For anyone who has had surgery at a hospital, surgical center or doctor’s office, chances are high that a certified registered nurse anesthetist (CRNA) provided the anesthesia and stayed with the patient throughout the entire procedure.
South Carolina has more than 1,300 CRNAs who provide every type of anesthesia in all health care settings, including epidurals, spinal and nerve blocks, twilight sedation and pain management. Their role is critical: They are responsible for the safety of their patients before, during and after anesthesia.
CRNAs have been safely providing anesthesia care to patients for more than 150 years. The nation’s 53,000 nurse anesthetists administer more than 45 million anesthetics each year and are the primary providers of anesthesia to U.S. military personnel and to patients in rural areas who otherwise might not have access to services.
To date, 40 states have modernized their laws to delete language requiring physician supervision for practicing CRNAs. South Carolina is not one of them, and it’s time for that to change.
This past legislative session, Sen. Tom Davis, R-Beaufort, and Rep. Phillip Lowe, R-Florence, introduced bills that would remove the physician supervision requirements for CRNAs currently found in our state’s Nurse Practice Act. The legislation, Senate Bill 563 and House Bill 4278, would not impact health care facilities that currently have supervising anesthesiologists but, rather, would give smaller sites more choice in how to provide anesthesia care.
As president of the South Carolina Association of Nurse Anesthetists (SCANA), I urge lawmakers to pass this important legislation in 2020. As South Carolina’s aging population grows and medical costs continue to rise, this change would go a long way toward innovating the delivery of health care and meeting our higher demand for services.
Numerous studies have found that CRNAs have an exceptional safety record and are the most cost-effective providers of anesthesia. A landmark study published in Nursing Economic$in 2010, and updated in 2016, shows that a CRNA working as a sole anesthesia provider is 25 percent more cost effective than an anesthesiologist or other provider models.
In addition, researchers studying anesthesia safety have concluded there is no difference in care or patient outcomes between CRNAs and anesthesiologists. We attribute that to CRNAs’ extensive training. Nurse anesthetists receive a minimum of 7 to 8½ years of education and training and complete an average 8,636 clinical hours before they are licensed to be a CRNA. That’s on top of 10,000 hours of patient care they provide at the undergraduate level. By 2025, all graduates of anesthesia programs will earn doctoral degrees.
The national trend toward independent CRNAs comes at a time when anesthesia care has never been safer. The Institute of Medicine, American Association of Nurse Anesthetists and American Society of Anesthesiologists concur that anesthesia care is nearly 50 times safer today than it was just 30 years ago, due to advancements in monitoring technology, anesthetic drugs, provider education and standards of care.
States that have eliminated supervision requirements are seeing the benefits. Rural, inner city and other medically underserved areas are filling gaps in services to improve access. At the same time, they are reducing the cost of health care while still achieving the highest quality of care possible.
South Carolina should join those states. I encourage lawmakers to update our antiquated laws to allow CRNAs to best serve the needs of our patients and communities now and in the future.