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Nurse Anesthesia: A Specialty with Endless Opportunities
by Marlene McDowell Minority Nurse Writer
One of the most critical components in surgery is anesthesia, and Certified Registered Nurse Anesthetists continue to play a pivotal role in its practice. And because of the autonomy, one-on-one patient care, and critical-thinking skills required, becoming a CRNA can lead to many exciting career paths.
While CRNAs administer more than 32 million anesthetics annually to patients, many people are unaware of the myriad of professional options available to them. Wherever anesthesia is delivered, nurse anesthetists practice: traditional hospital surgical suites and obstetrical delivery rooms; critical access hospitals; ambulatory surgical centers; the offices of dentists, podiatrists, ophthalmologists, plastic surgeons, and pain management specialists; and U.S. military, Public Health Services, and Department of Veterans Affairs health care facilities. Many CRNAs are often amazed at the twists and turns their career paths take after becoming a nurse anesthetist, but for the anesthesia professionals here, they would not have it any other way.
Where anesthesia can lead
According to the American Association of Nurse Anesthetists (AANA) 2009 Practice Profile Survey, most CRNAs derive their income from a group practice (33%) or a hospital (35.3%). In addition, 96% of full-time CRNAs reported working primarily in one of the aforementioned practice settings. The remaining CRNAs are evenly split between management, administration, and education, and an overwhelming number of nurse anesthetists find their career choice fulfilling. The survey also revealed that 37% of full-time CRNAs have been practicing for more than 20 years.
Get certified!CRNAs must meet the following requirements in order to practice: • A Bachelor of Science in Nursing (B.S.N.) or other appropriate baccalaureate degree • A current nursing license • At least one year of experience as a registered nurse in an acute care setting • Graduation from an accredited nurse anesthesia educational program • Passing the national certification examination following graduation In order to be recertifi ed throughout their careers, CRNAs must also complete the following: • Obtain a minimum 40 hours of approved continuing education every two years • Document substantial anesthesia practice • Maintain a current state licensure • Prove they have not developed any conditions that could adversely affect their ability to practice anesthesia
Six years after Elizabeth Ann Thompson, C.R.N.A., became a registered nurse, she began looking for a position that was more challenging but allowed her to stay in the clinical area. "On the advice of two nurse anesthetists, I considered becoming a CRNA. I was a little reluctant at first; however, the more I found out about the profession, the more it intrigued me," she says. Thompson finds it surprising that much of the public and health care professionals alike still do not realize that there are nurses who administer anesthesia. "Although I work in a hospital care team setting, I like the fact that many nurse anesthetists are the primary providers of anesthesia in rural America. I provide anesthesia for a great deal of orthopedic and eye surgeries," she says. "Thirty-two years later, I still really enjoy what I do."
Less than two years into his career as a nurse anesthetist, Nelson Aquino, C.R.N.A., M.S., recognized his passion for working with younger populations and wanted to elevate the level of care he was able to offer his pediatric patients. "I decided to enter anesthesia school in 2006...to allow myself to have more one-on-one patient care with the children facing surgery," he says. "It is a great feeling to be able to help a child and his or her family during one of their most vulnerable moments. Knowing that I am able to ease their worries and comfort them is the best part of my job."
In order to advance the profession of nurse anesthesia, dedicated educators are needed to teach future nurse anesthetists how to provide the quality care that has been the hallmark of the profession for nearly 150 years. CRNAs can become clinical and didactic educators, as well as program directors. A CRNA since 1997, Juan Quintana, C.R.N.A., M.H.S., D.N.P., had worked in the ICU for 10 years before deciding to become a nurse anesthetist. Quintana practices anesthesia and works as a clinical coordinator for nursing schools in Texas. Among other things, coordinators do the clinical scheduling between college or university nurse anesthesia programs and teaching hospitals. CRNAs can also supervise during clinicals, providing students with hands-on experience administering anesthesia and allowing them to put into practice what they’ve learned in the didactic setting. "If you enjoy health care and autonomy, if you fi nd yourself wishing you could do more for patients, if you love helping patients feel better and handle stressful situations in their lives, then this is a great job for you," Quintana says.
The commitment and sacrifice of CRNAs in the military has contributed much to the rich history of nurse anesthesia in the United States. Nurse anesthetists have been the main providers of anesthesia care to U.S. military personnel on the front lines since WWI, including current conflicts in the Middle East. Nurses first provided anesthesia to soldiers on the battlefields of the Civil War. It was the military that started Derrick Glymph, C.R.N.A., D.N.A.P., down the path to a career in nursing. "I initially became a licensed practical nurse through the military. After completing that program, a nursing mentor encouraged me to complete my [Bachelor of Science in Nursing] degree," he says. "After learning about nurse anesthesia, I realized it fi t my needs and desire for more autonomy." An Army reservist for 19 years, Glymph holds the rank of major. Since graduating from nurse anesthesia school in 2004, he was deployed to Afghanistan with a Forward Surgical Team as the sole anesthesia provider, then mobilized to the Walter Reed Medical Center in Washington, D.C. In 2008, Glymph returned to school to earn his Doctor of Nursing Practice, which he completed this year. "A terminal degree in my field did not exist when I entered nurse anesthesia school, and now it’s a reality for me," Glymph says. "Obtaining this degree has allowed me to encourage other minority nurses to also pursue one."
One of the most highly regarded nursing specialties, nurse anesthetists have been leaders in the nursing and health care community for decades. As advanced practice registered nurses, CRNAs carry a heavy load of responsibility and are compensated accordingly. "Throughout my time in the military and since becoming a nurse anesthetist, opportunities for leadership and education continue to come my way," Glymph says. And the field continues to grow and evolve. Even before the turn of this century, anesthesia care was nearly 50 times safer than in the early 1980s, according to a report from the Institute of Medicine. "You have the knowledge and experience," Quintana says. "You must take control of the situation and take action."