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  • Paul J. Gough, Pittsburgh Business Times

State asked to allow nurse anesthetists to do more to help in crisis

By Paul J. Gough – Reporter, Pittsburgh Business Times

Apr 7, 2020, 1:47pm EDT Updated Apr 7, 2020, 2:35pm EDT

Pennsylvania's certified registered nurse anesthetists are urging the Pennsylvania Department of Health to waive a supervision requirement to allow them to fully help patients to the level of their training.

Nurse anesthetists are advanced practice nurses that deliver medications including anesthesia during surgery, medical procedures like colonoscopies and dental procedures. They normally work under the supervision of an MD anesthesiologist but have a substantial course of training in their own right: Not just an RN degree but also generally two or three years of advanced practice training beyond it and thousands of clinical hours.

But even though they play a critical role, Pennsylvania's nurse anesthetists aren't given by law what is called a title designation: They can't practice except under the supervision of an anesthesiologist. That, said its trade association the Pennsylvania Association of Nurse Anesthetists, is a critical distinction and an area of opportunity in the commonwealth if health officials allow it.

Pennsylvania is the only state that doesn't allow nurse anesthetists to practice their full scope, which is critically important during the COVID-19 pandemic. New York, the only other state in the country that has the same strictures, last month relaxed them to allow nurse anesthetists to practice to the full level of their training.

That's what Pennsylvania Association of Nurse Anesthetists (PANA) is advocating with the Pennsylvania Department of Health. It's also what the Trump administration, through the Centers for Medicare and Medicaid Services, has done on the national level.

"We are highly educated and trained professionals," said Jess Poole, a Westmoreland County nurse anesthetist and government relations director of PANA. "Our skill sets should be utilized."

That's because in the COVID-19 emergency, some of the skill sets that nurse anesthetists have — the proper intubation and use of ventilators — are really needed. There's already a nationwide shortage of ventilators and more are going to be needed, as well as the skilled medical professionals who know how to use them.

Poole said that it's crucial for nurse anesthetists to be able to help out. Previous attempts to allow it, before a crisis, have not been successful in the Pennsylvania Legislature. But Poole said the Wolf administration has the power to allow them to do it on a temporary, emergency basis.

PANA has requested a waiver from the supervision requirement but it's not yet been granted.

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