Get to know Certified Registered Nurse Anesthetists

You may not be familiar with the term Certified Registered Nurse Anesthetist or CRNA, but most likely, you or a family member has benefited from their expertise. A CRNA is an advanced practice registered nurse (APRN) who specializes in providing anesthesia care to patients in hospitals, surgery centers and other healthcare settings.

From working in Texas' major hospital systems, where they often collaborate with physicians in providing care to patients, to the most rural counties, where they are often the only anesthesia provider within miles, CRNAs are making a difference and helping Texans access the healthcare they need when they need it.

According to the American Association of Nurse Anesthesiology (AANA), CRNAs played a significant role in caring for patients with COVID-19 and continue providing lifesaving care today. Because CRNAs specialize in advanced airway management, including intubation, and advanced ventilator management, including turning operating room ventilators into ICU ventilators they were able to step right into the Covid crisis and immediately make a difference.

James Stockman, MSNA, CRNA, NSPM-C, President of the Texas Association of Nurse Anesthetists (TxANA), practices in Nacogdoches, a small city in northeast Texas with a population of slightly over 30,000. He has seen first-hand for nearly 20 years the importance of CRNA presence in rural communities.

The education needed to practice as a CRNA in the United States is the highest among all nursing professions. According to AANA, it takes a minimum of seven to eight years of education and experience to prepare a CRNA. The education and experience required to become a CRNA include the following:

• A baccalaureate or graduate degree in nursing or another appropriate major.
• An unencumbered license as a registered nurse and/or APRN in the United States or its territories.
• A minimum of one year of full-time work experience, or its part-time equivalent, as a registered nurse in a critical care setting within the United States, its territories, or a U.S. military hospital outside of the United States. The average experience of R.N.s entering nurse anesthesia educational programs is 4.5 years, according to the NBCRNA.
• Graduation from a nurse anesthesia educational program accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs.

The rigorous training of CRNAs allows them to make lifesaving decisions and actions, and care for a patient before, during and after a procedure.

The difference between a physician anesthesiologist and a CRNA is that anesthesiologists are medical doctors (M.D.s) or doctors of osteopathic medicine (D.O.s) who administer anesthesia, while nurse anesthetists are APRNs who may assist or collaborate with doctors in administering anesthesia. While physicians delegate the administration of anesthesia to a CRNA, an Attorney General Opinion has confirmed that state law does not require CRNAs to practice under physician supervision.

According to a recent study, individual facility characteristics and rural/urban considerations play a significant role in facilities' use of anesthesia service delivery models. Allowing CRNAs to provide anesthesia services independently may help alleviate anesthesiology provider shortages, particularly in rural locations, without adversely affecting the patient's quality of care while reducing total anesthesia delivery costs.

Patients can be sure that the care provided by CRNAs is high-quality and safe. According to a scientific literature review prepared by the Cochrane Collaboration, an internationally recognized authority on evidence-based practice in healthcare, there are no differences in care provided by nurse anesthetists or physician anesthesiologists based on existing literature. More information, including peer-reviewed studies, can be found at www.crnasafe.com.

The Texas Department of State Health Services frequently publishes data showing a shortage of nursing workforce in the state, and Stockman urges all those interested in nurse anesthesia to be a part of the solution to anesthesia and nursing needs.

"All nursing professions are stronger in numbers," Stockman said. "Addressing the nursing shortage should be a priority, its important to patients and our healthcare system. Addressing the nursing shortage also creates a strong pipeline for registered nurses to advance into APRN programs, giving the best care to patients in Texas."