Certified Registered Nurse Anesthetists (CRNAs) work collaboratively with healthcare teams or independently. They administer or assist with administering anesthesia for patients undergoing procedures in various healthcare settings. CRNAs can be present for planned surgical procedures, in emergency settings, in pain management clinics, in dental offices, and in birth centers to name a few.
Nurse anesthetists are responsible for caring for and monitoring a patient’s anesthesiology needs during a procedure, but their work pre- and post-procedure are critical. They will gather medical history, medication information, and assess the patient’s physical and emotional condition when possible. They are constantly looking for and identifying any potential issues that could interfere with plans for anesthesia.
As with other nursing specialties, CRNAs have taken on more responsibility and needed to master increasingly complex healthcare conditions and tech-based equipment. Because of this, changes to the practice entry requirements now require all nurses entering a CRNA program to exit with a doctor of nursing practice (DNP) or a Doctorate of Nursing Anesthesia Practice (DNAP) . Practicing CRNAs aren’t required to return to school for this additional advanced degree if they already have a master’s degree and have been in practice. Although it’s not required, some nurses may find that employment parameters are changing and that the DNP might be a requirement in a new place of employment.
CRNAs have careers that are dynamic and exciting. They can work directly with patients or they may choose to work in administration where they can have an impact on the conditions for patients and nurses. CRNAs also have options to work in government settings or to become active within committees to help shape the policies that surround CRNA work and career expectations. As CRNAs take on more leadership roles, they can use their direct real-world experience to inform the nuances of proposed changes.
As in all nursing specialties, time spent on the job is an excellent way to build skills and empathy for patients. CRNAs will want to continue learning about the rapid changes in the field with certification through the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA). Certification, which needs to be renewed to stay current, helps you remain informed on the latest developments that impact the duties you perform in your work. By staying up-to-date on the most current techniques and developments, you’ll be able to offer high-quality patient care that will result in better outcomes for your patients and the best performance by your team. Certification is a way to learn about everything from patient care to technological changes in equipment that can change your process.
Celebrate the CRNAs on your team this week and if you’re a CRNA take time this week to reflect on the work you do with your patients and your healthcare team. Be proud of the change you make in each patient’s life as you perform a critical task within the process.
CRNAs recently received a public recognition of their career path when U.S. News and World Report published a Best 25 Jobs of 2020 and nurse anesthetist came in at the number 21 slot.
This nursing career has a lot going for it. It pays well, is constantly changing, and has lots of patient interaction. Nurse anesthetists often assist during surgery or may be in charge of the patient’s entire anesthesia plan and process. In fact, in some places, including rural areas or on the frontlines of the military, nurse anesthetists are often the main providers of anesthesia care to a patient.
Nurse anesthetists bring home a large paycheck. Although the U.S Bureau of Labor Statistics reports the amount will vary based on location, an average annual salary comes in at $167,950. Nurses interested in this path will complete a rigorous educational training. After your early nursing career, a typical path starts out in a critical care role, such as the intensive care unit, where they gain valuable training on evaluating and caring for patients with life-threatening injuring or illnesses. These nurses often have a masters’ degree, but more and more nurse anesthetists earn doctoral degrees. Beginning in 2022, all nurses entering accredited anesthesia programs will be required to earn a doctorate in the specialty.
This role requires initial certification and continued professional certification as the field changes rapidly. Lifelong learning in this specialty is essential for providing the best nursing care and ensuring the best patient safety.
Because of their role in providing essential care, nurse anesthetists routinely work in many areas, so finding a role that suits your career plans and your lifestyle is possible. Flexibility within this role isn’t as common as within other nursing roles, but because there is such a high demand for this role, the job variety is excellent.
According to the AANA, nurse anesthetists provide care to patients in varied locations and settings. From a chaotic battlefield to an organized dental office, nurse anesthetists are required to provide focused, deliberate, and incredibly precise anesthesia care. This role is also essential in pain management clinics and in surgical settings.
CRNAs also play an active and important role in the policies and regulations surrounding the patient care and the professional standards of this specialty. The CRNA Political Action Committee represents the interests of CRNAs and their patients in Washington and in the political establishment of each state.
Nursing leaders and those who take an active role in political decisions can offer a perspective that speaks to ensuring patients have equal access to the best care possible, no matter where they live or their income. These nurses are also proficient in speaking about veterans’ affairs, the opioid crisis, and patient safety.
CRNAs are a vital part of patient care. This week is acknowledgement of all they do.
During this year’s CRNA Week (#crnaweek), there are many nurse anesthetists who are remembering why they got into the profession, and even more are reflecting on how the face of the profession is changing.
John Bing, BSN, CRNA, American Association of Nurse Anesthetists (AANA) Region 6 director, and national AANA board of directors member, says one of his steadfast missions is to make sure the field continues to attract top nurses, but that it is especially welcoming to aspiring minority nurse anesthetists.
Bing knows first-hand how hard it is being a minority in the field. When he first started out, he was often the only African American in the OR, he says. At times, people assumed he was part of the housekeeping staff. Although he laughs about it now, Bing has made it a direct part of his mission to attract more minorities into this field.
