Is A Nurse Administering My Anesthesia? Are They Safe?

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)

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

The Association of Anaesthetists of Great Britain and Ireland (AAGBI, 2010) accentuated that when looking after a patient during anaesthetic care, the anaesthetic nurse must be competent in any circumstances for the safety of patient. On the case of Mrs D, there was an obvious need to communicate, so the anaesthetic nurse needs to be trained and encouraged appropriately (Mellanby, Podmore and McNarry, 2014). It is evident that the anaesthetic nurse needs to be confident enough when looking after patients to voice any concerns to the assembled team, regardless of how senior or intimidating they may appear (NMC, 2015). The anaesthetic nurse said that she communicated with the anaesthetists during this critical incident. Yet, the anaesthetists

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

| Assist anesthesiologists in administering pain and numbing medications to patients during operations. A certified registered nurse anesthetist (CRNA) must go through extensive schooling to understand the risks and uses for common anesthesia in the medical field.

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.

The journey to embrace the speciality of anesthesiology has been ecstatic and full of fond memories. It was not until the end of my internship that I finally developed a passion in anesthesiology and the field of critical care. I soon realized that with my zeal for clinical anatomy, command over concepts of physiology, dexterity in medical procedures and empathetic connection to my patients, this speciality would be an ideal match. In my opinion, anesthesiology demands a physicians ability to consolidate the core principles of clinical medicine with the knowledge of basic science principles delicately balanced with high standards of ethical code and conduct. I am confident that with my depth of knowledge, passion for clinical research as well

One day she had lunch with an anesthesiologist who told her some people suffocate and cough when under anesthesia (Lang 168). Memories and flashbacks filled Linda’s mind with her being on the table, not being able to move, feeling terror, and not seeing anything (Lang 168). After years of trying to find out what was wrong with her, she found out she awoke during surgery (Lang 168). Thus, this anecdote about Linda’s experience of “anesthesia awareness” or awakening during surgery and what she felt and experienced during the surgery supports the theme of explaining the concept of “anesthesia

The skilled CRNA is not only proficient in the operating room, but also comfortable dealing directly with patients and their family members. Once in the operating room this is where their wealth of knowledge, experience, and critical thinking really comes into play. Taking into account the patient’s history and current medical issues, the CRNA lays out a plan of care for the patient and makes decisions regarding the type, dose, and rate of medications needed to induce a safe anesthetic effect for the patient during the procedure. While the procedure is underway it is the duty of the CRNA to keep the patient stable and successfully handle any bumps in the road that might occur. This is the role of the nurse anesthetist that I have been most impressed with. The time that I spent in the OR following a CRNA I witnessed him handle difficult situation after difficult situation. As the patient’s respiratory status started to decline, I watched as he manipulated the ventilator; switching between modes and changing settings until a safe respiratory rate and saturation level was achieved. Later the patient went into an adventitious heart rhythm that began to affect their

Anesthetists need to be able to communicate effectively so that patients feel comfortable. They are required to support and stabilize patients, during trauma. Per the university of Kansas medical Center, Certified anesthetists deliver many types of services to the patients and they are divided into four categories: “pre-anesthetic preparation and evaluation; anesthesia induction, maintenance and emergence; post-anesthesia care; and peri-anesthetic and clinical support functions.” CRNAs mostly work in operating rooms, but they also offer anesthesia services in other areas, for instance, MRI units, cardiac catheterization labs, and lithotripsy units.

The earliest documentation of anesthetic care given to a patient by a nurse was the work done by Sister Mary Bernard in 1887. She was a catholic nun who worked at the St. Vincent hospital in Erie Pennsylvania,(Thatcher,1952,p 12). The nurse anesthetists of that time were trained by physicians at first, but as time went on the nurses took a more active role in the study and research of anesthetics and eventually surpassed their teachers in the field of anesthesiology. This advance led to role reversal, where the teacher became the student and the student became the teacher. By 1909 the first formal educational program designed for nurse anesthetists was started at St. Vincents Hospital in Portland Oregon,(Evans,1995,p 3). Upon graduation from the school, the nurse anesthetists were placed in all sorts of settings. Most impressive were the teaching positions held by nurses in the medical schools of that time. They became the primary instructors of anesthetic to medical students. The nurse anesthetist also held positions in the battlefields. During World War One, the American nurse anesthetist was the primary health giver to troops in the European theaters of