November 11, 2015
New Senate VA Bill Includes APRN Provisions that Compromise Patient Safety
Yesterday new legislation was introduced in the U.S. Senate that includes provisions advancing "full practice authority" for all advanced practice registered nurses (APRNs) and “all licensed health care professionals" in the U.S. Department of Veteran Affairs (VA). The bill, named the “Veterans Health Care Staffing Improvement Act,” was introduced by Senators Merkley (Oregon) and Rounds (South Dakota). The bill, S. 2279 has also been cosponsored by Senators Tillis (North Carolina), Warner (Virginia), Shaheen (New Hampshire) Wyden (Oregon), Tester (Montana) and Brown (Ohio).
The main purpose of the legislation is to ease the transition of military health care providers to the VA. However, the legislation also includes provisions advancing independent practice for all APRNs, including nurse anesthetists, in the VA, putting the safety of Veterans at risk. This bill is similar, but not identical, to legislation introduced in the House earlier this year. It has also been announced that companion legislation is expected to be introduced in the U.S. House of Representatives by Congressman Peter Defazio of Oregon.
Legislative provisions of this type are not unexpected as the nursing community continues to push the VA to release the proposed "Nursing Handbook." The handbook, granting independent practice for all APNs, has been delayed for over two years in response to concerns raised by ASA, Veteran Service Organizations and other stakeholders that nurse anesthetists should not be included in the mandated “full practice authority” initiative. The efforts of the nursing community to advance independent practice provisions through the Senate during the summer were unsuccessful.
As discussions about practice authority within VA continue, ASA encourages its members to remember that VA is still considering the contents of the Nursing Handbook and submitting comments on the importance of physician-delivered in and led anesthesia at www.SafeVACare.org is crucial to our advocacy efforts.
ASA leadership and staff will continue to review and monitor this legislation and will keep members updated on how they can continue to advocate to protect safe VA anesthesia care.