnect between people's actions inside and outside of social media, and the importance of knowing your audience. We'll talk about why many of these elements have led to a fear of engagement, and what we can do to take back social media and make it a positive environment moving forward.

So, you want to get involved in CRNA advocacy, but you don't know how. Or, you want to be involved, but you don't want to be the actual person doing the advocating. That's okay! Kimberly Gordon, faculty member at Wake Forest School of Medicine, is here to share her insights into CRNA state advocacy. We'll talk about how to build positive relationships with legislators, the importance of partnering with other associations, and the advantages of forming an independent expenditure. But most importantly, we'll talk about how you can get involved and how you can get others to join in.

Caroline Killmon, student at Wake Forest and student representative to the AANA Education Committee, joins us to talk about some of the barriers to student leadership within the nurse anesthesia community. We'll unpack issues such as bullying within the nursing profession, generational differences, millennial stereotypes, work-life balance and much more.

We've talked in a past episode about the doors that could very well be opened by a switch to the Nurse Anesthesiologist descriptor. However, what kind of unintended consequences might we face as a result? This week, we'll shift perspectives and speak with four nurse anesthesia educators about how they believe this change would affect not only their own particular educational programs, but CRNA students as a whole.

June 10, 2019 is the 30th anniversary of IFNA, and to celebrate, we're talking to Sandra Ouellette, who was one of the founders of the organization as well as a past president of IFNA. She'll give us a brief history of the organization from the earliest discussions to present day. We'll also hear from Jackie Rowles, current president of IFNA, about how the federation has made enormous strides over the last several years to connect with other international organizations, and to help create solutions for global access to care.

It's unfortunate but true, that as much time as CRNAs spend in school, there's little to no education offered on personal finance. So this week, Jeremy is bringing us a crash course. We'll get some simple tips on dealing with topics like budgets, debt, and insurance, and we'll learn what it takes to build a strong financial foundation and become a truly wealthy CRNA.

We finally got a chance to talk to Mike McKinnon, past president of the Arizona ANA, and he has a wealth of information to share about Anesthesiologist Assistants in the current healthcare environment. What kind of role do AAs play in overall healthcare costs, access to care, and the greater objectives of the ASA? What kinds of risks do they pose to CRNAs? We'll dive into these pressing issues, as well as some possible solutions moving forward.

This week, we speak with special guest Jenny Schmitt, President of the Oklahoma ANA, about the troubling state of the Oklahoma healthcare system. Amidst this struggle, the Oklahoma State Medical Association has launched a ruthless million-dollar anti-CRNA campaign aimed at frightening patients about receiving care from CRNAs. Jenny discusses how local CRNAs have fought to be heard, and why she believes CRNAs are the key to turning the tides in the future of Oklahoma healthcare.

Current AANA CEO Randall Moore, DNP, MBA, CRNA joins us live at the Mid-Year Assembly to discuss some thought-provoking hypotheticals. Who would advocate for CRNAs if the AANA didn't exist? How would the profession be different today without the organization? Find out on our first episode of the "What If" Series.

We're joined this week by Senior Director of Federal Government Affairs for the AANA, Ralph Kohl. Ralph has his finger on the pulse of all the current Congressional topics relevant to CRNAs, and he works each day to advocate for our goals as an organization. He'll share with us why it's essential for CRNAs to get involved in advocating both locally and nationally, as well as some simple ways you can take part. If you're not familiar with the AANA Mid-Year Assembly, or if you're not quite sure of the importance of your state and federal PACs, this is the episode for you.

At the mid-year assembly we took the opportunity to extend an offer to all the candidates running for office in the upcoming AANA elections to join us for a few minutes on this podcast. Not all candidates took us up on the offer, but all were invited. On this episode, you'll get to hear the candidates that did participate outline their platforms and vision for the future of the AANA. ----more---- The candidates appear at the below times. 1:29 - President Elect Candidate - Bob Gauvin 5:18 - VP Candidate - Heather Rankin - Heather's Facebook Page 7:00 - VP Candidate - Henry Talley 9:50 - Treasurer - Maribeth Massie 13:25 - Region 5 - Julia Harris - Julia's Facebook Page 16:05 - Region 5 - Kristie Hoch - Kristie's Facebook Page and Twitter 18:13 - Region 4 - Mike Anderson - Mike's Facebook Page and Twitter

This week, we'll continue the topic of how CRNAs can plan for a successful retirement. We'll talk about when you should take social security, how much money is safe to withdraw from your savings, and how taxes will affect you. We'll even take a look into a lesser-known way that high income earners like CRNAs can contribute to Roth IRA accounts and lower their tax burden in retirement.

