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Anesthesia registered nurse practice is neither codified by national legislation, nor are there uniform standards for the level of training or the scope of practice. Instead, ARN training needs and scope of practice are determined by local hospitals and by the anesthesiolo-gists with whom they train and practice. In the absence of uniform national standards, the level of training and the scope of practice vary greatly from institution to institu-tion and between anesthesiologists.Although CRNA practice in South Korea developed on the American model of practice, the professional model has diverged. In the United States, anesthesia services performed by an anesthesiologist are recognized as medical practice. When the service is provided by a CRNA, it is recognized as nursing practice. The status of CRNAs as advanced practice nurses is codified and protected by State Nurse Practice Acts.10In South Korea, CRNA practice was formally rec-ognized in 1973 when the national legislature enactedMedical Law Article 56. This law was strengthened in 2003 by the Revised Medical Service Act.1,5,7 However,although a professional nurse anesthesia system exists and the practice is recognized as an advanced anesthesia practice with certification, there is no clearly established or codified scope of practice by CRNAs.12The impact of this ambiguity was later highlighted by a Korean Supreme Court decision. In 2004, a patient died while under the care of a CRNA practicing in a small surgical clinic under a surgeon’s supervision. The CRNA was charged with illegally practicing medicine, and the case eventually made its way to the Supreme Court. In 2010 the court found the CRNA guilty of practicinga The International Federation of Nurse Anesthetists (IFNA) was founded in 1989 and currently has members in 41 countries. Its purpose is to promote quality anesthesia care worldwide. More information can be found on its website at http://ifna.site/.362 AANA Journal n October 2017 n Vol. 85, No. 5 www.aana.com/aanajournalonlinemedicine without a medical license. This decision threw the practice of nurse anesthesia into a state of confusion,and since that time CRNAs have practiced without guar-anteed legal protection.3,6,7,12The problem of professional identity for CRNAs is further exacerbated by developments affecting member-ship in KANA. Originally established by Sr Kollmer to support and guide the practice of CRNAs, KANA now accepts both CRNAs and ARNs for membership. Falling under the auspices of the Korean Nurses Association, KANA is required to maintain at least 1,000 members on its rolls to keep its affiliation as a specialty practice. With only 619 CRNAs in the country and a single uni-versity program preparing nurses to practice as CRNAs, this requirement would be impossible to meet.3,13 But by expanding its membership to include ARNs, KANA is able to continue its support of nurse anesthesia practice.