Some nurses finally get the recognition they deserve | PennLive Opinion

July 28, 2021

By Matt McCoy

It used to be that certified registered nurse anesthetists (CRNAs) were the best-kept secret in health care. Not anymore.

Right before the General Assembly adjourned for its summer recess, lawmakers passed and the governor signed into law Act 60 of 2021, which grants formal title recognition to CRNAs in Pennsylvania.

The enactment marks the end of a legislative review that stretched more than a decade, and it brings tremendous professional satisfaction to the state’s 3,700 CRNAs and students, who will finally be recognized for their advanced education, specialized training, and clinical skills.

Until that moment a few weeks ago, Pennsylvania remained just one of two states (New York is now the lone holdout) that failed to formally recognize “certified registered nurse anesthetist” in some form.

Because there was no definition for nurse anesthetists under the state’s Professional Nursing Law, CRNAs were recognized only as registered nurses, despite clear differences between the two health-care professionals.

CRNAs are the hands-on providers of anesthesia care, operating safely in every setting where anesthesia is administered, including hospital operating and delivery rooms; ambulatory surgical centers; the offices of dentists, ophthalmologists, and plastic surgeons; pain management centers, and more.

Act 60 also expands the providers that CRNAs are permitted to work with to include podiatrists.

While many CRNAs practice with physician anesthesiologists, increasingly, CRNAs practice on their own in collaboration with other health-care professionals.

Act 60 also reinforces that nurse anesthetists are able to perform the full scope of anesthesia services without the involvement of physician anesthesiologists and embraces the existing patient care model of collaboration between CRNAs and their physician colleagues.

More than 49,000 CRNAs safely administer well over 34 million anesthetics nationwide each year --- and Pennsylvania remains at the forefront.

With 13 university-led programs, including York College’s WellSpan Health Nurse Anesthetist Program, our commonwealth is a national leader in anesthesia education and training. So, it has always been frustrating that our state didn’t even officially recognize these professionals.

It was costly, too. Without an official CRNA designation here, many students left. And even after they left, some graduating students had to wait as long as six months to get credentialed in out-of-state facilities, because state boards had to verify that students met requirements to be classified appropriately there.

This new law stems the flow of this “health-care brain drain” and reinforces our reputation for education and training.

Act 60 also remedies issues with credentialing that meant logistical and financial challenges for CRNAs.

Pennsylvania-based nurse anesthetists who serve in the military, for example, had to secure designation in another state to provide anesthesia in the armed services. Our CRNAs could not assist on rapid response teams in states affected by natural disasters unless they served only as RNs because they lacked formal credentials.

But it was the pandemic that finally put this decades-long professional slight into perspective.

In response to COVID-19, many CRNAs wanted to contribute more to the facilities where they worked but couldn’t. Likewise, hospitals and other health-care institutions wanted to use CRNAs to their fullest capacity but couldn’t.

And they couldn’t because of the way the state-licensed CRNAs as RNs, which limited our role to provide the most advanced, critical care services during the biggest health-care crisis of our lifetime.

Of course, none of this would have been possible without the bipartisan cooperation of the administration and lawmakers, especially Rep. Tarah Toohil (R-Luzerne) and Sen. John Gordner (R-Columbia), whose measure ultimately was signed into law.

In the most ordinary situations, surgery and anesthesia can be frightening or intimidating. But nurse anesthetists provide comfort and reassurance by never leaving their patient’s side.

We’re usually the last people patients see before a procedure begins and the first to greet them when they awake. It’s humbling to realize that now they will get to know us for who we really are -- finally and officially -- as CRNAs in Pennsylvania.

Matt McCoy, DNP, CRNA, is president of the Pennsylvania Association of Nurse Anesthetists.

https://www.pennlive.com/opinion/2021/07/some-nurses-finally-get-the-recognition-they-deserve-opinion.html

Guest Opinion: Fitzpatrick fighting opioid epidemic with critical legislation

By Angelarosa DiDonato

Published June 14, 2021 in the Bucks Courier Times

While the COVID-19 pandemic has dominated headlines across the globe, another public health crisis has been running in the background unabated. Each day, 150 Americans die from a drug overdose. From September 2019 to September 2020, more than 5,000 Pennsylvanians died from a drug overdose, a 22% increase from the previous year. Three-quarters of these deaths are attributed to opioids.

