The medical system has to be careful with who administers anaesthesia

Mar 12, 2016 Letters

Dear Editor,
Please forgive any evident lack of basic comprehension on my part, but at the selfsame time please endeavor to assist in allaying my rising concerns. Kaieteur News. March 10, an article captioned “Bitter Complaints of the Nurse Anesthetists really stirred my conscious psyche. The quintessence of my inquiry centres around anaesthesia and its so called administration by Nurses. Correct any misguidance/assumption that may follow but currently in Guyana what form of anaesthesia is being administered by nurses? In the selfsame voice, with no allowance for the catching of breath, pray tell me whence, where, by whom and what form did the training for this medical speciality take?
Granted nurse anaesthesiologyis nothing new, for in the United States, Certified Registered Nurse Anaesthesists (CRNA), have been providing anaesthesia cares for over a century and a half. However, this is where the pedal meets the metal, nurse anaesthesiology is a graduate prepared profession, and in addition to the nurse being a Registered Nurse, she / he must also complete a Master’s degree in anaesthesia. Of further essential importance candidates are strictly required to have completed or have 1 year of full time nursing experience in a medical or surgical ICU. The nurse must also be Board Certified in anaesthesia.
Are our nurses being held to the same or almost the same level? Or are patients’ lives being placed at risk while the Government searches for the main vein in which to administer the vital lifesaving serum. On a diversionary note, is there an absence of trained anaesthesists in Guyana? I mean the guys at the fully trained end of the spectrum, that is,doctors who have graduated from medical school, are fully registered medical practitioners, have completed Residency training and have applied and completed postgraduate training in the speciality called anaesthesia.
Why should the Ministry of Public Service has as its mandate, the task of creating the position of Nurse Anaesthesists? An 8 year wait beggars description and smacks of professional disregard. Is there not a General Medical Council, that at best overseers quality assurance of anaesthesia, especially since the Nurse Anaeasthesist forms part of the Anaesthetic team? She is certainly a step up from a nurse having undergone a different discipline of training.
Again to whom is the registered Nurse Anaesthesist accountable, once she has administered anaesthesia, and to this inquiry I ask what type of anaesthesia is she legally permitted to administer, irregardless of whether it is regional or local, better known as conduction anesthesia? Forget about the five year contract given to these nurses, but what further training, if any have these RNAs undergone? The plot thickens, while the clot sickens. .
While I am in some degree of sympathy with the nurses in requesting their rights and deserves, I nevertheless strongly feel that an issue of such major civic concern is being disregarded or lightly glossed over both by the government and the Minister of Health. To this end I am calling on both the President and the Minister of Health, Mr. G. Norton to investigate, instigate, abrogate remediate at the earliest opportunity thereby eliminating the possibility of “ had we known” being uttered. The nurse- anaesthesist is executing her skill/ expertise on citizens in public health institutions. Who speaks for these individuals? Perhaps it is timely to jog the memory as to what anaesthesia means and entails. It is an induced temporary state, with one or more of the following features— pain relief, muscle relaxation (conductive anaesthesia), memory loss (dissociative anaesthesia) and unconsciousness as in the case of general anaesthesia. For one moment let not the public be lulled into a sense of quasi anaesthesia, but it must be clearly stated that anaesthesia regardless of the type administered has its accompanying risks, some of which can be and are ultimately fatal.
The clarion has sounded, loud and clear, far and near, town and country plane and train now it behooves the Government and all appropriate health agencies to wake up, shake up and take up this inquiry, not only seeing it through to fruition but putting in place appropriate training, qualified personnel, quality assurance measures etc., and time would tell if we have averted the death knell.
Yvonne Sam.

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The medical system has to be careful with who administers anaesthesia

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