Did you know nurses have been providing anesthesia services to patients in need for over 150 years? Now known as certified registered nurse anesthetists (CRNAs), these crucial medical providers’ beginnings can be traced back to the American Civil War, when nurses provided anesthesia services to wounded soldiers on the battlefield. While it wasn’t until 1956 that credentialing for modern CRNAs became codified, today, these healthcare providers serve as the primary anesthesia provider in rural areas, and are considered the main anesthesia provider to U.S. military personnel around the globe. In this blog, we’re diving into the immense positive impact these advanced practice nurses make in improving the health of our country, and taking you through a day in the life of a CRNA.
What impacts do CRNAs have on patient outcomes?
According to the American Association of Nurse Anesthesiology (AANA), CRNAs safely administer more than 50 million anesthetics each year in the U.S. Anesthesia studies have also shown that anesthesia care is nearly 50 times safer now than in the 1980s, and that there is no difference in the quality of anesthesia care provided between a CRNA and a physician-trained counterpart.
CRNAs practice with a high degree of autonomy and carry great responsibility; consequently, they are both well-respected and well-compensated. These critical providers practice in a variety of settings where anesthesia services are needed including, but not limited to, hospital settings, obstetrics, and pain centers, as well as physician offices for dentists, ophthalmologists, podiatrists, and plastic surgeons. Other settings include Public Health Services and Department of Veterans Affairs healthcare facilities.
A Day in the Life of a Nurse Anesthetist: Preparation
We asked Sonya Brown, CRNA, to give us a peek into the day in her life working as a nurse anesthetist. Here’s what she had to say:
Having worked in both nursing and anesthesia for many years, I can say that there is no such thing as a “typical” day. However, there are routine skills that you employ while caring for a patient—usually involving care before, during, and after anesthesia.
Before anesthesia, the CRNA evaluates their patient to best determine the proper anesthetic plan, prepares their anesthesia room, checks the anesthesia gas machine, and prepares medications.
A Day in the Life of a Nurse Anesthetist: During Anesthesia
During anesthesia, the CRNA monitors heart rate, blood pressure, and respiratory status, which may include oxygenation status, tidal volumes, peak airway pressures, and respiratory rate. Invasive monitoring may be needed as well.
CRNAs also monitor pain and change in vital signs; they act accordingly to provide the best care for the patient.
A Day in the Life of a Nurse Anesthetist: Following Anesthesia
For CRNAs, post-anesthesia care usually involves management of pain, nausea, and vomiting and continued monitoring of vital signs until the anesthetic wears off or the patient is ready to be discharged from anesthesia services.
Throughout the day, you witness patients who might be scared and intimidated. It is your job to gain rapport and trust; remember, you are the CRNA who holds the patient’s life in your hands. One of the best parts of being a CRNA is finding out more about the patient and listening to ease their fears. Recently, a patient told me that she lost her daughter to cancer, then her son-in-law months later, leaving her new responsibilities caring for her grandsons. I had another similar situation where a patient recently lost her son-in-law and she debated canceling her own surgery due to the funeral not even being scheduled. When patients share their lives with you, it is a blessing that helps to put your own life into perspective.
Future Job Outlook for CRNAs
So, what does the future look like for CRNAs? Healthcare service providers are in high demand as the general population continues to age. CRNAs in particular are needed, specifically in under-served and rural areas. According to estimates by the U.S. Bureau of Labor Statistics, overall projected employment of CRNAs is expected to grow by 9% by 2032. In addition, about 60% of states reported a shortage of CRNAs, according to a 2010 study by the RAND Corporation.
Many managed care plans recognize the cost effectiveness of CRNAs in providing high-quality anesthesia care with reduced cost to the patient and insurance companies. Consequently, CRNAs are ultimately helping to control the escalating costs of healthcare. Therefore, CRNAs will continue to play a major role in shaping the future of anesthesia care in the U.S.
CRNAs will also use their expertise to advance innovations, such as progressive techniques in regional anesthesia and multimodal opioid-sparing strategies. Finally, CRNAs roles are expanding to include leadership roles and involvement in the business of healthcare delivery, allowing CRNAs to contribute solutions to the operational issues that challenge our healthcare systems.
With the high demand of CRNAs, their cost effectiveness, increasing development of anesthesia sites, and expanding roles in the profession, it’s a great time to be a CRNA.
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Editor’s Note: This article was originally written by Sonya Brown, CRNA, in January 2020 and published on Barton Associates’ website. It was updated in May 2024 by Mike Connors to reflect current information.