As a result of advocacy by more than 100,000 ASA members, Veterans and their families, VA has amended a proposal that would mandate “independent” practice for all Advanced Practice Registered Nurses (APRN), effectively abandoning the VA’s proven model of physician-led, team-based anesthesia care. As originally proposed in the "Advanced Practice Registered Nurses" rule or “VHA Nursing Handbook,” Veterans would lose access to safe, high-quality physician-led anesthesia. After an enormous outpouring of opposition, however, VA revised this plan in the Final Rule and specifically excluded nurse anesthetists, effectively preserving the current model of physician-led anesthesia care.
ASA was joined in opposition to the proposal by the leading experts on surgical anesthesia care in the VA, the Chiefs of Anesthesiology, who informed VA leadership that the proposal “would directly compromise patient safety and limit our ability to provide quality care to Veterans.” Leading national medical associations, prominent Veterans organizations, and bipartisan Members of Congress also challenged the VA on this change.
With 12 to 14 years of education and 14,000 to 16,000 hours of clinical training, physician anesthesiologists serve a critical role in providing safe anesthesia care. For VA patients who have poorer health status, the involvement of a physician anesthesiologist in their care is an imperative. Without physician involvement, VA would be lowering the standard of care for our Veterans and putting their lives at risk. ASA salutes VA for preserving the proven anesthesia team-based care model where physicians and nurses work together to provide the best care possible for our nation’s Veterans.
As part of this final rule, VA has started a 30-day comment period “on the question of whether there are current anesthesia care access issues” including “potential future anesthesia care access issues.” This information is being collected for “future rulemaking,” and will not change this final rule; however, ASA urges its members to participate by submitting a public comment expressing appreciation to Secretary McDonald and Under Secretary of Health Shulkin at www.SafeVACare.org.
View supporting documents on the issue
Access advocacy resources for the Protect #SafeVACare initiative (members-only)
If you have any questions, please contact Amanda Ott of the ASA Advocacy Division in Washington, D.C. at (202) 289-2222.