Washington State
House of Representatives
Office of Program Research
Health Care & Wellness Committee
ESSB 6286
Brief Description: Addressing the anesthesia workforce shortage by reducing barriers and expanding educational opportunities to increase the supply of certified registered nurse anesthetists in Washington.
Sponsors: Senate Committee on Ways & Means (originally sponsored by Senators Rivers, Cleveland, Dhingra, Dozier, Nobles, Padden, Robinson, Wellman and Wilson, L.).
Brief Summary of Engrossed Substitute Bill
  • Establishes a grant program to incentivize certified registered nurse anesthetists to precept nurse anesthesia residents.
  • Directs the Center for Health Workforce Studies at the University of Washington to study the workforce shortages in anesthesia care in each facility providing anesthesia services.
Hearing Date: 2/14/24
Staff: Chris Blake (786-7392).

Anesthesia is the use of medicines to prevent patients from feeling pain during health care procedures such as dental procedures, some screening and diagnostic procedures, and surgery.  The medicines, known as anesthetics, may be administered by injection, inhalation, topical lotion, spray, eye drops, or skin patch.  Anesthesia may be local anesthesia for a small part of the body, regional anesthesia for larger areas of the body where the patient may either be awake or sedated during the procedure, or general anesthesia which affects the whole body and the patient is unconscious and unable to move.


Advanced registered nurse practitioners (ARNPs) are one of the three primary health professions in Washington that may perform anesthesia on a general basis within their scope of practice.  An ARNP is a registered nurse who is licensed by the Washington State Board of Nursing upon meeting requirements related to graduate education, national specialty certification and supervised advanced clinical practice hours.  Among the certifications recognized by the Board is the certified registered nurse anesthetist designation issued by the National Board of Certification and Recertification for Nurse Anesthetists.  The curriculum requirements for ARNP education programs include the completion of at least 500 hours in direct patient care in the ARNP role with clinical preceptor supervision and faculty oversight.

Summary of Bill:

Nurse Anesthesia Preceptor Grant Program.

The Board of Nursing must establish a grant program to provide incentives to certified registered nurse anesthetists to precept nurse anesthesia residents in health care settings.  Funds must be distributed equally among qualified applicant preceptors who provide at least 80 hours per year to precepting nurse anesthesia residents.  The grant program is subject to appropriation.


Anesthesiology Workforce Study.

The Center for Health Workforce Studies (Center) at the University of Washington must study the workforce shortages in anesthesia care in each facility providing anesthesia services in Washington.  In conducting the study, the Center must collaborate the Board of Nursing, the Medical Commission, and the Department of Health.  


The Center must submit an initial report to the Legislature by June 30, 2025, with updated reports submitted annually until the submission of the final report on June 30, 2029.  The final report must detail the progress made in the previous five years and findings and policy recommendations to address workforce shortages and barriers to further expand the education of certified registered nurse anesthetists.  The reports must: 

  • identify the factors and barriers to entry into the profession of nurse anesthesiology;
  • evaluate and assess the current training and pipeline for certified registered nurse anesthetists;
  • develop recommendations to reduce barriers for persons who would like to become nurse anesthetists and increase the available training slots for nurse anesthesia residents;
  • create and maintain an implementation plan to improve the pipeline of certified registered nurse anesthetists;
  • identify the number of qualified anesthesia providers who may practice independently at facilities providing anesthesia services, including physician anesthesiologists and certified registered nurse anesthetists; and
  • provide policy recommendations to expand the nurse anesthesia workforce and optimize the cost of providing anesthesia services, including initiatives, to allow independent anesthesia providers to practice at the top of their licenses.
Appropriation: None.
Fiscal Note: Available.  New fiscal note requested on February 2, 2024.
Effective Date: The bill takes effect 90 days after adjournment of the session in which the bill is passed.