South Dakota laws related to certified registered nurse anesthetists—or CRNAs—haven’t been updated since 1979. But a bill to give CRNAs broader practice outside of hospital settings is now moving to the senate floor.
Senate Bill 50 brings South Dakota CRNA practices up to par with national standards. It also expands collaboration to non-physician care providers like dentists, and gives them authority to prescribe controlled substances for pain management based on their training.
Taylor Rehfeldt is clinical director of Mt. Marty’s Nurse Anesthesia Department. She says CRNA students in South Dakota receive the education to handle these responsibilities.
“I have watched some of the best and brightest students leave our state because they had better practice opportunities in our surrounding states," she says. "They are exposed to these opportunities through clinical rotations in North Dakota, Minnesota, Iowa and Nebraska.”
Other proponents say allowing CRNAs to practice to the full extent of their training would lessen wait times and hours of driving for South Dakota’s rural residents.
But opponents argue CRNAs don’t have the same expertise as anesthesiologists, and some are concerned giving them prescriptive authority will worsen the opioid crisis.
Ryan Schellpfeffer is an anesthesiologist with Avera McKennan in Sioux Falls. He argues access is already good in the state.
“Twelve of the 22 west river counties and 29 of the 44 east river counties have anesthesia providers, meaning that there’s someone there to take care of you if you need a procedure and put you to sleep. And of the counties that don’t have anesthesia providers, all of them boarder a county that does with the exception of Harding County up there in the northwest.”
But the bill’s prime sponsor, Senator Deb Soholt, says if patients had access to anesthesiologists everywhere, she wouldn’t have brought this bill in the first place.
“But the fact of the matter is we don’t. And we are seeing if you cross the border into North Dakota or Iowa or Nebraska or Montana, that you’re going to somehow end up being able to do this work but you come into South Dakota and our CRNAs are less-than? That’s something I don’t believe about our CRNAs and I don’t think you believe it either.”
The Senate Health and Human Services Committee passed the bill unanimously. It now moves to the Senate floor.
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