What the department could not understand was that even in those circumstances where an anesthesiologist may provide supervision of CRNAs, the anesthesiologist may not be supervising all of the time. Twenty-nine percent of anesthesiologists providing supervision of unscheduled surgery were, according to the survey, on call. Given the lack of evidence to support the supervision requirements in the hospital licensing standards, the department resorted to generalities. In fact, the overwhelming evidence is that anesthesiologist supervision of CRNAs does not improve the quality of care. It reflects the same historical misconception that nurse anesthetists have fought for 100 years - that nurse anesthetists cannot master the body of anesthesia knowledge to be effective administrators of anesthesia.
Nurse anesthetists are effective administrators of anesthesia.
There is no evidence that CRNAs supervised by physicians with knowledge of anesthesia techniques and equipment are any more effective than those who are not. To the contrary, there is ample evidence that CRNAs need no more guidance concerning anesthesia techniques or equipment than do anesthesiologists. The New Jersey standards reflect a fundamental inability to understand the reality of anesthesia practice. Hidden beneath the Department of Health's rhetoric is a fundamental truth - the hospital standards regarding supervision have nothing to do with quality of care and everything to do with suppressing competition and institutionalizing physician control of CRNA practice. It is a shame that New Jersey's standards so unnecessarily combine worthwhile provisions dealing with monitoring and equipment with the turf battle of supervision.