This year’s Certified Registered Nurse Anesthetists (CRNA) Week, celebrated from January 20-26, calls attention to the work of nurse anesthetists and the patient care they provide.
Sponsored by the American Association of Nurse Anesthetists (AANA) , this week of celebration was once known as National Nurse Anesthetists Week. The Additional of “certified registered” helps people understand the rigorous training and continuing education for this specialty.
Nurse anesthetists work closely with a medical team and in some states, they are often the sole anesthetist on a team. According to the AANA, nearly 53,000 certified nurse anesthetists and student nurse anesthetists provide care throughout the country. Career growth in the field continues to attract top talent as the opportunities for lifelong learning and fast-paced advancements offer a dynamic environment. In addition, nurse anesthetists are among the highest paid nurses with a median annual salary of $165,000.
CRNAs have a vital role in patient care at all stages of surgery or a procedure. They assess patients prior to anesthesia, monitor them during the procedure, and continue to watch for any difficulties or problems after they come out of anesthesia. In this role, nurses offer compassion, comfort, and an intense focus on the details of medical care. They must assess visually and with equipment readings to understand how a patient is tolerating anesthesia.
In this career, CRNAs can work with a wide range of medical teams. They can practice in hospitals, stand-alone facilities, dentist offices, trauma teams, surgical facilities, military units, or pain management clinics to name only a few areas. The variety of settings means a CRNA can choose to work in specialties that hold particular interest or match an educational background or a life experience best.
Anyone interested in this field should have the correct path of educational attainment. According to the AANA, “graduates of nurse anesthesia educational programs have an average of 9,369 hours of clinical experience.” Programs for nurse anesthetists can range from 24 to 51 months. Program requirements can vary with the university, but will include essential clinical placements. Certification and recertification are also required to become a CRNA and maintain that professional standing. By 2022, students will be required to enter doctoral programs for this field.
Many CRNAs say the direct patient care, the satisfaction of being an essential part of the medical team, and the technical challenges of the work make this an exciting career path. In some states, CRNAs provide the majority, if not all of, the anesthesia care. Anesthesiologists work with patients of all ages and in settings so varied, their days are never the same. But the responsibility of keeping patients safe and being their advocate in a vulnerable time is rewarding.
Sometimes nurses know they are destined for a lifelong nursing career; for other nurses, it’s as if the career chooses them.
That’s how Jonathan Llamas DNP (c), BSN, RN-BC, PHN, found his way to nursing. Knowing the career would be a good fit for his compassionate nature and his innate ability to have empathy for others, Llamas applied for nursing school right out of high school.
“I knew the work was selfless and inspiring,” he says, “but I went into nursing school with some naiveté. I knew I had the qualities to be a successful nurse, but I didn’t understand the amount of hard work and dedication required for me to excel in the heavily science-based coursework.”
Llamas was unprepared and struggled with the demands of the course load. Looking back, Llamas sees how his path started to become rockier, even as he wanted to succeed. He lacked the mindset to focus on his work. “I didn’t commit the time necessary for me to be successful,” he says.
Transferring to community college, Llamas finished his prereq courses, but says his lackluster GPA set him up for a cycle of rejections from other nursing programs. Determined, Llamas pressed on but struggled with setbacks that would have had other students choosing another path.
“Based on my GPA, my community college counselor said, ‘You don’t have what it takes to be a nurse,’” says Llamas. Feeling demoralized by the comment, Llamas still felt that nursing was his calling. He just had to find a way to get there. “I had to prove to myself I could do it,” he says, “and that I could do well under pressure.”
The toll from the rejection was growing though. As a first-generation college student from a supportive Filipino family, Llamas recalls his mother’s upset at all the rejection for him and it struck a nerve.
“I looked in the mirror and thought, ‘How do I want to be remembered? Do I want to be a father who inspires his kid to rise above adversity or fold under pressure?’” Llamas says. “I didn’t want to be the latter. I wanted to make something of myself.”
Determined to succeed, Llamas applied to West Coast University’s nursing program, and they gave him another chance. He didn’t throw it away and graduated in 2013. I learned that if I wanted to be successful, I have to apply myself,” he says. “I carry that now. If you want something, you have to work for what you want. We are all different in terms of the resources we have initially. We are not all starting at the same starting line.”
“Hopefully my story will inspire others,” says Llamas. He wants students to be academically and mentally ready at the outset so they aren’t surprised by the intensity and high expectations of nursing school. “You have to sacrifice to be successful,” he says. “It’s hard, but it’s temporary. Do your research, and know why you want to be a nurse. Have a vision for yourself and your future.”
As Llamas has learned, there is a level of commitment to nursing that is necessary to be an exceptional nurse. “There’s a difference between your passion and your purpose,” he says. Having the inherent ability to be a successful nurse often makes one’s passion for nursing grow stronger, he says. “I understand that nursing requires sacrifice, but the most rewarding thing you can do is provide such incredible care to a patient.”
For Llamas, persistence has paid off. He is set to graduate this spring with his DNP from Loma Linda University and juggles his academic load with a full-time schedule as a psychiatric mental-health nurse. “I am fortunate to have hit this stride in my career,” he says. The advanced degree will help him reach his future goals of influencing change in nursing by providing a different form of influence beyond the bedside. He envisions working as an NP, becoming an educator to help future nurses, and using his platform to help other nurses.
“If you had said to me 10 years ago that I would accomplish this, I would have said you were crazy,” he says. “If I have impacted someone’s life for the better, then I have lived a life worth living. I feel blessed, humbled, and grateful for the opportunities that have come my way.”
