CRNA

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Outline

Overview

  1. Who is the Certified Registered Nurse Anesthetist (CRNA)?
    1. Advanced practice RN
      1. Provide care before, during, after surgery
        1. Assess patient preoperatively
        2. Administers anesthesia
          1. Surgery
          2. Procedures
        3. Maintains airway
          1. Intubation
          2. Laryngeal mask airway
        4. Monitors
          1. Vital signs
          2. Oxygenation
          3. Perfusion
        5. Provide postoperative care
      2. Trauma stabilization
      3. Critical care interventions
    2. Autonomous role
      1. Overseen by anesthesiologist
      2. In some states
        1. Work without anesthesiologist
    3. Highest paid advanced practice nurse
      1. Competitive field
      2. Growing profession

Nursing Points

General

  1. Where does the CRNA work?
    1. Medical/surgical hospitals
      1. Labor and delivery
      2. Emergency
      3. Surgery
    2. Outpatient surgery centers
    3. Office settings
      1. Dental
      2. Plastics
    4. Pain management facilities
    5. U.S. military facilities

Assessment

  1. Steps to become a CRNA
    1. Earn a bachelor’s degree
      1. Excel in this program!
    2. Obtain state licensure
    3. Gain experience
      1. Acute care setting
        1. At least one year
        2. Preferably 2 plus years
    4. Earn a doctorate or master’s degree in anesthesia
      1. Many programs available
      2. Intense program
        1. 24-36 months
          1. Classwork
          2. Clinical hours
        2. Student cannot typically work
      3. Graduate
        1. Pass boards!

Nursing Concepts

  1. Clinical judgement
  2. Oxygenation
  3. Patient-centered care
  4. Pharmacology

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Transcript

Hey guys!  Today I am going to talk to you about the CRNA or Certified Registered Nurse Anesthetist including what they do and how to get to the status!

So who exactly is the CRNA?  Well guys this is an advanced practice RN who has received specialized training to provide care to patients before, during, and after surgery which predominately includes understanding pharmacology of anesthesia medications to appropriately and safely administer anesthesia.  Anesthesia in simple terms is a combination of medications given to a patient so they have a loss of sensation and also awareness so they are able to tolerate a necessary procedure.


With the administration of anesthesia, the CRNA will also maintain the patient’s airway because with anesthesia they will no longer be able to do this on their own.  Maintaining the airway can mean inserting an endotracheal tube or laryngeal mask airway. While under anesthesia the CRNA will very closely monitor the patient to be sure their vital signs are adequate for perfusion and oxygenation.  The CRNA will also provide care postoperatively until handoff takes place to the postoperative care unit. Often times this means providing pain relief to the patient immediately following surgery.

The role of the CRNA tends to be quite autonomous meaning they are making decisions regarding medications to administer during surgery or a procedure on their own.  In some states CRNA’s work without an anesthesiologist present. In the facility where I work there are anesthesiologists available but the CRNA, on their own will provide anesthesia for inducation and intubation.  If an anesthesiologist is needed they are available but not unless they are called for. The CRNA does however work closely with the surgical staff and surgeon during a procedure. This is definitely a very important but high stress advanced practice nursing role which makes sense that it is one of the highest paid advanced practice nursing roles.  The good thing for those who are interested is this role is still growing but it definitely is competitive!

So where does the CRNA work?  Well, I’m sure you are all aware of the typical surgical setting in hospitals like in the OR, ER, and labor and delivery but it is also common to find CRNA’s in the outpatient surgery centers.  You may even see CRNA’s in the office setting like dental offices where procedures are performed or plastic surgery offices. Pain management facilities are a growing practice that often has CRNA’s on staff to provide anesthesia for quick procedures.  U.S. Military facilities will also have CRNA’s available.

So how can you become a CRNA?  Well if you don’t already have a BSN that will be your first step!  And guys I won’t sugar coat it getting into anesthesia school is super competitive and this starts with have excellent grades in your undergraduate program!  After that education is completed you will take your boards to gain state nursing licensure. You will want to gain experience in the acute care setting preferably the critical care unit but I have heard of some programs accepting ER experience so definitely look into this.  Most programs are asking for at least a year but the more years you have the better! After you’ve gained adequate experience you will want to apply to a program, some are master’s level but some are turning to the doctorate level either way this program lasts between 24 to 36 months.  In these months you will complete classroom education and then clinical hours. Guys keep in mind that most programs do not allow you to work nor would you want to! Finally after completing the program you will graduate and take and pass the boards! Now you are ready to administer anesthesia!

Ok, guys lets review!  The CRNA is an advanced practice RN who provides care before, during, and after surgery with the administration of anesthesia, they maintain airways and monitors patients in an autonomous role.  CRNA’s can work in the hospital setting, outpatient surgery centers, office settings, and pain management facilities. The steps to becoming a CRNA are completing a BSN program, gain state licensure, complete acute care experience, complete a doctorate or master’s nursing program in anesthesia and of course passing boards!