If you're like many CRNAs, retirement is not too far off in the distance. And the first step in preparing for retirement is knowing what to expect. How can you maintain your current lifestyle when you walk away from a regular paycheck? What kind of expenses will you encounter? Jeremy will help get your wheels turning on this first part of the CRNA Retirement Ready series.

Special guests Carole Doyscher and Joe Rodriguez join us for a spirited debate discussing how the CRNA title may or may not have become a limitation to growth and understanding of the profession as a whole. However, what should CRNAs be called instead? What are the potential repercussions of this kind of change? The answer is not so simple.

We continue our historical series with a journey back into the very first years of nurse anesthesia where Agatha Hodgins began her career. Following a quite unexpected series of events, Agatha would ultimately become the foremost anesthesia expert and educator of her time, as well as the founder of the AANA.

Former AANA presidents Richard and Sandra Ouellette pay us a visit to share the story of how the National Commission On Nurse Anesthesia Education was brought about in a time of turmoil to rebuild CRNA educational programs from the bottom up.

Chris Bettin and Dan Lovinaria, two of the creative minds behind National CRNA Week, make a special appearance. Tune in to find out why more and more CRNAs and SRNAs are getting involved in promoting their profession, and why the importance of this event extends far beyond a single week.

Join us this week as we talk to Ashley Fedan about the world of opportunities that social media offers to the CRNA community, as well as some of the pitfalls. As an administrator of a Facebook forum of over 25,000 CNRAs and SRNAs, she'll give you a look behind the scenes.

Special guests Sandra Ouellette and Nancy Bruton Maree return to delve into the history of nurse anesthesia education as seen through their own personal experiences in the field. How have educational programs evolved over the last several decades, and what awaits us in the future?

Former AANA presidents Sandra Ouellette and Nancy Bruton Maree are back, and this week they'll begin a two-part series on the history of the AANA. To kick things off, this episode will focus on the problems with the Anesthesia Care Team Statement.

The California Association of Nurse Anesthetists former president Julia Harris joins the program to discuss the merits of opioid-free anesthesia.

Having a voice for CRNAs in the legislature is incredibly important. On this episode of the podcast, we'll speak with Patrick Ballantine, lobbyist for the NCANA, about what kinds of conversations are happening on the legislative level and how you can get involved in making sure CRNA interests are represented in government. ----more---- Patrick Ballantine served 10 years in North Carolina State Senate, winning all 5 general elections with over 65% of the popular vote. He was first elected in 1994 and quickly rose through the ranks, being elected the Senate Republican Leader in 1998 and re-elected unanimously in 2000 and 2002. Under his leadership, the number of Republican Senators in the 50 Member State Senate increased from 11 to 22. Ballantine also co-sponsored tort reform that would help provide quality affordable health care for all North Carolinians. He sponsored regulatory reform and welfare-to-work legislation. Ballantine called for a restructuring of state government which had become bloated, non-responsive, and inefficient. He was a champion for small businesses and at the same time won environmental awards for his stewardship. Further, Ballantine established and chaired a statewide committee of diabetes stakeholders to develop a national legislative model to protect and support children with diabetes in schools. Ballantine is an attorney licensed to practice in State Court, Federal Court, and the United States Supreme Court. Ballantine graduated from the University of North Carolina at Chapel Hill with a BA in Political Science, and he received his law degree from the University of Dayton, where he was bestowed the Order of Barristers.

Past AANA presidents Sandra Ouellette and Nancy Bruton Maree join the program on this edition of the show to discuss how the CRNA profession has evolved to its current state. Sandra and Nancy will share stories of their experiences as presidents of the AANA. We'll also take a look at the future of the industry and some of the major issues facing CRNAs going forward. ----more---- Ms. Bruton-Maree graduated from N.C. Baptist Hospital School of Nurse Anesthesia, Guildford College (BS) & Wake Forest University (MS). She is a member of Sigma Theta Tau and Chaired the NCANA Program and Publications Committees, served on NCANA Education & Research, Bylaws, Finance, & Strategic Planning Committees. Ms. Bruton-Maree served as NCANA Secretary, President-Elect, and twice President of the NCANA. Additionally, she served as AANA member Continuing Education Committee, Editorial Advisory Committee, Journal Editorial Advisory Board, Practice Committee, educator and Chairperson of the Council on Accreditation of Nurse Anesthesia Educational Programs, & Chairperson, Education Committee. She served as AANA Director, Region 2, AANA Vice-President, AANA President-Elect, & AANA President. She also served as member, Vice-Chair & Chair of the N.C. Board of Nursing. She served President of Anesthesia Review & Update from 2007 to 2017 and is retired as Program Director & Visiting Assistant Professor of Raleigh School of Nurse Anesthesia/UNCG. Ms. Bruton-Maree was awarded the Helen Lamb Outstanding Educator award by the AANA in 2008, and the Agatha Hodgins Outstanding Accomplishment Award in 2018. Ms. Bruton-Maree is currently a Consulting Associate at the School of Nursing, Duke University.

