February 5 through 11 is a national observance of National PeriAnesthesia Nurse Awareness Week, sponsored by the American Society of PeriAnesthesia Nurses (ASPAN). Nurses who help transition patients pre- and post-procedure are there to offer intensive medical care and equally essential caregiving. They especially want patients to know they are there for them. They are their advocates throughout the process.
If you are interested in a career as a perianesthesia nurse, you’ll find the challenges of the position range from using your advanced nursing skills in urgent situations to incorporating the most basic hands-on comfort skills. Charged with caring for patients at critical pre- and post-procedure points, perianesthesia nurses must be able to multitask, to identify and respond to patient conditions immediately, and to do this all with a calm demeanor to help keep patient stress at bay.
Perianesthesia nurses especially enjoy their work caring for patients before and after procedures that require any anesthesia. Before a procedure, they are the nurses who are there to find out any information that could have an impact on the anesthesia care. With more and more patients appearing with several health conditions, they have to factor in variables like medications, physical condition and limitations, and emotional stability in their patient assessment. While they are assessing and gathering information, they are also providing a calm and unwavering support to help nervous patients know they are in trusted hands.
Perianesthesia nurses are also there when patients come out of anesthesia and are sometimes confused, uncomfortable, or even nauseated or vomiting. Post-procedure, nurses are once again continually monitoring a patient, assessing vital signs, reassessing existing health conditions, and at the same time, offering that hands-on caregiving that helps patients feel safe. Perianesthesia nurses then help determine how a patient can safely move to their next place whether that is to home, another hospital, or another care facility.
Many perianesthesia nurses say they have perfected a way to develop a rapport with patients that can build the trust necessary for completing such a long task list in a short time and under pressure. Once a nurse has identified a topic that helps the patient relax, they can begin conversations about family, pets, schooling, movies, or books that are both informative for nurses and distracting for patients. Many nurses also say they use those nuggets in the conversation to help bring a patient out of a drowsy and sometimes confused anesthesia.
For those considering this branch of nursing, ASPAN offers many resources and is an excellent reference to find out information about certification (through the American Board of Perianesthesia Nursing Certification, Inc.) that must be renewed every three years, scholarships for education, career resources, mentoring opportunities, conferences, and up-to-date anesthesia information.
This week, recognize and appreciate the perianesthesia nurses on your team. Their skills often help the entire procedure proceed smoothly and safely.
The celebration of IV Nurse Day every January 25 recognizes the work infusion nurses do with and for their patients. Infusion nurses are an essential part of the care team, acting to properly care for infusion needs and collaborating with other members of the health care team.
“Challenges in our ever-changing healthcare system combined with new, developing technologies and complex infusion therapies, afford the opportunity for the infusion nurse to use his/her expertise in infusion therapy to provide holistic patient care,” says Marlene Steinheiser, MSN, RN, CRNI®, director of nursing education of the Infusion Nurses Society (INS), Infusion Nurses Certification Corporation.
Of the primary responsibilities of an IV nurse, acting with the patient’s health and welfare in mind is primary. Celebrated since 1980, IV Nurse Day focuses attention on this essential care. “The infusion nurse acts as an advocate for patients receiving infusion therapy, ensuring that safe, quality infusion care is delivered,” says Steinheiser. “Patient assessment, with particular attention to the patient’s vasculature and prescribed therapy, is important so that the appropriate vascular access device (VAD) is selected to accommodate the treatment plan.”
Steinheiser also says that many infusion nurses also take on leadership roles where they provide education and guidance to other nurses while also continually monitoring for complications and setting in motion effective interventions when needed.
Student nurses interested in the career will find infusion nurses are not limited to specific settings. “Infusion nurses’ roles may vary depending upon the practice setting,” Steinheiser says. “Infusion nurses work in many settings, agencies, and organizations including, but not limited to, hospitals, nursing homes, ambulatory infusion clinicals, physician offices, and patient homes.”
According to Steinheiser, expert infusion nurses can help reduce complications by sharing their knowledge and educating patients, family members, and other healthcare team members and always assessing the patient. “Skilled VAD insertion, prevention of complications and early identification coupled with implementation of interventions, minimizes further damage that can result from infusion-related complications,” she says.
Like any nursing career, this branch of nursing requires continual education to stay current with best evidence-based practices that help prevent, reduce, and treat any complications or challenges. “Due to the invasive nature of infusion therapy, infusion nurses can encounter possible adverse events with any infusion, such as extravasation, catheter malposition, nerve damage, or infection,” Steinheiser says. “The infusion nurse is prepared with advanced knowledge and continuing education to promptly address these situations.”
