Improving Diversity in Graduate Nurse Anesthesia Programs

Improving Diversity in Graduate Nurse Anesthesia Programs

Racially and ethnically diverse populations have grown in the US. The US Census Bureau finds that approximately 37% of the population is made up of minority groups. Nurses currently make up the largest group of health care professionals in the US, and the need for culturally diverse nurses in the workplace has been identified by many nursing leaders. The demand for culturally competent care has brought attention to the need for culturally diverse nurses. Several studies have identified that failure to provide culturally competent care can influence health outcomes. A 2009 study published in Health Affairs found that increasing minority representation in the health care workforce could have a positive effect on curbing the health care disparities found in minority populations. 

The need for culturally competent health care highlights the need for a diverse nursing workforce, particularly since patients tend to migrate towards providers that share their ethnic background. Minority nurses and possibly advanced practice nurses are in a position to help these often underserved minority communities receive care that will increase their likelihood of compliance with medical treatment and increased health literacy.

Additionally, implementation of the Affordable Care Act will allow for the expansion of health insurance to historically underserved populations. This expansion will require an increase in the number of health care professionals available to care for these populations.

Of the almost 3 million registered nurses in the US, approximately 133,000 are black and 55,000 are Hispanic. A 2013 study published in Journal of Transcultural Nursing reveals that minority students account for about 27% of the students in undergraduate schools of nursing. The low number of minority students represented in the undergraduate nursing school enrollment numbers highlights the difficulty noted by graduate schools when it comes to attracting and enrolling minority registered nurses.

Federal initiatives like the Promoting Postbaccalaureate Opportunities for Hispanic Americans program authorized under Title V of the Higher Education Act of 1965 are designed to expand postbaccalaureate opportunities and academic offerings for universities that are educating the majority of postsecondary Hispanic students. According to a 2010 brief published by Excelencia in Education, there were 176 emerging Hispanic-Serving Institutions (HSIs) in 2007. Federal law requires that in order to receive a designation as a HSI, an institution must have at least 25% Hispanic undergraduate enrollment. Emerging HSIs are those with Hispanic enrollment within the range of 12% to 24% and have the potential to become HSIs over the next few years. The HSI designation allows an institution to qualify for grants and other modes of funding. A 2010 study published in Journal of Latinos and Education found that, behind funding, the most important issue facing the presidents of HSIs was the lack of academic preparedness of the students.

Challenges are faced by Hispanic nurses desiring to pursue advanced nursing degrees. Like undergraduate enrollment, the number of registered nurses with baccalaureate degrees applying for advanced practice nursing tracts is low. There are four HSI institutions that offer nurse anesthesia in these fine programs: University of Miami, Kaiser Permanente / California State University, Inter-American University of Puerto Rico, and the University of Puerto Rico. A relatively large Hispanic applicant cohort of prospective students submit to these diverse nurse anesthesia programs along with other urban located institutions within the US. A barrier that some underrepresented students encounter is the lack of academic preparedness and/or lackluster graduate exam scores. This lack of academic preparedness equals fewer applicants who are adequately prepared for undergraduate and graduate education. In the event that a student is successful in an undergraduate program, lack of preparedness could lead to the preparation of a graduate application packet that is not representative of the candidate’s true potential.

Optimization of the nurse anesthesia program application packet can mean the difference between acceptance and rejection. The graduate application for nurse anesthesia school normally contains many components. The application is the first glimpse of the candidate presented to the admission committee. One crucial component of the process is the essay. The essay should contain information that the candidate wants to express describing his or her participation in leadership and extracurricular activities. Admission committee members take note of well-rounded candidates. Candidates should include evidence of involvement in professional nursing organizations and hospital committees. These types of activities highlight the candidate’s desire for professional development. The essay should be edited for grammar, spelling, and content before the packet is submitted to ensure that the candidate appreciates attention to detail.

