SB 143 / HB 185  – The SAVE Act

*This bill was filed jointly in the House and Senate.

Primary Senate Sponsor: Sen. Ralph Hise (R-Madison)

Primary House Sponsors: Rep. Donny Lambeth (R-Forsyth), Rep. Josh Dobson  (R-Avery), Rep. Sarah Stevens (R-Surry), Rep. Gale Adcock (D-Wake)

Bill Summary

This bill defines Advanced Practice Registered Nurses as the following:

  • Nurse Practitioner (NP)
  • Certified Nurse Midwife (CNM)
  • Certified Nurse Specialist (CNS)
  • Certified Registered Nurse Anesthetist (CRNA)

Nurse Anesthesia Definitions

The bill defines nurse anesthesia activities as the following:


  • Performing health assessment
  • Recommending, requesting, and evaluating diagnostic studies
  • selecting and administering preanesthetic medications

Anesthesia induction, maintenance, and emergence

  • Providing safety checks
  • Selecting, implementing, and managing anesthesia
  • performing tracheal intubation and extubation and providing mechanical ventilation
  • Managing blood, electrolyte, fluid, and acid base balance
  • Evaluating client’s response from anesthesia, and implementing pharmaceutical treatment

Postanesthesia care

  • Providing follow up care: evaluations, complications, implementing corrective actions, requesting consultations
  • Administering respiratory support via pharmacological or fluid suport
  • Documenting all aspects of care to provider that assumes patient’s care following anesthesia
  • Releasing clients from care

Other Care Scopes

  • Central vascular access catheters and epidural catheters
  • Emergency situations including cardiopulmonary resucitation
  • Consultations on respiratory and ventiltor care
  • Initiating and managing pain relief therapy

Population Focus Areas

The bill outlines the following APRN population focus areas:

  • Family/Individual across life span
  • Adult gerontology
  • Neonatal
  • Pediatrics
  • Women’s health/Gender-related issues
  • Psychiatric/Mental Health

The bill outlines  the scope of CNMS, CRNAs, CNS, and NPs, practicing independently.

The bill changes the language of supervision to collaboration between dentists and CRNAs.

The bill also removes the subcommittee of the Nursing Board to work jointly with the NC Medical Board to develop rules and regulation on medical acts and to determine fees.

The bill also sets fees for APRNS.

The bill also allows the Board to have grandfathering exemptions for APRNS.

Bill Movement

This bill was filed in the House and Senate on February 26, 2019.