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Study: Nurse anesthetists don't need physician supervision

by Heather Mayer, DOTmed News Reporter | August 05, 2010

But just because these findings show nurse anesthetists are capable of providing anesthesia without supervision, it doesn’t mean they are about to tackle jobs that can only be done by anesthesiologists. While nurse anesthetists are certified to conduct any pain management and anesthesia, Cromwell said, they wouldn’t be able to tend to intensive care units as doctors do, for example.

“That’s not something that would be in a CRNA license,” Cromwell told DOTmed News.

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But even with this distinction, anesthesiologists call the findings misleading.

“The study reflects a fundamental misrepresentation, a misunderstanding of what the practice of anesthesia involves,” said Hannenberg.

He pointed out that in some cases, both a nurse anesthetist and a physician administered anesthesia, but the paperwork may be filed by only the nurse anesthetist, thus showing there was no supervision.

“That number is significantly inflated,” he said.

What’s more, nurse anesthetists do not work with high-risk patients, anesthesiologists do, but the outcomes were nearly the same. Hannenberg pointed out that the nurse anesthetists should have much better outcomes because they work with low-risk patients.

“If outcomes are the same, that speaks to unnecessary complications and mortality in the nurse group because you would expect it to be dramatically lower,” he said. “Why isn’t it lower? That’s a cause for concern. If unsupervised nurse anesthetists take care of complex or sick patients as [the report] suggests should be allowed, you’d have to expect that mortality and outcomes would be far worse … The level of care is far from equivalent.”

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