To the editor:

Our rural communities are bearing the brunt of our nation’s healthcare crisis. According to the Indiana Hospital Association, in an emergency, rural patients often travel twice as far as urban residents to the closest hospital. As a result, although only 20 percent of Americans live in rural areas, they account for 60 percent of trauma deaths.

To improve patient outcomes in rural communities’ access to care is critical. However, rural hospitals are at the greatest risk of closure, furthering the accessibility problem. One of the most agreed-upon strategies for improving access to care is to reduce the regulations restricting the practice of advanced practice registered nurses, such as nurse anesthetists.

Certified Registered Nurse Anesthetists (CRNAs) are the sole anesthesia providers in the vast majority of rural hospitals, enabling these facilities to offer surgical, obstetrical, trauma stabilization, interventional diagnostic, and pain management services. However, in Indiana, we do not realize the full benefit of CRNAs extensive education and training because CRNAs face strict supervision requirements that limit their practice. By removing the current immediate presence supervision requirement and expanding the types of doctors that can supervise the practice of CRNAs, the Indiana General Assembly has an opportunity to improve access to care in our rural communities.

—Karen Kolb, CRNA
Jasper