Updated: Sep 17
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 recognized 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 in 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.