Gov. Wolf Grants Waiver to Suspend CRNA Supervision Requirement

Pennsylvania Association of Nurse Anesthetists

FOR IMMEDIATE RELEASE

CONTACT: Kurt Knaus, P: 717-724-2866

E: kurt@ceislermedia.com

Gov. Wolf Grants Waiver to Suspend CRNA Supervision Requirement

Temporary blanket waiver affects many advanced practice nurses

Removing physician supervision requirement will expand the capacity of both physicians and CRNAs to meet growing demand and enhance hands-on care

HARRISBURG (May 6, 2020) --- Gov. Tom Wolf today announced a temporary blanket waiver that will enable advanced practice nurses, including certified registered nurse anesthetists (CRNAs), to practice to the fullest extent of their education and training to enhance the state’s response to the health-care crisis caused by the COVID-19 pandemic.

The waiver was included in an executive order he signed to protect health-care practitioners for good-faith actions taken in response to this crisis.

“We’re grateful to the administration for recognizing the value of CRNAs,” said Angelarosa G. DiDonato, DNP, CRNA, president of the Pennsylvania Association of Nurse Anesthetists (PANA), which represents more than 3,700 CRNAs and students in the state. “CRNAs are uniquely qualified to care for critically ill patients who are suffering from this respiratory pandemic. Patient health and safety is paramount, and we’re eager to put our skills to work to help.”

The governor’s action mirrors steps taken by several other states like New York, West Virginia, Maine, Michigan, New Jersey and Arizona to remove barriers that allow them to better utilize all available health-care providers without risking patient safety. The Centers for Medicare and Medicaid Services also removed the national physician supervision requirement in response to COVID-19.

Pennsylvania regulations still require physician supervision of a CRNA in a hospital setting. The governor’s waiver temporarily suspends that requirement, however, giving health-care facilities more flexibility to tap into the unique skillset of CRNAs to fulfilling critical roles outside the operating room during this crisis.

Removing the supervision requirement of CRNAs, and allowing them to practice to the fullest extent of their education and training, avails more physicians to provide hands-on care, expands the capacity of both CRNA and physician providers, and augments the state’s health-care system to continue to meet the growing demands of this pandemic.

CRNAs possess a skillset uniquely suited to aid in management of this crisis. Most have cared for patients as sick as, or even more acutely ill than, the COVID-19 patient. In the operating room, the nurse anesthetist serves as the frontline, critical care intensivist; surveilling, assessing and implementing appropriate interventions.

Much has been said about the importance of ventilators during this crisis, and CRNAs not only routinely use them, but they tailor their complex settings to each patient. Due to a nurse anesthetist’s science-based education and clinical experience, CRNAs understand the why and how of their equipment, allowing them to manage complex patients.

CRNAs also possess hands-on skills extending far beyond their already vast critical care experiences. CRNAs perform rapid physical assessments, airway and ventilatory management, volume resuscitation and hemodynamic management, patient triage, emergency preparedness, and procedural skills that include central and arterial invasive line placement.

“As frontline health-care professionals, CRNAs play a crucial role in the state’s response to this pandemic, especially one related specifically to respiratory failures,” DiDonato said. “With our medical community facing unprecedented challenges, this waiver gives facilities the ability to fully utilize the unique skill set of CRNAs.”

For more information, visit www.PANAforQualityCare.com or follow along on social media via Twitter at @PANACRNA or on Facebook at www.facebook.com/PANACRNA.

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Important Message to PANA Members

March 25, 2020

Dear PANA Members:

Earlier today, the Pennsylvania Association of Nurse Anesthetists sent a letter to Gov. Tom Wolf and state Health Secretary Dr. Rachel Levine, urging them to formally recognize certified registered nurse anesthetists and to act swiftly to give our professionals the ability to practice to the full extent of our education and training to help Pennsylvania respond to the COVID-19 health-care crisis.

You can read the entire letter here: https://bit.ly/3akUMb0.

As frontline health-care professionals, we play a crucial role in the state’s response to this pandemic. Unfortunately, the full contribution of CRNAs is being limited.

First, in Pennsylvania, education and training for CRNAs is extensive. Yet, there are limits placed on our practice, even though those limits are not based on any data or research, and CRNAs can safely practice beyond these limits. New York, West Virginia, Maine and Arizona already have acted to remove barriers on CRNAs to better utilize all available providers to respond to this health-care crisis without risking patient safety. Pennsylvania should do the same.

