NJ Association of Nurse Anesthetists

May 26, 2009

Dear NJANA Member,

This past year has been a one of great change. As June 16, 2009 draws near we have had several conversations with the New Jersey Board of Nursing regarding the APN regulation. Because of staffing issues within the Board of Nursing it is possible that not all applications for APN certification will be processed by the June 16, 2009 deadline. The Board of Nursing has issued the enclosed document and distributed it to New Jersey Hospital executives. The Board of Nursing will still upholding the deadline for applying for APN status on or before June 16, 2009. NJANA has been in direct contact with the Board concerning this impending deadline and the amount of certification applications which need to be processed. The repeal of the current CRNA regulations will be postponed only for those Nurse Anesthetists (with or without a master’s degree) who have applied for APN status on or before June 16, 2009 and whose APN certification is pending. This will afford those Nurse Anesthetists who have applied on or before June 16, 2009, but have pending APN certifications the ability to work under the old regulations until they receive their APN status. To verify that your certification is pending you may email the Board of Nursing APN@dca.lps.state.nj.us.

APNs in New Jersey must work in collaboration with a physician and have established a joint protocol. The regulation regarding joint protocols can be found on our website at www.NJANA.com. In addition to the regulation, you will also find a sample template of a joint protocol for your review. You are encouraged not to sign a joint protocol which will require you to work under supervision as the APN statue is clear in that APNs work in a collaborative arrangement; NOT under supervision. By its nature, a joint protocol is a contact between an APN and a collaborating physician. When negotiating a joint protocol, the parties should negotiate each of the items that must be addressed in a joint protocol. This document may be as simple or complex as the two parties agree upon. Since the joint protocol is a binding legal agreement, once it is signed by both parties it will be difficult to have it amended to delete unfavorable provisions.

In closing, I would personally like to applaud all of you who have completed this process and have taken a very large step forward for our practice in New Jersey; you are the BEST! We hope to see all of you at our upcoming fall meeting. Please see the enclosed save the date card.

Sincerely,

Russell R. Lynn, MSN, CRNA
President, NJANA

APN Certification for Nurse Anesthetists

The June 16, 2008 adoption of N.J.A.C. 13:37-7 Certification of Advanced Practice Nurses, recognized the inclusion of Certified Registered Nurse Anesthetists (CRNAs) prepared at the Master’s level in Nurse Anesthesia among those eligible to apply for certification as an Advanced Practice Nurse (APN) in the State of New Jersey. All CRNAs who are prepared at the Master’s level must submit an application with supporting documentation to the NJ Board of Nursing (Board) if they want to continue to practice anesthesia after June 16, 2009. This documentation can also be submitted at any time after that, but until it is complete at the Board, the CRNA cannot practice anesthesia.

Of significantly more importance in regards to timing, an alternative certification process was included in the adopted rules which permits currently working CRNAs who are not prepared at the Master’s level to obtain certification as an APN. This alternative certification process is valid only until June 16, 2009. CRNAs who are not prepared at the Master’s level will not be able to apply for certification after June 16, so it is imperative that they get their application and supporting documentation in as soon as possible.

As the alternative certification process period ends on June 16, 2009, the Board will continue to process those applications post marked prior to the June 16, 2009 expiration date. Due to limited personnel resources and involved processes in certifying CRNAs as APNs, it is plausible that individuals, who have submitted their paperwork prior to the June 16, 2009 expiration date, may not be certified until several weeks following the expiration date.

N.J.A.C. 13:37-1(c) states "a nurse anesthetist who has not obtained certification as an advanced practice nurse shall cease to administer anesthesia on June, 16, 2009". The Division of Consumer Affairs is interpreting this to mean that a non-master’s educated nurse anesthetist who has not begun the certification process shall cease to administer anesthesia in the State of New Jersey on June 16, 2009. Otherwise, a nurse anesthetist, who meets all of the requirements of N.J.A.C. 13:37-1 and who has submitted their application for APN certification prior to June 16, 2009 will be permitted to continue administering anesthesia until the Board is able to complete the certification process.

For further information, contact
George Hebert at the Board of Nursing, (973) 504-6516 or
email APN@dca.lps.state.nj.us

NJ Board of Nursing Link
The web page has not been updated as of August 26. However, you can access the following links for important information.

AANA Contact Information for transcripts (only contact AANA if your school is now closed)
Transcripts can be requested from snalomski@aana.com; the fee is $50.00. A fax or mail request will be accepted. The fax number is 847-692-7082.

1. When do I have to do this by?
Completed applications must be received by the Board of Nursing no later than June 16, 2009. Please do not procrastinate!

