February 5, 2013 – Legislative Reception, Carnegie Room at the Capitol Plaza Hotel 5:30 pm – 7:30 pm
February 6, 2013 – MoANA Lobby Day – Meet in the Capitol Room or the Capitol Plaza Hotel for a legislative briefing at 7:45 then make legislative visits at the Capitol

Morning/Afternoon/Evening Senator/Representative _____________. My name is ____________. I am a Certified Registered Nurse Anesthetist (CRNA) and I am a constituent in your district. I am urging you to oppose SB682/HB1399, a bill that would severely restrict the current ability of CRNAs to provide needed pain management services, primarily in rural areas of the state. The practice of pain management is within the Scope of Practice of CRNAs and is regulated by the Missouri Board of Nursing. As advanced practice nurses we take the care and safety of our patients very seriously. Again, I ask you to oppose SB682/HB1399 – if you have further questions do not hesitate to contact the office of John Bardgett at 573-634-8760.

If you are hesitant to speak directly with your legislator please leave an evening voicemail or send an email message!

To determine who your legislators are, visit this URL:
http://www.senate.mo.gov/llookup/leg_lookup.aspx

You will need your full nine-digit zip code – you can look up the last four digits here:
https://tools.usps.com/go/ZipLookupAction!input.action

Click on the name of your Senator and Representative and it will take you directly to their website.

The fee for exhibiting is $400.00. This fee includes a table along with recognition for being an exhibitor. You may also sponsor a break, lunch or a speaker. These opportunities are outlined on the exhibitor registration form. These sponsorships are a great way to show support for the Missouri and Kansas CRNAs and receive additional recognition and exposure.

Would you please take a moment to complete the Exhibitor Information Sheet and return it with payment by March 16, 2012.

A block of rooms has been reserved at the Westin Crown Center for your use if you or your representatives desire lodging. Address information is included at the top of this letter. A block of rooms will be held until March 2, 2012 for a special rate of $139.00 per night. Please make your reservations soon by calling 1-816-474-4400 and state that you are with the KANA/MOANA Nurse Bi-State Spring Meeting.

Please call or email any questions you may have. We appreciate your support for continuing education of nurse anesthetists and look forward to seeing you in April. We hope you find this meeting enjoyable and worthwhile.

KANA-MoANA Bi-State Meeting Exhibit Form

Contacts
Sharon Niemann, CRNA
Program Chair, KANA
2641 S. 218th West
Goddard, KS 67052
niemanns@newmanu.edu
316-942-4291 x2272

Carol Kemna
Executive Director, MoANA
205 E. Capitol Ave., Ste. 100
Jefferson City, MO 65101
ckemna@bardgett.net
573-634-8760

Support the Truman Medical Center School of Nurse Anesthesia at their 2nd Annual Fundraiser and Auction!

When: January 20, 2012 – 6:00pm to 10:00 pm
Where: Boulevard Brewing Company, 2501 Southwest Boulevard, Kansas City, MO
What: Featuring beer tasting, buffet dinner, and a silent auction

Tickets are $55 per person / $100 per couple or a table of 10 for $500

To register, call Truman Medical School of Nurse Anesthesia at 816-404-1100 or email SHANI.MIZNER@TMCMED.ORG.

Proceeds fund scholarships for students to participate in medical missions and attend national meetings.

Download the TMC Fundraiser flyer

News releases about the Nurse Anesthetists at Scotland County Hospital bearing the theme “Caring for Rural Americans” will be published on the following rural newspapers to celebrate the Nurse Anesthetists Week: 1) Memphis Democrat (Scotland County) 2) The Sentinel in Edina, MO (Knox County 3) Schuyler County Times, Lancaster, MO (Schuyler County) and, 4) The Media, Cahokia. MO (Clark County).

Last Thursday, January 12th, Sallie was also a guest speaker at the Edina Rotary Club meeting at Edina, MO (Knox County) and represented Scotland County Hospital in anticipation of the opening of the new Surgery Center. In the presentation, she outlined not only what services the Scotland County Surgery Center provides but more importantly, the availability of CRNAs as sole providers of anesthesia services in this rural county in the northeastern part of Missouri.

In the pic: Carol Kemna, MoANA Executive Director; Sallie Poepsel, MoANA Past President; Missouri Governor Jay Nixon; Scott Broughton, Director of Region V

Remember your emotions and anxiety level influence your child. Keep calm and in control of your emotions to help your child do the same. Follow the recommendations listed to accomplish this goal. For more information, talk with your child’s physician, surgeon and nurse as well as staff at the hospital or surgicenter.

