January 21 through 27 is National CRNA Week, and we’re celebrating by getting up-close and personal with the CRNAs who make the medical world go ‘round! Certified Registered Nurse Anesthetists (CRNAs) safely administer about 43 million anesthetics each year, making surgeries and medical treatments safer. These professionals not only administer anesthesia, but also help ensure patient comfort and security.
CRNAs come from all walks of life and work in a wide range of communities. Interestingly, the American Association of Nurse Anesthetists (AANA) reports that CRNAs are the sole providers in nearly 100% of rural hospitals in some states as well as within the U.S. Armed Forces. Make sure to thank your favorite CRNA during CRNA week and surprise them with something special to say thanks! We love the idea of gifting them a personalized stethoscope with custom engraving as an awesome way to pay tribute.
What Does a CRNA Do Every Day?
What’s life like as a CRNA? Let’s take a closer look. Every day, nurse anesthetists monitor patients during surgery. This requires preparing and administering drugs before anesthesia, managing patients’ airways, and pulmonary status during surgery and closely observing their physical reaction to drugs. They may also perform pre-anesthesia screenings to determine a patient’s risk and administer epidurals in maternity wards.
But there are many other things that CRNAs are responsible for each day, according to Lincoln Memorial University Clinical Coordinator and CRNA Joy Lewis. “We do pre-op and post-op rounds, consults for pain management, place central lines, respond to codes, place and manage labor epidurals, upon consultation implement respiratory and ventilatory management including establish emergency airways,” says Lewis.
Dan Lovinaria, a CRNA with Veterans Affairs at Minneapolis Medical Center, says there’s an emotional aspect to the job, too.
“Being a VA CRNA comes with a tremendous responsibility and a great deal of accountability,” he says. “Patients are often anxious and nervous about their surgical procedures. It is my duty and responsibility to set the tone and make an immediate connection with my patients upon their arrival in the preoperative phase. Something as simple as providing warm blankets to my patients goes a long way. The little things make a significant impact.”
What’s the Schedule Like?
Surgeons have notoriously demanding schedules, whether they’re responding to emergencies or running on a tight, pre-determined schedule. Since CRNAs are required to be present for many of those surgeries, their schedules may be even busier than a surgeon’s.
“Oftentimes our schedules are busier than the surgeons if we work at a hospital with [obstetrics]. Once you place an epidural you may not be able to leave, and they will still want the operation to start on time,” Lewis says.
Lovinaria says he and his team work various shifts, including 8-hour, 10-hour, 12-hour, and overnight shifts.
Who’s Their Boss?
But there’s good news, too. CRNAs operate on a more autonomous schedule—they’re not required to be supervised by an anesthesiologist in any of the 50 states—so their shifts and schedules vary compared with traditional registered nurses. CRNAs may work as part of an anesthesia care team or as individual providers.
Robert J. Gauvin, a CRNA who’s also the president of Anesthesia Professionals, Inc. in Dartmouth, Massachusetts, says owning an anesthesia care business means more work but even more autonomy.
“Because of my unique position as a business owner and practicing CRNA, a typical day involves the 30-plus CRNAs in my group taking care of one to 45 patients in multiple facilities, followed by two to three hours of administrative duties,” Gauvin says. “On a weekly basis, I try to build in dedicated office days that allow me to focus on developing the business side of my practice.”
What About the Education Factor?
Because CRNAs have a much more specialized skill set than traditional RNs, they’re required to have extra education. Most CRNAs start out as RNs and are then required to complete a master’s degree in nursing (MSN), which typically takes about two years. CRNAs must then pass the National Certification Exam (NCE), which covers the knowledge, skills and abilities needed by entry-level CRNAs.
“Pursuing my studies as a CRNA demanded my efforts and abilities in many ways: mentally, physically, emotionally, financially, and so on,” says Mary Nguyen, a CRNA at Lourdes Hospital in Paducah, Kentucky. “My whole world was completely changed. With that being said, I’d do it all over again to have the privilege to work in my position as a CRNA.”
Nguyen also emphasized the importance of the CRNA certification exam. “The best advice that I can give to others is: ‘Respect the Test!’ The National Certification Exam (NCE) requires a level of thinking and comprehension of anesthesia that is only attained after rigorous clinical experiences paired with thorough reading and studies,” she says.
And then, of course, CRNAs must put a significant amount of time and money into continued education in order to keep their certification active. According to CRNA Bruce Schoneboom, the Senior Director of Education and Professional Development with the AANA, CRNAs must regularly become re-certified.
“The National Board of Certification and Recertification for Nurse Anesthetists’ new recertification program is called the Continued Professional Certification (CPC) Program and consists of eight-year periods. Each period is comprised of two four-year cycles. Every two years CRNAs will check in through a simple, online process known as the ‘two-year check-in,’” Schoneboom says. CRNAs must complete 100 additional education credits in an eight-year period.
Is It as Rewarding as They Say?
Talk to any nurse, and he or she will tell you that there’s a certain pride in putting on a pair of scrubs every morning. But is being a CRNA just as fulfilling as the traditional RN track? Yes, say CRNAs. And the proof is in the pudding: CRNA is a career with one of the highest job satisfaction ratings within nursing.
“There are so many rewarding moments being a CRNA. The one-to-one patient/CRNA interaction is a very valuable experience, and so is engaging the vets’ caregivers or significant others about the anesthesia plan of care,” says Lovinaria, adding that it’s the critical thinking component of the job and its dynamic changes that keep him on his toes.
Nguyen agrees: “I can honestly and wholeheartedly share that even on my worst day, doing what I love is better and more rewarding than a single day doing something else. I would choose this profession over any other option available,” she says.
Make sure to give your favorite CRNA plenty of props during CRNA Week this year!