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