William Self: Ease staffing shortages, improve access by modernizing laws on anesthesia providers

One of the many worrisome side effects of our continuing battle against COVID-19 is the creation of severe staffing shortages across many industries and professions, including health care. Fortunately for Floridians, proposed bills in the state Legislature could help ease shortages and improve access for patients by updating the laws governing how anesthesia providers collaborate with other health professionals to deliver care.

As a Certified Registered Nurse Anesthetist (CRNA), I see the impact of staffing shortages firsthand. At the facility where I practice, we have a shortage of seven to nine anesthesia providers. This lack of personnel, combined with outdated and confusing state requirements related to supervision of CRNAs, sometimes results in patient surgeries being delayed or rescheduled.

The two bills (SB 986 & HB 437) currently being considered in the Legislature, filed by Senate Health Policy Committee Chair Manny Diaz, and House Regulatory Reform Subcommittee Chair Bob Rommel, would clarify that CRNAs are authorized to administer anesthesia in hospital, surgical and clinical settings in collaboration with specified licensed health care practitioners. This would allow physician anesthesiologists to practice the delivery of anesthesia directly to their own patients.

One of the key things to understand about these bills is that they would not expand the scope of practice for CRNAs. Rather, they would clarify language in the current law that has led to misconceptions about supervision requirements for CRNAs during anesthesia delivery. By modernizing and making these statutes clear, the bills would enable our highly skilled CRNAs to practice to the full extent of their training in a collaborative way with physicians and other health care professionals.

Here is one example of how this legislation would improve the current situation. Many surgeries and procedures that require anesthesia — from colonoscopies to dental surgery — are performed in a physician’s office or in an ambulatory surgery center, rather than in a hospital. There have been some misconceptions among the physician community that a physician anesthesiologist is the only one who can supervise a CRNA in the delivery of anesthesia in these outpatient settings. By spelling out how the CRNA will collaborate with physician specialists and the entire health care team in a variety of settings, the new legislation will give facilities more options for how they staff and manage their workflow — which, in turn, will provide better access for patients.

With this proposed legislation, Florida would join 43 other states that have already eliminated obstacles and unnecessary supervision requirements for CRNAs. These versatile professionals are the primary providers of anesthesia care in rural communities, medically underserved areas, and throughout the U.S. military.

Florida faces immediate health care staffing shortages due to COVID-19, but also in the longer term. According to a 2021 report by the Florida Hospital Association, our state could have a shortage of more than 59,000 nurses in less than 15 years. In this environment, we must make the highest and best use of the health care expertise we already have.

I am proud of the way that Florida’s CRNAs stepped up during the COVID-19 crisis when the state needed us, volunteering thousands of hours to help staff vaccination sites and using our expertise in critical care and ventilator management to lend support to hospital intubation teams.

On behalf of the Florida Association of Nurse Anesthesiology, I thank Sen. Diaz and Rep. Rommel for championing these forward-looking bills, and I urge all Floridians to support this legislation in the interest of advancing quality patient care.

 ___

William L. Self, DNP, CRNA, APRN, is president of the Florida Association of Nurse Anesthesiology. He earned a Master of Science in Nursing-Nurse Anesthetist Program and a Doctor of Nursing Practice from the University of North Florida.