In Midtown Atlanta, you will find a community-based teaching hospital affiliated with the Emory Healthcare system. In 1931, this facility was renamed in honor of Dr. Crawford W. Long, the Georgia physician who was the first to use ether anesthesia during surgery. Per medical memorabilia, Dr. Long’s operation (in 1842) involved the removal of a neck tumor, after he used an ether-soaked towel to make the patient “insensible.” Today’s world of anesthesia includes something rarely seen in 1842 – nurse anesthetists.
If you are a registered nurse (RN) interested in specializing, consider a career as a nurse anesthetist, which hails a long and celebrated history. According to the American Association of Nurse Anesthetists (AANA), nurses gave anesthesia during the American Civil War (1861-1865). They were actually the first professional group to provide such services. Alice Magaw is widely considered the nursing pioneer in this specialty. She collaborated with Dr. Charles Mayo (Mayo Clinic in Rochester, MN) to develop a showcase of anesthesia techniques, which were viewed by physicians and nurses throughout the United States. Named the “Mother of Anesthesia” by Dr. Mayo, she is credited with countless achievements during the nineteenth century.
The Career at a Glance
The credential CRNA (Certified Registered Nurse Anesthetist) was established in 1956. To become a CRNA, a registered nurse must graduate from an accredited nurse anesthesia education program and pass a national certification exam. Each year, CRNAs provide anesthesia in collaboration with surgeons, anesthesiologists, dentists, and podiatrists. They practice in every setting where anesthesia is delivered, such as surgical suites, delivery rooms and ambulatory surgery centers. Since WWI, nurse anesthetists have been the main provider of anesthesia to U.S. military personnel on the front lines. Also, many facilities in medically underserved areas and rural America offer anesthesia care primarily provided by CRNAs.
According to the U.S. Bureau of Labor Statistics, the median annual wage for nurse anesthetists in May 2015 was $157,140. Employment in this field is expected to grow by 19% between 2014 and 2024, with an estimated 7,400 positions being added during that period.
CRNAs practice with autonomy and professional respect, but carry a heavy load of responsibility and are typically compensated accordingly. Duties fall into four general categories:
Pre-anesthesia preparation and evaluation such as requesting consultations and diagnostic studies; obtaining informed consent; selecting and initiating a planned technique (local, regional or general anesthesia).
Anesthesia induction, maintenance and emergence such as selecting/administering anesthetics, accessory drugs and fluids; managing a patient’s airway and pulmonary status (intubation, mechanical ventilation, extubation); selecting/applying invasive and non-invasive monitoring devices for measuring the patient’s physiologic data during surgery.
Post-anesthesia care including managing the emergence and recovery; providing relief from pain and anesthesia effects; preventing and managing complications.
Other clinical support functions including responding to emergency situations by providing airway management and emergency fluids/medications; providing basic or advanced cardiac life support.
Educational Preparation of a Nurse Anesthetist
Admission to a CRNA program requires a bachelor’s of science in nursing degree, a license as a registered nurse and a minimum of one year in acute care nursing. Programs take 24-36 months of graduate work: (1) Classroom material covering anatomy, physiology, chemistry, physics, biochemistry, pathophysiology and pharmacology as related to anesthesia; and (2) Clinical experience covering various techniques and procedures. The AANA offers a journal for continuing education; articles from recent editions include:
- Carbon Dioxide Embolism during Laparoscopic Surgery
- Intrathecal Hydromorphone for Cesarean Delivery
- Physiology of Nicotinic Acetylcholine Receptors
- Prolonged Neuromuscular Block in Elderly Patients
- Dexmedetomidine as a Pediatric Anesthetic Premedication
More than 40,000 CRNAs provide services in America’s healthcare system and are qualified and permitted by state laws/regulations to practice ineverystate of the nation. This could translate into wide job opportunities, as CRNAs are “in demand” per the AANA. By providing high-quality and cost-effective patient care, CRNAs offer an attractive option for hospitals and other healthcare facilities paying close attention to their ‘bottom lines.’
Earning a BSN degree does not instantly qualify a nurse for this career path; however it is a vital step in the process. Advancing your education as a registered nurse can improve job opportunities and options, such as starting on a path to becoming a nurse anesthetist. For additional details about this exciting and rewarding nursing specialty, look to the AACN website: http://www.aana.com/.