Nurse anesthetists have been providing anesthesia care to patients in the United States for nearly 150 years.
The credential CRNA (Certified Registered Nurse Anesthetist) came into existence in 1956. CRNAs are anesthesia professionals who safely administer more than 34 million anesthetics to patients each year in the United States, according to the American Association of Nurse Anesthetists (AANA) 2012 Practice Profile Survey.
CRNAs are the primary anesthesia providers in rural America, enabling healthcare facilities in these medically underserved areas to offer obstetrical, surgical, and trauma stabilization services. In some states, CRNAs are the sole providers in nearly 100% of the rural hospitals.
According to a 1999 report from the Institute of Medicine, anesthesia care is nearly 50 times safer than it was in the early 1980s. Numerous outcomes studies have demonstrated that there is no difference in the quality of care provided by CRNAs and their physician counterparts.
CRNAs provide anesthesia in collaboration with surgeons, anesthesiologists, dentists, podiatrists, and other qualified healthcare professionals. When anesthesia is administered by a nurse anesthetist, it is recognized as the practice of nursing; when administered by an anesthesiologist, it is recognized as the practice of medicine. Regardless of whether their educational background is in nursing or medicine, all anesthesia professionals give anesthesia the same way.
As advanced practice nurses, CRNAs practice with a high degree of autonomy and professional respect. They carry a heavy load of responsibility and are compensated accordingly. CRNAs practice in every setting in which anesthesia is delivered: traditional hospital surgical suites and obstetrical delivery rooms; critical access hospitals; ambulatory surgical centers; the offices of dentists, podiatrists, ophthalmologists, plastic surgeons, and pain management specialists; and U.S. military, Public Health Services, and Department of Veterans Affairs healthcare facilities.
Nurse anesthetists have been the main providers of anesthesia care to U.S. military men and women on the front lines since WWI, including current conflicts in the Middle East. Nurses first provided anesthesia to wounded soldiers during the Civil War.
Managed care plans recognize CRNAs for providing high-quality anesthesia care with reduced expense to patients and insurance companies. The cost-efficiency of CRNAs helps control escalating healthcare costs. Across the country, nurse anesthetist professional liability premiums are 33% lower than 20 years ago (or 62% lower when adjusted for inflation). Legislation passed by Congress in 1986 made nurse anesthetists the first nursing specialty to be accorded direct reimbursement rights under the Medicare program.
Approximately 41% of the nation’s 44,000 nurse anesthetists (which includes CRNAs and student nurse anesthetists) are men, compared with less than 10% in the nursing profession as a whole. More than 90% of U.S. nurse anesthetists are members of the AANA.
Education and experience required to become a CRNA include:
- A Bachelor of Science in Nursing (BSN) or another appropriate baccalaureate degree.
- A current license as a registered nurse.
- At least one year of experience as a registered nurse in a critical care setting. (UTC requires at least two years as a registered nurse in a critical care setting.)
- Graduation with a master’s degree from an accredited nurse anesthesia educational program. As of October 2009 there were 109 nurse anesthesia programs in the United States utilizing more than 1,900 approved clinical sites. These programs range from 24-36 months, depending upon university requirements. All programs include clinical training in university-based or large community hospitals.
- Pass a national certification examination following graduation.
In order to be re-certified, CRNAs must obtain a minimum of 40 hours of approved continuing education every two years, document substantial anesthesia practice, maintain current state licensure, and certify that they have not developed any conditions that could adversely affect their ability to practice anesthesia
Source: American Association of Nurse Anesthetists (AANA)