National Nurse Anesthetists Week: 25-31

2015 Poster - Helping New Mothers

Certified Registered Nurse Anesthetists Fact Sheet

Nurse anesthetists have been providing anesthesia care to patients in the United States for more than 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) 2013 Practice Profile Survey.
CRNAs are the primary providers of anesthesia care in rural America, enabling healthcare facilities in these medically underserved areas to offer obstetrical, surgical, pain management and trauma stabilization services. In some states, CRNAs are the sole providers in nearly 100 percent 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 registered 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 personnel on the front lines since WWI. 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.
In 2001, the Centers for Medicare & Medicaid Services (CMS) changed the federal physician supervision rule for nurse anesthetists to allow state governors to opt out of this facility reimbursement requirement (which applies to hospitals and ambulatory surgical centers) by meeting three criteria: 1) consult the state boards of medicine and nursing about issues related to access to and the quality of anesthesia services in the state, 2) determine that opting out is consistent with state law, and 3) determine that opting out is in the best interests of the state’s citizens. To date, 17 states have opted out of the federal supervision requirement, most recently Kentucky (April 2012). Additional states do not have supervision requirements in state law and are eligible to opt out should the governors elect to do so.
Nationally, the average 2013 malpractice premium for self-employed CRNAs was 33 percent lower than in 1988 (65 percent 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.
Nearly 48,000 of the nation’s nurse anesthetists (including CRNAs and student registered nurse anesthetists) are members of the AANA (or, greater than 90 percent of all U.S. nurse anesthetists). More than 40 percent of nurse anesthetists are men, compared with less than 10 percent of nursing as a whole.
Education and experience required to become a CRNA include:

  • A Bachelor of Science in Nursing (BSN) or other 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.
  • Graduation with a minimum of a master’s degree from an accredited nurse anesthesia educational program. As of Nov. 1, 2014, there were 114 accredited nurse anesthesia programs in the United States utilizing more than 2,500 active clinical sites; 32 nurse anesthesia programs are approved to award doctoral degrees for entry into practice. Nurse anesthesia programs range from 24-36 months, depending upon university requirements. All programs include clinical training in university-based or large community hospitals.
  • Pass the National Certification Examination following graduation.
In order to be recertified, 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.

50 Reasons for Nurses to be Thankful

Thankful Nurses

Thankful Nurses

Thanksgiving is a time for reflection, and nurses can look beyond their own families for things to be grateful for. No matter how you feel about your job or what your career has been like, you can always find something redeeming about nursing. Here are fifty reasons for you to give thanks this holiday season.

Sometimes it is difficult to be thankful in a profession so challenging and all-consuming, but as you can see, you have many reasons to be thankful for your job, despite those challenges. You care for people from birth to death in so many often traumatic circumstances. Yet, you do it with grace. You are very fortunate to be part of a career field with so many options. Many jobs do not have the flexibility or choices that you have and that is probably one of the best perks of your job.

Feel free to add your own to the list. I only went as far as fifty, but I could have come up with fifty more. I’m interested in what other nurses are grateful for! Lets see how many more we can come up with!

1.You get to make a difference in other people’s lives.
2.You get to wear scrubs, or what amounts to pajamas, to work.
3.You know how to talk to doctors and make them listen.
4.You cherish the time you get to spend with your family because you know life is precious.
5.Your holidays off are the best times of the year, even if you know you have to work the next one.
6.Your co-workers have your back during some of the worst times.
7.Bodily fluids wash off with soap and water.
8.You only have to work three days per week if you work 12s.
9.Patients often tell funny stories.
10.You’re part of a community of nurses when you pass boards.
11.You have many options open to you in your nursing career.
12.You can always go back to school to become a more specialized nurse.
13.Certifications in specialties make you a more valuable nurse, usually resulting in higher pay.
14.You can share horror stories with nurse colleagues and laugh about them.
15.You can call that cranky doctor in the middle of the night and ruin his sleep.
16.You can save lives with quick action and critical thinking.
17.Assertiveness training in nursing leads to assertiveness in other parts of your life.
18.No matter how sick your kids get, you can deal with it.
19.You can assess certain patients from the door with experience.
20.If you are unhappy with your workplace, you can always find another job.
21.Nurses who work holidays have potluck parties so everyone can have fun.
22.You get the chance to decorate the unit for the holidays.
23.With your cheerfulness, you can brighten the day of someone in the hospital for the holidays.
24.When census is low, you can get called off.
25.As your seniority grows, you can become more in charge of the unit and its direction.
26.You never have a dull day.
27.Taking off your shoes at the end of a shift feels like heaven.
28.If a patient passes away, you can clean them so the family sees them in peace.
29.You can really develop a connection with patients and their families.
30.DVRs and Netflix exist so that you don’t miss great TV and movies because you’re working.
31.Gloves and protective gear are plentiful to protect from disease.
32.You wash your hands so much that you are less likely to get sick.
33.Hand sanitizer makes your shift flow so much easier.
34.You can type as fast as lightening after so much charting.
35.Despite your lack of muscles, you can lift surprisingly heavy weights.
36.There is no need to wear makeup and do your nails for your shift.
37.You know a hundred ways to save a life.
38.One look at a list of lab results can tell you what’s wrong with a patient.
39.You can wear Crocs without any fashion backlash.
40.If you get your clothes dirty, there are always more scrubs in the OR to change into.
41.You get paid more than minimum wage — though admittedly not nearly enough.
42.You get to choose the needle gauge based on your patient’s behavior.
43.Stabbing people with needles is easy, convenient, and fun.
44.IV pumps mean you don’t have to count drips anymore.
45.Plastic bedpans mean you can just throw away messes instead of trying to clean them.
46.Disposable plastic syringes mean that you can throw away used needles.
47.CPR, ACLS, and 911 exist to save lives that would otherwise be lost.
48.You have your beloved brain sheets and refer to them constantly throughout the shift.
49.You don’t have to chart by hand anymore.
50.Computers have reduced errors and saved many lives in the process.

