What is a Nurse Anesthetist?
Nurse anesthetists provide anesthesia and related care before and after surgical, therapeutic, diagnostic and obstetrical procedures. They also provide pain management and emergency services, such as airway management.
The practice of anesthesia is a recognized specialty within the profession of nursing, and nurse anesthetists are essential to the health care workforce. The Certified Registered Nurse Anesthetist (CRNA) administers anesthesia for all types of surgical cases, from the simplest to the most complex. CRNAs provide anesthesia in collaboration with surgeons, anesthesiologists and other qualified health care professionals and practice in every setting in which anesthesia is delivered, including traditional hospital surgical suites and obstetrical delivery rooms, ambulatory surgical centers, dentists’ offices, pain management clinics, and more. They have long held an important role on the battlefield as well.
An independently licensed health professional, the CRNA is of special importance in medically underserved areas. With CRNAs on staff, health care facilities can offer obstetrical, surgical, and trauma stabilization services when otherwise it would not be possible. In some states, CRNAs are the sole providers of anesthesia services in the majority of rural hospitals.
The CRNA credential came into existence in 1956. As advanced practice nurses, CRNAs practice with a high degree of autonomy and professional respect. They carry a heavy load of responsibility and are compensated accordingly. In order to be a CRNA, advanced education and training are required. The field is demanding, and thus the preparation for it must be as well.
In Kansas, CRNAs make up 70 percent of the anesthesia providers, and 83 percent of the hospitals in our state rely exclusively on CRNAs for anesthesia care.
Generally, the path to becoming a CRNA begins with a 4-year undergraduate degree in nursing or another field. Although it is not required to possess a degree in nursing, a current license as a registered nurse is required to enter a nurse anesthesia program. After acquiring the necessary experience in an acute care setting, students will enter a doctorate program accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs (COA). Clinical residencies afford supervised experiences for students during which time they are able to learn anesthesia techniques, test theory, and apply knowledge to clinical problems. Students gain experience with patients of all ages who require medical, surgical, obstetrical, dental, and pediatric interventions.
Graduates must then pass the national certification examination. Recertification is required of CRNAs on a biennial basis.
CRNAs administer anesthesia and anesthesia-related care in four general categories: (1) pre-anesthetic preparation and evaluation; (2) anesthesia induction, maintenance and emergence; (3) post-anesthesia care; and (4) perianesthetic and clinical support functions.
CRNAs also provide clinical support services outside of the operating room. Anesthesia and anesthesia-related services are expanding to other areas, such as MRI units, cardiac catheterization labs and lithotripsy units. Upon request or referral these services include providing consultation and implementation of respiratory and ventilatory care, identifying and managing emergency situations, including initiating or participating in cardiopulmonary resuscitation that involves airway maintenance, ventilation, tracheal intubation, pharmacologic, cardiopulmonary support, and management of blood, fluid, electrolyte and acid-base balance.
Administrative and Other Professional Roles
Many CRNAs perform administrative functions for departments of anesthesia. The services provided by these department directors and managers are extremely important to the overall functioning of an anesthesia department and directly affect the efficiency and quality of service provided. These functions include personnel and resource management, financial management, quality assurance, risk management and continuing education.
Some CRNAs have chosen to specialize in pediatric, obstetric, cardiovascular, plastic, dental or neurosurgical anesthesia. Others also hold credentials in fields such as critical care nursing and respiratory care. In addition to their membership in the AANA, many CRNAs also belong to in a variety of anesthesia and subspecialty organizations, including the following:
International Anesthesia Research Society
American Society of Regional Anesthesia
American Association of Critical Care Nurses
American Society of Perianesthesia Nurses
Association of PeriOperative Room Nurses