The Practice of Anesthesia

Formerly Position Statement Number 1.1

Anesthesia is a recognized specialty within both the nursing and medical professions.  The practice of anesthesia by a nurse anesthetist constitutes the practice of nursing.  

It is well-established that nurse anesthetists practice nursing. Anesthesia administration has been a proper nursing function both in practice and in law for more than 100 years.  Courts have long recognized the administration of anesthesia by nurses as a proper nursing function.  In Frank v South, 194 S.W. 375 (Ky. 1917), the court ruled that a nurse giving anesthesia was not engaged in the practice of medicine within the meaning of the statute forbidding the unauthorized practice of medicine.  Although Frank v South is many years old, its finding that nurse anesthetists do not practice medicine is still relevant because it has never been overturned or contradicted by another court.  In Montana Society of Anesthesiologists v. Montana Board of Nursing, 339 Mont. 472, 171 P.3d 704 (2007), the Supreme Court of Montana reaffirmed this legal principle, recognizing that anesthesia is a specialty within the field of nursing and that nurse anesthetists practice nursing.1

State laws, rules and regulations, and court opinions recognize that healthcare professionals share overlapping practice areas and responsibilities.  A responsibility identified in a state’s medical practice act or rules may also, for example, be included in the practice act and rules governing nursing.2

Anesthesia is not the exclusive practice of nursing or medicine, but falls within the scope of practice of both professions.3


  1. Montana Society of Anesthesiologists v. Montana Board of Nursing, 339 Mont. 472, 480, 171 P.3d 704, 710-11 (2007) (The Supreme Court of the State of Montana ruled that nurse anesthetists practice nursing, not delegated medicine.  The Court found that nurses are exempt from Montana’s Medical Practice Act “as long as they render nursing services in the lawful discharge of their duties as nurses,” and Montana’s Nurse Practice Act authorizes CRNAs to practice “in their specified field (anesthesia) as long as they meet the licensing and qualification requirements for a CRNA.”) 
  2. Sermchief v. Gonzalez, 660 S.W.2d 683, 688 (Mo. 1983) (The Supreme Court of Missouri refused to draw “the thin and elusive” line separating the practice of medicine and the practice of nursing and determined that services performed by professional nurses were within the scope of professional nursing and were not the unauthorized practice of medicine.)
  3. American Association of Nurse Anesthetists.  Legal Issues in Nurse Anesthesia Practice. Park Ridge, IL. 2010.

Adopted by AANA Board of Directors March 1987.
Revised by AANA Board of Directors June 1997.
Reaffirmed by AANA Board of Directors February 2005.
Revised by AANA Board of Directors August 2011.