By Lynda Lampert, RN

How to Teach Young Children About Nursing

Nurse products for kids

Nurse Nicole visits Stuffy Bear Factory at Chesterfield Town Center, VA.

Explore fun and creative methods to teach young children about the profession of nursing.

1. Develop products to introduce nursing as a future career choice to young children.
2. Display products to introduce nursing as a future career option for young children.

Nurse product line:

The nursing shortage has drawn attention to the need to encourage young children to choose nursing as a future career goal. The Adventures of Nurse Nicole is designed to help young children become aware of nursing. Helps children develop skills that are needed to become a nurse. The products will focus on the current realities related to what nurses do in the nursing profession. The tools developed are age-specific such as books titled, “N is for Nurse & Wash Your Hands.” In addition, another tool is an age-specific animated DVD titled, “Battle of the Germs.” Other items available are bears and t-shirts for children. The information reviewed in the books and DVD was used by a nurse to create teaching materials for children.

Free nursing gifts are available on site when Nurse Nicole visits Stuffy Bear factory at Chesterfield Town Center, VA or visit the website

Happy Holiday Season,

Nicole M. Brown, RN aka Nurse Nicole

Book Review: “Nursing From Within” by Elizabeth Scala

Book by Elizabeth Scala

Book by Elizabeth Scala

Spiritual Practice Nurse Elizabeth Scala is a nurse, Reiki Master, healer, certified coach, facilitator, teacher, author and speaker. Her latest book, “Nursing From Within: A Fresh Alternative to Putting Out Fires and Self-Care Workarounds”, is her own prescription for reinvigorating your nursing practice with heart, self-love, balance and magic.

There are three major groupings that nurses struggle with:

Self –Nursing is hard work. It’s physically demanding. It’s exhausting.
Even when you’re off you’re thinking about work or bringing work home
with you. Nursing is a labor-intensive job.

Others – While nursing is hard for you, you know how challenging it can be to work in a team. Not just the coworkers- but the patients. Patients are also getting older, sicker and much more acute.

Global – Nursing is the biggest group that makes up the healthcare system. This is the
age of technology. Documentation goes electronic and charting becomes time consuming and obsessive. Family members get confused on what to do next. Caregivers (that’s us) get exhausted.

Nursing from Within™ is an innovative and uplifting guide for nurses at all levels of the profession. Learn how to shift your inner perspective so you can enjoy the work of helping others, regardless of how stressful or challenging the environment you are working in may be. Are you ready to rediscover the joy and passion of nursing? ‘Nursing from Within: A Fresh Alternative to Putting Out Fires and Self-Care Workarounds’ is available now. Get your copy today by visiting Elizabeth Scala’s site, or purchase directly from Amazon.

This Book is a Must Read!!
Nicole M. Brown, RN

A calendar of the Virtual Blog Tour (In case you would like to follow along with our other nurse bloggers):

Books by Nicole M. Brown

The Adventures of Nurse Nicole: N is for Nurse

The Adventures of Nurse Nicole: N is for Nurse

The Adventures of Nurse Nicole: Wash Hands

The Adventures of Nurse Nicole: Wash Hands

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