Senate Unanimously Approves CRNA Designation Bill; Legislation Sent to House for Consideration

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CONTACT: Kurt Knaus, 717-724-2866

Senate Unanimously Approves CRNA Designation Bill;

Legislation Sent to House for Consideration

HARRISBURG (June 24, 2019) --- In the final days of legislative session before the General Assembly adjourns for summer, the state Senate today unanimously approved a measure (S.B. 325) that would formally recognize certified registered nurse anesthetists as “CRNAs” under Pennsylvania statute.

Pennsylvania remains one of just two states (New York is the other) that do not recognize CRNAs in some fashion. Under the state’s Professional Nursing Law, there is no official definition for “certified registered nurse anesthetist,” meaning these professionals are recognized only as registered nurses.

The measure, which is sponsored by state Sen. John R. Gordner (R-Columbia), now goes to the House, where Rep. Tarah Toohil is sponsoring a companion measure (H.B. 1064).

“We are so grateful to these legislative champions for all the work they are doing to advance the profession of nurse anesthetists and ensure these advanced practice nurses finally get the recognition they deserve,” said Derek Reckard, president of the Pennsylvania Association of Nurse Anesthetists, which represents more than 3,700 CRNAs and students in Pennsylvania.

These professional designation bills are simple, non-controversial title recognition measures, which is why similar measures have passed in previous legislative sessions. This is the second consecutive legislative session that Gordner’s measure passed the Senate, and the third time the full Senate has approved the measure. The Senate Consumer Protection and Professional Licensure Committee approved the bill June 12.

CRNAs operate 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.

The lack of professional designation brings logistical and financial challenges for CRNAs.

Pennsylvania CRNAs who serve in the military must secure designation in another state to serve as an armed forces anesthesia provider because the commonwealth does not recognize CRNAs. Pennsylvania-based military CRNAs pay more traveling out of state to obtain credits or meet other legal requirements to stay licensed and credentialed. They also pay more out-of-pocket expenses renewing multiple licenses.

Pennsylvania CRNAs also cannot assist on rapid response teams in states affected by natural disasters because they lack the formal credentials.

Moreover, with 13 nurse anesthetist programs here, Pennsylvania ranks among the top draws nationally for CRNA students. But that leadership position in education and training is at risk once students realize they face hurdles to getting credentialed after graduation.

After receiving training in Pennsylvania, many CRNAs relocate to states where they are fully recognized and credentialed for clinical practice, contributing to “brain drain.”

“The time is now to finally get this bill over the finish line,” Reckard said. “Every CRNA in Pennsylvania is committed to working with members of the House of Representatives to help them understand how important this bill is to keeping patients safe, ensuring access to quality care and reigning in rising health-care costs.”

Learn more about CRNAs in Pennsylvania at www.PANAforQualityCare.com. Additional details are available via Twitter at @PANACRNA and on Facebook at www.facebook.com/PANACRNA.

Pa. CRNA among Prestigious Fellows at Penn

Ji Su (Jenny) Kim graduated May 20 from the University of Pennsylvania’s Doctorate of Nursing Practice Program after serving her final year as a fellow of the prestigious Barry & Marie Lipman Family Prize. Only 16 students receive a fellowship each year.

The prize celebrates leadership and innovation in the social sector with an emphasis on impact and transferability of practices, and in finding ways to resource and connect change-makers to bring innovative ideas to new places and solve problems around the world.

Kim came to the United States from South Korea when she was just a kid. After high school in Georgia, she went to Penn and received a bachelor’s degree in nursing. Soon after, she left for California to serve as a Level 1 trauma center pediatric intensive care unit (ICU) nurse.

Kim came back to Penn in 2016 to finish her doctorate and, for now, plans on sticking around. She will work as a certified registered nurse anesthetist (CRNA) at a large academic hospital in Philadelphia after graduation.

With so much health education, medical training and real-world clinical experience, it only made sense that as a fellow Kim would study … economic development?

“I chose that discipline because it was the one I knew about the least and I wanted to learn more about it,” Kim says. The other fields were health, social justice and education. The 16 fellows are divided into four groups of four to study each discipline.

Students interested in the fellowship submit an application with short-answer essays and must complete an in-person interview. Kim’s fellowship ran from August 2018 through graduation.

