Pennsylvania CRNA's Are After Independent Practice (Again)
Posted by Clark Venable on 5/24/2007
Currently pending in the Pennsylvania Legislature is House Bill 1256 to amend the state law that currently requires CRNA's to be supervised by physicians. If enacted, Certified Registered Nurse Anesthetists would no longer be 'supervised' but 'shall administer anesthesia in collaboration with a physician or dentist' (emphasis mine). Furthermore, such collaborating physician only needs to be available electronically (i.e. a phone call away). I'm told that this new language would essentially give CRNA's the ability to practice independently in the State of Pennsylvania.
I think this is a very, very bad idea. In a year when the Governor has made patient safety a centerpiece of his legislative agenda, telling CRNA's that they can practice without supervision seems to me to be a step in the wrong direction. CRNA's are nurses. Highly trained (and the most highly paid) advanced practice nurses, yes, but still nurses. The proposed legislation seeks a substantial change in the status quo and should not be enacted without clear proof that the quality of care Pennsylvania's residents receive will not be adversely affected.
The CRNA lobby is arguing that you really only need anesthesiologists in teaching institutions. I hope our legislators will pause to consider how silly this assertion is. I know a lot of CRNA's. A few of them are very, very good. I would let any one of my physician colleagues (that's about forty people) give my family members an anesthetic. I would only let a handful of CRNA's do the same, and then only with physician supervision immediately available.
Perhaps we should amend this bill so that only the Governor, and members of the legislature and their families will receive anesthesia only from CRNA's and without physician direction for, say, the next ten years and see how good an idea they think this is.
Pennsylvania's citizens are aging. They need physicians to evaluate them before, during, and after their surgery and anesthesia. If you're in favor of this bill, you're probably also in favor of RN First Assistants doing routine cholecystectomies and other surgeries. Those performing surgery have to try really hard to kill a patient. We just have to not pay attention for one minute.
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