The Anesthesia Brief · Issue #2

The whole landscape,
in five minutes.

By Marc Smith, DNP, CRNA & Shantall Ruiz Cummins, DNP, CRNA · June 2026

If you're thinking it, we're talking about it.

Welcome back. Every Tuesday we read the bills, the board actions, the pay data, the shortages, all the fine print nobody else bothers to translate, and hand you what matters in about five minutes.

Let's get into it.

This Week's Top Story

They'll lend a future doctor twice what they'll lend a CRNA

Starting July 1, a future CRNA can borrow $20,500 a year and $100,000 total for school, half of what a future physician, lawyer, or pharmacist gets, because the Department of Education left nursing out of the "professional degree" tier. The fix already has a number. Sen. Jeff Merkley's Nursing is a Professional Degree Act (S. 4568), now in the Senate health committee, would add nursing back to the professional tier and restore the $200,000 cap; a bipartisan House companion from Rep. Jen Kiggans backs it. Meanwhile the AANA and nine other nursing groups are suing to block the rule, with 25 state attorneys general filing a separate suit.

⏱ Act This Week

A new federal rule just changed the math on out-of-network billing. Here's the plain version, when you bill a patient's insurance and they're not in your network, the No Surprises Act lets you take a lowball payment to a neutral referee instead of just eating it. Filing that challenge used to cost $115, so small claims weren't worth it; as of June 11, it's $15. If insurers have been shorting you on smaller out-of-network cases, it's finally cheap enough to fight back.

This Month's Number

That's the market median for a CRNA right now. If you don't know your number cold, you're negotiating from behind. Know it before you sit across from anyone.

Board Watch

A Tennessee nurse anesthetist was caught diverting fentanyl on the job last year. He was slurring and nodding off in the surgery center, and the hospital's AI monitoring software missed it for months. In November he signed a consent order with the state board, which is a settlement where the provider accepts the board's discipline instead of fighting the charges at a hearing. The lesson holds; software alone doesn't catch diversion. The people in the room do, which is why knowing the signs and being willing to say something matters more than any monitoring system.

Scope, Moving

Two new anesthesiologist-assistant training programs just opened; one is at Lipscomb University in Nashville, and the other, Nevada's first, is at Nova Southeastern. With licensure bills also active in Michigan, Kansas, and Maryland, the physician-supervised care-team model is expanding fast. On the CRNA side, California's AB 876 became law, confirming that a CRNA isn't limited to RN scope when delivering anesthesia.

Drug Shortage Flash

Lidocaine, bupivacaine, ropivacaine, rocuronium and morphine are all on the FDA shortage list right now. Check your sources before you count on them.

Coming to Your OR

Fingertip ultrasound is real, and it's slick. Sonivate's SonicEye mounts the probe right on your fingertip, so you scan and stick with the same hand instead of juggling a separate transducer. It's built for vascular access and blocks, where one-handed imaging actually changes the workflow.

Here's the part we want to sit with for a minute. Substance use disorder is one of the real occupational hazards of this profession. We work every day with the most powerful drugs in medicine, and addiction is a disease, not a character flaw.

The CRNA in that Tennessee story was almost certainly a skilled provider who got sick, the same way any of us could. That's what makes it so easy to miss, and it's why the signs matter; a colleague who suddenly wants every heavy-narcotic case, who comes in early and stays late, whose wastes don't quite add up, whose patients seem to hurt more than the chart says they should, who keeps disappearing or turns up on days off.

If something feels off, you don't have to be certain, and you don't have to handle it alone. Call the AANA Peer Assistance Helpline at 800-654-5167. It's free, confidential and staffed 24/7. It's there for you, colleagues, or students.

Reaching out isn't turning someone in; it's how they get into treatment instead of becoming a statistic. It could be the call that saves a life.

The Anesthesia Brief is free. Built by two CRNAs who wanted one place to find everything.

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Legislative data, LegiScan & OpenStates (CC BY 4.0). Drug shortage data, ASHP / openFDA. Federal regulatory data, FederalRegister.gov (public domain). Compensation, Marit Health (market feed), BLS, AANA.