Her team’s work involved looking deeply into nonprofit organizations --- financial statements, tax filings, board structures, etc. --- and determining what impact they have on a community and the potential for transformative experiences by those who seek or utilize the services.

More than 100 nonprofits apply for the review and chance to win. Kim’s team collectively narrowed the field to 40 organizations, and then to 12. The students present the slimmed down selection to the prize committee. Kim presented on a homeless organization that provides mobile hygiene services. It began in San Francisco but has since expanded to other cities.

“We had personal leadership coaches counsel us through our leadership goals for the year as well as a public speaking coach to give us feedback on our presentation styles and delivery,” Kim said. “These two things were invaluable in fostering confidence, ownership, and realization of being the subject matter expert.”

After all the presentations, the prize committee, which includes faculty and the Lipmans, picks three winners. The overall winner receives $250,000 but all three get access to Penn staff and faculty to share information and best practices to advance their cause.

That her fellowship discipline had nothing to do with anesthesiology made no difference. The minds around her influenced her and inspired her, and the whole experience will help her as a CRNA.

“It really opened my eyes to where we fit into this larger system,” she said. “The rest of the world really doesn’t operate in silos. In the real world, everyone really kind of works together. This experience showed me how to work collaboratively. We all need each other and we need to use each other’s strengths to elevate the whole.”

Kim may be staying in Philadelphia for now, but don’t expect her to stay put for long.

Her father passed when she was in high school, so she watched her mom raise three children. Her family benefited from a community that supported them, which is why she is committed to finding a way to give back for all that she received.

Her ultimate goal is to go on medical mission trips --- short term at first to gain experience, and then longer term to help as many and as much as she can. That is also among the reasons she became a CRNA. You can go anywhere in the world where there is surgery or pain and suffering, and you can be a part of relieving it, she said.

“If I do my job right, you’ll never know I was here,” Kim says in a video about the fellowship. “It’s such a great privilege to be able to have that hand print in someone’s life without needing the glory that comes with it afterwards. And really, it’s the invisible hands in the world that really are the drivers and the movers part of us making us wholly connected at the same time.”

When seconds count, CRNAs are there

National CRNA Week kicked off Jan. 21 as a way to remind patients, families, medical professionals and others: “Every Breath. Every Beat. Every Second. WE ARE THERE!”

As usual, PANA is taking it a step further, stretching National CRNA Week into a month-long campaign to introduce Pennsylvanians to the highly skilled professionals behind the mask --- the men and women who are by their side during surgical procedures, from open-heart surgery to routine outpatient procedures.

CRNAs are the face of anesthesia care in Pennsylvania. There are more than 3,000 CRNAs and CRNAs-in-training in the commonwealth, providing hands-on anesthesia care in every setting: hospital operating and delivery rooms; ambulatory surgical centers; the offices of dentists, podiatrists, ophthalmologists, and plastic surgeons; and pain management centers.

It’s time to take off that mask and help our patients know who we are and what we do. The role of a CRNA requires intensive training and education and nurse anesthesia is a high-responsibility career. CRNAs provide anesthesia care for millions of patients each year. Nurse Anesthetists are most frequently the first responders to intraoperative emergencies, acting quickly with expert knowledge and skill in the care of our patients.

The average nurse anesthetist completes 9,000 clinical hours of training when you combine the clinical ICU experience as a RN required to enter CRNA training, the clinical experience obtained in an undergraduate nursing curriculum and the clinical anesthesia training in a nurse anesthetist program. That’s impressive. Our high level of education and clinical experience contributes to our capable, vigilant care of each patient.

CRNAs are the primary providers of anesthesia care in rural America, enabling health-care facilities in these medically underserved areas to offer obstetrical, surgical, pain management and trauma stabilization services. We’re battle tested, too, serving as the main providers of anesthesia care to U.S. military personnel on the front lines since World War I. CRNAs remain the primary anesthesia providers in austere combat theaters.

CRNAs are proud of their safety record and career. And that’s why this month, we are encouraging patients, families, medical professionals and others to learn more about the professionals behind the mask and appreciate the work we do. Because when it matters, nurse anesthetists are by your side for every breath, every heartbeat, every second. WE ARE THERE!

Jodie Szlachta, CRNA, Ph.D., is the President of the Pennsylvania Association of Nurse Anesthetists (PANA).