Q. What is a Certified Registered Nurse Anesthetist?
Certified Registered Nurse Anesthetists (CRNAs) are highly skilled advanced practice registered nurses who specialize in the field of anesthesiology and pain management. Nurse anesthetists have been providing anesthesia care to patients in the United States for more than 150 years. As licensed independent practitioners, CRNAs undergo significant post-graduate education and training averaging 30 months in duration and resulting in a master’s or doctoral degree in nurse anesthesia.
Q. What is the CRNA’s role?
CRNAs are responsible for patient safety before, during and after surgery. Nurse anesthetists administer every type of anesthesia to all types of patients in any healthcare setting. CRNAs provide continuous pain relief and sustain patients’ critical life functions throughout surgical, obstetrical and other medical procedures. In addition to anesthetic agents, CRNAs select and administer adjunct drugs to preserve life functions. These advanced practice registered nurses also use technologically advanced monitoring equipment and interpret a vast array of diagnostic information throughout the course of the anesthetic process.
Q. What is the American Association of Nurse Anesthetists?
Founded in 1931, the American Association of Nurse Anesthetists (AANA) is the professional organization representing more than 90 percent of the nation's CRNAs. AANA members number 47,000, including CRNAs and student registered nurse anesthetists. More than 40 percent of the nation’s nurse anesthetists are men, compared to approximately 10 percent in the nursing profession as a whole. The AANA headquarters is located in Park Ridge, Illinois, with a satellite office in Washington, D.C.
Q. Do CRNAs work with physicians?
Yes. Like all anesthesia professionals, CRNAs collaborate with all members of the surgical team including surgeons, endoscopists, radiologists, podiatrists, obstetricians and other physician specialists to ensure the safest, most comfortable experience possible for their patients. State laws and regulations vary on whether CRNAs must be supervised by a physician; well over half of all states do not require physician supervision. In any case, nurse anesthetists always are independently responsible for their own actions. Surgeons quite properly defer to nurse anesthetists as the experts in anesthesia care.
Q. Is there a difference between a CRNA and a physician anesthesiologist?
Like anesthesiologists, CRNAs provide the full range of anesthesia services in collaboration with surgeons, endoscopists, radiologists, podiatrists, obstetricians, and other physician specialists. 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 deliver anesthetics using the same state of the art techniques and leading edge equipment, resulting in an exemplary safety record. Numerous studies have demonstrated that there is no difference in outcomes when anesthesia is administered by a CRNA or by an anesthesiologist.
Q. Is anesthesia safe?
Advances in pharmaceuticals, technology and training for nurse anesthetists and anesthesiologists have contributed significantly to improvements in patient safety. According to the Institute of Medicine (IOM), AANA, and the American Society of Anesthesiologists, anesthesia care is nearly 50 times safer than it was just 30 years ago, and in a 1999 report, the IOM identified anesthesia as one of the safest healthcare specialties. Today, perioperative deaths attributed to anesthesia occur approximately once for every 250,000-300,000 anesthetics provided, representing a dramatic increase in patient safety despite an aging U.S. population and older, sicker patients being treated in operating rooms nationwide. Numerous outcomes studies have confirmed the safety record of CRNAs and demonstrated that there is no difference in the quality of anesthesia care provided by CRNAs and anesthesiologists.
Q. How do CRNAs affect medical liability?
Just like physicians, nurse anesthetists are responsible for securing their own liability coverage. In part because the care delivered by CRNAs is getting safer all the time, nurse anesthetist professional liability premiums are 33 percent lower today than 25 years ago, 62 percent lower when adjusted for inflation. The same legal principles that govern the liability of surgeons working with nurse anesthetists apply to surgeons working with anesthesiologists.
Q: Is there a cost differential between an anesthesiologist and a CRNA? If the cost is the same, why not get an anesthesiology physician?
The mean annual compensation for an anesthesiologist is about $400,000, nearly two and one-half times that of a CRNA whose median total compensation is about $165,000. Because Medicare pays the same fee for an anesthesia service whether it is provided by a CRNA, an anesthesiologist, or both working together, the higher cost of the anesthesiologist must be is borne by the hospital, the healthcare facility or the patient.
Q. Do CRNAs need to be recertified?
Yes. 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 they have not developed any conditions that could adversely affect their ability to practice anesthesia.
Q: Is it possible for a nurse to ever be as well‐trained as a physician?
CRNAs and anesthesiologists undergo similar education and training, and research shows that CRNAs deliver anesthesia care that is the same high quality as that of anesthesiologists. The focus should be on outcomes, not titles. CRNAs are highly educated advanced practice registered nurses who specialize in anesthesia, have extensive experience in acute care settings, and hold advanced degrees in addition to their undergraduate nursing education and training.