Healthcare News & Insights

Anesthesia administration: Court will decide who can do it

Should nurses be allowed to administer anesthesia without a doctor’s supervision?

This is a debate that’s been plaguing hospitals around the country. It started in 2001 with a change to Medicare and Medicaid regulations. The change allowed states to opt out of a requirement that nurse anesthetists be supervised.

Many believe this is a good change. Reason: It gives increased access to healthcare for people in rural areas who have to travel outside their local community to find a facility that has an anesthesiologist.

The two sides of the debate are:

  • Nurse anesthetists, who specialize in administering anesthesia. Argument: They are highly capable of administering anesthesia without the supervision of a physician, because they learn about the same drugs, equipment and standards of care as physicians do.
  • Anesthesiologists, who are physicians who specialize in administering anesthesia. Argument: Anesthesia is a complex and technically demanding area of medicine that requires the skill of a physician, or at least the supervision of a physician, in case complications arise.

Colorado is one of 17 states that have decided to allow nurse anesthetists to administer anesthesia without physician supervision. Due to this decision, the state finds itself embroiled in a legal battle.

In 2010, anesthesiologist and medical societies filed a lawsuit in state court. The lawsuit asserted that allowing nurse anesthetists to deliver anesthesia without supervision wasn’t consistent with state law — a requirement for opting out of the federal rule.

However, the lawsuit was dismissed. A judge ruled the legislature did intend for the practice to be allowed. But that didn’t stop the medical societies. They appealed the ruling last May. Nationally, both sides are keeping a close watch on this case.

Colorado isn’t alone. The California Society of Anesthesiologists petitioned the State Supreme Court to take another look at its 2009 lawsuit for opting out of the supervision requirement. Much to the chagrin of the California Hospital Association, the suit hasn’t been successful. The association is on the nurses side due to the difficulty it’s had staffing anesthesiologists in facilities in California’s rural areas.

Where does your facility stand on this debate? Share thoughts in the box below.






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