The construction of a comprehensive application will most likely yield an interview, but the interview process can be intimidating. Most admission committees attempt to evaluate the student’s preparedness for the rigors of the program. The types of questions revolve around principles of physiology, pathophysiology, and pharmacology. Candidates who recognize their deficiency in interviewing should seek out opportunities to practice these techniques. Career centers may offer opportunities to hone interviewing skills.

Prospective students tend to focus on securing a seat in a nurse anesthesia program, but it is unclear how many actually consider the rigorous nature of the program. The amount of preparation that goes into the admission to a nurse anesthesia program is only minimized by the challenges of the didactic and clinical experiences for a new student. These challenges should be considered in conjunction with other stressors that can include financial obligations, reduction of income, and family responsibilities.

How to Strengthen your Application and Secure an Interview

According to the American Association of Nurse Anesthetists (AANA)’s 2012 demographics of nurse anesthetists in the United States and Puerto Rico, as an aggregate number, there is less than 10% of underrepresented minority nurse anesthetists from the 44,000 advanced practice nurses practicing in hospitals, surgery and endoscopy centers, and dental and pain management offices. Less than 3%, 3.2%, and 0.5% are from Hispanic, African American, and American Indian groups, respectively. To learn more about becoming a certified registered nurse anesthetist (CRNA), visit www.aana.com/ceandeducation/becomeacrna. Here, students will find information about the requirements of becoming a CRNA as well as a list of accredited nurse anesthesia programs, frequently asked questions, and a list of related published articles. It is imperative that prospective applicants into a nurse anesthesia program peruse not only the nurse anesthesia program of interest website, but also our national nurse anesthesia association website.

It is vitally important that underrepresented minority nurses learn more about the history of nurse anesthesia and national implications of advocacy. The book Watchful Care by Marianne Bankert is a great resource. It will expand your knowledge about nurse anesthetists and prepare you adequately for the interview, if the admission committee members ask any questions about this well-read topic. The top candidates definitely shine during the interview if they have read this material.

Another way to strengthen your application is to include your shadowing experience with a CRNA in the operating room. You should contact the CRNA and ask to meet him or her in the operating room on an agreed time. Be prepared to witness the CRNA prepare the room by checking the anesthesia machine and related equipment as well as prepare medications for the planned anesthetic prior to a patient’s arrival in the operating room. In addition, you will witness the CRNA interview the patient extensively about his or her medical and surgical history, review and secure the anesthesia consent, and perform an oral exam to assess a Mallampati score (I – IV) to anticipate an easy or difficult intubation prior to entering the operating room. During the shadowing experience, ask plenty of questions about what type of anesthetic is being administered (such as general, regional, or sedation), fluid management, positioning considerations, and more.

Along with learning the history of nurse anesthesia, as a critical care nurse with a baccalaureate degree, you should study and schedule the critical care registered nurse (CCRN) exam offered by the American Academy of Critical Care Nurses (AACN). Information regarding this exam can be found on the AACN website (www.aacn.org). This test demonstrates aptitude in critical care nursing and professional commitment towards excellence. A significant number of nurse anesthesia programs require applicants to earn critical care experience and sit for and pass the CCRN exam prior to actual submission of the essay for a nurse anesthesia program.

Another viable option for underrepresented minority nurses to improve the application process, handle the stressful interview, comply with the rigor of a nurse anesthesia program, excel for clinical preparedness, and learn about doctoral programs in nurse anesthesia programs is to register and attend Diversity CRNA Information Sessions & Airway Simulation Labs scheduled in 2014. This event, sponsored by the Diversity in Nurse Anesthesia Program (www.diversitycrna.org), offers an opportunity to those interested in nurse anesthesia education to fully engage oneself and learn comprehensive information about the process, network, and participate in a hands-on simulation experience in the lab. You will also have the opportunity and access to meet four nurse anesthesia program directors, AANA senior leadership, minority CRNAs, and nurse anesthesia students from across the country. As a result, you will have the ability to include details about your experience in your eventual essay and articulate it during your interview.

