Dominick Francia
Senior Project Paper CRNA
Mrs. Basile
9 November 2012

Nurse anesthetists provide anesthesia to patients in virtually every medical practice setting, for a variety of surgical and essential pain assistance procedures. Additionally, they care for patients before, during, and after medical procedures or surgery by an assortment of tasks including: patient assessments, patient preparation for anesthesia, administering and maintaining anesthesia to ensure proper sedation and/or pain management, overseeing the patients recovery from anesthesia, and last caring for the patient's immediate post-operative needs. The credential CRNA evolved in 1956 in the United States, and is an acronym for Certified Registered Nurse Anesthetist. CRNA professionals are those who administer more than 33 million anesthetics safely to patients each year in the United States, according to the American Association of Nurse Anesthetists (AANA) 2011 Practice Profile Survey. CRNAs are the primary providers of anesthesia care in America enabling healthcare facilities to offer obstetrical, surgical, pain management and trauma stabilization services. In some states, CRNAs are the exclusive providers in nearly 100 percent of their hospitals. CRNAs provide anesthesia in cooperation with surgeons, anesthesiologists, dentists, physicians and other qualified healthcare 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, which is why I have chosen this as a potential future career choice. I enjoy being considered a highly reputable person, and I also enjoy thorough compensation for any duty I perform. Furthermore, this profession provides limitless opportunities for professional growth, income, and independent opportunities. CRNAs practice in every setting in which anesthesia is delivered: traditional hospitals, surgical and obstetrical delivery rooms, critical access hospitals, ambulatory surgical centers, dental offices, podiatrists, ophthalmologists, plastic surgeons, pain management clinics, and U.S. military and government facilities. Because the delivery of anesthesia is used in a such a vast array of settings and locations, this makes a CRNA career more marketable for nursing professionals, and job opportunities among them significant. When selecting a career path, one must consider the long term effects and outcome of their post secondary education. Considerations should be made to ensure that I am not only choosing a profitable profession, but also one that will market me for jobs in healthcare industry upon graduation, and in the future. Nationally, the average 2012 malpractice premium for self-employed CRNAs was 33 percent lower than in 1988 (62 percent lower when adjusted for inflation). More than 45,000 of the nation’s nurse anesthetists (including CRNAs and student registered nurse anesthetists) are members of the AANA (or, greater than 90 percent of all U.S. nurse anesthetists). More than 40 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, and graduation with a minimum of a master’s degree from an accredited nurse anesthesia educational program. As of June 2012 there were 112 accredited nurse anesthesia programs in the United States utilizing more than 1,850 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. You must also pass the national certification examination following graduation. Strategies for career retention and advancement in the global workplace are easily met due to the continuing education factor that is built into the job certification requirements. 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 current state licensure, and certify that they have not developed any conditions that could adversely affect their ability to practice anesthesia.

The marketability of the CRNA professional provides many opportunities for advancement, and in salary benefits. Certified registered nurse anesthetists are some of the highest-paid advanced practice nursing professionals. Salaries vary greatly by region, type of facility one works, the number of years in practice, and the sub-specialty categories of work. According to a Merritt Hawkins & Associates study from 2009 the average salary for CRNAs was $189,000, although in 2005 the average annual CRNA salary was reported to be $160,000. Starting salaries tend to be closer to $110,000-$140,000 range in our Northeast region of the United States. Additionally, opportunities to work as an independent contractor, or even start a business of providing CRNA staffing could open up the possibility of increased salary. Both interviewees stated that in addition to the compensation for their job, they are given outstanding health benefits through their hospital employer within their facility. They also have access to their employers pharmacy in which they are not required to pay for prescriptions prescribed by one of their network providers. The working hours can be grueling and differ based upon the need of individual facilities one works. Hours vary and are generally between 36 and 45 hours a week plus additional time if you are on call, and have to report to the hospital for any emergency procedures. Staff members usually work on a rotating on call schedule and are required to be on call 1 to 2 times per month. They also are compensated (with wages) for wearing the pager while on call. If they are called upon for emergency services they have to report immediately to their facility. Therefore, one cannot live to far away from their place of employment if they are required to be on call.

