Dwight D. Eisenhower Army Medical Center observed Certified Registered Nurse Anesthetists Week from January 22-28. Nurse anesthetists have been providing anesthesia care to patients in the United States for nearly 150 years.

The credential Certified Registered Nurse Anesthetist came into existence in 1956. CRNAs are anesthesia professionals who safely administer more than 32 million anesthetics to patients each year in the United States, according to the American Association of Nurse Anesthetists Practice Profile Survey.

CRNAs are the primary providers of anesthesia care in rural America, enabling health care facilities in these medically underserved areas to offer obstetrical, surgical, and trauma stabilization services. American Association of Nurse Anesthetists advises that in some states, CRNAs are the sole providers in nearly 100 percent of the rural hospitals.

According to a 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 health care 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 health care facilities. Nurse anesthetists have been the main providers of anesthesia care to U.S. military personnel on the front lines since WWI, including current conflicts in the Middle East. Nurses first provided anesthesia to wounded soldiers during the Civil War.

Managed care plans recognize CRNAs for providing highquality anesthesia care with reduced expense to patients and insurance companies. The cost-efficiency of CRNAs helps control escalating health care costs. Legislation passed by Congress made nurse anesthetists the first nursing specialty to be accorded direct reimbursement rights under the Medicare program.

More than 44,000 of the nation’s nurse anesthetists, including

CRNAs and student registered nurse anesthetists, are members of the AANA, or greater than 90 percent. Approximately 41 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 an acute care setting.

•Graduation with a minimum of a master’s degree from an accredited nurse anesthesia educational program. As of August, 2011 there were 112 nurse anesthesia programs in the United States utilizing approximately 2,450 approved clinical sites. These 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 a current state license, and certify that they have not developed any conditions that could adversely affect their ability to practice anesthesia.