BACK TO THE FUTURE! Governor Signs Ceremonial Professional Designation Bill

More than a year after Gov. Tom Wolf signed into law Act 60 of 2021, which granted formal title recognition to the state’s Certified Registered Nurse Anesthetists (CRNAs), members of the Pennsylvania Association of Nurse Anesthetists (PANA) got to join the state’s top executive for a ceremonial bill signing at the Capitol Building.

Public bill signings were halted during the COVID-19 pandemic and only recently restarted, with PANA visiting Harrisburg on Sept. 20, 2022. Even though it was delayed in coming, the ceremony still made for a glorious day. Act 60 remains one of the biggest legislative achievements in a generation for CRNAs and SRNAs in Pennsylvania --- one that took more than a decade to secure.

With no definition for nurse anesthetists under the state’s Professional Nursing Law, CRNAs were recognized only as registered nurses. Now, with Act 60, everyone knows us for who we are and what we train to be --- Certified Registered Nurse Anesthetists.

Thank you again to every CRNA and SRNA in Pennsylvania, and to dedicated PANA board members and trustees, for everyone’s tireless advocacy to get this law across the finish line and significantly advance our profession.

Learn more about the issues at www.PANAforQualityCare.com. Click on “Legislative Updates.”

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Some nurses finally get the recognition they deserve | PennLive Opinion

July 28, 2021

By Matt McCoy

It used to be that certified registered nurse anesthetists (CRNAs) were the best-kept secret in health care. Not anymore.

Right before the General Assembly adjourned for its summer recess, lawmakers passed and the governor signed into law Act 60 of 2021, which grants formal title recognition to CRNAs in Pennsylvania.

The enactment marks the end of a legislative review that stretched more than a decade, and it brings tremendous professional satisfaction to the state’s 3,700 CRNAs and students, who will finally be recognized for their advanced education, specialized training, and clinical skills.

Until that moment a few weeks ago, Pennsylvania remained just one of two states (New York is now the lone holdout) that failed to formally recognize “certified registered nurse anesthetist” in some form.

Because there was no definition for nurse anesthetists under the state’s Professional Nursing Law, CRNAs were recognized only as registered nurses, despite clear differences between the two health-care professionals.

CRNAs are the hands-on providers of anesthesia care, operating safely in every setting where anesthesia is administered, including hospital operating and delivery rooms; ambulatory surgical centers; the offices of dentists, ophthalmologists, and plastic surgeons; pain management centers, and more.

Act 60 also expands the providers that CRNAs are permitted to work with to include podiatrists.

While many CRNAs practice with physician anesthesiologists, increasingly, CRNAs practice on their own in collaboration with other health-care professionals.

Act 60 also reinforces that nurse anesthetists are able to perform the full scope of anesthesia services without the involvement of physician anesthesiologists and embraces the existing patient care model of collaboration between CRNAs and their physician colleagues.

More than 49,000 CRNAs safely administer well over 34 million anesthetics nationwide each year --- and Pennsylvania remains at the forefront.

With 13 university-led programs, including York College’s WellSpan Health Nurse Anesthetist Program, our commonwealth is a national leader in anesthesia education and training. So, it has always been frustrating that our state didn’t even officially recognize these professionals.

It was costly, too. Without an official CRNA designation here, many students left. And even after they left, some graduating students had to wait as long as six months to get credentialed in out-of-state facilities, because state boards had to verify that students met requirements to be classified appropriately there.

This new law stems the flow of this “health-care brain drain” and reinforces our reputation for education and training.

Act 60 also remedies issues with credentialing that meant logistical and financial challenges for CRNAs.

Pennsylvania-based nurse anesthetists who serve in the military, for example, had to secure designation in another state to provide anesthesia in the armed services. Our CRNAs could not assist on rapid response teams in states affected by natural disasters unless they served only as RNs because they lacked formal credentials.

But it was the pandemic that finally put this decades-long professional slight into perspective.

In response to COVID-19, many CRNAs wanted to contribute more to the facilities where they worked but couldn’t. Likewise, hospitals and other health-care institutions wanted to use CRNAs to their fullest capacity but couldn’t.

And they couldn’t because of the way the state-licensed CRNAs as RNs, which limited our role to provide the most advanced, critical care services during the biggest health-care crisis of our lifetime.

Of course, none of this would have been possible without the bipartisan cooperation of the administration and lawmakers, especially Rep. Tarah Toohil (R-Luzerne) and Sen. John Gordner (R-Columbia), whose measure ultimately was signed into law.

In the most ordinary situations, surgery and anesthesia can be frightening or intimidating. But nurse anesthetists provide comfort and reassurance by never leaving their patient’s side.

We’re usually the last people patients see before a procedure begins and the first to greet them when they awake. It’s humbling to realize that now they will get to know us for who we really are -- finally and officially -- as CRNAs in Pennsylvania.

Matt McCoy, DNP, CRNA, is president of the Pennsylvania Association of Nurse Anesthetists.

https://www.pennlive.com/opinion/2021/07/some-nurses-finally-get-the-recognition-they-deserve-opinion.html

State asked to allow nurse anesthetists to do more to help in crisis

By Paul J. Gough – Reporter, Pittsburgh Business Times

Apr 7, 2020, 1:47pm EDT Updated Apr 7, 2020, 2:35pm EDT

Pennsylvania's certified registered nurse anesthetists are urging the Pennsylvania Department of Health to waive a supervision requirement to allow them to fully help patients to the level of their training.

Nurse anesthetists are advanced practice nurses that deliver medications including anesthesia during surgery, medical procedures like colonoscopies and dental procedures. They normally work under the supervision of an MD anesthesiologist but have a substantial course of training in their own right: Not just an RN degree but also generally two or three years of advanced practice training beyond it and thousands of clinical hours.

But even though they play a critical role, Pennsylvania's nurse anesthetists aren't given by law what is called a title designation: They can't practice except under the supervision of an anesthesiologist. That, said its trade association the Pennsylvania Association of Nurse Anesthetists, is a critical distinction and an area of opportunity in the commonwealth if health officials allow it.

Pennsylvania is the only state that doesn't allow nurse anesthetists to practice their full scope, which is critically important during the COVID-19 pandemic. New York, the only other state in the country that has the same strictures, last month relaxed them to allow nurse anesthetists to practice to the full level of their training.

That's what Pennsylvania Association of Nurse Anesthetists (PANA) is advocating with the Pennsylvania Department of Health. It's also what the Trump administration, through the Centers for Medicare and Medicaid Services, has done on the national level.

"We are highly educated and trained professionals," said Jess Poole, a Westmoreland County nurse anesthetist and government relations director of PANA. "Our skill sets should be utilized."

That's because in the COVID-19 emergency, some of the skill sets that nurse anesthetists have — the proper intubation and use of ventilators — are really needed. There's already a nationwide shortage of ventilators and more are going to be needed, as well as the skilled medical professionals who know how to use them.

Poole said that it's crucial for nurse anesthetists to be able to help out. Previous attempts to allow it, before a crisis, have not been successful in the Pennsylvania Legislature. But Poole said the Wolf administration has the power to allow them to do it on a temporary, emergency basis.

PANA has requested a waiver from the supervision requirement but it's not yet been granted.