An additional application requirement of some anesthesia programs is the Graduate Record Examination (GRE). It is incumbent of any prospective applicant to visit the GRE website (http://www.ets.org/gre) to learn about the comprehensive information about the scores and the actual make-up of the exam (verbal reasoning, quantitative reasoning, and analytical writing).

So, now it is up to you. Will you peruse through the suggested websites to broaden your knowledge base about proper preparation for entry into nurse anesthesia? Do you want to be a competitive applicant for a nurse anesthesia program? Do you want to be academically and clinically prepared for such a program? If you answered yes to these questions, be proactive in your educational goals to advance your professional development in a nurse anesthesia program. You can do it!

Wallena Gould, CRNA, EdD, is the founder and chair of the Diversity in Nurse Anesthesia Mentorship Program (www.diversitycrna.org) and chief nurse anesthetist at Mainline Endoscopy Centers.

Martina Steed is a CRNA and Associate professor and Assistant director in the Department of Nurse Anesthesia at Webster University in St Louis, Missouri.  She is also a small business owner and PhD candidate in the College of Health Sciences at Walden University.

Minority CRNAs and Student Registered Nurse Anesthetists: Soaring to New Heights with Doctoral Degrees

Minority CRNAs and Student Registered Nurse Anesthetists: Soaring to New Heights with Doctoral Degrees

So many are called, but only a few are chosen! You have finally made the decision to apply to a nurse anesthesia program. Before you start navigating any of the 113 accredited nurse anesthesia programs’ websites and firing up the search engines, you must be proactive in being well acquainted with the most updated Practice Doctorate Standards for Accreditation of Nurse Anesthesia Programs. These proposed changes will determine what doctorate degree will be awarded upon successful completion of a nurse anesthesia program.

How do you become a Certified Registered Nurse Anesthetist (CRNA)? In order to be a CRNA, you must graduate from a nurse anesthesia program accredited by the Council of Accreditation of Nurse Anesthesia Educational Programs (COA) and successfully pass the national certification examination administered by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA).

Today, CRNAs are masters’ or doctorate-level advance practice registered nurses (APRNs). Although there are many accredited nurse anesthesia programs offering master’s degrees including Master of Science (MS), Master of Science in Nurse Anesthesia (MSNA), and Master of Science in Nursing (MSN), you may consider applying to a nurse anesthesia program that offers a Doctor of Nursing Practice (DNP) or Doctor of Nurse Anesthesia Practice (DNAP). Many nurse anesthesia programs are currently in transition into doctoral degree programs in nurse anesthesia. It has been determined by the COA, that by 2025, all accredited nurse anesthesia programs will be mandated to offer a doctoral degree including DNP or DNAP.

In addition, in June 2007, the American Association of Nurse Anesthetists (AANA) Board of Directors adopted a position statement on a proposed change for all nurse anesthesia programs to transition from master’s degree programs into doctorate degree programs by 2025. Nursing schools and allied health programs will award DNP and DNAP degrees upon completion of a capstone project and fulfilling the requirements of the nurse anesthesia curriculum. AANA Chief Executive Officer, Wanda Wilson, CRNA, PhD, stated, “to best position CRNAs to meet this challenge and remain leaders in anesthesia care, the AANA strongly supports doctoral education that encompasses technological and pharmaceutical advances, informatics, evidence-based practice, systems approaches to quality improvement, and other subjects that will shape the future for anesthesia providers and their patients.” Presently, many nurse anesthesia programs are hiring doctoral-prepared faculty and transitioning to the practice doctorate while others are still conferring master’s degrees.