Although many people don’t like to think about death and dying, it will happen eventually. When it does, those who are fortunate enough to have hospice and palliative care nurses caring for them will understand the importance of these nurses’ roles.
Palliative and hospice care nurses provide care for those who are the end of their lives. They are there for the final transition and use an entire array of medical knowledge and tools, skills, compassion, and life experiences to help in the best ways they can. Hospice and palliative care nurses strive to make patients as comfortable as possible both physically and emotionally. As their physical body shuts down, these nurses can use a combination of medication, music, talk, touch, and companionship to make the process something the patient is comfortable with.
The Hospice & Palliative Nurses Association and the National Hospice and Palliative Care Organization offer resources and education about this nursing specialty. Palliative and hospice nurses often provide education to the public as many people think of nurses as providing life-saving care and aren’t sure what end-of-life care entails. If they haven’t had interactions with hospice care, they may not comprehend all that goes into the nursing practice as someone approaches end of life.
While many find the end-of-life stage difficult to cope with, these nurses often consider it a supreme privilege to be present during someone’s last days. Nurses often develop deep connections with these patients as they try to meet their wishes and help them die with a sense of dignity and control. They also become close to families and even provide guidance and education to help families cope and to make them feel like they can take an active part in offering comfort and acceptance.
Hospice and palliative care nurses deal with grief, often very profound grief, on a daily basis. While the dying patient is coping with life coming to an end, a circle of loved ones is doing the same and trying to prepare for life after the person’s death, while also making the most of the final days. These nurses are especially skilled in managing grief and helping others learn coping skills while they still focus fully on the patient.
Hospice nurses need to take special care to make sure they are also able to cope with profound levels of grief and death in their lives so they don’t get burned out or experience compassion fatigue. Forming strong relationships with other nurses in this specialty is important as is joining professional organizations devoted to hospice and palliative care and even continuing education like certification or additional coursework or conferences. There is much to be learned from others in similar work and hearing how they cope and even what might be a red flag to take notice of. Turning to others and counseling professionals if needed can help nurses stay focused while acknowledging and honoring the challenges of providing end-of-life care on a daily basis.
This career path is one that offers great rewards and hospice nurses are often remembered as a steady presence in a chaotic time.
This week, the American Association of Nurse Practitioners (AANP) leads the celebration of National Nurse Practitioners (NP) Week to mark the distinctive benefits of this career path.
According to the AANP, approximately 248,000 nurse practitioners hold an NP license in the United States. The career is especially appealing as NPs generally have more autonomy than other nurses. In some states, NPs are able to practice on their own without physician oversight, and, in doing so, can provide a full spectrum of care. They assess, diagnose, treat, and make a continual care plan for patients, so they are involved in each step of the patient’s care. Because of that, NPs often form close, long-lasting relationships with those they care for. NPs are able to prescribe medications across the US and almost half hold hospital privileges as well.
Nearly 98 percent of NPs hold graduate degrees and more than 8 in 10 hold some kind of primary care certification. For all the education NPs earn, the Bureau of Labor Statistics reports that they are rewarded with a salary that hovers around $111,000 annually. The job outlook is growing faster than average with a 31 percent growth predicted by 2026.
If you’re interested in this in-demand career path, you’ll need to obtain a master’s in nursing degree along with plenty of extra credentials like certifications. NPs often hold more than one certification and the credentials can be in related areas like neonatal care and pediatric care. You’ll need to pass an NP state licensing exam so you can be registered to practice in your state.
Many nurses find the NP role helps them make a positive impact when access to healthcare is essential and sometimes not in easy supply. NPs can make big inroads into the health of communities as they are able to care for patients in a variety of settings and situations. Nurse practitioners who want to practice autonomously need to have the extra information to know how to do that while protecting themselves and their patients.
NPs can and should connect with peers and colleagues to share the challenges of the role and talk about the satisfaction of this role. Networking will help their professional development and the information learned will often improve their patient care as well.
When patients need care as a result of a violent or abusive situation, they often rely on forensic nurses to help provide a knowledgeable and compassionate bridge between the legal and health systems.
Today celebrates Forensic Nurses Day, and there is a continued need to understand the valuable work they perform and why forensic nurses are a crucial part of any hospital team. The day wraps up a week-long recognition by the International Association of Forensic Nurses (IAFN) to call attention to the work they do.
Forensic nurses have duties that overlap both nursing and legal needs. They provide the specialized healthcare and attention victims of violent acts require. With sensitivity, they help patients through immediate and long-term trauma of the physical after effects of being a victim of violence. But forensic nurses are also the best advocates for these patients in court and legal systems. As a first responder to the patient’s health needs, these nurses collect evidence in a specific way to help the legal system gather needed information and observations to prosecute.
A career in forensic nursing begins with a RN or APN and a desire to help those who have been victimized by violence, sexual assault, or neglect. Forensic nurses work with people of all ages and demographics. As the violence can be within a family (spousal abuse, child abuse, or elder abuse) or among strangers, those requiring care could be anyone. According to the IAFN, forensic nurses’ skills are also needed in corrections facilities, in corrections centers, and in the aftermath of mass tragedies as well.
As with other nursing specialties, certification is a good career move for this field as technology continues to move at a rapid pace. Certification is offered in specialties or in the advanced practice of forensic nursing. Many nurses with significant training in emergency care or critical care become certified Sexual Assault Nurse Examiners (SANE) to provide treatment and collect evidence of sexual assault victims.
When patients receive care from a forensic nurse, they know someone has their back and can help them take steps toward recovery and healing.