There continue to be ongoing, system-wide changes at Veterans Affairs (VA) medical centers in an effort to address recent issues with wait times and the health care needs of our nation’s veterans. In 2001, the Centers for Medicare and Medicaid Services finalized a rule allowing states the authority to decide whether certified registered nurse anesthetists (CRNAs) require physician supervision or to “opt out” and allow them to practice independently.1 In May 2016, a similar proposed rule was released by the VA to permit full practice authority for advanced practice registered nurses (APRNs)—meaning APRNs would be able to provide health care services within their scope of practice without physician oversight.2 The proposed rule would apply to all types of APRNs, including certified nurse practitioners, CRNAs, clinical nurse specialists, and (possibly in the future) certified nurse midwives.
Massarweh NN, Awad SS. Veterans Affairs Proposed Rule for Advanced Practice Registered Nurses in the Operating RoomA Step Forward or Overstepping?. JAMA Surg. Published online November 09, 2016. doi:10.1001/jamasurg.2016.3996