Requirements for admission into a doctoral degree nurse anesthesia program include a bachelor’s degree in nursing or other appropriate baccalaureate degree; active RN licensure; a minimum of one to two years critical care experience; acceptable GRE and/or TOEFL; CCRN (preferred) scores (if applicable); a calculated GPA of 3.0 or higher; letters of references from nursing supervisors and/or colleagues; and a formal one-to-one panel intensive interview. Most, if not all, doctoral nurse anesthesia programs require candidates to complete and implement a capstone project. It is an evidence-based practice intensive written document that is subject to peer scrutiny and guidance approval by committee. In the DNP programs, your capstone project will be related to nurse anesthesia practice, leadership, or an education focus.

In the past five years, CRNAs with master’s degrees have been able to work and enroll in doctorate programs. Some of the CRNAs have completed a Doctor of Philosophy (PhD) and Doctor of Education (EdD) program that culminates in a dissertation and successful defense, while many have enrolled or been awarded a doctorate of nursing practice degree (DNP or DNAP). This article will illustrate six distinct interviews of minority CRNAs with DNP degrees and student registered nurse anesthetists who are in pursuit of their doctorate in nursing practice.

The following interview was conducted with Dr. Gould, CRNA, EdD, and Dan Lovinaria, CRNA, MBA, DNP, the associate director of the University of Minnesota’s BSN-DNP nurse anesthesia program.

Where did you obtain your master in nurse anesthesia?

Lovinaria: “I have been a registered nurse in Honolulu, Hawaii since 1991 where I obtained my bachelor of science in nursing (BSN) at the University of Hawaii at Manoa. While in Honolulu, Hawaii, I have worked in nurse specialties including rehabilitation, psychiatric, nursing home, risk management, telemetry, infection control, nursing staff education, and lastly, critical care nursing. After intensive exploration and understanding of the noble nurse anesthesia profession, I had decided to pursue my master in nurse anesthesia at St. Mary’s University of Minnesota and earned a certificate in nurse anesthesia at the Minneapolis School of Anesthesia in September 2000 and successfully obtained my master and certificate in December 2002.”

Where did you obtain your DNP and what was your capstone project on as your research focus?

Lovinaria: “While practicing as a full-time CRNA at Fairview Southdale Hospital, I had decided to pursue my doctorate in nurse practice (DNP) at the University of Minnesota in Minneapolis and successfully obtained the DNAP in December 2008. My clinical capstone project was on the “Implementation of Perioperative Blood Glucose Protocol in Diabetic Patients Undergoing Cardiac Surgery.”

What is the DNP degree? What are the criteria for the nurse anesthesia program for the DNP at the University of Minnesota?

Lovinaria: “A DNP is one of the highest terminal professional degrees in nursing that primarily emphasizes on translating evidence rather than generating new evidence or research. The DNP curriculum generally includes advance practice, leadership, informatics, teaching, health policy, program evaluation, ethics, and more importantly, application of clinical research. The DNP degree is to prepare registered nurses to become advance practice registered nurses, including: certified registered nurse anesthetist (CRNA), nurse practitioner (NP), certified nurse midwife (CNM), and clinical nurse specialist (CNS).”

What is the length of the program for a DNP at the University of Minnesota nurse anesthesia program? Would you suggest nurses search online well in advance before applying to a nurse anesthesia program and for mentoring opportunities?

Lovinaria: “The BSN-DNP program is a 36-month program (9 semesters) full-time study. The Post-MS DNP can be earned in one academic year (3 semesters) as a full-time student, or in two academic years (6 semesters) as a part-time student.

It is important that registered nurses of color be proactive in exploring and searching the specific nurse anesthesia programs of interest, understanding its requirements, and being strategic by taking the opportunities to visit nurse anesthesia programs to meet program directors. As an Associate Program Director of the BSN-DNP nurse anesthesia program at University of Minnesota, I highly recommend prospective students participate in shadowing different clinical CRNAs to understand the profession and attending nurse anesthesia information sessions, including the well-organized and established Diversity in Nurse Anesthesia Mentorship Program held all over the country.”

How does a student find a research focus on their capstone project? How is it different from a PhD dissertation?

