National CRNA Week is the American Association of Nurse Anesthetist's annual celebration of anesthesia patient safety and the nation's 49,000-plus certified registered nurse anesthetists.
CRNAs (certified registered nurse anesthetists) are registered nurses educated, trained and licensed to administer anesthesia. They administer anesthesia to patients in nearly every clinical setting where a procedure requiring anesthesia is being done. The vast majority of rural hospitals in the U.S. depend on the professional skills of CRNAs in surgical suites and obstetrical delivery rooms. They can also be found in physician and dentist offices, public health departments and the military, both at the front line treating wounded soldiers and at VA hospitals. CRNAs administer approximately 40 million anesthetics to patients in the U.S. each year.
The roots of the CRNA profession go back to when nurses administered anesthesia to wounded soldiers on the battlefields of the Civil War. The CRNA credential came into existence in 1956 and is now overseen by the Council on Certification of Nurse Anesthetists. Currently, there are 49,000 nurse anesthetists in the United States and 512 CRNAs in Colorado, according to the American Association of Nurse Anthesthetists.
Today, CRNAs are master's or doctoral prepared advance practice nurses who enjoy a high degree of autonomy and professional respect. They are required to have a bachelor's degree in nursing, registered nurse licensure, a minimum of one year acute care experience (such as ER or ICU), and the successful completion of both an accredited nurse anesthesia education program and the national certification examination. They are licensed, independent practitioners.
In Colorado, 99.9 percent of counties with surgical services use CRNAs to administer anesthesia in various health care settings, with 71 percent of Colorado rural hospitals using CRNAs as the sole anesthesia provider. CRNAs have a long history of safe patient outcomes.
Delta County Memorial Hospital is fortunate to have a team of CRNAs who have worked for the hospital for up to three decades. They include Kathy Akers, CRNA, MS - 11 years; Christine Hamilton, CRNA, MS - 13 years; Chris Marshall, CRNA - 30 years; Jerry Young, CRNA - 30 years; Heather Driver, CRNA; and Joseph McBeain, CRNA.
"The really great thing about CRNAs who have lived in this community for awhile is that wherever we go, the grocery store, bank, restaurant or Walmart, we see patients we know who also recognize us as professional CRNAs," commented Kathy Akers. "Some patients and families we have known and worked with for a couple of generations in one family," she added. "These personal relationships with patients are a bonus to everyone -- we know their family and medical history and they know and trust us as professional CRNAs."
At DCMH, all patients are seen by one of the aesthesia providers prior to surgery. Some are seen days or weeks in advance and some are seen just prior to their procedure. This pre-anesthetic visit is used to assess patient health history which includes past surgeries, any past anesthetic complications, a review of current illnesses and disease processes as well as all medications and treatments currently in use, and drug or food allergies which may interfere with the anesthesia drugs. The type of anesthesia to be used is also discussed. Sometimes lab work, EKGs, and/or chest X-rays may be ordered. The more complicated patients may require collaborative work involving the CRNAs, internal medicine and cardiology as well as the surgeon.
Once the anesthetic is administered to a patient, the CRNA is at the bedside during the entire surgical procedure until the patient is safely in the recovery room. A patient having any type of anesthetic is monitored continuously for changes, even subtle ones, in vital signs. Changes may indicate the need for more, or different, medications, keeping in mind the patient and their individual issues.
Some surgeries are more complicated than others. Some patients are more complicated than others. At times problems arise during surgery. The CRNAs work together on problem solving those difficult cases.
"This hospital administration, as well as the physicians and surgeons, are very supportive of the CRNAs at DCMH, encouraging us to practice in the absolute best way to benefit each patient and to ensure the utmost in patient safety and positive outcomes," said Akers.
So the next time you, or a family member, are scheduled for a surgery, either in-patient or same-day surgical procedure, know there is an experienced professional, local CRNA who will make sure that any anesthestic medications that are needed for your care will be administered in a professional manner. Their job is to keep you safe and comfortable for any type of surgical procedure. And who knows? They may turn out to be a neighbor of yours, too!