California’s Department of Public Health has issued a letter clarifying the role of certified registered nurse anesthetists (CRNAs) in response to recent controversies regarding their scope of practice in the state. The letter emphasizes that CRNAs can administer anesthesia as ordered by a physician, without the need for direct supervision by an operating practitioner or anesthesiologist. However, it stipulates that CRNAs must operate within their defined scope of practice, as the Nursing Practice Act outlines.
The letter cites relevant legal authorities to support its directives, including the California Society of Anesthesiologists v. Superior Court case and section 2725 of the California Business and Professions Code. It also highlights that CRNAs are not authorized to practice medicine or surgery beyond anesthesia services and emphasizes the role of a hospital’s Committee on Interdisciplinary Practice in granting expanded privileges to registered nurses.
Sandra Bordi, DNP, CRNA, president of the California Association of Nurse Anesthesiology, commended the Department of Public Health for upholding legal precedents. She emphasized the importance of accurately representing healthcare providers’ roles and qualifications, particularly in underserved areas where misconceptions about CRNAs’ scope of practice persist.
The letter’s release follows incidents at Modesto hospitals where CRNAs were cited for practicing beyond their authorized scope, leading to canceled surgeries and negative patient outcomes. While the California Association of Nurse Anesthesiology asserts that CRNAs have historically provided independent anesthesia care, the California Society of Anesthesiologists advocates for physician-led anesthesia care models to ensure patient safety and quality of care.
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