EILEEN FISCHER email@example.com
Connecticut Post Online found HERE
Article Last Updated:08/15/2007 10:53:04 AM EDT
It's a nursing specialty that nurses are proud to say dates back to the battlefields of the Civil War. As the first professional group to administer anesthesia services in the United States, nurse anesthetists are considered the first clinical nursing specialty, according to the American Association of Nurse Anesthetists Web site.
Today, more than 30,0000 certified registered nurse anesthetists, a certification that began in 1956, work on teams with medical doctors at hospitals across the country providing anesthesia services to 27 million patients each year, according an AANA report in 2005. Dr. Thomas Bladek, chairman of the department of anesthesiology at St. Vincent's Medical Center in Bridgeport, said the hospital employs 18 full-time CRNAs and 12 full-time board certified anesthesiologists.
"Certified registered nurse anesthetists have been around for quite some time," said Bladek, recalling how St. Vincent's had three CRNAs when he joined the hospital in the 1960s. "Virtually every hospital has them in operating rooms, some have more than others.
"The more rural the hospital, the more CRNAs are employed," he said.
CRNAs are usually under the direct supervision of medical doctors, he said, although in some areas they are in independent practices.
At St. Vincent's, both CRNAs and medical doctors are in the operating rooms administrating anesthesia, except for open heart surgeries and major surgical cases that require intense monitoring, when only MDs are allowed, Bladek said.
"This practice is different in other hospitals," he said.
Across town at Bridgeport Hospital, CRNAs are allowed in high-risk surgeries, including heart surgeries, but always with a medical doctor, said Nancy Moriber, director for the Bridgeport Hospital and Fairfield University certified registered nurse anesthetist program, one of three in the state. "In most hospitals, nurse anesthetists work in a team approach. Every patient has a minimum of two anesthesia providers. That has always been my choice of practice," said Moriber.
The road to becoming a CRNA is a long and intense one. It may be a job not everyone is familiar with and with the current nursing shortage that only promises to get worse, it's a growing specialty that is attracting a growing number of both men and women. "It's a 29-month program and the candidates [for the program] must be registered nurses with a bachelor of science in nursing and a minimum of one year of critical care experience," said Moriber, noting that candidates must have a GPA higher than 3.0. There are 104 CRNA programs nationally, she said, graduating more than 2,000 students each year, and across the board, these programs have to turn people way. Each Bridgeport Hospital/Fairfield University class takes 12 students per year and is always full, said Moriber, 42, who received her CRNA from Columbia University in New York in 1990 when she was 24, a relatively young age. Most students in the program are between 27 and 35 or in their late 40s or 50s, she said. Graduates receive a master's degree in nursing in addition to the certification. It is also one nursing specialty that attracts a high number of men — about 50 percent of CRNAs are men, she said. In general, only 4 percent of nurses are male.
The pay is also a draw, said Moriber. While a new registered nurse may expect $60,000 in salary, a CRNA can make between $100,000 and $150,000, she said. But, it is still less than what an anesthesiologist commands, which is between $250,000 and $500,000 a year, she said. Bridgeport Hospital employs 34 CRNAs. With one medical doctor supervising two to four CRNAs, this team approach can help lower medical bills, Moriber said.
"Nurses produce safe care at a reduced cost," she said.
For Moriber, the high-pressure job was always appealing. "I thrive on stress," she said. "I like the patient contact, the one-on-one; you have control of the patient. I look at it as caring for the patient while someone else is doing the curing."
Starting with the pre-op interview to waking the patient in recovery, CRNAs work on all types of cases, including orthopedics, neurosurgery, vascular surgery, ob/gyn cases and general surgery, providing epidural and spinal anesthesia when needed, said Donna Nunno, a CRNA at St. Vincent's.
A nurse for 17 years before going back to school for her CRNA, Nunno, 39, graduated from the CRNA program at the Hospital of St. Raphael's in New Haven in 2006, earning a master's degree in biological science/anesthesia. The Milford resident said she became interested in the specialty while working as a nurse in St. Vincent's intensive care unit. The training she got was similar to a doctor's residency, she said.
"It's very intense. We do on-call and work many hours," she explained. "It's a great clinical experience at St. Raphael's. The first year was just academics to get my master's then 17 months of clinical training and testing for boards."
There are oral comprehensive boards and national boards to take to become licensed, she said.
On the job, she works a rotating schedule with three, 12-hour shifts a week, she said.
"We always have supervision, from beginning to end," she said. [The doctors] will come in frequently to check on how things are going and offer advice as needed. We have a very close working relationship."
Nunno agrees it's a growing profession and finds that patients are very open to it.
"There are some people who don't know what an anesthetist is, but I never met anyone who felt uncomfortable [with me]," she said. "They know we work with the doctors."
Contact the Fairfield University and Bridgeport Hospital Nurse Anesthesia program at 384-3054. For information on the Hospital of St. Raphael School of Nurse Anesthesia, call 789-3351.
The New Britain School of Nurse Anesthesia may be reached at (860) 224-5612.