Nurse anesthetists are advanced practice nurses that receive additional training (typically a master’s degree from a nurse anesthesia educational program) and pass a national certification examination following graduation. They provide anesthesia care to patients in hospital operating rooms and obstetrical delivery rooms, ambulatory surgical centers, and the offices of dentists, podiatrists, ophthalmologists, plastic surgeons, and pain management specialists.

Typically, nurse anesthetists work in collaboration with surgeons, anesthesiologists, dentists, podiatrists, and other qualified healthcare professionals. According to the American Association of Nurse Anesthetists (AANA), “when anesthesia is administered by a nurse anesthetist, it is recognized as the practice of nursing; when administered by an anesthesiologist, it is recognized as the practice of medicine. Regardless of whether their educational background is in nursing or medicine, all anesthesia professionals give anesthesia the same way.”

However, a new California regulation that allows nurse anesthetists to administer anesthesia without the supervision of a physician has created a huge controversy. The California Medical Association and the California Society of Anesthesiologists filed a joint law suit against Gov. Arnold Schwarzenegger to reverse the regulation.

The two physician groups claim that the new regulation puts surgery patients a huge risks because nurse anesthetists do not have enough training or experience to administer anesthesia on their own, especially when responding to complications from anesthesia or problems in the recovery room. They also argue that there is no need for the law since California does not suffer from a severe shortage of anesthesiologists.

AANA disagrees with the physician groups and argues that numerous studies have demonstrated that there is no difference in the quality of care provided by nurse anesthetists and anesthesiologists. Nurse anesthetists say that they safely administer approximately 32 million anesthetics to patients each year in the United States, and that in some states, they are the sole providers in nearly all of the rural hospitals. They warn that if they are not allowed to independently administer medication to stop pain or to prepare a patient for surgery, many rural patients would not get emergent care within the time they need it.

It is important to note that 14 other states have similar laws to the California law: Alaska, Iowa, Idaho, Kansas, Minnesota, Montana, Nebraska, New Hampshire, New Mexico, North Dakota, Oregon, South Dakota, Washington, and Wisconsin. They all have large rural populations where access to an anesthesiologist is always a problem.