Lovinaria: “DNP students learn about the components of the DNP scholarly leadership project by completing a series of three seminar didactic courses. Students complete the project-related clinical work and write their final DNP project paper under the direction of a faculty project director/advisor during a series of three project direction practicum.

Students are expected to submit capstone project proposals as part of their application packets. However, students also find generated evidence to translate into practice during their clinical rotation at various perioperative care settings.

A PhD dissertation is embodying results of original research and especially substantiating a specific view, whereas a DNP capstone project is translating evidence into clinical practice in ways that improve the quality and safety of patient care and outcomes, improve organizational systems, and processes.”

What type of support is provided for a nurse anesthesia student enrolled in the DNP program at the University of Minnesota?

Lovinaria: “Upon start of the DNP program at the University of Minnesota, students are immediately assigned to a faculty advisor to help facilitate, guide, coach, and direct them to successful completion of the program. Students are required to meet with faculty advisor on an ongoing basis for guidance and support.”

What opportunities exist for CRNAs with a DNP?

Lovinaria:CRNAs with DNP degrees will have opportunities to advance in various positions. DNP leads to degree parity with other health care professions and assist graduates to assume leadership roles in clinical practice including Chief CRNAs, Directors of Nurse Anesthesia, Anesthesia Program Directors, Clinical Professors, and Health Care Policymakers.”

The following interview was conducted with Dr. Gould, CRNA, EdD, and Wonedwesson Goshu, CRNA, DNP, of Texas.

Where did you obtain your MSNA?

Goshu: “I earned the Master of Science in Nursing Anesthesia at Saint Mary’s University of Minnesota, Minneapolis, in 2004. It was there that I was able to start building a network of fellow students, mentors, and professionals from the nursing industry to build upon both my education and experience as well as branch out into other areas of opportunity such as speaking engagements on a variety of topics related to obtaining a nursing degree, the anesthesia field, and DNP.”

Where did you obtain your DNP and what was your capstone project on as your research focus?

Goshu: “I graduated from the DNP program at Rocky Mountain University of Health Professions in 2011. My capstone project described the level of Advanced Practice Nurse (APN) knowledge, awareness, and attitudes toward non-operating room (non-OR) timeout procedures before and after participation in an online educational intervention. In this process, the researcher seeks to answer the following questions:

(a) According to the literature, what is the current level of health care knowledge regarding non-OR timeout procedures?

(b) What is the level of Advanced Practice Nurse (APN) knowledge, awareness, and attitudes toward non-operating room (non-OR) timeout procedures before and after participation in an online educational intervention and at a six-week follow-up?

Post-DNP, I have used my research in teaching and sharing my experiences with students and peers and it often proves very effective and invaluable to those seeking more information on what it is really like to pursue a DNP. By telling my personal story, I hope that men and women alike will realize that they too can reach these same goals.”

What is the DNP degree? Did you work while you were enrolled in the program?

Goshu: “A lot of organizations define what DNP is and I think my school website describes it well. In a nutshell, the Doctor of Nursing Practice (DNP) degree utilizes system redesign and evidence-based decision-making to implement their program, which effectively prepares advanced practice leaders to affect change in the health care industry, whether it be influencing health policies, social change and procedures, and more.

The setting provides its education through coursework, directed independent study, and capstone project implementation.

The DNP graduate is trained to adapt to a variety of venues amongst diverse demographics. Point of care is a major focus as is research, the pace of the industry and its demands, and the DNP program pinpoints the need for highly degreed individuals with a skillset and approach of leadership.

Social responsibility, consumer savvy, financial/clinical/political factor expertise, care model transformation; these are all study areas that the graduate becomes immersed in. There are so many more facets to it; I encourage anyone considering their DNP to research it further by looking online. I would also be happy to assist in any way I can to provide good information in a positive way because I believe in it wholeheartedly!

