French
Union of Nurse Anesthetists
Nurse Anesthetist in France
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French
Union of Nurse Anesthetists |
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There are about 7500 Nurse
Anesthetists in
The French nurse anesthetist
is called : Infirmier Anesthésiste
Diplômé d’Etat (IADE), meaning Certified (National Diploma) Nurse
Anesthetist.
The IADE is a state
registered nurse with a specific national diploma in nurse anesthesia. The role
is defined within the National Law
( 2002-194 -
February, 11th 2002) concerning the nurse skills , and especially within
Article 10:
" The Certified Registered
Nurse Anesthetist is the only one enabled ( authorized), in condition that an
anesthesiologist can intervene at any moment and after that an anesthesiologist
has examined the patient and determined the procedure, for the application of the
following techniques:
-
General
Anesthesia,
-
Regional
anesthesia and re-injections when the device has been placed by an
anesthesiologist,
-
Perioperative
resuscitation ( stabilization).
He is providing care and can
at the exclusive initiative of the anesthesiologist, realizes the technical
skills that are required by the procedure.
He is in charge, in Recovery
room, of acts that are requiring anesthesia techniques as quoted in the first
paragraph.
He is ,moreover, enabled for
the post operative pain management requiring anesthesia techniques as quoted in
the first paragraph.
Skills of article 9 (
referring to Emergency
The student nurse anesthetist
can participate to these activities in condition to be supervised by a nurse
anesthetist and an anesthesiologist."
Actually nurse anesthetists
administrate and/or participate to the administration of anesthesia , maintain
and control anesthesia until the recovery period. The responsible physician is
an anesthesiologist supervising 2 or 3 operating rooms with a nurse anesthetist
in each room.
Nurse anesthetists are also
participating to Emergency Mobile Units (SAMU, SMUR) and are recognized as
resource persons for cardio-respiratory resuscitation procedures.
They are recommended for
supervising Recovery Rooms, Surgical Intensive Care Units and Emergency Units.
Education :
After a basic nursing
education (3 years post baccalaureate), a 2 years experience of care near the
patient (including preferably at least 1 year in intensive or critical care
units) the student shall succeed to an admission examination to start a nurse
anesthesia program of education. The studies are 2 years long with theoretical
and clinical curses. At the end of the program the student shall pass and
succeed to a national final examination to obtained the National Diploma of
Nurse Anesthetist.
There are 25 civil programs
and 3 military programs. The nurse anesthesia program of education is a
national one. (See below details)
FRENCH NURSE ANESTHESIA PROGRAM
·
To educate certified registered nurse and
midwives to advanced nursing polyvalency in anesthesia, rescue, emergency and
pain control;
·
To manage the education for preparing the
admission examination to the nurse anesthesia programs;
·
To provide continuing education;
·
To promote research and support the
documentation in nursing in the above areas;
·
Admittance capacity;
·
Number and qualifications of staff members;
·
List of clinical training sites, quality of
clinical training instructors and report on activity of clinical training
departments receiving students;
·
School plans and list of equipment;
·
Projected budget for the program;
·
Plurianual analysis of regional and
transregional needs;
·
Motivated notice of Regional Director of
Health and Social Affairs;
·
Secretariat.
Article 4
The program director is a Certified Registered Nurse Anesthetist with a
Diploma of Health Management. He is responsible for:
·
The Educational project:
·
The organization of theoretical and clinical
training;
·
The management and supervision of the
faculty;
·
The education control;
·
The general management of the program.
The program director is
appointed by the Regional Government Authority (Préfet) after notice of the
Nursing Committee of the High Council of Health Professions. He is in a full
time position.
Article 5
Nurse anesthesia teachers
shall be Certified Registered Nurse Anesthetists with the Diploma of Health
Management with a five years nurse anesthesia practice experience.
Article 6
For each program, a
University Anesthesiology Teacher is appointed by the Regional Authority (
Prefet) as Scientific Adviser. He is responsible for the scientific containing
and quality of the program. He is accountable for the quality of medical
teachers.
Article
8
A- To be allowed to begin a
nurse anesthesia program, the candidate shall:
-Be a certified registered nurse or midwife, or
recognized as equivalent according to law..
-Justify of a minimum of two (2) years of practice as a
full time nurse or midwife.
-Pass the examination of admittance to the nurse
anesthesia program.