Interviewing the two Nurse Anesthetists was an eye opener, with a thorough description of the educational element required and clinical work that is necessary to obtain an anesthesiology degree. While both interview candidates had identical responses in terms of schooling and service requirements, they had differences in opinion in terms of compensation within their respective field. The male candidate felt he was inadequately compensated and was not concerned with the Obamacare plan, while the female candidate felt she was compensated well for her job, and is highly concerned with the Obamacare plan. Interviewee 2 indicated that her employer has already spoken to hospital employees, and presented forthcoming changes in their healthcare should the Obamacare plan be approved. Changes include: lowered wages(25% decrease ) and changes in the number of staff members(lay-offs) across the entire hospital employee population. Both spoke very highly of the respect shown toward them by other service industry professionals, and indicated they were given terrific medical benefits that included their families. Lastly, both candidates were in agreement that the nurse anesthetist job is very stressful, and that it is beneficial to have an outlet to manage your stress.

In listening to the responses of both nurse anesthetists I feel that I have benefited significantly from hearing perspectives from two individuals that work in the same field of work, but different locations. Hard work and determination is needed in order to enter the field and to assist people during a time of helplessness. Additionally, both interview candidates reflected upon their personal dedication to the well being of their patients. Along with hard work and dedication there is an additional component of having empathy toward the patients. Endurance is another word that comes to mind, because of the grueling hours one may have to work, the time spent on your feet, and the personal balance while working in stressful situations. Being able to communicate effectively with patients, their families, and your colleagues with whom you are working is another key component of this career where you continually function as part of a team.

I think I have the qualities it takes to be successful in this field. I like to be placed in challenging situations, enjoy learning new things, and have built up stamina by working out and by getting adequate amounts of sleep. Additionally, I believe that my involvement in various sporting programs throughout my life has taught me many lessons that I can take with me and use to my advantage. Specifically, functioning as part of the team , continually challenging myself, and contributing my best qualities to ensure the teams success are traits I encompass and bring with me. I also feel that my family dynamics has had an impact on me as well, and will contribute to my success in my career path. I have a large family, so I feel that I have learned how to communicate effectively with a variety of different people, from infants to the elderly. Hard work, determination, dedication, communication skills, stamina and empathy, are all traits one must have in order to be successful in this career, and those are qualities I possess and will utilize to be successful. The plan I have is to major in biology and obtain my nursing degree. Once I have graduated and have obtained my BS for a Registered Nurse, I plan on utilizing my skills in a critical care unit and to possibly work in a major trauma unit. After I have successfully completed a minimum of three years of service, I plan to apply to colleges to begin the final step in my career path of completing anesthesia school.

In conclusion, I feel that becoming a Nurse Anesthetist will bring me a feeling of accomplishment and satisfaction, given the fact that I would be helping people every day in their time of need. Helping people daily, rising to meet new challenges, continuing my education, and being able to utilize the skills associated with this career choice would bring me tremendous satisfaction.

Resource Page https://www.cwds.state.pa.us/cwdsonline/Admin/ViewHomePage/PublicHomePage.aspx?xpCYFkUGysBn_bKh_0fv6X6wp00q@2n2oq95vkXXpihEu5vOwWUFpTudW9l2Qrd66L1DVyoMtPDVJ7Suzhwx3aMD2hWCkUk6KCYhswps408-FaKTj9YV2dq0JcLrIpJ3GRpRfTFxgCZqso_4DEkRkr_BUdWDTRj3 (PA Career Link)

Nick Francia, CRNA

Ann DeLattre, CRNA

www.nurse-anesthesia.org

allnurses.com/certified-registered-nurse/