The INS is an excellent resource for current and future infusion nurses. The organization offers free educational podcasts (available to members and nonmembers) where nurses can learn about and refresh their skills for safe infusion practices. And the learning center provides both virtual education and recorded educational sessions from prior conferences and webinars, and what Steinheiser calls a key resource for infusion nurses, the Infusion Therapy Standards of Practice.
As with other nursing practices, nurses with the desire to specialize in infusion therapy may study and take the certification exam offered twice a year, says Steinheiser. “To assist the nurse in preparing for this exam, INS has study material which covers the eight core components of infusion nursing,” she says. “Once nurses pass this exam, they are considered infusion nurse specialists and can begin using the credential CRNI®. The CRNI® is capable of an expanded role in directing evidence-based clinical practice, research, and quality improvement activities.”
Infusion nurses care for all patients, providing care that helps many other healthcare processes go more smoothly. “Infusion nurses provide for all patient populations, from the neonate to the elderly patient, and follow them along the continuum of care,” says Steinheiser. “Infusion nurses use their critical thinking skills, perform advanced procedures using state-of-the-art technology, and ensure safe infusion care.”
Certified Registered Nurse Anesthetists (CRNA) Week runs this week from January 21 to 27 and is an excellent opportunity for student nurses to find out more about this path in a nursing career.
With more than 52,000 nurse anesthetists and student nurse anesthetists, the career is thriving and attractive for several reasons. Many nurse anesthetists say the patient interaction they have is unsurpassed. They are with patients before, during, and after surgery, so there’s a necessary trust that is quickly established with the skill and care of the nurse.
Nursing students who are considering this as a career have many resources they can reference and various organizations that will help them succeed on this career path. The American Association of Nurse Anesthetists (AANA) is especially aware of promoting health and wellness among the student nurses who seek a career in this branch of nursing. The AANA’s 2017 report Wellness and Thriving in a Student Registered Nurse Anesthetist Population explored the significance of the relationship between student wellness and how well students do in their academic program.
To celebrate CRNA Week, Minority Nurse recently posed some questions to Michael Neft, DNP, MHA, CRNA, FNAP, FAAN, and assistant director of the Nurse Anesthesia Program University of Pittsburgh School of Nursing and nursing student Sara Wilkinson, BSN, RN, CCRN SRNA at University of Tennessee Health Sciences Center. The following are their answers.
Why is the AANA particularly aware of the health and wellness among student nurses looking to enter or actively studying in this field?
Student nurses are the future of the profession, and it is important to cultivate and prepare for a long and healthy career. Students who aspire to enter into nurse anesthesia programs must be healthy mentally and physically. They must have healthy outlets for stress relief, and healthy lifestyle habits that will support them throughout our educational programs.
Nurse anesthesia education programs are required by their accreditation standards to provide education content on wellness and substance use disorder. The AANA actively encourages members, students, as well as educational programs to engage whenever possible in healthy behaviors, whether that includes physical activity or simply reducing stress by encouraging individuals to take time for their loved ones or to engage in an activity they love.
The AANA is committed to providing resources and information about ways to become involved in establishing a healthy lifestyle and even offers fun runs, wellness tutorials and a massage therapy area at many of their conferences.
How does establishing good health and wellness practices now help a student nurse become better? And how will taking care of oneself now carry over once they graduate and are several years into a CRNA career?
Nursing has unique stressors like dealing with patient care situations that require critical thinking, fast decision making, and autonomy is tough. If the student nurse does not have the ability to cope with these situations autonomously, it is very difficult to care for patients. Maintaining both mental and physical health and wellness are at the foundation of successful practice.
Developing healthy lifestyle habits early, helps students handle stress more effectively, set clear goals, and develop a clear plan to achieve them. They also assist students with discipline, good study habits, prepare for clinical experiences properly, and self-evaluate objectively. It also helps to establish diet and exercise plans that can be adjusted as one transitions to practice, to avoid elimination of healthy habits out of inconvenience.
Maintaining a school-life balance is also important to develop a support system and find time for small, pleasant breaks to gives a fresh perspective and recharge. Establishing healthy behaviors and habits early is vital to long-term health, wellness, and maintenance of a successful career.
Do you have any advice for student nurses about considering this field and being aware of any challenges unique to this branch of nursing?
For student nurses considering the field of nurse anesthesia, awareness about the depth and breadth of study is valuable, but is important to be well, so that an individual will have the endurance to graduate. A strong support system and personal discipline are necessary to allow for healthy stress relief and appropriate professional conduct. Anesthesia remains the field with the highest incidence of drug abuse and unhealthy coping behaviors, due to high stress and access.
