W.T.G. Morton, a dentist, first demonstrated the efficacy of ether as an anesthetic agent at the Massachusetts General Hospital in 1846, and J.Y. Simpson began using chloroform in 1847 to relieve the pain of childbirth in England. The idea of general anesthesia for surgery gained rapid popularity. However, some physicians and laymen believed it might be a mixed blessing, and they were proven right at the time. Having no qualified anesthetizer, the job of anesthetist was passed to whomever was available, from house officer to medical students to janitors. From 1850 until about 1875, surgical morbidity and mortality could be blamed on either infection or anesthesia. After 1875, anesthesia was cited as the cause of the greatest incidence of morbidity and mortality. The furor over the high death rate was common to both the United States and Europe. American surgeons decided that the major cause of the adverse anesthesia effects was the "occasional anesthetist." They called for clinicians to dedicate themselves solely to the specialty of anesthesia, and the new professional nurse answered the call. Nurse anesthetists have been providing anesthesia care in the United States for more than 100 years.
Certified Registered Nurse Anesthetists (CRNAs) are anesthesia specialists who administer approximately 65% of the 26 million anesthetics given to patients each year in the United States. CRNAs are the sole anesthesia providers in approximately 50% of all hospitals and nearly 70% of the rural hospitals in the United States.
CRNAs provide anesthetics to patients in collaboration with surgeons, anesthesiologists, dentists, podiatrists 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.
Managed care plans recognize CRNAs for providing high-quality anesthesia care with reduced expense to patients and insurance companies. The cost-efficiency of CRNAs helps keep escalating medical costs down. Legislation passed by Congress in 1986 made nurse anesthetists the first nursing specialty to be accorded direct reimbursement rights under the Medicare program.
A total of 45% of the nation's 28,000 CRNAs are men, versus approximately 5% in the nursing profession as a whole.
The advanced nursing profession of nurse anesthesia requires a bachelor's
degree in nursing and a master's degree in nurse anesthesia. A PhD also is
available. Certification is granted via examination by an accredited
educational facility, and recertification is required every two years.
Certified Registered Nurse Anesthetists (CRNAs) are licensed professional registered nurses who have obtained, through additional education and successful completion of a national examination, certification as anesthesia nursing specialists. CRNAs are qualified to make independent judgments relative to all aspects of anesthesia care, based on their education, licensure, and certification. The practice of anesthesiology by nurses has been recognized by the courts as the practice of nursing since 1917. CRNAs provide anesthesia and anesthesia-related care upon request, assignment, or referral by a patient's physician (or other healthcare professionals authorized by law), most often to facilitate diagnostic, therapeutic or surgical procedures.
CRNAs practice in every setting in which anesthesia is delivered:
Traditional hospital surgical suites
Obstetrical delivery rooms
Plastic surgeon offices
Ambulatory Surgical Centers
U.S. Military facilities
Public health service facilities
Veterans Administration medical facilities