VA Grants APRNs Full Practice Authority. Almost.
The VA declines to give certified nurse anesthetists full-practice authority, claiming there is no issue with access to anesthesia care. Nursing organizations disagree.
After a comment period that spurred much debate and garnered 179,734 public comments, on Dec. 14 The Department of Veterans Affairs announced it is amending its provider regulations to all allow full practice authority to APRNs employed at the VA.
But not all of them.
The final rule will allow the VA's certified nurse midwives, clinical nurse specialists, and nurse practitioners to practice to the full extent of their education, training, and certification. The agency declined, however, to grant full practice authority to certified registered nurse anesthetists.
In a news release, the VA said it did not have immediate and broad patient access challenges to anesthesia care across its health system and therefore chose not to finalize the provision which included CRNAs as one of the APRN roles receiving full practice authority.
Some in nursing are disappointed with this decision.
"The AANA is terribly disappointed by the VA's decision to not grant full practice authority to CRNAs because now veterans will continue to deal with long wait times for needed healthcare procedures that require anesthesia services," AANA President Cheryl Nimmo, DNP, MSHSA, CRNA told HealthLeaders Media via email.
"And the solution to the problem is right there—a highly educated, qualified, motivated, and proven CRNA workforce that is currently being underutilized due to practice barriers imposed by physicians to benefit physicians. Let me be clear: Veterans are not the beneficiaries of this decision."
Nimmo points out that while the VA says there is no issues with access to anesthesia care, the VHA Independent Assessment in 2015 identified numerous access problems such as:
- Delays in cardiovascular surgery due to lack of anesthesia support
- Increasing demand for procedures requiring anesthesia outside of the operating room
- Slow production of colonoscopy services in comparison with the private sector