Think about what you do when stressed. Review your lifestyle habits: exercise, eating, alcohol use, and other substance use. Some prospective students may want to employ a lifestyle coach who can look at a person individually and help one to develop positive lifestyle habits that will set one up for success in graduate school and a stressful career. Good study habits, a healthy respect for one’s self and career, use of study resources, and strong, supportive relationships will be required to succeed and thrive in this field.
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!
When nurses think of the big responsibilities in their careers, patient safety is predominant. But communication skills? Those aren’t often at the top of the list.
Nurses train for years to ensure the safety of their patients. Their unwavering advocacy for patients has done nothing less than transform healthcare. But patient safety can’t happen without clear communication skills. Nurses must have excellent communication skills to provide the best care for patients and to earn the respect of their peers.
What kinds of communication skills will nurses use? Here is just a small sample of how nurses use various communications skills throughout the day:
- Communicating with healthcare team members on a patient’s condition, diagnosis, treatment, complications, progress
- Explaining to patients about self care, about their diagnosis and prognosis, about resources, and about everything from medications to diet and exercise
- Talking with family and loved ones about patient needs, follow-up care, disease, recovery, medication
- Communicating with professionals in non-healthcare fields to help secure grants, influence policy, or explain a professional need
- Educating the public on healthcare issues that are important to their age, region, or personal health, or educating students on nursing practices or nursing career options
How can you improve your communication skills? Here are a few pointers:
- Be precise and clear. If you need information or you need someone to do something, say so. If you are giving information, present it in basic terms.
- Ask if anyone has questions. Your audience could be a roomful of academics at a conference, a team of colleagues in your unit, or a single patient—always ask if anyone has follow-up questions. Don’t assume that your audience heard and understood everything you said. This last step gives you an opportunity to recognize where your communication can be strengthened and to convey the needed information.
- Write clearly. Whether you are writing a memo or a research paper, use fewer words and make them have greater impact. Decide what you are trying to say, use short paragraphs for ease, add bullet points to emphasize your main points, and make sure you reread everything before you send it..
- Consider your tone and body language. The way you speak and hold yourself can support your words and intent, but if they are out of whack, your unspoken actions can cause confusion. Make sure you speak in even tones when possible and that your body language is approachable.
- Learn about best practices. You’ll find books, seminars, presentations, and even casual discussions that can all help you sharpen your skills. If you’re a nurse manager, bring this up in each employee review and ask for it in turn from your own supervisor.
Communication can always be improved. Each time it is, your capability as a nurse is strengthened.
As the demand for educated and qualified nurses continues to grow, prospective nursing students might wonder how they can afford nursing school now to open their career possibilities over a lifetime.
If you have applied to schools and are receiving acceptances and award letters, it’s time to crunch the numbers to figure out the best choice for your money. Schools offer many awards including merit scholarships, grants based on merit or need, and loans that fall into many categories. You can also make some other adjustments to shave off some costs without impacting your education.
How do you know you can afford nursing school? Here are some questions to ask.
Will You Be a Full-time or Part-time Student?
Some colleges and universities award scholarships based on the student’s academic load. If you are trying to decide which route is for you, check with the schools to see if there is substantially more money available that could impact your choice. Consider your employment potential as well. Part-time status takes longer to complete, but you may be able to work and go to school (and your employer might pay for part of your education).
Where Will You Live?
Living on campus generally costs more money. Attending a college that’s closer to home lets you save thousands of dollars on campus housing and meal plan fees. If you are already living at home, you’ll save by continuing to live at home and commuting to school.
Can You Take a Hybrid Route?
Are there any online courses that cost less? If you are aiming for a BSN, could you take a prerequisite class and some of your basic classes at a cost-saving community college and then transfer to a four-year college to finish your degree?
What Aid Is Available?
A strong academic record and solid application will likely land you some merit scholarship funding. Like a grant, that’s money the school gives to you. You don’t have to pay it back, but you do need to find out if the award will be renewed each year you are at the school. If you apply to a four-year college, you need to know you can afford all four years.
How Much Debt Are You Willing to Take On?
After any merit or need-based scholarships and grants, you can be awarded loans. Loans always have to be paid back. Federal loans come from the government and while they have to be paid back, they often have low interest rates, and you don’t start repayment until after graduation. If federal loans don’t meet your entire need, you can apply for private loans, which have higher interest rates and varying repayment policies.
What Are Your Post-graduation Plans?
Some nurses can have some student debt forgiven if they apply for and fulfill the requirements of the NURSE Corps Loan Repayment Program. In addition, some states offer specific loan repayment or forgiveness plans for nurses.
Figuring out how to afford nursing school is going to be different for each student, but there are many options and choices available. For many students, finding the right balance just takes some investigating.