Scope of Practice and the VA
The Department of Veterans Affairs (VA) Office of Nursing Services (ONS) continues to advance a new policy document--VHA Nursing Handbook-- that would mandate "independent" practice for all Advanced Practice Registered Nurses (APRNs), effectively abandoning the VA's proven model of physician led, team-based care, including anesthesia and critical care.The American Society of Anesthesiologists strongly opposes this policy and especially the inclusion of the surgical/anesthesia setting and nurse anesthetists in the "VHA Nursing Handbook."
The leading experts on surgical anesthesia care in the VA, the Chiefs of Anesthesiology, have informed VA leadership that the new policy "would directly compromise patient safety and limit our ability to provide quality care to Veterans." The VA leadership has ignored their concerns. Leading national medical associations, prominent Veterans Service Organizations (VSOs), and bipartisan members of Congress have also challenged the VA on this change. With 12 to 14 years of education and 14,000 to 16,000 hours of clinical training, physician anesthesiologists serve a critical role in providing safe anesthesia care.
For VA patients who have poorer health status, the involvement of a physician during their acute critical care is an imperative. Without physician involvement, the VA would be lowering the standard of care for our Veterans and putting their lives at risk.
The Solution:
To protect patient safety, the VA should continue to follow the team-based physician-led care. Please support efforts to preserve patient safety standards by retaining current policies within the VA.
The DCMS Board of Directors directed that the full membership be asked to engage in this issue because of its far-reaching implications. Comment now at www.SafeVACare.org to ensure Veterans receive the safe, high quality care they earned and deserve.
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