Nurse anesthetist
A nurse anesthetist (AE) is a registered nurse educated and trained to administer anesthesia. Their title, Certified Registered Nurse Anesthetist (CRNA), reflects their qualifications and abilities.
Education
Nurse anesthetist education and training varies in different nations. In the United States, for example, education is overseen by the American Association of Nurse Anesthetists' Council on Accreditation of Nurse Anesthesia Educational Programs.
Historically, CRNAs received an anesthesia diploma or certificate. However, a master's degree is the current point of entry into the CRNA profession. In the U.S., nurse anesthetists must first complete a four-year Registered Nursing baccalaureate degree. Then, most nurse anesthesia programs in the United States require a minimum two years of nursing experience in a critical or acute care environment. Because most programs have far more qualified applicants than available spaces, successful candidates usually have several years of experience in nursing in addition to specialized education in nursing or other health disciplines. Following that, applicants to nurse anesthesia school compete to enroll in an accredited program of anesthesia education for an additional two-and-a-half to three years which combines intensive theory, didactic education and clinical practice. Upon completion of their education and passage of a national certification examination, they are then certified by the Council on Certification of Nurse Anesthetists (CCNA). Most CRNAs have master's degrees in either anesthesia or nursing. CRNAs also have continuing education requirements and a recertification program every two years thereafter, plus any additional requirements of the state in which they practice.
Some nurse anesthetists continue their education to the terminal degree level, either earning a Ph.D., DNSc (Doctor of Nursing Science) or DNP (Doctor of Nursing Practice). At the terminal degree level, nurse anesthetists have a wider variety of professional choices available to them, and may teach, participate in administration or pursue research. Approximately 42% of the United States' 28,000 CRNAs are men, versus approximately 5% in the nursing profession as a whole.
Scope of practice
CRNAs practice in all 50 United States. Each state's Board of Nursing has its own regulations for professional Nursing practice and establishes practice guidelines for nurse anesthetists. All states have nurse anesthetist associations, which govern nurse anesthesia practice. In addition, nurse anesthetists train and practice in 107 different countries, as delegates from other counties participate in the yearly World Congress of the International Federation of Nurse Anesthetists. Recent studies find anesthesia care worldwide is operationally a nursing function.
CRNAs practice in a wide variety of settings including for the military, in public and private sectors, traditional hospital settings, pain clinics, physician's offices, or solo. They may work with podiatrists, dentists, anesthesiologists, surgeons, obstetricians and other professionals requiring their services. CRNAs can administer anesthesia in all types of surgical cases, applying all the accepted anesthetic techniques - general, regional, local, or sedation.
According to the American Association of Nurse Anesthetists, CRNAs provide the majority of anesthetics in rural settings in the United States, and in over two-thirds (66%) of all rural hospitals are the sole anesthesia providers. CRNAs may practice as employees, independent contractors, in an as-needed basis, or in short-term contractual agreements often called locum tenems.
State laws vary, but CRNAs may work independently, under the direction of supervision of, in collaboration with, or with the consent of a physician in all 50 states. In none is there a requirement for anesthesiologist supervision.
Compensation
According to numerous salary reports throughout the years, CRNAs remain the highest compensated of all nursing specialties. Their average reported annual salary range in 2005, reported by the AMGA Medical Group Compensation and Financial Survey, was $130,000.[1]
History
Nurse anesthetists have been providing anesthesia care in the United States for over 125 years and were the first professional group to specialize in and provide anesthesia services in the United States. Nurses first provided anesthesia to wounded soldiers during the Civil War. In the 1880's, at St. Mary’s Hospital in Rochester, Minnesota (now the Mayo Clinic), Dr. William W. Mayo, and Alice McGaw, who is identified as the "mother of anesthesia", set up a showcase for surgery and anesthesia and attracted students from across the United States and the world. Four formal educational programs to prepare nurses as anesthetists were in existence before World War I. More than 90% of this country’s nurse anesthetists are members of the American Association of Nurse Anesthetists.
In the US Military, CRNAs provide a critical peacetime and wartime skill. During peacetime, they provide the majority of anesthesia services for the retired service member, active duty military and their dependents. CRNAs function as the only licensed independent anesthesia practitioners at many military treatment facilities, including Navy ships at sea. They are also a leading provider of anesthesia for the VA and Public Health medical facilities. During wartime, they are usually the primary anesthesia providers at forward positioned medical treatment facilities, and play a key role in the education and training of nurses and technicians in the care of trauma patients. In addition, CRNAs have provided the majority of anesthesia services in every U.S. war during the 20th century. They are represented by such heros Second Lieutenant Mildred Irene Clark, CRNA, BA, who provided anesthesia for casualties from the Japanese bombing of Pearl Harbor. American military CRNAs have been casualties, POWs, and have served directly in the heat of battle.
External links
- American Association of Nurse Anesthetists
- Council on Certification of Nurse Anesthetists
- The International Federation of Nurse Anesthetists (IFNA), representing 45,000 nurse anesthetists worldwide
- Anesthesia History
- Nurse Anesthesia Associations
- Nurse Anesthetists at a Glance
- No Significant Differences in Anesthesia Outcome by Provider
- Resource Website for Student Nurse Anesthetists and CRNAs