VA Ruling on APRN Practice: A Breakthrough for Veterans Health Care

VA Ruling on APRN Practice: A Breakthrough for Veterans Health Care 

AACN Continues to Call for Inclusion of All APRNs in VA Final Ruling

December 13, 2016—Today, the U.S. Department of Veterans Affairs (VA) issued a final rule regarding Advanced Practice Registered Nurses (APRNs) providing clinical care in the Veterans Health Administration (VHA). The rule grants three of the four APRN roles (nurse practitioners, certified nurse-midwives, and clinical nurse specialists) the ability to practice to the full extent of their education and training, but does not include certified registered nurse anesthetists (CRNAs). AACN acknowledges the tremendous progress made by recognizing three APRN roles, which underscores this monumental change in policy at the VA. This change will help meet many of the current demands facing the VHA’s ability to increase access to care. However, AACN believes the full cadre of clinicians will not be maximized within the VHA if CRNAs are excluded. AACN appreciates the opportunity that the VA has provided to allow for an additional 30-day comment period on full practice authority for CRNAs. We stand firm in our view that CRNAs would increase access, and will submit additional comments to the VA in collaboration with our colleagues in the community.

AACN Board Chair Juliann Sebastian, PhD, RN, FAAN, states "Currently, AACN's member institutions are educating nearly 90,000 APRN students, who will be vital to creating optimal healthcare delivery in our country. Whether in deployment abroad or in clinics at home, APRNs are critical to ensuring the health of our nation’s service members and Veterans. AACN will impress upon the VA the impact that CRNAs have on Veterans’ care and the need to ensure consistency with practice standards of the profession.”

AACN has been collaborating with the American Association of Nurse Anesthetists, the American Association of Nurse Practitioners, and the American Nurses Association, among many others in the Veteran, nursing, and healthcare community over the past three years to urge the VA to finalize this rule for all four APRN roles. Over 1,400 public comments were submitted by AACN advocates to the VA when the proposed rule was released earlier in May. This demonstrates the high priority that AACN members place on this policy. 

The implications of this rule for Veterans’ health care and for the profession are far-reaching. AACN will work with the current and new Administration on the final rule’s implementation so that it supports all four roles, which will drive stronger, seamless care delivery. For additional background on this issue and the association’s advocacy efforts, visit AACN’s website.