Many healthcare facilities and practices utilize certified registered nurse anesthetists (CRNAs) to administer anesthesia to patients. While these professionals may be highly competent in their area of expertise, physicians must be aware of the restrictions on a CRNA’s scope of practice.
A CRNA is a licensed registered nurse who has completed additional training in anesthesia in an accredited program and is certified by a national organization to give anesthesia to patients.
A CRNA is authorized under regulations to administer anesthesia as part of a medical regimen and, if credentialed, may perform a variety of functions under the supervision of a physician, including diagnostic spinal taps, placement of endoscopes and insertion of bronchoscopes, “Bougie” devices and epidural catheters. CRNAs do not have authority to independently prescribe or write medical orders.
Despite national certification, CRNAs are considered to be registered nurses in New York. Therefore, they can only execute medical regimens under the supervision of a physician. The supervising physician must be an anesthesiologist who is “immediately available” (physically present within the hospital and preferably within the operating suite) or a specially credentialed operating physician who has accepted responsibility for supervising the CRNA. Regulations require operating physicians to accept this responsibility when there is no anesthesiologist supervision.
For more information about regulations and medical liability related to supervision of CRNAs, visit our pages 12-13 of our Fall 2015 Dateline.