On The Quick
Veterans Administration Rules in Favor of APRNs
Full practice authority for NP, CNS and CNM
It’s official: Effective January 13, Veterans Health Administration (VHA) nurse practitioners, clinical nurse specialists and certified nurse midwives have full practice authority, even in states that do not yet grant autonomy to advanced practice registered nurses. To make that possible in states like California, the VA is exercising its authority to preempt state law. The one exception is the ability to prescribe and administer controlled substances, which remains subject to applicable state regulations.
The final rule means that the VA’s 5,769 APRNs can practice “to the full extent of their education, training and certification” within the scope of their VHA employment.
THE CRNA QUESTION
Omitted from the final autonomy rule are the VHA’s approximately 937 certified registered nurse anesthetists (CRNAs). Although the VA included CRNAs in its original proposal last May, an American Society of Anesthesiologists lobbying campaign generated 104,256 negative comments. In its official response to those comments, published in the Federal Register on December 14, the VA reaffirmed its belief that CRNAs provide safe care even without a physician’s supervision. However, the VA conceded that it “does not have immediate and broad access problems in the area of anesthesia care … that require full practice authority for all CRNAs.” Although the new rule is final, the VA invited additional public comments on the question of CRNA autonomy to help shape future regulations. The comment period closed on January 13.
OPENING THE DOOR
“Amending this regulation,” declares VA Under Secretary for Health David J. Shulkin, M.D., “increases our capacity to provide timely, efficient, effective and safe primary care; aids VA in making the most efficient use of APRN staff capabilities; and provides a degree of much-needed experience to alleviate the current access challenges that are affecting VA.” In a supportive comment, the Federal Trade Commission added that the move could “broaden the availability of healthcare services outside the VHA system, as well as within it, and … generate additional data in support of safe APRN practice.”
This article is from workingnurse.com.