TANA urges you to contact your Senator and Representative to ask them to vote YES on SB 1014/HB 629. The bill will be heard in the House Health Subcommittee on Tuesday, March 24 and the Senate Health Committee on Wednesday, March 25, and then we anticipate this bill will be in front of all legislators soon after it works its way through the committee process, and toward the House and Senate floor within the next week or two.
If you are unsure who your legislators are, please click here and you will be able to insert your mailing address to confirm.
Even if you only get to speak to a staff person in your legislators office that answers the phone, tell them you are a constituent, a concerned CRNA, and you are asking that they vote YES on this bill. Share how this affects your practice!
- SB 1014 by Senator Steve Dickerson/HB 629 by Representative Mary Littleton is being brought by the Tennessee Association of Nurse Anesthetists (CRNAs) to address language within the pharmacy statute related to the definition of “prescription order”, clarifying the ability of a CRNA to carry out their scope of practice to select, order and administer drugs during services ordered by the physician, dentist or podiatrist provided by a CRNA in collaboration with the ordering physician, dentist or podiatrist that are within the scope of practice of the CRNA and authorized by clinical privileges granted by the medical staff of the facility.
- This bill is not an attempt to expand scope of practice for CRNAs. This bill is needed to ensure that the definition of “prescription order” reflects the current practice of CRNAs, thus allowing CRNAs to continue practicing as they do now. The issue was raised because of inquiry for interpretation received by the Board of Pharmacy, not as the result of any issue related to quality of care provided by CRNAs.
- This is not about prescriptive authority as contemplated under TCA 63-7-123. CRNAs do not need a Certificate of Fitness for prescriptive authority to carry out their scope of practice. CRNAs have been providing anesthesia and related services long before there was prescriptive authority in Tennessee.
The prescriptive orders given by a CRNA specified in this bill would not go outside of the facility to a retail pharmacy.
Who are CRNAs?
Certified Registered Nurse Anesthetists (CRNAs) are highly educated anesthesia professionals who provide the full range of anesthesia and pain management services. As advanced practice registered nurses, CRNAs have been providing anesthesia in the United States for more than 150 years.
CRNAs select, order and administer general, regional, and local anesthesia in addition to rendering pain management services.
General Anesthesia – The patient is completely unconscious after being given injected and/or inhaled drugs.
Regional Anesthesia – The patient remains awake, though sedated, while a portion of the body is made numb.
Local Anesthesia – Injection of a painkilling drug into a specific body part, which can be followed by intravenous drugs to keep the patient sedated.
Pain Management – Encompasses pharmacological, non-pharmacological, and other approaches to prevent, reduce, or stop pain sensations.
CRNA Practice Setting
CRNAs practice in every setting in which anesthesia is delivered: traditional hospital surgical suites and obstetrical delivery rooms; critical access hospitals; ambulatory surgical centers; the offices of dentists, podiatrists, ophthalmologists, plastic surgeons, and pain management specialists; and U.S. military, Public Health Services, and Department of Veterans Affairs healthcare facilities. Currently, there are more than 2,400 CRNAs licensed to practice in Tennessee, and the Tennessee Association of Nurse Anesthetists has more than 2,100 CRNA and student members.
CRNA Education and Training
Nurse anesthesia educational programs range from 24-36 months, depending upon university requirements. All programs include clinical training in university-based or large community hospitals. Education and experience required to become a CRNA include:
A Bachelor of Science in Nursing (BSN) or other appropriate baccalaureate degree.
A current license as a registered nurse.
At least one year of experience as a registered nurse in a critical care unit.
Graduation with a minimum of a master’s degree from an accredited nurse anesthesia education program. Tennessee has six accredited nurse anesthesia programs. According to the 2013-2014 NBCRNA Annual Summary Report, a student receives an average of 1683 hours of anesthesia and an average of 2069 clinical hours during their program.
Pass the national certification examination following graduation.
In order to be re-certified, CRNAs must obtain a minimum of 40 hours of approved continuing education every two years, document substantial anesthesia practice, maintain current state licensure, and certify that they have not developed any conditions that could adversely affect their ability to practice anesthesia.
Tennessee Association of Nurse Anesthetists