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  • Matt McCoy, DNP, CRNA

It's time for nurse anesthetists to get formal recognition

By Matt McCoy

Because of the global pandemic caused by COVID-19, all of us have had to confront personal and professional challenges we never thought we’d have to face. Even now, more than a year after this health-care crisis began, response and recovery efforts continue, with certified registered nurse anesthetists playing a major role.

CRNAs are the best-kept secret in health care. 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.

CRNAs promise their patients to be there for every heartbeat, every breath. When this pandemic separated families in crisis, that promise took on a whole new meaning. Many of us have been serving as frontline health-care workers, fulfilling critical roles inside and outside the operating room during this crisis. That’s because CRNAs are uniquely qualified to care for critically ill patients who are suffering because of this respiratory pandemic.

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, podiatrists, ophthalmologists, and plastic surgeons; pain management centers and more.

In response to COVID-19, many CRNAs have wanted to contribute more in the facilities where they work but couldn’t. Likewise, hospitals and other health-care institutions have wanted to use CRNAs to their fullest capacity but couldn’t, all because of the way the state licenses CRNAs, sometimes limiting our role to provide advanced, critical care services.

That’s because Pennsylvania remains just one of two states that fails to formally recognize “certified registered nurse anesthetist” in some form. Because there is no definition for nurse anesthetists under the state’s Professional Nursing Law, CRNAs are recognized only as registered nurses, despite their advanced education and training.

This brings logistical and financial challenges, and Pennsylvania CRNAs often have to obtain credentials from other states for certain activities.

Pennsylvania nurse anesthetists who serve in the military must secure designation in another state to provide anesthesia in the armed services. They cannot assist on rapid response teams in states affected by natural disasters because they lack formal credentials. And, after receiving training in Pennsylvania, many nurse anesthetists relocate to states with full credentialing, contributing to the state’s “brain drain.” Bipartisan measures have been introduced in both the state House and Senate to finally recognize nurse anesthetists as “CRNAs” under Pennsylvania statute. It’s an idea whose time has come, and it’s long past time for the state to act.

Two-thirds (67%) of Pennsylvania voters support professional designation for certified registered nurse anesthetists, including those who identify as Republican (59%), Democrat (75%) and Independent (62%), according to results of a statewide public opinion poll conducted last year by G. Terry Madonna Opinion Research.

Broad support like this should give lawmakers the confidence they need to advance this measure and finally provide CRNAs with the professional designation they deserve.

The commitment of CRNAs during this health-care crisis has availed more physicians to provide hands-on care, expanded the capacity of both CRNA and physician providers to help patients, and augmented the state’s health-care system to continue to meet the growing demands of this pandemic.

This crisis still requires an all-hands-on-deck approach. Our health-care systems are still challenged to function at high capacity. As long as response and recovery efforts continue, CRNAs will remain a critical part of the solution. It is time for nurse anesthetists to finally receive the formal recognition they deserve for their contributions to this crisis and the safe, affordable delivery of care overall.

McCoy is President of the Pennsylvania Association of Nurse Anesthetist and a resident of Westtown Township, Chester County.


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