Re: Nurse Anesthetist (RN/NA) Prescriptive Practice
Date: September 9, 2011
The Board of Registration in Nursing (Board), Board of Registration in Medicine (BORIM), Board of Registration in Pharmacy and the Drug Control Program (DCP) reviewed, conferred and agreed to revisions in respective regulations related to Nurse Anesthetist (RN/NA) prescriptive practice in accordance with Chapter 191, Acts of 2010 which added a statute at Chapter 112, § 80H and amended Chapter 94C §7(g) and § 9.
The Board's regulations at 244 CMR 4.00 have been updated to reflect the addition of RN/NA to those Advanced Practice Registered Nurses (APRN) who may apply for prescriptive practice authorization. RN/NA prescriptive authority is limited to the immediate peri-operative care of a patient; it stipulates the same requirements as other APRN prescribers, and does not alter the current practice of nurse anesthesia.
The BORIM posted on their website a statement providing guidance to physicians as to Physician Supervision of CRNAs. The guidance refers to 243 CMR 2.10 and states that a physician who is not an anesthesiologist may be a supervising physician for a CRNA as long as he/she complies with the requirements of 243 CMR 2.10.
DCP has amended their regulations at 150 CMR 700.000 in accordance with the amended statutes at Chapter 94C, §§ 7(g) and 9. DCP has posted Guidance for the Nurse Anesthetist on Activities Involving Controlled Substances and a revised Massachusetts Controlled Substance Registration form which includes RN/NA as healthcare providers who may apply for prescriptive authority.
In order to prescribe or issue a medication order for a controlled substance  during the immediate peri-operative care of a patient, a nurse anesthetist must have current Registered Nurse licensure, Board authorization to practice in the category of RN/NA, current registration (Massachusetts Controlled Substance registration) with DCP and, where appropriate, registration with the U.S. Drug Enforcement Administration (DEA) and written collaborative prescriptive practice guidelines.
 Controlled substance means a drug, substance, or immediate precursor in any schedule referred to in M.G.L. c. 94C or 105 CMR 700.000. All prescription drugs are controlled substances in Massachusetts (regardless of federal scheduling), including anesthetics and many therapeutics
This information is provided by the Division of Health Professions Licensure within the Department of Public Health.