New VA Policy - CRNAs will not have full practice authority

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Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.

In a final rule issued today, CRNAs will not be able to independently administer anesthesia in VA facilities.

"The Department of Veterans Affairs (VA) is amending its medical regulations to permit full practice authority of three roles of VA advanced practice registered nurses (APRN) when they are acting within the scope of their VA employment," the agency said in the rule. "Certified Registered Nurse Anesthetists (CRNA) will not be included in VA's full practice authority under this final rule, but comment is requested on whether there are access issues or other unconsidered circumstances that might warrant their inclusion in a future rulemaking"/QUOTE]

While CRNAs were omitted, certified nurse-midwives, nurse practitioners, and clinical nurse specialists got the go-ahead for full practice authority to provide advanced nursing nursing services to the full extent of their professional competence.

The American Society of Anesthesiologists lobbied heavily against VA CRNAs having full practice authority.

What are your thoughts about this??

To read more, see:

Nurse Anesthetists Left Out of New VA Policy

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Specializes in Critical Care, Emergency, Education, Informatics.

It's interesting that they are limiting the one group that has been pretty much on it's own for a long time. The one group of advanced practice RN's that actually got the educational and clinical components of their education right from day one, and only getting better.

It's about the lobby, not the reality.

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Hi tnbutterfly, do you have an email I can contact you at? How do I send you a message?

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Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.
Hi tnbutterfly, do you have an email I can contact you at? How do I send you a message?

Since I am an Admin, you can send me a Private Message even if you don't yet have 15 posts. Click on my username and on the next screen you will see a SEND PM button.

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Specializes in Anesthesia.

This is my response to the reopening for comments on the VHA ruling on CRNAs.

"I am writing to express my disappointment in the decision to not include giving CRNAs the independence we deserve in the VHA. I realize that the VHA has stated that CRNAs' independence is not needed to increase access to care in VHA, but if that were true then the VHA would not be sending VA patients to military treatment facilities (MTFs) where all CRNAs work independently. The military system allows all anesthesia providers (CRNAs and anesthesiologists) to work in a true team environment without the need for anesthesiologist supervision. The military truly works as a team where every provider works independently for the betterment of all our patients. It is time for the VHA to parallel our military anesthesia and allow CRNAs the independence we deserve.

Please do what has been proven to be safest and most efficient for our VHA patients (several which are my family members) and give all APRNs including CRNAs the independence we deserve."

You can leave your responses here: Regulations.gov

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Where will this decision put DNAPs? Seeing as the doctorate is what most schools are transitioning to?

I assume this is why they are requiring the doctorate... to prevent being held back by the lobbying of Anesthesiologists...?

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Specializes in Critical Care, Emergency, Education, Informatics.
Where will this decision put DNAPs? Seeing as the doctorate is what most schools are transitioning to?

That has no bearing on the issue. It's the liscense that makes the difference. Locally we've got a couple of the old certificate NP's left, MSN, and DNP. All perform the same job with the same level of supervision. (well the two certificate aren't doing hands on patient care they are admiin positions now just waiting to retire.)

Their name badge all says APRN. The degree and such is in small print. The same as the docs though.

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Specializes in Anesthesia.
Where will this decision put DNAPs? Seeing as the doctorate is what most schools are transitioning to?

I assume this is why they are requiring the doctorate... to prevent being held back by the lobbying of Anesthesiologists...?

A DNAP/DNP/PhD etc does not change an APRNs scope of practice.

The requirement for a doctorate is in order to give APRNs the credit for the credit hours that are already required, and better prepare them for lifelong learning/EBP/leadership that is expanded upon in the DNP curriculum.

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Specializes in Vents, Telemetry, Home Care, Home infusion.

tnbutterfly, Thanks for posting this article so allnurses members can respond re denial full CRNA practice authority.

Per the last paragraph in article:

The public has 30 days from the final rule's official publication on Wednesday to weigh in on it. Comments can be submitted here: VA Regulations

AP44 - Final Rule with Comment Period - Advanced Practice Registered Nurses

Add your comment by using link at top right corner of VA regulation page

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This is very disappointing, but not terribly surprising. The media and the public tend toward negative views of the VA in terms of the care they provide to veterans. The ASA was able to springboard off this sentiment by claiming that allowing CRNA's full practice authority in the VA would constitute a lower standard of care. They had a lobbying campaign with the words "When Seconds Count, Physician Anesthesiologists Save Lives." The message was clear: if you or your loved ones' life was at stake, would you want a doctor or a "nurse"? I can imagine the headlines if the ruling had included CRNA's among the APRN's granted full practice authority: Nurses putting veterans to sleep in the VA: How slashing costs may threaten the lives of veterans....

You are right, it's all about the lobby. The evidence doesn't matter, the reality doesn't matter, it's all $$$$$$$$$ and how it looks to the public. Sad.

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Specializes in Anesthesia.
This is very disappointing, but not terribly surprising. The media and the public tend toward negative views of the VA in terms of the care they provide to veterans. The ASA was able to springboard off this sentiment by claiming that allowing CRNA's full practice authority in the VA would constitute a lower standard of care. They had a lobbying campaign with the words "When Seconds Count, Physician Anesthesiologists Save Lives." The message was clear: if you or your loved ones' life was at stake, would you want a doctor or a "nurse"? I can imagine the headlines if the ruling had included CRNA's among the APRN's granted full practice authority: Nurses putting veterans to sleep in the VA: How slashing costs may threaten the lives of veterans....

You are right, it's all about the lobby. The evidence doesn't matter, the reality doesn't matter, it's all $$$$$$$$$ and how it looks to the public. Sad.

There are already VA facilities with only CRNAs. There are around 100 military treatment facilities that have VA agreements where VA patients go and are treated by independent APRNs including CRNAs. The whole issue is a farce.

The AANA president has filed for freedom of information act for all the files from the VA concerning this decision and one Congressman has also asked for a full briefing with documentation in this decision.

The fight is not over, and you can still make comments posted on the link above showing support for CRNAs.

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