So what nursing concepts can we apply to the CRNA role?  Well clinical judgement most definitely as this is a very autonomous role in which appropriate decision-making is essential in providing patient-centered care.  Pharmacology is definitely appropriate as CRNA’s must understand how different medications work to produce analgesia and amnesia in surgical patients.

We love you guys! Go out and be your best self today! And as always, Happy Nursing!

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Nursing Leadership & Management Study Plan

Concepts Covered:

  • Documentation and Communication
  • Preoperative Nursing
  • Legal and Ethical Issues
  • Communication
  • Integumentary Disorders
  • Studying
  • Prenatal Concepts
  • Prioritization
  • Intraoperative Nursing
  • Emergency Care of the Cardiac Patient
  • Delegation
  • Fundamentals of Emergency Nursing
  • Factors Influencing Community Health
  • Community Health Overview
  • Concepts of Mental Health
  • Neurological Emergencies
  • Test Taking Strategies
  • Basics of NCLEX

Study Plan Lessons

Admissions, Discharges, and Transfers
Advance Directives
Advocating For Your Patient
Applying for Jobs
Barriers to Health Assessment
Bed Bath
Being Successful in Orientation
Career Planning & Job Selection Course Introduction
Caring Licensed Practical Nurse Nursing Mnemonic (CLPN)
Certified Nurse Midwife
Charge Nurse
Climbing the Clinical Ladder
Communicating with Family Members
Communicating with Other Departments
Communicating with Other Nurses
Communicating With Other nurses
Communicating with Patients
Communicating With Pharmacy, RT, OT, PT
Communicating with Providers
Communicating With Providers
Communicating with UAPs
Communication Course Introduction
Confidence Building as a New Grad Nurse
Confidence in Communication
Confidence in Communication – Live Tutoring Archive
CRNA
Daily Charting
Day in the Life of a Community Health Nurse
Day in the Life of a Labor Nurse
Day in the Life of a Med-surg Nurse
Day in the Life of a Mental Health Nurse
Day in the Life of a NICU Nurse
Day in the Life of a Peds (Pediatric) Nurse
Day in the Life of a Postpartum Nurse
Day in the Life of an ICU (Intensive Care Unit) Nurse
Day in the Life of an Operating Room Nurse
Delegation
Documentation Basics
Documentation Course Introduction
Documentation Pro Tips
Documenting Escalation (Chain of Command)
Fall and Injury Prevention
Finding Your First Nursing Job as a New Grad
Fire and Electrical Safety
First Year in Nursing Course Introduction
Flight Nurse
Forensic Nurse
Fundamentals Course Introduction
Giving Handoff Report
Giving the Best Patient Education
Handling Job Rejection
Handoff Report
HIPAA
How to Give a Perfect Nursing Report (plus report sheet)
How to Take Nursing Report
How to Write A Nursing Progress Note
ICU Nurse Report to Floor Nurses
Interviewing with Behavioral Questions
Interviewing with Nurse Manager
Introduction to the Electronic Medical Record (EMR)
Invoicing Process
Joint Commission
Legal Aspects of Documentation
Legal Considerations
Legalities of Charting
License Maintenance
Linen Change
Live Bedside Report OB and PACU
Live Bedside Report Medsurg (Medical surgical)
MSN (Masters) vs. DNP (Doctorate)
Networking 101
NRSNG Live | From Student to Real Nurse
NRSNG Live | Avoiding Legal Issues as a Nurse
NRSNG Live | So You Want to be a Surgical Nurse?
NRSNG Live | The Successful State of Mind
Nurse Educator
Nurse-Patient Relationship
Nursing Care Delivery Models
Nursing Interviews & Resumes Course Introduction
Nursing Report & Communication Course Introduction
Nursing Skills (Clinical) Safety Video
Nursing Skills Course Introduction
OB (Labor) Nurse Report to OB (Postpartum) Nurses
Oncology nurse
Patient Education
Patients with Communication Difficulties
Portfolio
Precepting a New Nurse
Precepting a Student
Prioritization
Prioritization
Prioritizing Assessments
Provider Phone Calls
Radiation Safety for Nurses
Remaining Calm
Report For Transferring To a Higher Level of Care
Research Nurse
Resume and Cover Letter
RN to MSN
Safety Checks
SBAR and How to Give Handoff Report like a BOSS – Live Tutoring Archive
SBAR Communication
SBAR Communication Nursing Mnemonic (SBAR)
SBAR Practice Scenarios
Shift change and Patient handoff
The Customer Voice
The Medical Team
The Nurse Routine
The Top 5 Things You Need To Know About Documentation 1 – Live Tutoring Archive
The Top 5 Things You Need To Know About Documentation 2 – Live Tutoring Archive
Therapeutic Communication
Time Management
Transition To Practice
Transition to Practice Course Introduction
Trusting your Gut
What Guides Nurses Practice
Why CEs (Continuing education) matter
Working night shift
Working with a Preceptor