West Virginia CRNAs to Administer Anesthesia Without Physician Supervision

West Virginia’s certified registered nurse anesthetists (CRNAs) will soon have greater professional autonomy under a new law set to take effect on July 7. The legislation, known as Senate Bill 810, allows CRNAs to administer anesthesia in cooperation with — rather than under the supervision of — a physician, dentist, or podiatrist.

Key Changes Under the New Law

• New Practice Agreement: The law redefines the working relationship between CRNAs and other healthcare providers as one of "cooperation." This means CRNAs and physicians, dentists, or podiatrists work together as a team, each contributing an area of expertise based on their education, training, and licensure. This move removes the prior requirement for CRNAs to practice "in the presence and under the supervision" of a physician or dentist.
• Wider National Trend: With the passage of Senate Bill 810, West Virginia joins 44 other states that have determined that direct physician supervision for CRNAs is unnecessary under nursing laws. This legislative shift reflects a broader national trend towards greater CRNA autonomy.
• Impact on Rural Healthcare: With 75% of anesthesia providers in the state being CRNAs, the change is expected to significantly improve healthcare access in rural areas, where physician shortages are common. As the sole anesthesia providers in many rural hospitals, CRNAs are seen as essential to maintaining quality care in these settings.

Community Support and Collaboration

The American Association of Nurse Anesthesiology (AANA) and the West Virginia Association of Nurse Anesthesiology (WVANA) were major supporters of the bill. According to WVANA President Justin James, CRNAs are well-equipped to make anesthesia-related decisions based on their training, licensure, and experience.

"Gov. Morrisey’s action ensures West Virginia’s most vulnerable patients have access to value-based, high-quality care and optimizes anesthesia care throughout the state," James said. "By signing this important legislation, West Virginia now recognizes that CRNAs are trained and qualified to make decisions regarding all aspects of anesthesia care."

Other key supporters included AARP West Virginia, the West Virginia Nurses Association (WVNA), the West Virginia Board of Nursing (WVBON), Americans for Prosperity (AFP), and the American Legislative Exchange Council (ALEC). These groups advocated for the bill as a way to improve healthcare access and reduce costs.

Broader Impact on the U.S. Healthcare System

CRNAs are crucial to the U.S. healthcare system, safely administering more than 58 million anesthetics each year across various settings, including hospitals, ambulatory surgery centers, pain clinics, and military healthcare facilities. This legislative shift reflects a broader movement towards team-based, patient-centered care, recognizing the critical role CRNAs play in improving access and outcomes, especially in underserved areas.

🤔CRNAs, what do you think about this new legislation?