A nurse anesthetist is an advanced practice nurse who specializes in providing anesthesia services to patients in a great many different settings and for all kinds of different reasons. This article will explain how to become a Certified Registered Nurse Anesthetist (CRNA):
The History of Nurse Anesthetists – Some people mistakenly think that the concept of a nurse, rather than a doctor administering anesthesia before a medical procedure is a new one but that is far from the case.
The history of the nurse anesthetist profession dates all the way back to the 1850s and the Crimean War. During that campaign “real anesthesia” – nitrous oxide, chloroform and ether – were all used in field hospitals on a regular basis for the first time – the techniques having been introduced in both America and Europe about ten years earlier. Anesthesia was primarily administered to the wounded soldiers by the growing number of nurses (at that time almost exclusively women) who were following Florence Nightingale’s lead into the nursing profession. When the American Civil War broke out just a few years later nurses in the US also headed out to the battle fields to provide anesthesia services and were , in essence, the first nurse anesthetists.
In Cleveland, Ohio in 1908 a nurse who had been working as a surgeon’s private anesthetist, Agatha Hodkins, had become so adept at her job that she began teaching other nurses on an informal basis. That passion for educating others lead she and her boss, Dr George Chiles to travel Europe teaching nurses and doctors there about the advantages of a nurse anesthetist and upon their return to Cleveland they founded the Lakeside Hospital School of Anesthesia. Several years later in 1931 Hodkins had a sufficient numbers of graduates from her schools to gather together her new peers and create the the National Association of Nurse Anesthetists, which was renamed the American Association of Nurse Anesthetists (AANA) in 1939 and still exists (and partially governs) the profession today.
In 1934 the then NANA began discussing how to implement a formal qualification that would serve as certification for nurse anesthetists. The first such exam was administered in 1945 but certification and accreditation did not become mandatory for a nurse anesthetist to practice until 1978.
Research has consistently shown that there is no difference in the level of skill or the quality of care provided by a certified registered nurse anesthetist than there is an anesthesiologist who holds an MD. Recent research has also shown that anesthesia in the 21st century is safer than it ever has been, thanks mainly to the higher levels of education that CRNA candidates receive. In a 1999 report the Institute of Medicine found that anesthesia care in the US was about 50 times safer than it was found to be in the early part of the nineteen eighties.
Where Nurse Anesthetists Work – Nurses anesthetists can often be found working wherever there is a need for anesthesia services. More than 2/3 of the rural hospitals in the US rely only on the services of a nurse anesthetists to meet their patients needs and good CRNA (certified registered nurse anesthetists) candidates are always in demand in these facilities.
CRNAs do not only work in hospital settings though. They can be found in dentists’ offices, doctors offices that perform small in office surgical procedures and nurse anesthetists are still the primary providers of anesthesia services for the military all over the world.
What do Nurse Anesthetists Actually Do? – Wherever they work a CRNA has basic duties that do not change from setting to setting. In the course of his or her work a CRNA must:
- Be responsible for performing a basic physical assessment prior to anesthesia to help ensure the patient is a suitable candidate.
- Provide or at least particiapte in pre op education for the patient.
- Prepare patients for the adminstarion of anetrhseis both physically and as far as possible emotionally
- Actually admianater the initail anesthesia and maintain it during the surgery while monitoring the patient’s vital signs and condition at all times.
- Oversee the patient’s recovery from the anesthesia once they are awoken.
The Education Required to Become a CRNA – Back when Miss Hodkins first founded her nurse anesthetist school there was no formal certification or indeed any real requirements beyond holding a registered nurse license to become a working nurse anesthetist. That has changed a great deal over the years though.
In 1986 the AANA decreed that from then on in order to enter a formal nurse anesthetist training program (CRNA school) a nurse must not only hold a registered nurse designation but also have earned a Bachelors of Science in Nursing. The rules changed again in 1998 when it was decided that all such programs must award an advanced degree in the form of a Masters degree. By 2025 the AANA has no decreed that they would like to see doctoral level education become the standard for new nurse anesthetists entering practice but as of 2011 no formal plan for the implementation of such rules had been created.
How Long Does a Nurse Anesthetist Program Take to Complete? – On average an accredited nurse anesthetist program takes 24 to 36 months to complete depending upon whether a nurse is a full time or a part time student. These nurse anesthetist schools include both a clinical and a classroom component and there is a mandatory amount of time spent working under the supervision of licensed professionals in a hospital; setting.
In order to gain entrance into any accredited CRNA program in 2011 a nurse must be a currently licensed RN with a BSN, have at least one to two years of experience working in a critical or acute care setting and have achieved a GPA of at least 3.0 when they gained their BSN.
In order to be eligible to take their certification exam after they graduate a CRNA candidate must attend a program that has been accredited by the AANA. The organization maintains a list of such programs at their website at http://www.aana.com. The list is a great resource for those considering entering such a program as it details the course basics and provides up to date contact information for each school so that a prospective student can easily investigate those programs that interest them further.
The Outlook for Certified Registered Nurse Anesthetists – Opportunities for CRNA jobs are projected to continue to increase all over the country, especially as managed care becomes the norm for all insurance companies and hospitals are forced to try to keep their costs down.
In addition to being the sole providers of anesthesia for 2/3 of the nation’s rural hospitals CRNAs are also found in large numbers in urban inner city hospitals as well. In many cases without the services of a CRNA many of these facilities would be unable to offer proper care to their patients so many of them offer signing bonuses and tuition forgiveness programs to candidates willing to sign a longer term contract to work for them.
A CRNA may also find work in a private doctor’s or dentists office and these can often be very lucrative positions. On average though whatever setting they choose to work in according to the AANA one can expect, in 2011, to be able to command an annual Certified Registered Nurse Anesthetist (CRNA) salary of at least $105,000, although that figure is often higher and will increase with experience.