Yes, I worked full-time while attending school, which was hard at times, but well worth the effort. In hindsight, time management is the key to juggle family, work, and school under the pressure and I greatly benefitted from the experience and its challenges in many ways. It made me the person I am today and I am happy to share my story with those that are facing obstacles, searching for tools, and wanting to also share information.”

Did you have any speaking engagements on your capstone topic at state and national nurse anesthesia association meetings?

Goshu: “In August 2012, I was fortunate to be one of the AANA Annual Meeting speakers in San Francisco to share my findings from my research and how to improve and implement timeout to improve patient safety. My title was ‘Time Out for Patient Time.’

I found the experience very positive in so many ways. It was invigorating to be able to share my story, experience, and my knowledge with so many industry professionals. I was blown away to find that my passion for the subject matter and the industry as a whole could be even more inspirational—to me and hopefully others—when I was able to interact with a large audience. Having enjoyed comedy my whole life, I felt as though I had discovered a way to educate and entertain while speaking on a topic I love and that total experience has led me to follow this journey through speaking engagements, and it has been awesome!”

What opportunities exist for CRNAs with a DNP?

Goshu: “While attending the AANA meeting I was approached to apply for teaching positions. This is another example of the scope of opportunity available to CRNAs with a DNP. Remember, a DNP will implement evidence-based practice and policy strategies that optimize access to care and clinical outcomes. It prepares you for leadership roles in the nursing discipline itself, which reflects such rapid growth that this type of higher education is a benefit to nurses, doctors, and patients alike.

It has been my experience that the profession offers such diversity (Nurse Practitioner/NP, Certified Registered Nurse Anesthetist/CRNA, Certified Nurse Midwife/CNM) and is employment-rich—job opportunities are abundant and equally diverse—that I am continually striving to learn more, set goals, teach, mentor, and better my knowledge base every chance I get. That included obtaining my DNP and I have never regretted it.

Again, my passion for the industry has led me to speak out on the topic, especially to high school and college students, and I make myself available to do so at events, tradeshows, job fairs—even just corresponding to emails through my website. CRNA is a career worth pursuing and a DNP can only enhance the experience.”

The following interview was conducted with Dr. Gould, CRNA, EdD, and Dr. Angella Jones, CRNA, DNP, of Michigan.

Where did you obtain your Master in Nurse in Nurse Anesthesia?

Jones: “I received the DNP from Oakland University in 2011. My capstone project was ‘Angiotensin Converting Enzyme Inhibitor Induced Angioedema in a Midwestern Hospital.’ I observed what appeared to be an unusual number of African American patients admitted with this life-threatening condition, although when researching, I found that much of the literature used the term ‘rare condition’ when describing it. This piqued my interest and was the motivation for my capstone project.”

What is the DNP degree? Did you work while you were enrolled in the program?

Jones: “This degree is a practice doctorate. It is geared toward nursing clinicians performing as experts in their discipline. Many other professions have made the practice doctorate entry level. These professions include: dentistry, medicine, podiatry, pharmacy, and physical therapy. This degree is the next step in the evolution of advanced practice nursing. I worked full-time during my DNP education. The programs are usually flexible, and they are geared toward the working student.”

Do you teach as a faculty member in a nurse anesthesia program?

Jones: “I am a guest lecturer at University of Detroit Mercy in the anesthesia program and I am a full-time professor at South University. I teach advanced practice nursing students pharmacology, advanced pathophysiology, and advanced nursing practice.”

What opportunities exist for CRNAs with a DNP? And, why is it important to get a DNP?

Jones: “The opportunities available for those obtaining the DNP are both personal and professional. Personally, there is immense satisfaction in furthering your nursing education and being viewed as an expert in the profession. Professionally, the DNP will allow nursing to be viewed as an expert discipline by other professions that require a clinical doctorate as entry level. This degree will allow nursing to play a bigger role in this dynamic health care environment. It will also allow nursing the opportunity to be in a more decision-making position and have to more control over our profession.”

