Section 6.3 Number of Directors, Election, Term of Office, and Submission of Nominations. (a) The First Board of Directors of the NBCRNA shall be composed of six (6) directors (the “First Directors”). (b) Except for the First Board of Directors, the number of directors of the NBCRNA shall be eleven (11). The number of directors may be increased to any number or decreased to not fewer than three (3) from time to time by amendment of these Bylaws. Eight (8) directors shall be certified registered nurse anesthetists who are currently recertified; one (1) director shall be a board-certified anesthesiologist; one (1) director shall be a board-certified surgeon; and one (1) director shall represent the interests of the public.
Reading the above it appears that the 11 members of the NBCRNA Board of Directors, or potentially as few as 3, have complete authority over the NBCRNA certification and recertification of all practicing nurse anesthetists in the United States. There are no shareholders, no voting members, no appointed or elected AANA representatives, meaning that the NBCRNA board of directors answers only to themselves.
Question 5) Concentrated authority, insistence on confidentiality, estranged relationship with the only national organization representing nurse anesthetists – How will NBCRNA address these concerns ?
President Vacchiano’s Response : As the certification agency for nurse anesthetists, the primary function of the NBCRNA is to serve the public safety by establishing certification and recertification programs which are in accordance with the standards of practice set by the AANA and the standards of education set by the COA. Unlike a membership service organization like AANA, the NBCRNA does not have members who elect officials and subscribe to services provided by the organization. As a non-profit organization, it also does not have shareholders who invest for financial gain.
The NBCRNA directors do not answer to themselves, but rather to the organization’s bylaws and to two accreditation agencies which evaluate NBCRNA’s policies, operations, due process for constituents, and collaboration with related agencies (such as the AANA). The NBCRNA does, in addition, answer to both public and professional stakeholders. One accreditation requirement is that NBCRNA seek feedback from the constituencies of interest before making substantive changes to programs.As an example of this, the CPC program underwent substantial change in response to feedback from CRNAs and the AANA after the initial proposal.
While the NBCRNA members must be guided by the mission of public protection, the board is comprised primarily of CRNAs who are all members of the AANA. Keep in mind that as practicing nurse anesthetists NBCRNA members are all personally subject to the decisions they make.Unlike having a certification board comprised of anesthesiologists or other types of nurses, the nurse anesthesia certification process is guided primarily by those who live it, abide by it, and care very deeply about it.
The NBCRNA has been an autonomous body for many years. Even before becoming incorporated, the certification and recertification councils were recognized as autonomous by AANA bylaws, in order to satisfy accreditation requirements that the certification board not be subject to undue influence by other organizations. NBCRNA’s standing bolsters the legitimacy of the CRNA credential which we all know regularly comes under attack when states advocate for practice rights for CRNAs. Currently, the board is comprised of 11 members, eight of which are practicing nurse anesthetists as mandated by our bylaws.
The NBCRNA strives to maintain an effective relationship with the AANA. As our professional association and certification board have evolved, we have had some growing pains, but we are committed to working together in mutual support of the profession that we all care about. While taking care to maintain the required “arms length” relationship with AANA, we are far from being “estranged”. Our executive boards meet on a regular basis, and the full boards also meet to discuss issues of importance. The NBCRNA changed the composition of the CPC committees in order to accommodate a request of the AANA board to appoint representation to each committee. We have recently signed joint letters of support on issues impacting CRNA practice.The NBCRNA is committed to maintaining the strength of our profession by administering a justifiable certification program while also supporting the strength of our professional association.
Regarding confidentiality, the NBCRNA works hard to keep members of the profession informed about issues concerning certification and recertification. There seems to be a misunderstanding as to where confidentiality concerns do arise. To maintain the legitimacy and integrity of our certification examination, as well as to protect the privacy rights of those experiencing certification or recertification issues, we ask volunteer members to agree to a confidentiality policy. Such a policy is routine in business and volunteer work.
Asking for volunteers or employees to maintain confidentiality is not a means of being secretive; it is a way to prevent miscommunication and misunderstanding that may occur when a number of people speak separately on behalf of an organization. To ensure stakeholders are informed the NBCRNA has greatly expanded avenues of open communication, from a new web site, to quarterly e-newsletters, to social media sites, to increased mailings and regular presence at professional meetings. We are committed to maintaining open communication and dialogue with all stakeholders.