Certified Registered Nurse Anesthetists ( Crnas )

I have obtained invaluable insights as to what the daily work of a nurse anesthetist entails. I felt a lighting bolt go off within me, if you will. I felt a renewed excitement for the route that I aim to take in my life. The shadowing experience was confirmation to me that I was on the right path to a future that I dream of daily. By observing and getting involved with regional and general anesthesia in the operating room setting, I discovered that my distinguished passion lies within the great challenges involved in clinical pharmacology and critical monitoring skills.

The CRNA has deeper understanding of disease processes, pharmacological treatment and technological interventions when caring for patients. Advance practice comes with a high level of responsibility; furthermore, increased autonomy is why I aspire to advance my nursing practice. I want to be the nurse that eases my patient’s way through what may be the most stressful time in their life. During my anesthesia shadowing experience I witnessed the complexity and compassionate care that the CRNA provided safely and efficiently. Most importantly I observed clear communication that was vital to all involved in the care of the patient’s unique needs. My shadowing experience fueled my drive to continue to pursuing CRNA School and extend my knowledge at the

My first encounter with a Certified Registered Nurse Anesthesia (CRNA) was during my undergraduate nursing OB/GYN rotation. I was impressed with the CRNA when she placed the epidural to the patient in labor. I remembered patient had difficulty staying still due to the contraction, but the CRNA took her time to explain the procedure while comforting the distressed patient. Once the epidural was in placed and the medication started working, I could tell the relief the patient experienced. I realized then that a CRNA goes beyond the delivery of anesthesia, pain management and monitoring of patients. Thus, obtaining this degree will prepare me to ease the patient’s mind through education, pain management, monitoring, experience and compassion.

Anesthesiologists give patients anesthetics in a variety of ways, such as “orally, intravenously, by gas or direct injection to render patients insensible to pain Anesthesiologists typically maintain the same daily schedule a surgeon follows, participating in both scheduled and unscheduled operations. Anesthesiologists are responsible for determining the proper anesthetic and dosage level for each patient. They monitor the patients progress prior to, during, and after surgery.”(“Anesthesiologist” 31)

They also take care of patients anesthesia before, during, and after surgery. They even give mothers epidurals during child birth for pain management. A CRNA can also perform physical assessments, participate in preoperative teaching, administer anesthesia to keep patients pain free, oversee recovery from anesthesia, prepare for anesthetic management, and follow the patients postoperative course from recovery to the patient care unit. These types of nurses are the only certified personnel to deliver anesthesia in most rural hospitals in the United States (Lippincott Williams & Wilkins 42).

Nurse Anesthetists are also known as CRNA, which means Certified Registered Nurse Anesthetists. Being a CRNA, one has big shoes to fill when it comes to their job. CRNA’s work with anesthesiologist surgeons and other physicians and medical professionals to give anesthesia to patients undergoing medical and surgical procedures. CRNA’s care for patients before, during and after a medical or surgery by doing a patient assessment , preparing the patient for anesthesia, they must maintain the anesthesia throughout the whole procedure to secure the proper sedation, and pain management, and as a CRNA they must make sure the patient recovers from the anesthesia properly. CRNA’s usually overshadow anesthesiologists. They perform much of the work

With change comes evolution. Most professions, specifically nurse anesthetist, as we know them today did not begin in the state they are in today. They grew through trial and error. Before revealing the history of this profession and most important, its leading pioneer, one must be familiar with the role of a nurse anesthetist. Nurse anesthetists, often confused with anesthesiologists, are nurses with baccalaureate degrees in nursing and master degrees in anesthesia who are responsible for administering anesthetics to patients preoperational. Contrary, anesthesiologists are physicians whose education requires a baccalaureate degree as well as medical schooling with special education in anesthesia. However, the anesthesia part of the education is very similar for both providers (KANA. 2011).

Certified registered nurse anesthetists are advanced practice nurses who are certified and specialized in the administration of anesthesia (“Position description,” 2014). CRNAs make their own independent decisions and judgments regarding the application of anesthesia, and, in most states, physician supervision of CRNAs is not required (“Legal issues,” 2010). The profession was introduced to the United States during the

While there was a policy in place for conscious sedation, even good policies rely on the vigilance of staff to adhere to them. Often times, working conditions allow for distractions, and even the best of practitioners, with the best of intentions, make errors. There were several areas presented in this scenario that require examination and improvement.

