Certified Registered Nurse Anesthetists (CRNAs) have proudly and courageously provided anesthesia care to enlisted men and women, officers, and veterans in all branches of the military, from World War I to the present. THANK YOU, for your service, and Happy Veterans Day!
Updated: May 26, 2022
Blanket waiver removing physician supervision requirement benefits health-care facilities, patients during pandemic
The Pennsylvania Association of Nurse Anesthetists achieved a significant victory for the profession in May when Gov. Tom Wolf announced a temporary blanket waiver removing the physician supervision requirement for certified registered nurse anesthetists (CRNAs).
The waiver has been hugely important as part of the state’s response to the health-care crisis caused by COVID-19. Advanced practice nurses like CRNAs can finally practice to the fullest extent of their education and training.
That avails more physicians to provide hands-on care. It expands the capacity of both CRNAs and physician providers. It augments the state’s health-care system to continue to meet growing demands during this pandemic. And it ensures patients get the best care.
But what has this waiver really meant for CRNAs, health-care facilities and the patients we serve? Here are some firsthand accounts from CRNAs on the frontline. (Please note that the names of the CRNAs and their facilities have been removed to ensure their anonymity and protection in the workplace.)
“I work in a critical access hospital and since the governor removed the supervision requirement, the anesthesiologists are now running their own room and I’m working in another room with my surgeon --- which means we are able to provide two times the services!”
“We at our local Hospital started a COVID response team in conjunction with the ER and ICU. We responded to all COVID intubations, put in an arterial line, a central line, and intubated the patients. We also helped manage vent settings/unstable patients as needed.”
“My hospital told our anesthesiologists that they will be taking their own assignment and that the CRNAs will work alone until we get caught up on elective surgeries. Many of our anesthesiologists resigned because they don’t want to give anesthesia.”
“Yes, we have provided a CRNA from our department for 24-hour coverage of the COVID units to act as an NP to help assess patients, place lines, and act as extenders for the critical care intensivists in our county. The chief in my group was able to use the supervision waiver for us to work outside of the OR and in the OR without supervising anesthesiologists.”
“The orthopedic surgeons at my hospital have always wanted an ologist available. That has all changed. The CRNAs are working alone and our ologist was given the option of working in a room or taking time off unpaid.”
It’s clear: Gov. Wolf’s decision to issue that temporary blanket waiver and remove the physician supervision requirement for certified registered nurse anesthetists is making a real difference.
The waiver was included in an executive order that the governor signed to protect health-care practitioners for good-faith actions taken in response to this crisis, and it remains in effect for the duration of the governor’s disaster proclamation, which gives him broad powers to manage this public health emergency.
The proclamation was renewed for 90 days in early June. Lawmakers challenged the extension. But state judges sided with the governor. That means the proclamation remains in place for at least two more months. As long as the governor’s disaster proclamation remains in place, so does his blanket waiver removing the physician supervision requirement for CRNAs.
Stories like these from our CRNAs prove that this policy shouldn’t just be implemented during a pandemic, but instead be permanent to ensure patient health and safely and to give greater options to health-care facilities to provide the best care to those in need.
Updated: Jan 19, 2021
Pennsylvania Association of Nurse Anesthetists
FOR IMMEDIATE RELEASE
CONTACT: Kurt Knaus, P: 717-724-2866
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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