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Battle to Allow CRNAs to Practice Independently in VA Hospitals 

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Tell Washington Veterans can’t wait months for the surgical care they need today. You can support veterans by advocating with Congress and the Veterans Administration (VA) to expand access to anesthesia care delivered by highly skilled Certified Registered Nurse Anesthetists (CRNAs). The VA is considering a proposal to give veterans direct access to CRNAs in the VA health system, but approval of this plan could take years. Join us in telling Washington veterans need care now.

Note on the issue

On behalf of the American Association of Nurse Anesthesiology (AANA), I am writing to invite you to participate in Veterans Need Care Now, a national coalition dedicated to reducing surgical wait times in the Veterans Health Administration by expanding direct access to Certified Registered Nurse Anesthesiologists (CRNAs) to meet our veterans’ growing health care needs. Our goal is to increase anesthesia access for veterans and ensure our nation’s heroes timely access to the high-quality health care they deserve. 


Today, more than 1,000 Certified Registered Nurse Anesthesiologists (CRNAs) serve in the Veterans Health Administration (VHA), providing the highest quality care to our nation’s veterans. Nationwide, CRNAs deliver more than 49 million anesthetics each year and practice in every setting from hospital emergency rooms to ambulatory surgical centers. CRNAs have historically provided much of the anesthesia to our active-duty military in combat arenas since World War I and predominate in veterans’ hospitals and the U.S. Armed Services, where they enjoy full practice authority in every branch of the military.


In 2016, the VA issued a final rule granting three of the four advanced practice registered nursing (APRN) specialties full practice authority (FPA), excluding only CRNAs. Since then, reports have continuously highlighted a lack of access to anesthesia services in the VA, which the APRN final rule cited as a reason to revisit the decision to leave CRNAs out. The decision to exclude CRNAs has caused veterans to continue to endure dangerously long wait times for anesthesia and other services due to the ongoing underutilization of CRNAs currently working in VHA facilities.


In April 2020, the VA issued Directive 1899 allowing CRNAs full practice in some VA facilities during the COVID-19 public health emergency to ensure that the VA had sufficient skilled providers to meet veterans needs during the pandemic.  This is an important move in the right direction, but it’s not enough. The VA needs to make full practice authority for CRNAs permanent throughout the VA.


To encourage the VA to change the existing practice laws to expand access to CRNA-provided care, AANA is creating a coalition of organizations, like MUSNAVC, that share a commitment to ensuring veterans better access to health care - now. 

Read further on the Issue and Background

CRNAs have full practice authority in the Army, Navy, and Air Force and are the predominant provider of anesthesia on forward surgical teams and in combat support hospitals, where 90% of forward surgical teams are staffed by CRNAs.

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Full Practice Authority was approved during the pandemic to VA CRNAs.  Now, there is a move to revert back to previous policy.


Let MUSNAVC know what your thoughts and comments are for supporting VA CRNAs full practice authority.

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