California Association of Nurse Anesthesiology Commends State Agency’s Clarifications of CRNA Scope of Practice
(Sacramento, CA)—California Association of Nurse Anesthesiology (CANA) President Sandra Bordi, DNP, CRNA, FAANA today issued the following statement regarding CRNAs’ independent practice authority in California:
“The California Association of Nurse Anesthesiology commends the California Department of Public Health (CDPH) for maintaining the precedent set forth by California Society of Anesthesiologists v. Superior Court and Business & Professions Code Section 2725 in their All Facilities Letter released on September 6, 2024.
“The AFL clarifies, among other matters, that CRNAs do not require physician supervision in California and that the Nursing Practice Act gives CRNAs legal authority to provide all direct and indirect patient services related to anesthesia care.
“Unfortunately, despite the AFL’s clarifications of existing state and federal law and regulations, false statements about CRNAs’ scope continue to decimate care in underserved regions of the state. Therefore, we are immediately calling on the California Board of Registered Nursing and the CDPH to better protect the public by providing clear guidance to hospitals about CRNAs’ independent authority. This guidance must include the fact that once a provider schedules a treatment regimen that includes anesthesia, both physician anesthesiologists and CRNAs are allowed to independently administer anesthesia care and services in the same way, as well as the fact that the 2012 court decision makes it clear that an ‘order’ does not imply ‘supervision’ or ‘direction.’
“Of note, anesthesia services are not limited to medication administration alone. These services are delivered during the perianesthesia time period, which includes pre-operative, intra-operative, and post-operative care. Anesthesia also encompasses services performed outside of the perioperative setting of an acute care facility, including, but not limited to, offices, clinics, and outpatient surgery settings. An order or directive entered on the chart or medical record of a patient registered in the hospital is authorization for the CRNA to select the type of anesthesia for the patient, to abort or modify the type of anesthesia for the patient during the course of care, and to select and administer medications related to the anesthesia services provided.
“For decades, CRNAs have routinely and regularly provided safe, effective, and cost-efficient anesthesia care in California. CANA and our legislative champions are committed to protecting patient access to timely and high-quality anesthesia services, whether the services are led by a CRNA or in collaboration with a physician anesthesiologist. We request the BRN and CDPH immediately follow suit by providing clear guidance regarding CRNAs’ independent authority in California.”
About California Association of Nurse Anesthesiology (CANA)
CANA is the definitive source of leadership, advocacy, and education for certified registered nurse anesthetists (CRNAs) in California. Since 1931, CANA has worked to advance patient safety, foster access to the highest quality anesthesia, and support the nurse anesthesia profession in California. Learn more by visiting www.canainc.org.
