ANA Response to Dept of Veterans Affairs Rule on APRNs

On December 13, 2016, the Department of Veterans Affairs (VA) released a final rule granting full practice authority to three of the four established Advanced Practice Registered Nurses (APRNs) roles when they are acting within the scope of their VA employment. Nurse Practitioners (NPs), Clinical Nurse Specialists (CNSs) and Certified Nurse-Midwives (CNMs) will now have full practice authority within the VA Health System as a mechanism for extending veterans access to a full range of qualified health professionals. ANA is disappointed that the VA failed to extend full practice authority to Certified Registered Nurse Anesthetists (CRNAs).

The following statement is attributable to American Nurses Association (ANA) President Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN, in response to the final rule:

“The American Nurses Association is pleased with the VA’s final rule allowing APRNs to practice to the full extent of their education and training. This rule puts veterans’ health first, and will help improve access to the timely, effective and efficient care they have earned. However, ANA is concerned with the final rule’s exclusion of CRNAs, which is solely based on the VA’s belief that there is no evidence of a shortage of anesthesiologists impacting access to care. We join with our colleagues in continuing to advocate for CRNAs to have full practice authority within the VA health care system.

“The 6,000 APRNs serving in the VA health care system are dedicated to delivering the best possible care to our heroes and their families. Today’s rule is the right policy at the right time, and we applaud the VA for taking this vital step in ensuring access to care and keeping America’s veterans healthy.”

APRNs are nurses who have met advanced educational and clinical practice requirements, and whose services range from primary and preventive care to mental health, birthing and anesthesia.

The proposed rule generated an unprecedented number of comments from veterans, health care providers and the general public. The final rule amends the VA’s medical regulations to permit full practice authority (FPA) for three of the four APRN roles when they are acting within the scope of their VA employment and authorizes the use of APRNs to provide primary health care and other related health care services to the full extent of their education, training, and certification, without the clinical supervision or mandatory collaboration of physicians.


The American Nurses Association (ANA) is the premier organization representing the interests of the nation’s 3.6 million registered nurses. ANA advances the nursing profession by fostering high standards of nursing practice, promoting a safe and ethical work environment, bolstering health and wellness of nurses, and advocating on health care issues that affect nurses and the public. ANA is at the forefront of improving the quality of healthcare for all.