CRNA

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CRNA

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Outline

Overview

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

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

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

Clinical judgement
Oxygenation
Patient-centered care
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!