Legislation pertaining to Certified Registered Nurse Anesthetists’ (CRNAs) scope of practice is currently before the Ohio House Health Committee. House Bill 191 was introduced early in 2017 by sponsor Representative Anne Gonzales. The bill proposes much needed scope of practice clarifications for Ohio CRNAs. The bill also seeks perioperative ordering for CRNAs and the removal of statutory physician supervision. Proponent testimony was given in December and January to the Health Committee. CRNAs were represented by individuals from OSANA, the AANA, OAAPN, the ONA and legal counsel. OSANA is anticipating opponent testimony within the next couple of weeks.
CRNAs always work with physicians in the operating room when providing anesthesia but don’t always work with anesthesiologists. There are well over 100 facilities in Ohio where CRNAs are the sole providers of anesthesia. In these facilities, CRNAs determine the anesthetic needs of the patient and carry out the anesthesia plan. The bill allows for hospitals to adopt of any or all portions of it based on how their individual medical staffs want to utilize their CRNA providers. The facilities where CRNAs are the sole providers of anesthesia have shown tremendous support and confidence that their medical staffs would opt to utilize CRNAs as most other states do, which is to the top of their education and training.
Given that CRNAs are trained in the independent practice of anesthesia in every program in the country, removal of supervision doesn’t change anything in their practice other than freeing supervising surgeons of perceived liability when working with CRNAs, and instead places it on the provider trained in that service. CRNAs in Ohio and 48 other states are not required to work with supervising anesthesiologists, nor have they ever been. The scope of practice currently being proposed is directly tied to CRNAs’ documented education, training, and certifications. It also reflects similar practices and statutes from the majority of states in the country.