There are no Texas laws or regulations that require physician supervision of CRNA practice. Section 157.058 of the Texas Occupations Code allows physicians to delegate tasks to CRNAs without imposing a supervision requirement:
Sec. 157.058. DELEGATION TO CERTIFIED REGISTERED NURSE ANESTHETIST.
(a) In a licensed hospital or ambulatory surgical center, a physician may delegate to a certified registered nurse anesthetist the ordering of drugs and devices necessary for the nurse anesthetist to administer an anesthetic or an anesthesia-related service ordered by the physician.
Attorney General Opinion JC-0117, issued on September 28, 1999, states:
“[A] CRNA practicing in accordance with a proper delegation from a physician is within the scope of practice of the practice of nursing.”
The opinion specifically states that Section 157.058 of the Medical Practice Act does not require a physician to supervise a CRNA’s selection and administration of anesthesia:
“Nothing in either the Nursing Practice Act or the Medical Practice Act requires a physician to ‘supervise’ a CRNA’s performance under section 157.058 of the Occupations Code.”
In a Letter From the Texas Board of Nursing (BON), dated December 13, 2004, Ms. Katherine Thomas, Executive Director of the BON stated:
“CRNAs, like other registered nurses, are not required to be supervised by physicians when carrying out nursing functions. For CRNAs, the administration of anesthesia or anesthesia-related service is a nursing function.”
Attorney General Opinion KP-0353, issued on February 9, 2021, again reaffirmed that state law does not require supervision:
“Chapter 157 of the Occupations Code does not, by itself, require a physician who properly delegates anesthesia related acts to a CRNA to supervise the CRNA’s performance of those acts.”
