By Mary Kay Moyer
In an effort to get to know our colleagues better, and to learn more about opportunities and role models in our state, MEANA interviews CRNA members across the state. Our summer member spotlight is on Paul Schneider, CRNA, APRN MAE Partner Nurse Anesthesia of Maine.
Paul received his BSN from Linfield College in McMinnville, Oregon and his Master of Anesthesiology from Gonzaga University in Spokane Washington. After graduation he left his life-long home of Oregon to work in Maine with Nurse Anesthesia of Maine. He has been active in MEANA, serving on various committees and also as president of the MEANA board of directors. Paul has a passion for travel and has been more places than I can begin to name.
Following is a Q&A with Paul.
Q. What drew you from the northwest coast to the northeast coast of Maine?
A. I had never really been to the east coast and I thought being right out of school was the perfect time to do that. My classmate, Laura Schneider (no relation), had interviewed with Nurse Anesthesia of Maine and told me how terrific the whole set-up was, and that it was a CRNA owned and operated company. It interested me so I came for an interview and accepted a position with the intent to work my three-year contract and head home to Oregon afterwards. That was about 12 years ago! That says something about Maine and Nurse Anesthesia of Maine.
Q. You were the Chief Nurse Anesthetist at Blue Hill hospital. Can you tell us about your clinical practice at Blue Hill?
A. Blue Hill is a great little Critical Access Hospital on the coast. Our biggest cases early-on were colectomies, hysterectomies, and C-sections, with a bunch of hernias and the like. That practice now has no OB, but offers a robust orthopedic and urology service along with GYN, podiatry and general surgery cases. You’ve go to love solo practice in these smaller places. I remember very early on in my career being called to the ED to evaluate an airway on a patient they were planning to transfer. I could not even get a yankauer suction tip in his mouth due to neck swelling. I vividly remember my very first awake nasal fiberoptic intubation. I also remember that, as I started, the ER doc left the room and never came back until it was all done. One never knows what will show up in these small places. You expect it at bigger hospitals, but the critical access hospitals are the wild cards.
Q. Describe your role as chief nurse anesthetist and your administrative responsibilities.
A. When Nurse Anesthesia of Maine acquired the contract for anesthesia services and appointed me as chief, there was a lot of work to be done. Policies were dated, supplies were inconsistent, anesthesia machines were at the end of their lives, and anesthesia involvement in decision-making was more of an afterthought. I was very busy with all of those aspects and with culture change. Networking is so important. If you need a piece of equipment you now have a connection who will advocate for you. Of course, all of that comes with the anesthesia service taking ownership for the department and implementing process improvement plans and setting goals. The anesthesia department is no longer an afterthought. We are consulted regularly and are an integral part of the hospital, providing input to meet the needs of the patients we serve in the best possible way from a scientific, holistic, and financial standpoint. I passed the chief position to Monica Coffey, FNP, CRNA a few years back and she has taken the department to a whole new level. Change is good!
Q. You’ve been with Nurse Anesthesia of Maine for several years and a partner since 2013. How would you describe the business and your role as a partner?
Nurse Anesthesia of Maine started out with nine CRNAs putting the group together and was founded in August, 2003, covering two locations. I joined them in July, 2004. The business has grown to nearly 50 FTE CRNAs and has an amazing administrative team. We now cover 11 hospitals and clinics with both ACT and supervised models with regular services and several more locations with other relief services providing great practice variety for NAMe’s
CRNAs. Hospitals and clinics are appreciating more and more the high quality and value nurse anesthesia services can offer them. This is a busy time in our industry as we work hard to secure practice rights and to provide additional research that demonstrates our exceptional quality outcomes that match other provider types. My role at NAMe is chairman of the board of managers. I set the agendas and gather committee reports and facility reports from committee and group chairs so that the board can be informed about everything going on within the company and the various practices. Like all the board members, there is always another email to read or project to research. I bring issues to the board that the associates bring to me. My goal is for great communication within the NAMe team. Though it takes a tremendous amount of time, I do find it rewarding.
Q. You have served your fellow Maine CRNAs during your time on the MEANA Board of Directors, including your service as president. Was there a dominant issue you dealt with as president?
A. I am embarrassed to say that of all the recent presidents, I think I had the tamest term. And, I am THANKFUL for that–timing is EVERYTHING! I had to write some letters to the board of dentistry about language they were looking at and I actively sought PAC contributions as we tried to get online donations set up, which never really hit the mark. I think my greatest contribution during my presidency was slightly revamping the board meeting format and diligently working on the bylaws that were dated and didn’t reflect how MeANA truly functioned. Stacey Whittington, president-elect at the time and James Husson, chair of the bylaw’s committee, spent many hours on this with me. Since my presidency, that work has continued and MEANA is many-times stronger and a more organized entity.
Q. What do you see as the biggest issue for Maine CRNAs in the next decade?
A. I think it is critical for Maine CRNAs to be reclassified as Licensed Independent Practitioners (LIPs). Currently, Blue Cross will not reimburse for CRNA services because we are”dependent.” That hurts small hospitals and clinics that do not employ an ACT model of care delivery. Though other insurance companies do reimburse, orders need co-signatures. It is ridiculous to me that a CRNA can’t get a required lab test reimbursed by an insurance company if it isn’t co-signed. Being classified as a LIP would solve that. So, that is not only a big issue for us, but for every hospital and clinic in the state. Another substantial issue is simply being able to recruit enough talent to our state. Years ago there might have been 300 ads on Gaswork….now there are 1300. Maine citizens need continued access to high quality anesthesia care provided by CRNAs. But, we need to get that talent to come to Maine to assure that care in the future.
Q. You are the most traveled person I know! Who else visits Australia for a long weekend? Favorite place you’ve been and place you would still most like to visit?
Unfair!!!!! I can’t answer it with just one place because I just CAN’T!!!
How about my top three? Bali: I loved the simplistic life lived in sheer beauty. From the Hindu Temples to the tiered rice fields, to the warm and beautiful people…it was wonderful.
Tanzania/Kenya/Uganda: Wow…just WOW! The amazing wildlife around every curve in the road, the stately giraffes, the trumpeting elephants with Mt. Kilimanjaro as the backdrop, the Silverback Gorillas, the unending varieties of birds, the cheetahs, leopards, and lions and the hippos. I cannot count how many times my breath was ‘taken away’ by the sights and sounds.
Costa Rica: It isn’t that Costa Rica was the most amazing place I have ever visited (but I did love it). It is because I was there for three weeks in nursing school in 1987. I lived with a family and had classes during the week and explored on the weekends. I was immersed in the culture and life of a different land where I didn’t speak the language, and I ate it up. I learned what we had in the USA was not what everybody has and it gave me the yearning to explore more. My number one ‘to-do’ is Antarctica. I am hoping I can pull that one off in 2018. Fingers crossed! I won’t be sitting home until then, my list of places to experience is plenty long!