Nurse anesthetists: scope of practice.

In a move championed by Assembly Member Flora, the measure would create an explicit statutory authorization for nurse anesthetists to perform anesthesia services, covering preoperative, intraoperative, and postoperative care and pain management when guided by an order from a physician, dentist, or podiatrist. It also clarifies that selecting and administering medications under that order falls within the nurse anesthetist’s duties and would not constitute a prescription under federal law, and it frames these provisions as declaratory of existing law and advisory opinions.

The bill expands definitions to include who qualifies as a nurse anesthetist, what counts as an accredited program, and what constitutes anesthesia services—encompassing care across the perioperative spectrum, medication selection and administration under orders, and emergency or resuscitation services. It creates a direct authorization for nurse anesthetists to perform anesthesia services. It specifies that an ordering clinician's directive for an individual patient serves as the authorization for the nurse anesthetist to select and implement the anesthesia modality and to adjust or abort that modality during care. It also clarifies that such medication actions under the order are not a federal prescription.

Regulatory oversight remains with the existing Nurse Anesthetists Act and the Board of Registered Nursing, with standards tied to national certification bodies and accreditation programs, and the bill preserves the process for developing standards when public safety requires. It characterizes the changes as declaratory of existing law and advisory opinions, including a referenced appellate decision, and it does not by itself create new funding or programmatic appropriations. The measure notes no explicit transition date within the text, leaving the effective timing to general state-law rules or future amendments.

Stakeholders include nurse anesthetists who would gain explicit statutory authority to deliver anesthesia services under orders, physicians, dentists, and podiatrists who provide those orders, hospitals and acute-care facilities that maintain relevant bylaws and committees, and professional and educational bodies that set certification and accreditation standards. The measure engages with ongoing questions about how modalities are defined in practice, how facilities coordinate with new authority, and how liability and compliance considerations align with existing regulations. Taken together, the proposal seeks to formalize and clarify the current practice framework within the state’s regulatory structure and advisory opinions.