We'll continue our conversation about what it's like to become a 1099 CRNA. We'll cover questions about taxes, should you incorporate, how you'll cover your own healthcare issues and much more. ----more---- For your reference, below is a graphic explaining the differences between SEP-IRAs and Solo 401(k)s:

The American Association of Nurse Anesthetists Chief Executive Officer Randy Moore joins the show this week to discuss the latest healthcare developments and how they're impacting CRNAs. He'll also talk to us about how the AANA is responding to those dynamic changes and reveal what keeps him up at night. ----more---- Dr. Randall Moore became the Chief Executive Officer of the American Association of Nurse Anesthetists on September 5, 2017. Prior to that, Randy served as a senior hospital administrator with Passavant Area Hospital/Memorial Health System in Jacksonville, IL. In addition to Randy’s hospital leadership experience, he has served as AANA Treasurer and Region 3 Director. In addition to his service to the AANA, Randy has held various leadership positions within the Illinois Association of Nurse Anesthetists - including region director, government relations chair, and president. Randy is retired from the Army Reserve after 22 years of military service. He has served in both the Illinois Army National Guard and Army Reserve as an infantryman, combat medic and CRNA. In 2012, Randy deployed with a Forward Surgical Team in Afghanistan providing combat causality care. Randy holds a Doctorate in Nursing Practice from The University of Alabama, a Master’s Degree in Business Administration from Southern Illinois University, a Master’s of Science in Nursing from Bradley University, and a Bachelor’s of Science in Nursing from Northern Illinois University.

Jeremy and Sharon will cover the details of what it looks like to become a freelance CRNA. What's it like to make that transition to getting a 1099 every year? Who is a good fit to transition from W2 to 1099? We'll answer those questions and more on part 1 of this conversation.

We have special guest Dr. Jackie Rowles on the show to cover the results of a AANA cultural task force that she chaired. We will learn what current members, former members, and non-members all think of the AANA, as well as evaluate the health of the organization. Jackie will give us the key takeaways from this special report. ----more---- Dr. Jackie Rowles is a Certified Registered Nurse Anesthetist (CRNA) and Board Certified Adult Nurse Practitioner (ANP-BC) with nationally and internationally recognized leadership and clinical expertise in the specialty of pain management, including medication management, diagnostic and therapeutic injections, and multi-modal approaches in the treatment of pain. She is the Nurse Anesthesia Program Director and an Associate Professor in the Leighton School of Nursing, as well as, a Clinical Instructor for the College of Osteopathic Medicine. Currently serving in her third term as President of the International Federation of Nurse Anesthetists (IFNA), Dr. Rowles is a past president of the American Association of Nurse Anesthetists (AANA), the Indiana Association of Nurse Anesthetists, served on the American Academy of Pain Management's (AAPM) Board of Directors for eight years with four years as Treasurer, and was a Nursing Organizations Alliance (NOA) Board Member for three years serving one year as Treasurer. Dr. Rowles is a member of the World Health Organization's Global Initiative for Essential and Emergency Surgical Care (WHO GIEESC), and was recently elected to the Board of Directors of the G4 Alliance (a global organization for access to Surgical, Obstetrics, Trauma, and Anesthesia Care). Dr. Rowles is the chair of the American Association of Nurse Anesthetists Task Force on Organizational Culture Assessment and serves as a member of the Ball State University College of Health Advisory Board. Click here to donate to Our Hearts Your Hands.

For the launch of "Beyond The Mask" we'll get to learn about your hosts, Jeremy Stanley and Sharon Pearce. They'll preview some of the future topics the podcast will tackle and some of the great guests that will join the show over the coming months. They'll describe how the podcast will bridge the gap from clinical conversations inside the operating room to organizational, financial, and personal topics important to CRNAs "Beyond The Mask".