The following interview was conducted with Dr. Gould, CRNA, EdD, and Kim Kimble, a student registered nurse anesthetist at Case Western Reserve University in Ohio.

Where did you learn about nurse anesthesia?

Kimble: “I’ve wanted to go into health care since I can remember. I fell in love with nursing while in grade school after having surgery. Once I graduated from nursing school, I was drawn to the ICU because of the vigilance and critical thinking skills that were required to take care of the patients. Nurse anesthesia allowed for continuity of the passion I have for critical care. But as an APRN, I will now have more autonomy in the care that I provide to my patients.”

Were you mentored by any CRNAs prior to being accepted and enrolled in the nurse anesthesia program at Case Western Reserve University?

Kimble: “Yes, prior to my acceptance into anesthesia school, I had the distinct pleasure of being mentored by two wonderful nurse anesthetists who are highly active within their state, national nurse anesthesia associations, and the Diversity in Nurse Anesthesia Mentorship Program. Dr. Wallena Gould, CRNA, EdD, and John Bing, CRNA, were instrumental in my admission into my first choice, Case Western Reserve University’s nurse anesthesia program.”

What is your capstone interest in a DNP program?

Kimble: “My capstone interest is how to successfully implement education on hypertension self-management in Medicaid patients.”

Would you want to present your findings from your capstone project at a state and national nurse anesthesia association meeting?

Kimble: “Absolutely. Any research that may contribute to improvements in the patient care provided by nurse anesthetists should be shared. Also, I am the student representative for the Ohio State Association of Nurse Anesthetists and would like to prepare a formal presentation at the fall or spring meeting.”

Why do you want to pursue the DNP degree upon graduating from the nurse anesthesia program?

Kimble: “Because our patient population is aging and disease processes are becoming more complex, there is an increasing educational expectation of health care professionals. I believe that doctoral preparation will ensure that I am well prepared to tackle our complex health care system. With a doctorate in nursing practice, I feel that I will be educationally equipped to implement scientific developments that will improve the safety, efficiency, and quality of patient care. “

The following interview was conducted with Dr. Gould, CRNA, EdD, and Daniel Vera, a student registered nurse anesthetist at the Inter-American University Puerto Rico.

Where did you learn about nurse anesthesia?

Vera: “In 2001 I was given the opportunity to train as an Anesthesia Technician at a Hospital in Southern California. At the time, I was not sure of what I wanted to study. It was then that I was introduced to the wonderful specialty of anesthesia. The hospital employed Certified Registered Nurse Anesthetists (CRNAs) in the operating room. The continuous care, compassion, knowledge, and enthusiasm of the CRNAs were of great influence in my decision to obtain my Bachelor’s Degree in Nursing and pursue a Master’s in Anesthesia.”

Were you mentored by any CRNAs prior to being accepted and enrolled in the nurse anesthesia program at Inter-American University of Puerto Rico?

Vera: “During the process of fulfilling the prerequisites of getting accepted into a nurse anesthesia program, I was introduced to you as the founder of the Diversity of Nurse Anesthesia Mentorship Program; you then became my mentor. Thanks to your guidance, I completed a series of steps in order to make my resume more competitive upon applying to anesthesia programs. As my mentor, you were also a big part of my support system, intellectually and emotionally. I met minority CRNAs with DNPs and those who were enrolled, very motivating. You, Dr. Gould, helped me every step of the way to navigate through the process as a student nurse anesthetist at Inter-American University of Puerto Rico.”

What is your capstone interest in a DNP program?

Vera: “While many issues have heightened my interest in nurse anesthesia practice, I would like to research the clinical significance of cricoid pressure during rapid sequence induction in patients at risk for aspiration.”

Would you want to present your findings from your capstone project at a state and national nurse anesthesia association meeting?

Vera: “Yes, it would be my honor to present my findings to colleagues and peers.”

Why do you want to pursue the DNP degree upon graduating from the nurse anesthesia program?

