Authority

[are-in]

I will be starting CRNA school in January (nail biting has begun!) and am looking for answers to some questions I have.

Question: Do CRNAs have prescriptive authority? I am not specifically speaking of Rx prescriptions outside of the OR per se, but more specifically authority to write pre-op and post-op orders when needed. Or is just about everything work on standing orders from a physician. (protocols)

Any insight would be helpful. And thanks for the continued flow of information on this site. It has been an amazing resource for me.

Are-in

[TraumaNurse]

Prescriptive authority for CRNAs is state dependent and also hospital bylaw dependent. Here in NJ, CRNAs have not been given prescriptive authority (It is being worked out with the BON and hopefully should be resolved soon) The CRNAs at my hospital do write post-op orders when needed but must write it as a verbal order from the ologist.

Some of those rules come from the hospital and not necessarily the state. There are places in which CRNAs have prescriptive authority within the hospital and can order meds for preop and postop purposes. CRNAs can not write scripts for meds outside of hospital.

Also, the term presriptive authority is confusing, because CRNAs do not actually prescribe meds, they order meds in a patients chart (which is not really prescription) and administer meds on their own all the time. I hope this helps a little. I'm not sure if I explained it very well.

[pokey sn]

Stupid question, but---I thought ordering a med and prescribing a med were one in the same when done in facility. Not true?

[meandragonbrett]

Stupid question, but---I thought ordering a med and prescribing a med were one in the same when done in facility. Not true?

I think this website might help answer your questions

Nurse Anesthetists and medications

[pokey sn]

Thanks Brett! That totally clarifies it! CRNA do not practice medicine but nursing. I can recall someone here posting that they were asked in an admissions interview, if anesthesia was the practice of medicine or nursing. They didn't state what the answer was, and I always wondered since I thought CRNA were actually prescribing anesthesia. Thanks for the insight into that. You are really a wealth of info!

Thanks,

Pokey

P.S. So all APRN's practice medicine right, except CRNA's and CNM's?

[meandragonbrett]

Pokey,

No, ALL APRNs, including nurse anesthetists, nurse practitioners, nurse midwives, and clinical nurse specialists ALL practice NURSING. If they were practicing medicine...they could lose their license (food for thought). APRNs have advanced learning and skills to do the things they do. Anesthesia is the practice of medicine and nursing, it just depends on who is providing the services.