CRNAs Looking for Opportunities to Help Pa. with Vaccination Program

Pennsylvania’s certified registered nurse anesthetists (CRNAs) possess unique skillsets that have made our professionals critical to the state’s response to the health-care crisis caused by COVID-19. So many of you have worked long and hard to meet the growing demands of this pandemic.

Because of your commitment to patient health, many of you want to do even more.

CRNAs have been reaching out to the Pennsylvania Association of Nurse Anesthetists (PANA) to examine ways our profession may be able to help the state implement and potentially expand its vaccination program by offering to support clinics or providing volunteers. With our high level of education and training, CRNAs are perfectly suited for the task at hand.

PANA has had discussions with the commonwealth during this critical juncture to offer our services and make sure they know about our willingness to take on a bigger role.

Unfortunately, at this early stage of the vaccine rollout and based on available supplies, the first phases of the program are locked in place. We will continue to work with the state on future opportunities as vaccinations progress in the weeks and months ahead.

If you want to make sure the state knows you are available to help, the Department of Health is encouraging individuals to register on Pennsylvania’s online registry for medical and non-medical volunteers: https://www.serv.pa.gov/.

If you want to stay on top of the work PANA is doing to offer its assistant, and any future opportunities that may arise from our work with the state, please visit https://www.pana.org/page/vaccineprovidercommitment.

Please note that these are two separate databases, and by signing up via the PANA site you are not adding yourself to a pool of volunteers. More information will be shared at a later date when it becomes available.

All of us at PANA are so proud of the work being done by CRNAs and SRNAs around the state, and we are so grateful that so many of you reached out to the association about your ideas on ways to help with the vaccination program. We have the same shared goals and will do all we can to help you so you can fulfill your mission to help others.

PANA Members Recount How Patients and Facilities Benefit from Waiver Removing Physician Supervision

Health-care facilities, patients benefit from waiver removing physician supervision during pandemic

We shared with you previously stories from the frontline among certified registered nurse anesthetists who are experiencing firsthand the effects of the state’s temporary blanket waiver removing the physician supervision requirement for CRNAs.

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.

As you know, Pennsylvania regulations still require physician supervision of CRNAs in a hospital setting. The temporary suspension gives health-care facilities more flexibility to tap into the unique skillset of CRNAs to fulfill critical roles outside the operating room during this crisis. After all, CRNAs possess a skillset uniquely suited to aid during a respiratory pandemic.

Without a doubt, the waiver has made a real difference. Here are some more voices from 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.)

“My hospital may not financially survive since elective procedures have been canceled. Our anesthesia team staffing had to change to preserve costs and the governor’s order helped us accomplish that.”

“Our role has been authorized for this expansion of function outside the operating room. The plan is to utilize CRNAs to run overflow ICU beds in our PACU and pre-op areas. CRNAs would manage patient care, manage ventilators, order labs, medications and appropriate radiology studies, and insert central and arterial lines as needed.”

“In our facility, CRNAs served in the OR, in labor and delivery, and on the intubation team for the ED and COVID/PUI patients; we also had a portion of our team train to perform supportive roles in our critical care units and also make the PACU into a makeshift ICU if the need arose but that has not been necessary as of this point.”

“Hospital administration along with the support of our MD Anesthesiologist (MDA) counterparts also suspended MDA supervision at the hospital, allowing the CRNAs to practice to the full extent of our knowledge and training. The CRNAs performed advanced practice skills and critical care decisions independent of the anesthesiologists. CRNAs were also the sole advanced practice provider at night during the first two weeks of the COVID crisis. For five weeks, the CRNAs put into practice the skills and knowledge to assist the ICU physicians, nurse practitioners, and nurses. The CRNAs knowingly put themselves literally face to face with COVID patients, intubating and securing the airways, and placing lines to insure vascular access. Our hospital was the hardest hit in central Pennsylvania by the COVID crisis, and had one of the lowest mortality rates. CRNAs were the keystone in the successful treatment and management of these patients.”

This waiver truly has given CRNAs the chance to showcase the value they bring not only to the state’s pandemic response and recovery efforts, but also to the safe, efficient, affordable delivery of quality health care generally. Stories like these and from our earlier post prove why physician supervision should finally be removed permanently in Pennsylvania.

PANA Members Discuss What Blanket Waiver During Pandemic Really Means

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.