Nurse Anesthetist

In the United States, Nurse Anesthetists have been providing anesthesia care to patients for more than 125 years now. A Nurse Anesthetist is a registered nurse and also an advanced practice nurse who has undergone special education and training to administer anesthesia. They are certified by the Certified Registered Nurse Anesthetist (CRNA) which reflects the nurse’s qualification. As per the numerous salary reports throughout the various years, the CRNA’s have been the highest compensated among all the nursing specialties. As per the AMGA Medical Group and Financial Survey, the average reported annual salary range in 2006 for a CRNA was approximately $140,000.

Certified Registered Nurse Anesthetist – History

The Nurse Anesthetists have been around in the United States for more than 125 years now and were also the first ‘nursing specialty group’. Catherine S. Lawrence was the first nurse to provide anesthesia during the civil was in 1861. As the physician residences in anesthesia did not exist very early on, many doctors attended these programs to learn anesthesia. Ms Magaw is often referred to as the ‘Mother of Anesthesia’. She set up a showcase for surgery and anesthesia that attracted many students from the United States and America.

After immense popularity, the nurse anesthesia specialty was formalized on June 17, 1931 and the National Association of Norse Anesthetist (AANA) held their first meeting which was organized by Agatha Hodgins. The main objectives of this organization were to establish a national qualifying examination and also establish an accreditation program for nurse anesthesia schools. The first national certification examination was held on June 4, ,1945 and 92 candidates took the exam.

Certified Registered Nurse Anesthetist – Scope

CRNA practice in all the 50 states of American and administer more that 27 million anesthetics to patients in a year. The Nurse Anesthetists work as independent licensed practitioners. Some states maintain some degree of supervision but this varies as per the laws of the state. The State Law does not define any aspect of practice rather it only defines the extent of supervision or collaboration with the surgeon or anesthesiologist. Any restrictions placed on the CRNA are dependent on the hospital’s credentialing process and also the anesthesia department’s guidelines. These privileges are based on prior training, certification and experience, similar to those of a physician.

The CRNA’s practice in an array of settings including traditional hospital settings, public and private sectors, physician’s office and in some cases also has a solo practice. They also play an important role in the Veterans Administration (VA), military and public health. Very often they also provide care along with an anesthesiologist in an Anesthesia Care Team.

CRNA’s can administer anesthesia in all types of surgical cases and can apply all the accepted anesthetic techniques like general, regional, local and sedation. The CRNA’s also also gaining a lot of prominence in the developing and under developed countries were a good anesthesiologist is either not available or is very expensive. Hence in 1989, ‘International Federation of Nurse Anesthetists (IFNA) was established which became an authoritative voice for the nurse anesthetists across the world. This organization has also developed standard of education, practice and code of ethics.

Certified Registered Nurse Anesthetist – Requirements

The education and experience required to be certified by the CRNA include the following:

• Current license as a registered nurse.
• A minimum of one year of experience as a registered nurse in an acute care setting.
• A Bachelor of Science degree in Nursing (BSN) or an equivalent baccalaureate degree.
• A master’s degree from an accredited nurse anesthesia educational program. There are about 110 nurse anesthesia programs available with more than 1700 affiliated clinical sites in the United States, These programs include clinical training in large community or university hospitals and the duration varies between 24 – 36 months depending on the program and the state offering the program.
• A national certification examination has to be cleared once the graduation is complete.

There is also a process of re-certification and all CRNA must obtain a minimum of 40 hours of approved continuing education every two years along with documenting substantial anesthesia practice, maintaining state license and lastly certifying that they have not developed any conditions that could affect their abilities to administer anesthesia in an adverse manner.