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Gov. Wolf Grants Waiver to Suspend CRNA Supervision Requirement

Pennsylvania Association of Nurse Anesthetists


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.”

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