Nurse anesthetists: scope of practice.

Assembly Member Flora's legislation clarifies the scope of practice for California nurse anesthetists by codifying their authority to provide comprehensive anesthesia services under physician, dentist, or podiatrist orders. The bill defines anesthesia services to encompass preoperative, intraoperative, and postoperative care, along with pain management and emergency services.

Under the proposed changes, when a physician, dentist, or podiatrist orders anesthesia services for a patient, nurse anesthetists would have explicit authorization to select and modify anesthesia approaches throughout the course of care. The bill specifies that medication administration by nurse anesthetists for these purposes does not constitute prescribing under federal regulations, while maintaining existing requirements for facility approval of anesthesia services in acute care settings.

The legislation preserves current certification standards overseen by the Board of Registered Nursing, which considers National Board of Certification requirements and may establish additional criteria based on public safety needs. The bill's provisions align with existing case law regarding nurse anesthetist scope of practice, including the California Society of Anesthesiologists v. Brown decision from 2012.