Movers and Shakers

Movers and Shakers is a new section that’s been added to our website. It will highlight CRNAs, SRNAs, legislators, hospital administrators and other folks who make a difference in our state and specifically for our profession. If you know of someone who makes a difference in your practice, please let us know. We will gladly feature them.

Our first “Mover  and Shaker” spotlight is Dr. Martin Blaney. Martin is the FIRST CRNA in our state to obtain prescriptive authority for  all  drug classes except schedule ll!  This  was made possible because of the new legislative law directing the Board of Nursing to rewrite Chapter 8 rules for critical access hospitals that went into effect this past summer. His ability to prescribe medications will greatly add to Martin’s armamentarium while practicing opioid free anesthesia in his rural practice setting. 

Congratulations Martin! You are a real trailblazer for others.  Please take a moment to read about this amazing CRNA.

Martin Blaney

I was born and raised in Maine, and with the exception of my years serving in the Army, I have pretty much lived, worked, and/or studied in every corner of this great state. I think it’s a great place to live and work.

I’ve spent the better part of the past nine years living on the Down East coast with my husband, Ryan. We love it there, and when I’m not working in Rumford, I volunteer maintaining hiking trails for Maine Coast Heritage Trust. Maine has beauty everywhere, but I am partial to the raw beauty found Down East. Whether it is hiking along granite cliffs that plunge 30-40 feet straight down into the sea, or camping on an uninhabited island just off the coast, my happiest times are when I’m outside, in the woods, appreciating nature’s simple wonders.

In 2012, while working at my first CRNA job, I started to delve into multi-modal analgesia practices. It took less than a week to leave behind opioids and “balanced anesthesia” in favor of better outcomes – rare, if any, post-op nausea and vomiting; high patient satisfaction scores; and quicker recoveries. It’s been eight years and my practice is nearly 100% opioid-free. I recently completed the state and federal requirements for prescriptive authority, and am looking to add pre- and post-operative medications to my current practice, in an effort to maximize the favorable results I’ve seen so far. I love the flexibility independent practice provides me, and I appreciate the efforts of the MeANA board and membership to further the practice of nurse anesthesia in Maine.

Here’s How You Can Gain Prescriptive Authority Too!

There are multiple steps to getting approved for prescription authority, and they need to be done in sequence.

  1. Complete a 45-hour graduate level advanced pharmacology course, either through a university graduate school (3 credits) or a CME provider (45 hours). I chose Barkley & Associates, and it cost $545.00. Whichever course the CRNA chooses to take, it MUST include classes on prescription writing and at least three hours specifically on managing opioid prescriptions. The Barkley course was comprehensive, and I had 90 days from registering to complete it. It took me longer, so I ended up paying $50.00 more for a 30-day extension. There were three exams to take throughout the course. Upon successful completion of the final exam, I received a CME certificate showing that it was an approved course for prescribers. I called the BoN to ask if they wanted me to send it in to have on file; they do not. While the course requirement is written into the Chapter 8 rules, it is for a DHHS requirement, not a BoN mandate. I was told to hold onto the certificate until such time I may be asked to provide it.
  2. The DEA requires all providers who prescribe medications to register with them. To obtain a DEA registration number costs $888.00, however, the Chapter 8 rule stipulates that CRNAs MUST ONLY prescribe using the DEA registration number of the Critical Access Hospital (or rural hospital) by which they are employed. This is important: We are not allowed to obtain our own DEA registration number under the Maine law. Instead, the DEA permits hospitals to allow providers who do not wish to obtain their own registration number to use the hospital’s DEA registration number with a suffix as a unique identifier for the provider. I confirmed this with the  Boston office of the DEA and the BoN.
  3. Go to your hospital’s chief pharmacist and request s/he add the CRNA to the list they are required to maintain of providers who use the hospital’s DEA registration number. The number is two letters followed by seven digits followed by a hyphen followed by a four digit unique suffix assigned to the CRNA. Once you have that, then
  4. Create an account with the Maine Prescription Monitoring Program as an advanced practice nurse specializing in anesthesiology (there’s no drop-down option for CRNA). You’ll need your DEA registration number for this. It’ll take a few days to get approved, but once approved you’re required to check the PMP prior to writing any prescriptions.
  5. Educate your surgeons on your intentions to prescribe.
  6. Prescribe.