Texas Attorney General Opinion: JC-117 Page: 1 of 10
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OFFICE OF THE ATTORNEY GENERAL STATE OF TEXAS
September 28, 1999
Ms. Katherine A. Thomas, M.N., R.N. Opinion No. JC-0117
Board of Nurse Examiners Re: Whether the Board of Nurse Examiners may
for the State of Texas regulate the selection and administration of
P.O. Box 430 anesthesia and the care of an anesthetized patient by
Austin, Texas 78767-0430 a certified registered nurse anesthetist, and related
Dear Ms. Thomas:
The Board of Nurse Examiners has, "for many years," considered the selection and
administration of anesthesia and the care of an anesthetized patient by a certified registered nurse
anesthetist (a "CRNA") to be the practice of professional nursing rather than the delegated practice
of medicine "requiring oversight/supervision by a physician." Letter from Penny Puryear Burt, Of
Counsel, Board of Nurse Examiners for the State of Texas, to Honorable Dan Morales, Attorney
General (June 5, 1998) (on file with Opinion Committee) [hereinafter "Board Letter of 6/5/98"].
You ask whether the Board's construction is correct. We conclude that your construction is correct
only in part. Under the Nursing Practice Act, see Act of May 13, 1999, 76th Leg., R.S., ch. 388, 1,
secs. 301.001-.555, 1999 Tex. Sess. Law Serv. 1431, 1665-98 (to be codified at TEX. Occ. CODE
ANN., ch. 301), and under the Medical Practice Act, see id., 1, secs. 151.001-165.160, 1999 Tex.
Sess. Law Serv. 1431, 1461-1528 (to be codified at TEX. OCC. CODE ANN., chs. 151-165), the
practice of professional nursing includes the selection and administration of anesthesia and the care
of an anesthetized patient by a CRNA, but only when those tasks are delegated by a physician.
Accordingly, we generally conclude that the Board of Nurse Examiners has authority to regulate the
selection and administration of anesthesia and the care of an anesthetized patient by a CRNA. We
further conclude that neither the Nursing Practice Act nor the Medical Practice Act requires a
physician to delegate the selection or administration of anesthesia or the care of an anesthetized
patient. If a physician does so, however, the delegating physician is not required as a matter of law
to directly supervise the CRNA, but he or she may choose to do so. We discuss limitations on this
authority more fully below.
The Nursing Practice Act, articles 4513 to 4528 of the Revised Civil Statutes, was repealed
and reenacted by the Seventy-sixth Legislature as chapter 301 of the Texas Occupations Code. See
Act of May 13, 1999; 76th Leg., R.S., ch. 388, 1, secs. 301.001-.555, 1999 Tex. Sess. Law Serv.
1431, 1665-98; id. 6(a), 1999 Tex. Sess. Law Serv. at 2439-40 (repealing articles 4513-4528).
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Texas. Attorney-General's Office. Texas Attorney General Opinion: JC-117, text, 1999; (texashistory.unt.edu/ark:/67531/metapth274426/m1/1/: accessed December 18, 2018), University of North Texas Libraries, The Portal to Texas History, texashistory.unt.edu; crediting UNT Libraries Government Documents Department.