Second, Pennsylvania remains one of only two states (New York is the other) that fails to recognize CRNA professional designation in some form, meaning we are recognized only as registered nurses. In times of need, CRNAs are in demand to help with crisis response. But Pennsylvania-based CRNAs cannot be part of response teams in other states that are asking for help --- and so many are --- simply because we lack the formal credentials that nearly every other state recognizes. That needs to change.

Now, we need you to take action, too.

First, send a personal message to Gov. Wolf and urge him to act on the health-care proposals PANA included in its letter. Fill out the form here: https://www.governor.pa.gov/contact/#OnlineForm.

This is all you need to say (there is a 1,000-character limit):

Gov. Wolf: As a certified registered nurse anesthetist (CRNA) in Pennsylvania, I stand ready to help our commonwealth address the health-care crisis caused by the COVID-19 pandemic. Recently, PANA, our statewide association, sent you a letter (which you can access here: https://bit.ly/3akUMb0), urging you to formally recognize CRNAs and allow us to practice to the full extent of our education and training to help Pennsylvania respond in this time of need. Other states already have acted to remove barriers on CRNAs to better utilize all available providers to respond to this health-care crisis without risking patient safety. Pennsylvania should do the same. As frontline health-care professionals, we play a crucial role in the state’s response to this pandemic. Please make these changes so we can help even more. Thank you.

Next, contact your local legislators. Ask them to please contact the governor and secretary and urge them to take fast action on the proposals made by PANA to address this health-care crisis. You can find your lawmakers here: https://www.legis.state.pa.us/cfdocs/legis/home/findyourlegislator.

This is all you need to say:

As your constituent, I wanted to be sure you knew that PANA, our statewide association, sent a letter (which you can access here: https://bit.ly/3akUMb0) to Gov. Tom Wolf and state Health Secretary Dr. Rachel Levine, urging them to formally recognize CRNAs and allow us to practice to the full extent of our education and training to help Pennsylvania respond to the COVID-19 health-care crisis. As a certified registered nurse anesthetist (CRNA), we play a crucial role in the state’s response to this pandemic, along with other frontline health-care professionals. Unfortunately, too many barriers are blocking our work. There are limits placed on our practice, even though those limits are not based on any data or research, and the state’s lack of credentialing limits emergency response. Please read our letter and urge the governor and his administration to act swiftly. Other states are acting. It is time for Pennsylvania to do the same. Thank you.

Like the rest of the country, we are watching with deep concern as the COVID-19 pandemic continues to affect a world already brought to a standstill. PANA continues to monitor the situation. But our culture is built on helping people. I hope we can count on you to do your part to advocate for our profession so we can get these changes made and fulfill our mission of keeping residents healthy and safe.

CRNAs Respond to COVID-19 Pandemic

As our country and the commonwealth continue their aggressive measures to stem the spread of the coronavirus (COVID-19), Pennsylvania’s certified registered nurse anesthetists (CRNAs) are taking action to ensure public health and safety.

As the hands-on providers of anesthesia care, operating safely in every setting where anesthesia is administered, CRNAs, like so many other health-care professionals, are on the frontline. That makes the profession a critical part of the national response.

“CRNAs hold leadership positions in their institutions of care and help to create policy about how best to protect fellow providers and patients,” said Angelarosa G. DiDonato, DNP, CRNA, president of the Pennsylvania Association of Nurse Anesthetists (PANA). “Our top priority is always public health and safety.”

As a precaution, many Pennsylvania hospitals are choosing to cancel elective cases requiring anesthesia, except where a condition is emergent or urgent and essential to the health of the patient. All decisions are made in consultation and coordination with patients and surgical teams.

CRNAs also are changing the way they work with patient airways, as COVID-19 is a respiratory illness that is characterized by mild to severe symptoms, including fever, cough, shortness of breath, and breathing difficulties.

The American Association of Nurse Anesthetists (AANA) is providing resources to support CRNAs as they develop strategic steps for managing patients with expected or confirmed infection. These tips go beyond meticulous hygiene and strict environmental cleaning and disinfection procedures to intubation and aerosolization techniques.

Excellence in care, safety, and continuous improvement of care are hallmarks of the anesthesia profession.

In Pennsylvania, the Department of Health is reporting new cases daily, which means everyone has a role to play. Remember these simple tips to protect yourself, your family and your community:

• Wash your hands often with soap and water for at least 20 seconds.

• Clean and disinfect frequently touched objects and surfaces.

• Avoid touching your eyes, nose and mouth.

• Avoid crowds and stay home, even when no exhibiting signs and symptoms.

• If you must work or be in public, follow guidelines for social distancing (stay six feet others).

Thank you for all you do always, but especially in times of crisis like we face together today. Be smart and be safe. Don’t hesitate to contact PANA with questions.