Statement of the Ohio State Medical Association
To The Health and Aging Committee
House Bill 548- Certified Registered Nurse Anesthetists
Opponent Testimony Presented by Monica Hueckel
Director, Government Relations
May 25, 2016
Chair Gonzales, Vice-Chair Huffman, Ranking Minority Member Antonio and members of the House Health & Aging Committee, my name is Monica Hueckel and I am the Director of Government Relations for the Ohio State Medical Association (OSMA). With 16,000 members, the OSMA is the state’s largest professional organization representing Ohio physicians, medical residents and medical students. I appear before you today as an opponent to House Bill 548.
House Bill 548 will allow Certified Registered Nurse Anesthetists (CRNAs) to prescribe medications for a surgical patient during the pre- and post- operative period and to allow the CRNA to give an order to another licensee, such as a nurse or respiratory therapist, to administer the medication to the patient. The bill also permits the CRNA to order another licensee to perform “clinical support functions” on a patient without stating or defining what these functions include.
We value the role that CRNAs provide in anesthesia care and recognize their importance on the surgical team. Yet, this bill seeks to replace the prescribing judgment of the physician, whether it is a surgeon or anesthesiologist, for the prescribing judgment of the CRNA. As you will hear from the panel today, this bill is not necessary and could cause confusion with duplicative or contradictory orders, jeopardizing patient care and safety.
Before turning to the panel, I wanted to briefly address the claims from the CRNAs that this bill does not expand their scope of practice. This is simply false. A CRNA cannot prescribe a medication for a patient during the pre- or post-operative period nor can the CRNA direct another licensee to administer a medication for the patient or perform clinical support functions on the patient. The Board of Nursing in 2008 wrote a letter to the Ohio State Association of Nurse Anesthetists (OSANA) to state unequivocally that the scope of practice of CRNAs does not authorize ordering individuals to administer medications during the pre- and post-operative period. The CRNAs had pointed to a 2007 email to a CRNA from a Board staff person as to their rationale to allow CRNAs to give medication orders, but the email clearly stated it was an informal staff opinion and not a position of the Board.
The Board stated in its 2008 letter to OSANA that the informal opinion given by a former staff person to a CRNA was not in accordance with the Nurse Practice Act and the Board further stated that the Assistant Attorney General to the Board concurred with the Board’s position. As the CRNAs continued to disagree with the Board’s interpretation of the Nurse Practice Act over the next several years, the Board requested an Attorney General Opinion.
In 2013, Attorney General Mike DeWine issued an AG opinion that clearly stated that the Nurse Practice Act does not authorize a CRNA to order or prescribe a preoperative or postoperative medication to be administered by another licensee.
We hope this helps clarify the history of this issue and underscores that this bill is indeed an expansion in the CRNA scope of practice. We look forward to further discussing the merits of this legislation with you.
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