R. Paul Rieker Jr.: CRNAs always supervised by doctors

March 25, 2013 

CRNA supervision

Regarding your March 21 article “Nurses protest new bill”: The article incorrectly stated that “certified registered nurse anesthetists now may work either ‘in collaboration with’ or ‘under the supervision of’ doctors.” It is the current legal standard in North Carolina that physicians supervise nurse anesthetists in all cases.

The N.C. Medical Board, Attorney General and Court of Appeals have all confirmed that physician supervision of nurse anesthetists is the law in North Carolina. In fact, in 2005 the N.C. Court of Appeals stated that physician supervision of nurse anesthetists providing anesthesia care “is a fundamental patient safety standard required by North Carolina law.” The article also contended that “CRNAs also may work independently – in collaboration with surgeons or other physicians.”

Remarkably, the story chose not to mention N.C. Medical Board and Attorney General opinions that say the exact opposite. A 1998 Attorney General advisory opinion clearly states that it is not lawful for nurse anesthetists to provide anesthesia care without physician supervision. This is why every hospital in North Carolina requires physician supervision.

House Bill 181, now under consideration by the General Assembly, codifies the current patient safety requirement of physician supervision of nurse anesthetists. With the passage of HB 181, this important standard of patient safety care will be protected.

R. Paul Rieker Jr., M.D.

President, North Carolina Society of Anesthesiologists, Raleigh

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