To Help You and Your Child Before Surgery and Anesthesia:

• Obtain accurate information about your child’s procedure and about what to expect.
• Talk with the surgeon, without your child, to get all the information you need.
• Ask if there is a pre-admission program for children and, if so, participate in it.
• Allow your child to share fears and concerns with you. Do not interrupt, minimize, or belittle your child. Let your child know that it is okay to feel afraid.
• Answer your child’s questions honestly. If you don’t know the answer, find out.
• Discuss the separation procedure with your doctor or nurse. How will your child be transferred from you to the healthcare provider? For example, if your child is an infant, will you be able to hold your child until the sedative takes effect?
• Compare the time your child will be in surgery to the length of a favorite cartoon or video.
• Let your child know to expect some pain after the surgery by saying, “When they wake you up, it will probably hurt.”
• Be present for your child’s immediate postoperative recovery period, if recommended by the anesthesia provider. In some settings it may be possible to be present for the beginning of the anesthesia.
• Be there with your child. Sit at the bedside and comfort your child. If appropriate, snuggle, cuddle, hold and touch your child.
• Ask about rooming-in with your child.
• Control your emotions and your behavior. Remember, although you may be very upset and anxious, display a calm, soothing, trusting manner.
• Try to avoid crying in front of your child.
• Take “2″ for you! Take two minutes (or longer) out of sight of your child to express your emotions and focus yourself on what your child needs from you — support!
• Be honest. It is wrong to tell your child “it won’t hurt” or that he/she is going to a birthday party when they are really going to the hospital. Telling your child that he or she is going to take a “nap” may raise fears later when the word “nap is mentioned to your child. Instead, tell your child, “The doctor or nurse will give you medicine to make you sleep so it won’t hurt when the doctor fixes your _____. The doctor and nurse will wake you up when they are done.”
• Alleviate your child’s fears. In no way should you threaten your child by saying something like “If you’re bad, they’re going to stick you with a needle.”
• Give some facts calmly, but without being too graphic or detailed about what your child will experience. If you don’t know the answer, say, “we’ll ask.”
• Remember your role as a parent. Your emotions and behavior can have an impact on your child’s outcome, so take your role as the parent very seriously.

Going Home
Ask your child’s doctor and nurse what you can do to care for your child after surgery and anesthesia.

References
LaMontange, Lynda L., Joseph T. Hepworth, Kathleen C. Byington, and Celeste Y. Chang, “Child and Parent Emotional Responses During Hospitalization for Orthopaedic Surgery: More about the Emotional Contagion Between PArental Anxiety and Their Child’s Anxiety,” MCN, American Journal of Maternal/Child Nursing, 22, 1997, pp. 299-303.

Zuckerberg, Aaron L., “Perioperative Approach to Children,” Pediatric Clinics of North America, 41(1), 1994, pp. 15-29.

Websites
A listing of Children’s Hospitals in the United States: http://www.childrenshospitals.net/

Source: American Association of Nurse Anesthetists

But anesthesia care is not confined just to surgery. The process also refers to activities that take place — before and after — an anesthetic is given. Before anesthesia, a preoperative interview with your nurse anesthetist supplies valuable information that helps determine your care. Open communication and cooperation are essential during the interview.

Communication and cooperation are necessary after surgery as well
The medications that you have been given can remain in your body for up to 24 hours after their administration. You are not completely “back to your old self” until the anesthetic has been totally eliminated.

Also during this time, it is still possible for substances entering your body to interact with the anesthetic. Certain substances may cause negative reactions. Therefore, check with your care provider about what medications you can take. Continue to cooperate with your nurse anesthetist and physician after surgery. Don’t hesitate to ask questions.

Don’ts After Anesthesia
After receiving anesthesia during a surgical procedure, you can play an active role in your recovery by heeding the straightforward list of do’s and don’ts that follows.

Don’t drive a car for at least 24 hours. After anesthesia, your reactions and judgment may be impaired. Such impairment makes driving a car dangerous to you and to others. It is especially important that you don’t forget to make arrangements for someone else to drive you home from the health care facility.

Don’t operate complex equipment for at least 24 hours. The same logic that applies to driving a car similarly applies to the operation of other equipment. This includes equipment used at home, such as a lawnmower, as well as that which is used on the job, such as a forklift truck.

Don’t make any important decisions or sign any legal documents for the day. The potential for impairment relates not only to physical activities but to your mental state also. Moreover, the anxiety that frequently accompanies important decisions is to be avoided. The day should be spent resting.

Don’t take any medications unless prescribed by or discussed with your physician. Some medications may adversely interact with anesthetic drugs or chemicals remaining in your body. Included are prescription drugs, such as sleeping pills or tranquilizers, and over-the-counter medications, such as aspirin.

Don’t drink alcohol for at least 24 hours. Alcohol is also considered a drug, meaning that an alcoholic drink has the potential to negatively react with the anesthetic in your system. This includes hard liquor, beer, and wine.

Do’s After Anesthesia
Do leave the health care facility accompanied by a responsible adult. This person will ensure that you travel home safely, as well as provide immediate care at home. You should continue to have this adult with you for 24 hours after surgery.

Do remain quietly at home for the day and rest. You need rest both because you have received anesthesia and because you have undergone a surgical procedure — even one that is considered minor. If, after a day, you still do not feel recovered, you may want to continue your rest for an additional day or two. Discuss your planned return to work with your physician.

