The title "Doctor"

I thought I would share this blog post arguing why DNPs should be called "Doctor"! I totally agree!

http://community.advanceweb.com/blogs/np_7/archive/2014/07/09/doctor-vs-doctor.aspx

What is a CRNA?

I wrote this for a school project, but I thought it might be interesting to someone out there so I'll share....  

Nurse Anesthetists are nurses who have advanced training to deliver anesthesia, providing amnesia, analgesia, and muscle relaxation. Advancements in anesthesia care have allowed for advanced surgical procedures and improved patient outcomes. Anesthesia was among the first areas of advanced practice nurses, and began in crude form as nurses aided doctors during surgery by holding a paper cone soaked in ether during the earliest surgeries. As anesthesia techniques became more sophisticated and technologically-oriented medical doctors began specialized resident training programs in anesthesia as well (Richards, 1993).

Education

            The first formal anesthesia-training program began in 1909, and it was open to physicians, dentists, and nurses. Early nurse anesthetists were active in research and published their findings and techniques as well as established the standards of care for the anesthesia specialty (Harris, n.d). These first anesthesia training programs accredited graduates with a certificate in anesthesia. Currently, the AANA is implementing new guidelines for newly enrolled nurse anesthesia students effective January 1, 2022 (Madsen Gombkoto, 2014). These new standards prepare graduates for public policy, advance standards of care, and to transform the health care system through practice doctoral degrees.

            The curriculum offered in nurse anesthesia programs is regulated by the Council of Accreditation (COA), which is recognized by the US Department of Education and the Council for Higher Education. The basic curriculum requires pharmacology of anesthetic agents and adjuvant drugs including concepts in chemistry and biochemistry (105 contact hours); anatomy, physiology, and pathophysiology (135 contact hours); professional aspects of nurse anesthesia practice (45 contact hours); basic and advanced principles of anesthesia practice including physics, equipment, technology and pain management (105 contact hours); research (30 contact hours); and clinical correlation conferences (45 contact hours) (AANA, nd).

Certification

            Certified Registered Nurse Anesthetists (CRNAs) must pass the national certification exam administered by the National Board of Certification and Recertification of Nurse Anesthetists (NBCRNA) after completion of  an accredited post-baccalaureate program (AANA, nd).

Scope of Practice

The AANA outlines the elements included in the scope of practice of CRNAs that is used by the Council for Accreditation (COA) of Nurse Anesthesia Programs.

• Perform a comprehensive history and physical examination
• Conduct a preanesthesia evaluation
• Obtain informed consent for anesthesia
• Develop and initiate a patient-specific plan of care
• Select, order, prescribe, and administer drugs and controlled substances
• Select and insert invasive and noninvasive monitoring modalities and clinical experience requirements
• Provide acute, chronic, and interventional pain management services
• Provide critical care and resuscitation services
• Order and evaluate diagnostic tests Request consultations Perform point-of-care testing
• Plan and initiate anesthetic techniques, including general, regional, local, and sedation. Anesthetic techniques may include the use of ultrasound fluoroscopy and other technologies for diagnosis and care delivery, and to improve patient safety and comfort
• Respond to emergency situations using airway management and other techniques; facilitate emergence and recovery from anesthesia
• Provide postanesthesia care, including medication management, conducting a postanesthesia evaluation, and discharge from the postanesthesia care area or facility

Specialty Organization(s)

            There are several specialty organizations that CRNAs can belong including American Association of Nurse Anesthetists (AANA), Tennessee/Oklahoma Association of Nurse Anesthetists (TANA/OANA --local branches of AANA), International Anesthesia Research Society, American Society of Regional Anesthesia, American Association of Critical Care Nurses, American Society of Perianesthesia Nurses, Association of PeriOperative Room Nurses, American Association of Respiratory Care, American Pain Society, Society of Office Based Anesthesi, Society for Obstetrical Anesthesia Perinatology, Society for Ambulatory Anesthesia. Many of these organizations have websites, which outline the criteria for membership and may also sponsor research journals.

References

AANA. nd. Qualifications and Capabilities of the Certified Registered Nurse Anesthetist. Retrieved from http://www.aana.com/ceandeducation/becomeacrna/Pages/Qualifications-and-Capabilities-of-the-Certified-Registered-Nurse-Anesthetist-.aspx

Harris, N. (n.d.) Retrieved from http://www.aahn.org/gravesites/magaw.html on December 1, 2013.

