No, while the selection and administration of anesthesia is a medical act, if such an act was validly delegated to a CNRA by a physician, the act is considered to be within the practice of nursing and governed by the Nursing Practice Act.  Any discipline for a violation of the standard of care by a CRNA would be carried out by the Texas Board of Nursing under the authority of the Nursing Practice Act.  Ultimate responsibility and accountability for the medical management of a patient under anesthesia remains with the delegating physician who may be subject to discipline for improper delegation dependent upon the facts and circumstances of each case, and how state statutes and regulations apply in those situations. 

165.1(a) (10) now requires the following:

"All non-biographical populated fields, contained in a patient's electronic medical record, must contain accurate data and information pertaining to the patient based on actual findings, assessments, evaluations, diagnostics or assessments as documented by the physician."

Non-biographical data/information is data that will typically change from visit to visit. For example, many EMR systems bring forward from the previous encounter non-biographical information such as symptoms, diagnosis, vitals, lab levels, history, previous treatments etc... However, because symptoms often resolve between encounters (as result of treatment), diagnoses may no longer be active or present (because of previous treatments), and vitals fluctuate, such data fields should not contain inaccurate, non-current, or irrelevant data that is not pertinent to the present illness/issue. Such information may be part of the patient’s history, but should not be reflected as current/present unless such symptoms/diagnoses are ongoing. Such information may become part of the patient’s historical data/information contained in the electronic medical record. Non-biographical information/data contained in a medical record for each encounter should be based on actual assessment, evaluations or other diagnostics that are documented by the physician.

Also see: EMR Position Statement

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Board rule 173 defines analgesic and anxiolytics as shown below:

Narcotic Analgesics-- Opioid or opioid-like dangerous or scheduled drugs that alleviate pain, but not including non-opioid based drugs such as acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs).

Anxiolytics--Dangerous or scheduled drugs used to provide sedation and/or to treat episodes of anxiety.

No, neither the Medical Practice Act nor the Nursing Practice Act authorize independent practice by a CRNA.  Additionally, Texas Attorney General Opinion No. KP-0266 found “A certified registered nurse anesthetist does not possess independent authority to administer anesthesia without delegation by a physician.” (Page 5). Since the selection and administration of anesthesia is a medical act, CRNAs must be properly delegated this act by a physician.  A CRNA who administers anesthesia without proper delegation from a physician would be liable for the unlicensed practice of medicine.