With an ebbing pandemic, patients look to nurse anesthetists for their care
Posted: March 04, 2022 | Word Count: 800
Throughout the nation, pandemic restrictions are easing as COVID-19 cases drop. By now, we are familiar with mask mandates and vaccine card requirements, but how has the pandemic impacted our healthcare delivery system?
Recognizing the need for patients to receive the care they need, and healthcare systems to have maximum workforce flexibility during the pandemic, the Centers for Medicare and Medicaid Services (CMS) in early 2020 announced temporary regulatory waivers for Certified Registered Nurse Anesthetists (CRNAs), including suspending physician supervision requirements and allowing CRNAs to practice across state lines. Governors also removed barriers to CRNA practice, granting state healthcare systems better flexibility — actions that saved lives and enabled CRNAs to provide patients with much-needed care.
CRNAs are highly skilled, advanced practice registered nurses licensed and certified to deliver anesthesia and administer pain management. It takes a minimum of seven to eight years of education and experience to prepare a CRNA — education that includes an undergraduate nursing degree, critical care experience and anesthesia education. CRNAs practice in every setting where anesthesia is delivered, from hospitals and pain management centers to dental offices, public health centers and the U.S. military.
As the pandemic wanes, the U.S. Department of Health and Human Services may consider rescinding the temporary waivers that increased the ability of CRNAs to provide high-level care to patients in need. The American Association of Nurse Anesthesiology (AANA) argues that reinstating regulations that have been proven to be unnecessary during the pandemic will reduce access to care for many patients, as well as drive up healthcare costs. The AANA is urging the White House to make permanent the removal of physician supervision for CRNAs, so that CRNAs can practice to their full licensure and provide patients with the care they need when they need it.
"CRNAs play an essential role in ensuring patients have access to critical anesthesia services, especially in rural and other underserved populations," said AANA president Dina Velocci, DNP, CRNA, APRN. "The waiver revealed the need for healthcare professionals to work at the top of their ability and highlights the crucial role CRNAs play in our healthcare system."
The fight against COVID-19
A study conducted by the AANA demonstrated how the removal of barriers to practice for nurse anesthetists allowed them to provide necessary care to patients with COVID-19.
CRNAs have been practicing independently under stressful conditions across America throughout the pandemic, providing their expertise and invaluable support in triage and rapid systems assessment, airway and ventilator management, vascular volume resuscitation, placing of invasive arterial and central lines and monitors, overseeing complex hemodynamic monitoring, emergency preparedness and resource management — all crucial for COVID-19 treatment.
Nationwide healthcare benefits from CRNAs working to their full ability
Even apart from the pandemic, nurse anesthetists are among the most utilized healthcare providers in the U.S., according to a report from the CMS. In fact, CRNAs play an essential role in ensuring that more patients have access to critical anesthesia services.
"Nurses do most of their demanding work out of the public eye, particularly advanced practice registered nurses like CRNAs whom patients generally only see when they need surgery," said Velocci. "The COVID pandemic changed that, with more CRNAs working in ICUs and other critical care environments. And data shows that removing physician supervision does not impact quality of care, and can increase healthcare costs."
A study published by the National Academy of Medicine confirmed that lifting barriers for CRNAs to fully use their training and expertise increases health equity and access to care for underserved communities across the U.S.
Need for caring delivery of anesthesia
CRNAs are members of one of the most trusted professions, according to a Gallup poll. And trust is essential for patients undergoing difficult medical procedures.
"CRNAs expertly care for the whole patient, not just their condition," added Velocci. "They are with the patient from the beginning of a procedure, through surgery, and in the post-op recovery room, making patient care more affordable and accessible."
People undergoing anesthesia often experience worry best alleviated by a human, caring approach. A recent AANA Foundation study about patient perceptions of anesthesia found that anxieties regarding anesthesia (or about their children undergoing anesthesia) were mitigated when patients and families could communicate face-to-face with anesthesia providers.
The most effective techniques for alleviating fears about anesthesia included communication with health providers around their specific issues, such as pain tolerance. For patients undergoing local anesthesia where they remain conscious throughout, receiving a good description of everything that would happen and talking directly with their provider were the most effective methods to reduce anxiety.
CRNAs implement effective techniques to relieve anxieties and improve the patient experience using sensitivity and empathetic communication.
To learn more about the vital role of CRNAs and how they can best serve U.S. healthcare needs moving forward, visit aana.com.