Madsen Gombkoto, R. L., Walker, J. R., Horton, B. J., Martin-Sheridan, D., Yablonky, M. J., & Gerbasi, F. R. (June, 2014). Council on Accreditation of Nurse Anesthesia Educational Programs Adopts Standards for the Practice Doctorate and Post-graduate CRNA Fellowships. AANA Journal, 82, 177-183.

Richards, E. (1993). The Problem of Certified Registered Nurse Anesthetists. http://biotech.law.lsu.edu/Books/lbb/x943.htm

Union Research Symposium

Today, we had the opportunity to present our research to the scholarship symposium at Union University. We had a very positive response to our work, and all of our anxieties were unwarranted! We enjoyed educating our anesthesia faculty on our new knowledge of malignant hyperthermia. The symposium was open to all areas of study and we even had questions from non-medical researchers. This was fun but challenging! Here are some pictures from our day!

My husband thought "Symposium" was a funny title so I had to share this picture with him

Our final mounted poster. It really turned out great

Our research group 3 - DNP - Anesthesia Students and 1- MSN - Education Student

The three anesthesia girls and my regular study buddies!

Anesthesia Machine Check

Well, After 9 month of talking about anesthesia we are finally getting to start putting our hands on some anesthesia equipment! YAY!! Okay, I know I am a nerd, but I am seriously EXCITED to start doing anesthesia! So, today was our first day in the simulation lab and we learned our "pre-flight" checklist. As a pilot's wife I can really appreciate this important first step to a successful day! Here are some pictures from our first day in "the sim." Much like flying, medicine has developed a similar education tool to help develop and perfect technique and emergency procedures. In anesthesia, "the simulator" is a mannequin that is very life like and has vital signs (HR, RR, BP, etc...). Our instructors can control the sim and allow him to respond to our actions. We also have actual anesthesia machines that we use to deliver our anesthetic to the sim. REALLY COOL technology!

Here I am.. Excited to get started doing anesthesia

My classmates (and the only other "Okie") in my class

My trusty sim partner

They think I am nerd ;)

Easter

One of the things I love about Union University is the core-values - Christ Centered, People Focused, Excellence Driven, and Future Directed. Each step of our education at Union focuses on these values. Our current technology course focuses on the future direction of health care and prepares us for the increasing importance of technology in our field. Union does an excels in all of these areas, but one of the things that sets us a part is being Christ-Centered. We have an amazing group of Godly professors at Union who are not only experts in their field but mentors in their faith. With the season of Easter upon and our last class period before breaking for Easter, we received an unexpected anatomy/pathology lesson. Our course instructor is a veterinary by trade but a skilled anatomist and has spent numerous hours in the cadaver lab perfecting various techniques to aid his teaching. After finishing our lecture on the pathology of the respiratory system, Dr. Wamble shared with us the physiology of the crucifixion. This lecture truly prepared my heart for the real reason for Easter and helped me to focus on the amazing grace of God! One of my classmates happened to be recording the lecture, and I think it is too awesome not to share! Enjoy & Happy Easter!

 

How thankful I am for His mercy! What an awesome season! After class I was able to travel home to Oklahoma again, and enjoy a wonderful Easter celebration with family.

Research

We are currently taking Advanced Research/Evidence-Based Practice. In this course, we are learning basic principles necessary to review literature, determine credibility, and compile a literature review. Throughout the course, we have had reading assignments which prepare us to complete a literature review of a topic of our choosing with a group. Our group consisted of three DNP anesthesia students and DNP education student who is an OR nurse. One of our nurses is a trauma nurse at The MED and we found the incidence of malignant hyperthermia in trauma patients to be a particularly interesting topic. We are looking forward to presenting our research at the scholarship symposium on April 29th at Union University.

OANA Meeting

I had a fabulous educational conference in Oklahoma! I enjoyed meeting the great group of anesthetists located in the state, and I am excited to join the ranks of the highly skilled group of professionals I met there, and I learned a lot about the politics of anesthesia and the job market in Oklahoma. The conference had a great day crammed pack of great lectures! Although, my lack of practical anesthesia knowledge left be a little lost in some of them! Overall, it was a great day and well worth my time and trip to Oklahoma!

And, Grandma did not complain too much! This is what the kiddos did while Mommy was learning!