Vera: “There are several reasons why anesthesia practitioners should obtain a Doctorate in Nursing Practice. In a few years from now, all the new graduates from nurse anesthesia programs will graduate with a Doctorate in Nursing Practice. I personally would like to become an instructor, educator, and mentor. I would like to transmit the passionate interest that I posses towards my profession to future students of different ethnicities. “

The following interview was conducted with Dr. Gould, CRNA, EdD, and Byron Anderson, a student registered nurse anesthetist at Arkansas State University.

Where did you learn about nurse anesthesia?

Anderson: “I learned about nurse anesthesia from my Godmother Fay-Theresa Smith, who works at Our Lady of the Lake Regional Medical Center (OLOLRMC) in Baton Rouge, Louisiana. When I attended Southern University A&M College in Baton Rouge, Louisiana, I wasn’t sure what I wanted to major in. At first I decided to major in biology pre-medicine because it was something that I was familiar with. It was Momma Fay that had a long conversation with me and encouraged me to choose nursing as a career option. I immediately questioned her by asking, “What does a nurse do that would make me interested in selecting that as a major?” She responded by saying, “NURSE ANESTHETIST, the most respected nurses in the hospital.” It was then that I began to research the career of advanced practice nurses that specialized in delivering safe anesthesia to millions of patients nationwide. I was so fascinated with CRNAs that I made a binder about all there was to know about this amazing profession. I unknowingly met my first CRNA when I was completing my OB rotation while pursing my BSN degree. He attended Texas Christian University and assured me that nurse anesthesia provided both professional reward and personal satisfaction. After his confirmation, I set a goal of doing whatever was required of me to become a CRNA.”

Were you mentored by any CRNAs prior to being accepted and enrolled in the nurse anesthesia program at Arkansas State University?

Anderson: “I was fortunate enough to be introduced to the Diversity in Nursing Anesthesia Mentorship Program (DNAMP) by my colleague and friend Kim Andrews, CRNA, APRN, where we worked together in a level-one trauma center in downtown Atlanta, Georgia. I attended my first DNAMP meeting and simulation workshop in Baltimore at the University of Maryland where I met the founder, Dr. Lena Gould, CRNA, EdD, and John Bing Jr., CRNA. It was there that I was able to gain more insight about the admission process and true rigors of CRNA programs. I was so inspired that the following year I attended the DNAMP airway workshop at Thomas Jefferson University and the University of Pittsburgh. Afterwards, I shadowed Mr. Alan Williams, CRNA, at the VA Medical Center in Atlanta.”

What is your capstone interest in a DNP program?

Anderson: “My capstone interest in a DNP program will focus on CRNAs and pain management with advanced interventional techniques. In November 2012, The Centers of Medicare & Medicaid Services (CMS) approved a ruling to allow millions of Americans to have access to CRNAs and allow CRNAs to bill Medicare directly for performing chronic pain management services. This was a huge victory for CRNAs and the American Association of Nurse Anesthetists (AANA). I am extremely interested in seeing an accredited and board-certified pain management fellowship program created specifically for CRNAs in the future. “

Who are the CRNA experts in that field and do you have access to them on your future capstone project for the DNP?

Anderson: “The experts in the field of pain management who I would want to learn more from are Arthur Zwerling, CRNA, DNP, DAAMP, and past-president of AANA Jackie Rowles, CRNA, MBA, FAAPM. I will seek their advice and hopefully they can serve on my doctoral committee.”

Why do you want to pursue the DNP degree upon graduating from the nurse anesthesia program?

Anderson: “I want to pursue my DNP to become an expert in the field of anesthesia as an African American male. My goal is to one day have an independent pain management practice in an urban area. Furthermore, I plan on teaching students nationwide about advanced pain management techniques. I believe that the future is bright for advanced practice nurses. I look forward to the day when all of my colleagues will graduate with a terminal degree.”