He even takes on leadership positions with the primary goal of making sure he is representing the minorities in the field. “You need to see that in leadership,” he says. “If others don’t see that, they won’t see a place for them. I make sure they see it.”
“Many times you would go in and you were it,” he says of when he started out. “Maybe you were the only one in the hospital or the department. Now you go in and you see a fair amount [of minorities].”
One of Bing’s specific approaches is to make sure he talks to patients as the anesthesia takes effect. He finds out what they like so they can chat about it—sports, cooking, books, kids—anything that helps them relax. “That’s like a sedative,” he says. “It calms them down and they remember that.”
And while he’s monitoring a patient, Bing does exactly what he teaches his students—he assesses his patient over and over and over. “You must rely on your instinct,” he says. During travels with students to countries like Nicaragua, Bing teaches students that not every machine is calibrated the same or even correctly.
“The machine is a guideline,” he says. “You are ultimately responsible for anything that happens. You can’t blame the machine for anything. Look at the patient.”
Bing says that while he’s checking blood pressure every five minutes or so, he is constantly “circling the block,” as he calls it. All the machines are incredibly helpful, but they should only confirm what a nurse anesthetist is seeing, hearing, smelling, and touching.
And getting stale in this profession is not an option, he says. “I say to my students, ‘Tell me how this patient could die today,’” he says. That forces students to look at the big picture and not just look for complications, but to look for other factors that could impact that patient on that day.
Bing clearly enjoys working with his students, but he understands first-hand how sometimes they are not the ones who chose the profession. “The last thing I thought I would be was a nurse,” he says with a laugh. As an African-American, there were few role models that looked like him.
A chance look at a jobs list that revealed six pages of nursing jobs, convinced Bing, an athlete in high school and college, to take a look. Bing says he turned to his buddy he was working out with and said, “We get to be around girls and have a great job!” But he still didn’t expect to land in this field. Eventually, nurses in the recovery room where he worked nudged him to give it a try.
Now, Bing’s mission is to attract minorities into nurse anesthesiology. He speaks to kids in schools, paying special attention to making the field appealing to boys and young men. As it is, 49 percent of nurse anesthetists are male, he says, which is a high number considering less than 10 percent of all nurses are male.
But Bing lets kids know that there are chances to be out on a helicopter go team or even in the midst of trauma situations. “Men like that kind of stuff,” he says and it certainly gets the attention of younger kids who don’t know those possibilities exist.
Add in the good salary, the camaraderie, and the fair amount of autonomy, says Bing, and a career as a CRNA shows kids who might not initially consider a nursing career that the path is open to more possibilities than they ever imagined.
John Bing, BSN, CRNA, AANA Region 6 director, and national AANA board of directors member, says most people don’t quite understand what a nurse anesthetist does and, in fact, there are not very many of them.
Many people believe a nurse anesthetist puts them to sleep, leaves, and then returns to wake them. Far from it, says Bing. “The job of a nurse anesthetist is always assessing,” he says. They are with the patient all the time, from the moment they greet the patient, through the entire procedure or surgery, and when they are brought out of anesthesia.
The job, says Bing, is like no other. “We are there pre-, inter-, and post-op,” he says. But he understands why the job is mysterious to some. Even Bing’s mom thought he just gave people a pill to make them go to sleep, he says with a laugh.
But nurse anesthetists appear happy with their jobs. On the just-released 2017 U.S. News and World Report Best Jobs list, a nurse anesthetist’s job placed fifth on best health care jobs and placed sixth on the best jobs overall. The reported salary median salary is $157,140.
Bing says he appreciates being able to develop a relationship with a patient in such a short amount of time. Being present through the entire procedure gives nurse anesthetists the ability to monitor every nuance of the patient’s reactions and behavior, he says. And the interactions before the anesthesia is administered means nurse anesthetists have the chance to build up trust and get to know a patient as a person. The patients remember that, says Bing, and you get to know them as a person.
And this field rarely gets stale, he says. CRNAs have to be recertified every four years, so continued learning is mandatory. One of the special draws for nurse anesthetists is the ability to work with people from the moment they are born until the day they die, says Bing. These nurses work with all ages and have to know the intricacies of how the human body reacts to the anesthesia at each age and with virtually any condition. “We get everybody,” says Bing. “And it is all acute.”
As a group, nurse anesthetists stick together, says Bing. With as high as 89 percent reporting approval for their job satisfaction, he says, they enjoy the work. And the AANA doesn’t encourage sub groups, he says. The group acts as one. “Eighty-five percent of our professional nurse anesthetists belong to our parent professional organization,” says Bing. “We don’t want to go out and have splinter groups. We are better together.”
The AANA is urging nurses to spread the word during National CRNA Week and suggests things like career days in schools, inviting legislators to a breakfast or coffee gathering, or even casual and formal public speaking opportunities to let people know about the profession. And use #crnaweek to spread the word o a wider audience.
It’s also a good time to celebrate what nurse anesthetists do. “In this country 100,000 people give anesthesia,” he says. “That means there are 3.5 million people per anesthetist. That makes [them] pretty special.”
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