Do arrange for someone to care for your small children for the day. Even if given instructions to play peacefully and not overtax you, children sometimes forget such directions or have trouble staying quiet for an entire day. The most predictable course of action is to leave small children and babies in the care of another responsible individual.

Do take liquids first and slowly progress to a light meal. Heavy foods can be difficult for your system to digest, thereby increasing the chance for discomfort. For your nourishment, start by taking liquids, then eat light foods, such as broth or soup, crackers or toast, plain rice, Jell-O, and yogurt.

Do call your nurse anesthetist, your physician, or the facility where you were treated if you have any questions. These professionals are interested in your welfare and want your care to go as planned. If you have questions, or feel your recovery is not progressing to your satisfaction, call them.

Remember:
Communication and cooperation are essential to the anesthesia process. Active participation in your care helps ensure your safety and comfort.

Do’s and Don’ts After Anesthesia:A Quick Guide

• Don’t drive a car for at least 24 hours.
• Don’t operate complex equipment for at least 24 hours.
• Don’t make any important decisions or sign any legal documents for the day.
• Don’t take any medications unless prescribed by or discussed with your physician.
• Don’t drink alcohol for at least 24 hours.
• Do leave the health care facility accompanied by a responsible adult.
• Do remain quietly at home for the day and rest.
• Do arrange for someone to care of your small children for the day.
• Do take liquids first and slowly progress to a light meal.
• Do call your nurse anesthetist, your physician, or the facility where you were treated if you have any questions.

CRNAs: A Tradition of Quality Care
Certified registered nurse anesthetists (CRNAs) are anesthesia specialists who administer more than half of the 26 million anesthetics given to patients in the United States each year. Nurse anesthetists represent a long-standing commitment to high standards in a demanding field. Prior to entering the Master’s Degree nurse anesthesia educational program, they must have at least one year’s acute care experience. Moreover, mandatory continuing education is required for recertification every two years.

Nurse anesthetists provide high quality anesthesia services combined with personal concern for the health and welfare of patients. They are happy to assist you and offer information about what to expect with your anesthesia.

Source: American Association of Nurse Anesthetists

In addition to their role in the procedure itself, nurse anesthetists make many preparations for you before surgery. You can — and should — take an active role in these preparations by communicating and cooperating with your nurse anesthetist and your surgeon.

There are several kinds of anesthesia
The one chosen for you is based on factors such as your physical condition, the nature of the surgery, and your reactions to medications. Frank and open discussion with your nurse anesthetist is key in the selection of the best anesthetic for you.

In particular, you must speak freely and follow instructions closely regarding your intake of medications, food, or beverages before anesthesia. Such substances can react negatively with anesthetic drugs and chemicals.

The preoperative interview is essential to effective communication
This confidential discussion with the nurse anesthetist prior to surgery provides information vital to your care. To help you prepare for the interview, we have included a questionnaire for you to fill out, and bring along to the preoperative interview. Information supplied by the questionnaire assists your nurse anesthetist in doing the interview thoroughly and efficiently.

Different types of patients or procedures may require different types of anesthesia
Pregnant patients should prepare before the onset of labor for the possibility of having an anesthetic, even if a natural childbirth is planned. During pregnancy, keep accurate records of allergies, high blood pressure, prescriptions, and over-the-counter medications. The use of drugs, including recreational drugs and alcohol, can increase the risk of anesthetic complications for both mother and baby.

Older adults go through complex physical changes while aging which may affect their bodies’ response to anesthesia. You or your family can assist the nurse anesthetist by providing a detailed list of all medications, including aspirin, taken regularly. Patients with hereditary disorders such as diabetes and sickle cell anemia, need special attention. These conditions can be managed properly if the nurse anesthetist knows about them before a procedure.

Children should be specially prepared for anesthesia, and for surgery in general. Allow them to bring favorite toys along for their stay. Make frequent reference to things children will enjoy after the procedure. If possible, take children on a hospital tour and let them talk with hospital personnel, particularly the nurse anesthetist.

Ambulatory care allows you to go home the same day as your surgery. It is important, however, to provide the same accurate information during the preoperative interview. In addition, preparations should be made before ambulatory surgery for another adult to accompany you to the health care facility, drive you home, and monitor your recovery.

Remember:
Speak frankly. Ask questions. Follow instructions. Provide your nurse anesthetist with a medical history. And, notify your nurse anesthetist or doctor immediately of any change in your physical condition prior to surgery. Communication and cooperation are essential to the anesthesia process.

CRNAs: A Tradition of Quality Care
Certified registered nurse anesthetists (CRNAs) are anesthesia specialists who administer more than half of the 26 million anesthetics given to patients in the United States each year. Nurse anesthetists represent a long-standing commitment to high standards in a demanding field. Prior to entering the Master’s Degree nurse anesthesia educational program, they must have at least one year’s acute care experience. Moreover, mandatory continuing education is required for recertification every two years.

Nurse anesthetists provide high quality anesthesia services combined with personal concern for the health and welfare of patients. They are happy to assist you and offer information about what to expect with your anesthesia.

Source: American Association of Nurse Anesthetists