2. Does everyone have to do this?
YES, as of June 16, 2009 the current regulations governing CRNA practice will be repealed and replaced with this version.

3. Do we have to take the CDS course every time we re-certify?
No, just for your initial certification.

4. Do we have to take a pharmacology course?
Everyone should have completed a minimum of 39 hours of pharmacology during their anesthesia program. The Standards for the Council on Accreditation has required more than 39 hours of Pharmacology didactic course work since as early as 1975. However, everyone must take the 6 hr CDS course only for their initial certification.

5. My Pharmacology course is greater then 5 years old, do I have to repeat this course or take additional pharmacology CES?
NO, the Pharmacology course work you had in your initial training program, regardless of the age is acceptable to satisfy this requirement provided you completed more then 39 hours.

6. I do not have my masters, can I apply?
Yes. CRNA's without a Masters degree may apply until June 16, 2009. After that date, a masters degree will be required to apply for APN certification.

7. My Master’s Degree isn’t in Nursing (MSN) can I still apply?
Yes, any Master’s Degree awarded from a Nurse Anesthesia Program is acceptable.

8. If I do not have my masters by June 16th, what happens?
As long as your application is received by the Board of Nursing by June 16, 2009 for APN certification and you meet the requirements as stated in the regulations, you will receive your Licensure.

9. Why do I need to take this (CDS) course?
This is a Controlled Dangerous Substances (CDS) course which all APN's must take because of having prescriptive
authority.

10. Where can I find more information about this?
Information is available on the Board of Nursing website (see link below)

11. I spoke with a lot of CRNA's & many of them know nothing about this. Why did this happen?
The APN regulations have been in the process of being rewritten for almost 9 years. During this time, letters have been sent to members, it has been discussed at every state meeting, and information has been posted on the NJANA website. There is also a paragraph in this letter as well as on our website, that explain this entire process.

12. Do I need certain recertification requirements?
The NJ Board of Nursing requires 30 hours of continuing education every two years to maintain Licensure and that you maintain your re-certification status with the AANA/NBCRNA. They will accept the continuing education credits provided by the AANA to meet this requirement as the AANA requirements of 40 CEUs every two years exceeds this NJ requirement. You do not have to meet any further pharmacology requirements once initial Licensure requirements are satisfied, therefore you do not need to meet a certain number of pharmacology hours to satisfy re certification requirements.

13. Can I become an APN in NJ if I’m moving to or want to work in NJ, but graduated more then two years ago?
Provided you are currently certified or re certified as a nurse anesthetist, you can apply to the Board of Nursing under what they refer to as endorsement (even if you are not an APN in the state you are currently practicing in) and obtain APN licensure in New Jersey.

14. How do I provide proof that I worked 1600 hours in the past 2 years?
Non Masters prepared CRNA's must submit proof to the Board of Nursing that they have worked 1600 hours in the past 2 years. This can be done by sending a letter from your employer. In the event you work for an agency or agencies, or work in multiple locations, you can get a letter from each are where you have worked stating the amount of hours you have worked. You can then write a summary letter stating that you have met the 1600 hour requirement.

15. If I have a Masters degree, should I have my transcripts sent from the university or from my anesthesia program?
Either should be acceptable, however it may be preferable to have them sent from the university. If you returned for your Masters degree after graduating from anesthesia school, you should have both transcripts sent. The school transcript will verify that you graduated from an accredited school, while the university transcript will confirm you obtained your masters degree.

16. In the application, Q. 24 asks about Pharmacology Education Completed. Could you please clarify this?
The application states you must prove either a 3 credit graduate level pharmacology course or 39 hours of pharmacology.

17. Why do we have to take a CDS course, especially if it is not specific for CRNA's?
This is a requirement which all Advanced Practices Nurses must complete according to the New Jersey State Board of Nursing Regulations. Therefore the course is targeting all APN's. This has to do with prescriptive authority, not specifically anesthesia. It is a one time requirement.

18. Do I need a DEA # ?
Anyone who will be prescribing or ordering narcotics will need a DEA #. If you plan to prescribe controlled dangerous substances after you become an A.P.N. you will also need C.D.S. registration and D.E.A. certification.

19. Should I apply now?
Once you receive your APN certification, you can apply.

20. Who do I contact?
C.D.S. You may go to the C.D.S. Web site at http://www.njconsumeraffairs.gov/drug/dchome.htm or contact the Drug Control Unit at (973) 504-6351 to obtain an application. (A.P.N.s are mid-level practitioners.)
D.E.A. 80 Mulberry St., 2nd Floor, Newark, NJ 07102. The Web site for the D.E.A. is www.deadiversion.usdoj.gov.

ADVANCED PRACTICE