The Department of Veteran Affairs has published its final rule on full practice authority for advanced practice registered nurses practicing in the VA system. This unique system would allow APRNs to practice to the full extent of their licensure regardless of disparate state practice regulations.

Nurse practitioners, nurse midwives and clinical nurse specialists are granted full practice authority under the final rule. Unfortunately, our certified registered nurse anesthetist colleagues were not granted these same privileges.

The VA has described two main arguments against allowing full practice for CRNAs. The main argument was that by granting CRNAs full practice authority the VA would be eliminating the team-based concept of care in anesthesia. For all of us in healthcare, we know this is simply not true.

Second argument the VA proposes that there is no shortage of physician anesthesiologists in the VA. Yet, CRNAs were in the top 10 VHA Occupations of critical need from 2011 through 2015. CRNAs can fill gaps in critical-access areas, and CRNAs should be allowed to practice to the full extent of their licensure, similar to their APRN colleagues.

The VA should allow full practice authority for all APRNs. The VA is seeking feedback on the ruling. I encourage APRNs, health care team members and the public to write in support of CRNAs. Comments may be submitted through

Natalie Mohammad


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