Letter: Villanova University Urges Support for CRNA Designation, S.B. 325

SUPPORTING DESIGNATION LEGISLATION IN PENNSYLVANIA

Re: CRNA Professional Designation Legislation: S.B. 325 (Gordner)

October 1, 2019

Dear Senator/Representative:

Pennsylvania has more nurse anesthesia graduate programs than any other state in the U.S., attracting students from across the country to study in Pennsylvania to become certified registered nurse anesthetists (CRNAs). Many choose the highly competitive Villanova University Nurse Anesthesia Program, which is administered in partnership with the Crozer Chester Medical Center.

Pennsylvania remains one of just two states that fail to formally recognize CRNAs in statute or provide licensure as a CRNA. There is no definition for “Certified Registered Nurse Anesthetist” under the state’s Professional Nursing Law, and there is no title designation for CRNAs and they are recognized only as registered nurses, not as CRNAs. This ignores the lengthy advanced education and training, required to become a CRNA.

Fortunately, in the final days of legislative session before the General Assembly adjourned for summer 2019, the state Senate approved a measure (S.B. 325) introduced by Sen. John Gordner that would formally recognize CRNAs under PA state law. This is the second consecutive legislative session that the measure passed the Senate. We are urging the House to do the same, immediately.

Nurse anesthetist programs like Villanova’s have seen firsthand the challenges our students and graduates face without title recognition in Pennsylvania. Many graduates opt to relocate to other states where CRNAs can practice to their full scope of their education and training. Without formal designation as a CRNA, our graduates who relocate to other states can wait as long as six months to become credentialed. In the absence of title recognition or CRNA license reciprocity, other state boards must verify that the graduates have met their state requirements to be licensed appropriately, which delays our graduates’ ability to work. Retention of these advanced professionals in Pennsylvania should be a priority for our commonwealth because of the outstanding health services that they provide thus improving the health and welfare of PA residents.

Nurse anesthetists must graduate with a minimum of a master’s degree from a nurse anesthesia accredited program, complete greater than 2,000 hours of clinical experience in anesthesia practice and pass a national certification exam in order to practice. The average nurse anesthetist completes 9,000 clinical hours of clinical training, including the clinical ICU experience as an RN required to enter CRNA training, the clinical experience obtained in an undergraduate nursing curriculum, and the clinical anesthesia training in a nurse anesthesia program. CRNAs are required to be nationally certified and must be recertified every four years, meeting strict continuing education standards.

Lack of title recognition in PA presents significant barriers for CRNAs in Pennsylvania who are active military personnel or who volunteer in emergency response teams. Pennsylvania CRNAs who are active military have to secure CRNA licensure in another state to serve as a CRNA in an active duty role of the armed forces. This is unacceptable because it adds additional fees and continuing education requirements to maintain licensure in another state to be eligible serve in our military. Nurse anesthetists have been the primary providers of anesthesia care to U.S. military personnel on the front lines since World War I, and remain the primary anesthesia providers in austere combat theaters. Yet, Pennsylvania’s battle-tested CRNAs are at a distinct disadvantage without CRNA licensure in Pennsylvania. Pennsylvania CRNAs cannot assist as part of emergency response teams in other states because they lack CRNA title designation in Pennsylvania, which diminishes the role our commonwealth can play in aiding states affected by hurricanes, floods or other natural disasters.

The CRNA graduates from Villanova University / CCMC Nurse Anesthesia Program are highly-qualified clinicians who are recruited across the country. CRNAs have been providing superior anesthesia care for more than 150 years and empirical evidence demonstrates there is no difference in the quality of anesthesia care when provided by CRNAs or physicians, independently, or together in a team model.

The CRNAs in Pennsylvania need title recognition and we urge you to both support S.B. 325 and urge immediate action by the House of Representatives.

Sincerely,

Donna S. Havens, PhD, RN, FAAN

Connelly Endowed Dean and Professor

Villanova University

M. Louise Fitzpatrick College of Nursing

Brother Norman Hipps: CRNAs deserve official designation in Pa.

This letter was published on TribLIVE on July 31, 2019

Pennsylvania is home to hundreds of student nurse anesthetists, yet Pennsylvania is one of just two states that fail to officially recognize CRNAs in some form. Because there is no “certified registered nurse anesthetist” title under the state’s Professional Nursing Law, CRNAs are recognized only as registered nurses, not as CRNAs.

This is the second consecutive legislative session that the measure passed the Senate, and the third time the full Senate has approved it. The House will have the opportunity to do the same when it returns to session this fall.

Certified registered nurse anesthetists are critical members of the health care team for everyone who faces the need for surgery. They provide an expert and assuring presence to patients in the moments before surgery begins and are the first to greet them when they awake.

Without formal designation, CRNAs have significant challenges.

Pennsylvania CRNAs who serve in the military must secure designation in another state to provide anesthesia in the armed services because we do not officially recognize CRNAs here. They cannot assist on rapid response teams in states affected by natural disasters because they lack formal credentials.

With 13 nurse anesthetist programs here, Pennsylvania ranks among the top draws nationally for CRNA students. But that could be at risk. Without an official CRNA designation, many graduating students wait as long as six months to get credentialed in out-of-state facilities, as state boards must verify that the students meet the requirements necessary to be classified appropriately there.

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 Pennsylvania, education and clinical training for nurse anesthetists is extensive and requires national board certification. At the Excela Health School of Anesthesia, in partnership with Saint Vincent College in Latrobe, we ensure our graduates are eligible to sit for the national certification examination administered by the National Board on Certification and Recertification of Nurse Anesthetists .

We also provide mentoring and quality experiences that enhance the learning experience through clinical hours as well as simulation experiences that help students grow professionally. Our college currently has more than 20 clinical affiliation sites in the tristate area. We focus on providing students the knowledge and skills they need to develop as competent and safe quality anesthesia practitioners.

The nurse anesthetists we graduate are respected in the field as professionals who are well-prepared and ready to meet the challenges of modern health care.

Professional designation in Pennsylvania would help us achieve our shared mission of keeping patients safe, ensuring access to quality care. It is time to recognize CRNAs for the skills they have and the value they bring to our commonwealth.

LETTER: It’s time to recognize the importance of CRNAs

This letter was published in the Times Leader on May 16, 2019.

Certified registered nurse anesthetists are the best-kept secret in health care. We’re usually the last people patients see before a procedure begins and the first to greet them when they awake. That’s because we’re there by their side for every heartbeat, every breath.

We’re so good at anesthetizing our patients that they sometimes don’t remember us. The state legislature often forgets us as well.

Pennsylvania is one of just two states that fail 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 the advanced, specialized training and extra education needed to practice.

That brings logistical and financial challenges.

Pennsylvania CRNAs who serve in the military must secure designation in another state to provide anesthesia in the armed services because we do not officially recognize CRNAs here. We cannot assist on rapid response teams in states affected by natural disasters because we lack formal credentials. After receiving training in Pennsylvania, a national leader with 13 nurse anesthetist programs, many CRNAs relocate to states where they can utilize the full scope of their education and training in clinical practices, contributing to “brain drain.”

Fortunately, bipartisan measures, including House Bill 1064 sponsored by state Rep. Tarah Toohil, serve as a wake-up call to address these issues. It’s long past time to finally recognize the importance of CRNAs and appreciate the value of the men and women behind the surgical masks.

Lisa Mullen

MSN, CRNA