-Pay the educational fees as determined by the government
Article 9
In addition to the agreed
capacity of students and not over 10% of the number of students for the first
year, some foreigners students with a non recognized nurse diploma can be
admitted in restricted conditions.
Article 11
Every year the dates for the
deadline application forms and the
admittance examination are determined by the regional governmental authority
under proposal of nurse anesthesia
program director.
Article 12
For passing the admittance
examination , the applicant shall present a dossier containing:
A written request for participating to the admittance
examination
A Curriculum Vitae
A justification of a two years ( 24 months) practice as a
full time nurse or midwife
A copy of titles, diplomas and certificates
A medical certificate certifying the vaccinations
requested by the Code of Public Health
A receipt of the payment of registration fees for the
admittance examination
The director is in charge of
announcing to the applicants the number of seats available for the program.
Article 13
The examining jury is appointed by the
Representative of Governmental Authority of the Region, based on the
nominations made by the Director of
Nurse Anesthesia program. It is composed of:
-The Official Representative of the Ministry of Health (
a physician);
-The Nurse Anesthesia Program Director;
-The Scientific Adviser;
-One or more anesthesiologists, teaching at the program;
-One or more head nurse anesthetists teaching at the
program;
-One or more head nurse anesthetist and nurse
anesthetists of hospital clinical training site.
-The number of anesthesiologists and nurse anesthetists
has to be equal.
Article 14
The admittance examination
shall evaluate the professional competencies and knowledge, and the ability to
follow a nurse anesthesia program. It consists of:
-A written anonymous admittance test for evaluating the
professional knowledge and capacities of synthesis of the applicant.
This test of a duration of
-An oral test on a professional item linked to clinical
learning, for evaluating the competencies achieved by the applicant during his
professional experience, and his readiness for care management and nurse
anesthesia program. The question, chosen
just before the evaluation by the examining jury, shall be the same for the
entire session. This test consists of a ten (10) minutes exposé with a ten (10)
minutes discussion with the jury. The candidate has twenty (20) minutes to
prepare the question. A minimum mark of 20/40 is required.
Are admitted, candidates
rated first until the number of seats agreed for the nurse anesthesia program.
A minimum mark of 40/80 is required.
Article 15
The admittance is only
available for the current year. A one year carry over can be by derogation
accorded in certain circumstances.
Article 16
The date for starting the
program is the first working day of October.
Article 7
The studies are full time.
The program includes a theoretical
education, practical and supervised training, clinical training and a personal
working time for research.
Article 18
For every year there is a
vacation period of twenty five (25)
working days and twelve (12) days off, determined by the director of the
program. A maximum of six weeks of
absence for health reasons can be accorded, but for period exceeding 2 weeks
the student will have to complete the time of education missing.
Article 19
Theoretical, practical and
clinical education is divided on three (3) sequences per year. Every sequence
shall be validated with a minimum mark of 10 /20.
Article 20
The clinical training period
is composed of compulsory and optional clinical training. The sites are
approved by the regional official representative of the Ministry of Health,
based on the selection made by the program director and the scientific
director.
The clinical training
evaluation is made by the anesthesia department head anesthesiologist, the
department head nurse anesthetist and the nurse anesthetist in charge of the
student.
A minimum mark of 10/20 is
required.
Article 21
The second year students can
participate to emergency and call shifts not exceeding 48 hours per month,
included in the total period of clinical training.
Article 22
Every period of clinical
training has to be validated.
Article 23
A clinical evaluation is
made every year on site and has to be validated.
Article 24
A personal research work has
to achieved and presented by the student at the end of the program.
Article 25
D-In case of failure on validations of theoretical, practical and
clinical evaluations, or in case of lack of personal research work, the student
will not be authorized to continue and or achieve the program. The program
cannot be achieved in more than 3 years.
Nurse
Anesthetist Diploma.
Article 26
Are authorized to sit for the final examination, the students with a complete validation of the sequences and clinical training and presentation of the personal research work.
Article 27
The final examination is organized by the regional
official representative of the Ministry of Health every year in September
Article 28
The final examination
consists of:
-A synthesis examination-paper of 2 hours, marked out of
20.
-A written test of 10 questions during 2 hours, marked
out of 20.
These tests are anonymous
and have a double correction by 2 members of the jury: an anesthesiologist and
a nurse anesthetist.
-A clinical and professional evaluation on clinical
training site, for a maximum of 5 hours evaluated by an anesthesiologist and a
nurse anesthetist. The evaluation is marked out of 40.
