A proposed Ohio law would give certified registered nurse anesthetists (CRNAs) the power to direct other healthcare workers to administer medication to a patient.
Under current law, a CRNA doesn’t have that authority. The medication order must come from a physician.
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To understand the proposal’s effect, it’s helpful to examine a scenario in which the law could be applicable. For example, a CRNA is visiting with one patient when a second nurse informs her that another patient is experiencing pain. If the law were enacted, the CRNA could direct the other nurse to administer a pain-relief medication to the patient.
In the absence of such a law, only a physician could direct the nurse to administer the medication.
It’s important to note that the law doesn’t apply to anesthesia; instead it applies to medications to treat pain, anxiety and nausea, for example. Under Ohio law, CRNAs are required to practice under the supervision of a physician.
Reactions to the proposal split along traditional lines, with nursing groups supporting it while the state’s largest doctors’ group is opposed. Each side says it has patients’ best interests at heart.
Jennifer Price, health policy director of the Ohio Nurses Association, said its policy council voted unanimously to support the proposal, Senate Bill 228. “Delaying the administration of medications, both pre- and post-surgery, places patients under unnecessary duress and could leave them anxious and in pain,” she said.
Jason Koma, spokesman for doctors’ group the Ohio State Medical Association, said OSMA is “actively opposed” to the legislation. “We have serious concerns with the potentially harmful consequences this bill creates because it eliminates the physician’s medical knowledge and expertise at a patient’s most vulnerable moment and substitutes it with a lesser-trained and -educated CRNA,” he said.
A similar Senate proposal in Ohio’s previous legislative session never made it to a vote.
In recent years, there’s been controversy between groups representing CRNAs and anesthesiologists over increased powers for CRNAs. Sixteen states, but not Ohio, have opted out of a federal rule that requires CRNAs be supervised by a physician, according to the American Association of Nurse Anesthetists.
Helping fuel the controversy are two recent studies that essentially concluded that there is no significant difference in the quality of care when anesthetic is delivered by a CRNA or by an anesthesiologist, the New York Times reported.
There are about 1,500 CRNAs practicing in Ohio, according to the Ohio State Association of Nurse Anesthetists.