The history of the Nurse Anesthetist dates back prior to the Civil War and were considered by many as the pioneers of the practice of anesthesia. As the complexity of administering anesthesia increased, physicians deemed the practice of anesthesia to be equivalent to the practice of medicine. As time progressed, some physicians attempted to have the practice of anesthesia banned from the nursing scope of practice. It was not until a case was brought in front of the California Supreme Court where they ultimately established the legal precedent granting nurse anesthesia its legality. Specifying that nurses can administer anesthesia and that they would be operating under their scope of practice as long as it was done under the guidance of a supervising physician (Hamric, Tracy, & O 'Grady, 2014). That law was federally mandated until 2001, when the Centers for Medicare and Medicaid changed the federal supervision rule of Anesthesiologist and Nurse Anesthetists in order for facility to receive reimbursement of care ("Certified Registered Nurse Anesthetists Fact Sheet", 2016). This offered states an “opt-out” rule allowing the unsupervised practice of nurse anesthetists. This change led to conflict in the anesthesia community between physicians and Certified Registered Nurse Anesthetists (CRNA) as the debate of a CRNA’s ability to practice autonomously was now the center of attention. With the costs of healthcare rising and the

The history of nurse anesthesia cannot be accurately studied without a thorough analysis of the pioneer and transformational leader, Alice Magaw. Charles Mayo called her the Mother of Anesthesia for many good reasons (CRNA Profiles, n.d.). It is worthy of the student anesthetist’s time to study the life, education, employment, leadership, publications, and legacy of Alice Magaw.

With all of the different specialties in healthcare, some get overlooked or may be under the radar. An uncommon and often disregarded career choice in healthcare is that of a Certified Registered Nurse Anesthetist or a Doctorate of Nurse Anesthesia Practice. Although not many people know about these healthcare careers, they play a vital role within the healthcare team. This field is growing rapidly and the likelihood of coming into contact with a nurse anesthetist during a hospital stay is on the rise. Knowing the history, education, responsibilities, and career outlook for a Certified Registered Nurse Anesthetist or a Doctorate of Nurse Anesthesia Practice can aide in understanding their very specific role in the care of patients.

Does the compliance with a sedation protocol improve after nurses receive a sedation competency over a three month period? The available data supported the hypothesis that nursing education and competency can lead to consistent best practices and positive outcomes for patients. The answers to this research question can help develop interventions that support best practices for patients who are mechanically ventilated and receiving intravenous sedation.

In the early 1980s it came to light that while the supply of nurses had reached a record high, only 80% of hospitals nationwide had adequate nurse staffing levels (American Nurse Credentialing Center, 2011, p. 8). To address this issue a taskforce was formed within the American Academy of Nursing (AAN). Through an initial study of 165 hospitals, the AAN determined the characteristics of healthcare organizations that were magnetically attracting and retaining nurses as employees (American Nurse Credentialing Center, p. 9). In this study the AAN found “Forces of Magnetism” that contributed to the high level of job satisfaction amongst nurses, superior quality of care, low job turnover, and high level of nurse involvement in leadership, decision-making, and research. In the early 1990s, catapulted by the findings of this initial study, the American Nurses Credentialing Center (ANCC) developed the Magnet Recognition Program. The intention of the ANCC’s Magnet Recognition Program was threefold: To reward hospitals that demonstrated “excellence in the delivery of nursing services to patients;” to encourage quality in the nursing work environment to support practicing professional nurses; and to guide navigation for the dissemination of evidenced-based clinical nursing practice (American Nurse Credentialing Center, 2011, p. 14).

Integrating evidence based practice helps with providing the best possible care to the patient. The nurse manager provided several examples of nursing practices that had been changed in the last year based on current best evidence and cited data that showed that this led to an improvement in the quality of care. She said that the hospital now has an obstetrician/gynecologist (OBGYN) in house at all times because it reduces the time in which to provide critical care. Recently they had to perform an emergency cesarean section and because they had an OBGYN in house, they were no fatalities. Another example is the use of nitrous oxide that has a ratio of 50% nitrogen and 50% oxygen to help with pain management. The nitrous is not continuous but is only activated when you bring it to your mouth. The Hospital Consumer Assessment of Healthcare Providers and Systems