IV- In addition of the 2 marks for the written tests and
the one for the clinical evaluation, there is the average out of 20 of the
marks for the 6 sequences and the clinical training of the two years of
education and the 2 clinical evaluations.
Article 29
To graduate, the student
shall have a final minimum mark of 80/160. A mark lower than 7/20 to one of the
written tests or the clinical evaluation is disqualifying.
In case of failure, the student
shall pass the next examination the year after. The program faculty will decide
of the needs for a complement of education or not.
Article 30
The examining board is
composed as following:
-The regional representative of the Ministry of Health;
-A scientific advisor from an other nurse anesthesia
program;
A Nurse Anesthesia Program Director or teacher of an
other program.
-One or more
Anesthesiologists teaching in nurse anesthesia programs
-One or more
Nurse Anesthetists with a minimum of practice of 3 years, one or more Head
Nurse Anesthetist from a clinical training site.
Article 32
The regional Representative
of the Government issues to the graduates the National Diploma of Nurse
Anesthetist. For non recognized nurse diploma foreign students a certificate is
delivered. This certificate will be recognized as national Diploma if the
applicant is fully recognized by authorities for the nursing practice.
Advisory
(or technical ) Committee:
Article 33
A-For every Nurse Anesthesia program, the Director is
assisted by an Advisory Committee for all the items concerning the education.
The committee advice are required for:
-Application of the official curriculum,
objectives of the program, pedagogical project,
organization of the program, practical, clinical studies and pedagogical research;
-Clinical
training sites agreement, clinical training and sequences evaluation process;
-Dates of holidays and vacation periods;
-Use of the rooms and pedagogical equipment;
-Faculty number, the type and the time of their participation;
-Estimated budget;
-Costs of the studies for the students and
the registration fees for the admittance examination;
-School regulations;
-Examination of the dossier presented by
students requesting a delay for their studies
for exceptional events;
The Director notify to the Committee:
-The pedagogical results of the past year;
-Approved budgets and the final accounts;
-The list of the students .
-Evaluation of continuing education
Article 34
The Director announces, as
per advice from the Committee , either the necessity to repeat the year for a
student or the stop of the education in case of failure for one or more clinical training or one or more
theoretical sequence. The Director notify every meeting to the Committee at
least 2 weeks before. He gives to every committee member and to the concerning
students a motivated report and the
student education dossier. Students receive their dossier on the same date than
the Committee.
Article 36
The Committee is appointed
and chaired by the representative of the Government. It consists of:
-Director of the program;
-Scientific Advisor;
-One representative of the Management Board
of the School location;
-The Nursing Director of the Hospital
receiving students for clinical training;
-One Anesthesiologist teaching at school
elected by peers;
-One Nurse Anesthetist teaching at school
elected by peers;
-One head Nurse Anesthetist from the clinical
training site elected by peers
-Two (2) students (one per year) elected by
fellows, one per class;
The students are elected for a one year term. The other
members are elected for 4 years. Each member has a proxy elected in the same
conditions.
The chairman of the Committee by his own or on the
request of the majority of the members of the committee can invite any expert
for advice for the Committee.
The Committee is meeting at least twice a year.
Article 38
On every Nurse Anesthesia
program the Director is assisted by a Disciplinary Board (DB) The DB is giving
advice concerning disciplinary items and the students acts when the safety of
the patients is not guarantied and involving the student responsibility.
The DB can propose the following sanctions:
-notice,
-admonition,
-temporary expulsion,
-definitive expulsion.
Article 39
The notice can be notified
by the program director without the DB agreement. In this case the student can
be assisted for his defense by a person of his choice.
Article 40- Article 51
The Disciplinary Board is
chaired by the Representative of the Government. It consists of:
-One representative of the Managing Board of
the nurse anesthesia program;
-Two
of the four elected persons of the Advisory Committee
-One
of the two teachers member of the Advisory Committee drawn;
-One of the two students member of the
Advisory Committee drawn.
The Director informs the
involved student of the Disciplinary process. The student can be assisted by
any kind of people. Witnesses can be heard. The quorum is required for any
decisions. The sanction is voted by a majority of the members.
The prerequisites imply a good knowledge of the basic
nursing education program. The applicants shall improve their knowledge for the
following topics:
I-
Elementary notions:
Genetics
Cell
Tissues
II
For every main function are
included definition, anatomy, physiology, pathology and nursing care:
Regulation and control functions
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