The opioid epidemic has had a devastating impact on Pennsylvania communities and, much like COVID-19, must be addressed from a variety of approaches. One essential step in reducing the human toll of the opioid epidemic is stopping addiction before it begins. For many, addiction begins with a prescription opioid after injury or surgery. Representative Brian Fitzpatrick, R-1, recently reintroduced legislation in Congress that would make non-opioid pain control options more accessible to patients.

The Non-Opioids Prevent Addiction in the Nation (“NOPAIN”) Act would increase access to safe, innovative, non-opioid pain management options. The NOPAIN Act, a bipartisan effort, would update reimbursement protocols that currently incentivize opioid use. With this legislation, health professionals will be better equipped to tailor treatment options to each patient’s individual needs, which could prevent millions of Americans from going on to long-term opioid use after a surgery.

I applaud Rep. Fitzpatrick for introducing this legislation and urge other members from the PA Congressional delegation, including Senators Toomey and Casey, to join him in supporting the NOPAIN Act. By introducing this legislation, Rep. Fitzpatrick is clearing the way to give health professionals access to more tools to manage their patients’ pain.

Angelarosa DiDonato is immediate past president of the Pennsylvania Association of Nurse Anesthetists.

It's time for nurse anesthetists to get formal recognition

By Matt McCoy

Because of the global pandemic caused by COVID-19, all of us have had to confront personal and professional challenges we never thought we’d have to face. Even now, more than a year after this health-care crisis began, response and recovery efforts continue, with certified registered nurse anesthetists playing a major role.

CRNAs are the best-kept secret in health care. In the most ordinary situations, surgery and anesthesia can be frightening or intimidating. But nurse anesthetists provide comfort and reassurance by never leaving their patient’s side. We’re usually the last people patients see before a procedure begins and the first to greet them when they awake.

CRNAs promise their patients to be there for every heartbeat, every breath. When this pandemic separated families in crisis, that promise took on a whole new meaning. Many of us have been serving as frontline health-care workers, fulfilling critical roles inside and outside the operating room during this crisis. That’s because CRNAs are uniquely qualified to care for critically ill patients who are suffering because of this respiratory pandemic.

CRNAs are the hands-on providers of anesthesia care, operating safely in every setting where anesthesia is administered, including: hospital operating and delivery rooms; ambulatory surgical centers; the offices of dentists, podiatrists, ophthalmologists, and plastic surgeons; pain management centers and more.

In response to COVID-19, many CRNAs have wanted to contribute more in the facilities where they work but couldn’t. Likewise, hospitals and other health-care institutions have wanted to use CRNAs to their fullest capacity but couldn’t, all because of the way the state licenses CRNAs, sometimes limiting our role to provide advanced, critical care services.

That’s because Pennsylvania remains just one of two states that fails to formally recognize “certified registered nurse anesthetist” in some form. Because there is no definition for nurse anesthetists under the state’s Professional Nursing Law, CRNAs are recognized only as registered nurses, despite their advanced education and training.

This brings logistical and financial challenges, and Pennsylvania CRNAs often have to obtain credentials from other states for certain activities.

Pennsylvania nurse anesthetists who serve in the military must secure designation in another state to provide anesthesia in the armed services. They cannot assist on rapid response teams in states affected by natural disasters because they lack formal credentials. And, after receiving training in Pennsylvania, many nurse anesthetists relocate to states with full credentialing, contributing to the state’s “brain drain.” Bipartisan measures have been introduced in both the state House and Senate to finally recognize nurse anesthetists as “CRNAs” under Pennsylvania statute. It’s an idea whose time has come, and it’s long past time for the state to act.

Two-thirds (67%) of Pennsylvania voters support professional designation for certified registered nurse anesthetists, including those who identify as Republican (59%), Democrat (75%) and Independent (62%), according to results of a statewide public opinion poll conducted last year by G. Terry Madonna Opinion Research.

Broad support like this should give lawmakers the confidence they need to advance this measure and finally provide CRNAs with the professional designation they deserve.

The commitment of CRNAs during this health-care crisis has availed more physicians to provide hands-on care, expanded the capacity of both CRNA and physician providers to help patients, and augmented the state’s health-care system to continue to meet the growing demands of this pandemic.

This crisis still requires an all-hands-on-deck approach. Our health-care systems are still challenged to function at high capacity. As long as response and recovery efforts continue, CRNAs will remain a critical part of the solution. It is time for nurse anesthetists to finally receive the formal recognition they deserve for their contributions to this crisis and the safe, affordable delivery of care overall.

McCoy is President of the Pennsylvania Association of Nurse Anesthetist and a resident of Westtown Township, Chester County.

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