Regulations on certified registered nurse anesthetists need to change

Jana Bailey, Opinion contributor
Published 6:19 a.m. ET Sept. 14, 2020

No one is a stranger to the crippling effects of COVID-19. And as hospitals around the country continue to deal with this pandemic, many nurse anesthetists like myself are on the frontlines, providing care for the surge of critically ill patients. This has been critical in the fight to save lives.

Certified registered nurse anesthetists’ unique skills and expertise have allowed us to step forward in a way few others can, leading the way in terms of advanced airway and ventilation management, which have been essential in addressing the deadliest part of this unforgiving virus.

As state president of the Kentucky Association of Nurse Anesthetists, I have seen Kentucky CRNAs step up to be the leaders, experts and educators that our advanced practice degrees and licensures prepare us to be. Whether it has been in urban hospital settings as part of the COVID-19 intubation and ventilatory management teams, in rural critical access hospitals as the sole anesthesia provider taking care of COVID-19 and non-COVID patients or traveling to hotspots to fill the desperate need for expert healthcare providers, they have all rose to the occasion. CRNAs accepted the personal risks, led by example, and made a difference in the lives they encountered. 

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When CRNAs can practice to the full extent of our education and training, as we can in Kentucky, then we are able to meet the ever-growing health care needs of those within our state and communities. We can ensure that needless delays do not occur for patients and their surgeries. All this, while still being the key component of the most economically efficient model for the delivery of anesthesia care, will continue to be crucial going forward as we begin economic recovery in the aftermath of this pandemic.

The federal government made the important decision to remove barriers to CRNA practice during this crisis, reinforcing the critical need for the skills we bring to bear in combating this pandemic. The recent decision from the Centers for Medicare and Medicaid Services temporarily lifted physician supervision requirements for CRNAs, allowing CRNAs to practice to the fullest extent of our education and training. This is helping increase the capacity of our delivery system to better meet the growing demands of this crisis.

But CRNAs are no stranger to the frontlines, having served in every American conflict since the Civil War. Currently, CRNAs serve their country as full practice, independent anesthesia providers in every branch of the military, on the front lines in combat-support hospitals and as the sole anesthesia providers on forward surgical teams.

The pivotal role CRNAs play in people’s lives and in providing access to the highest quality care has become overwhelmingly clear. That is why it’s important that the government’s emergency steps should not be temporary. It is a commonsense approach to improving access to the highest quality care while also driving down costs as our delivery system struggles with limited resources and growing demand for services.

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Many groups from both sides of the political and ideological spectrum have coalesced in support of this commonsense policy. Recently, the American Association of Nurse Anesthetists partnered with 24 national organizations and sent a letter to the U.S. Department of Health and Human Services supporting a path to permanently remove the burdensome supervision requirements for non-physician providers such as CRNAs. These essential reforms will help increase access to care, curb costs and improve the delivery of healthcare.

CRNAs have answered the call to help keep patients healthy and safe during this unprecedented time. If we are good enough to serve on the frontlines of a battlefield and in the face of a global pandemic, we are good enough to do so all of the time. Now is the time to make this commonsense change to ensure access to quality care for all Americans.

Read more about supervision, CRNAs, their education and exemplary safety record at

Jana Bailey, APRN CRNA, is the immediate past president of the Kentucky Association of Nurse Anesthetists.

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