In the United States, a Certified Registered Nurse Anesthetist (CRNA) is an advanced practice registered nurse (APRN) who has acquired graduate-level education and board certification in anesthesia. The American Association of Nurse Anesthetists’ (AANA) is the national association that represents more than 92% of the 40,000 nurse anesthetists in the United States. Certification is governed by the National Boards of Certification and Recertification of Nurse Anesthetists (NBCRNA). Education is governed by the Council on Accreditation (COA) of Nurse Anesthesia Educational Programs. The first school of nurse anesthesia was formed in 1909 at St. Vincent Hospital, Portland, Oregon. Established by Agnes McGee, the course was six months long, and included courses on anatomy and physiology, pharmacology, and administration of common anesthetic agents. Within the next decade, approximately 19 schools opened. All consisted of post-graduate anesthesia training for nurses and were about six months in length. These included programs at Mayo Clinic, Johns Hopkins Hospital, Barnes Hospital, New York Post-Graduate Hospital, Charity Hospital in New Orleans, Grace Hospital in Detroit, among others. Early anesthesia training programs provided education for all levels of health providers. For example, in 1915, chief nurse anesthetist Agatha Hodgins established the Lakeside Hospital School of Anesthesia in Cleveland, Ohio. This program was open to nurses, physicians, and dentists. The training was six months and the tuition was $50. A diploma was awarded on completion. In its first year, it graduated six physicians, two dentists, and 11 nurses. Later, in 1918, it established a system of clinical affiliations with other Cleveland hospitals. Some nurse anesthetists were appointed to medical school faculties to train the medical students in anesthesia. For example, Agnes McGee also taught 3rd year medical school students at the Oregon Health Science Center. Furthermore, nurse anesthetist Alice Hunt was appointed instructor in anesthesia with university rank at the Yale University School of Medicine in 1922. She held this position for 26 years. In addition, she authored the 1949 book Anesthesia, Principles and Practice. This is most likely the first nurse anesthesia textbook.
Nurse anesthetists must first complete a bachelor’s degree in a science related field or a Bachelor of Science in Nursing. They must be a licensed registered nurse. In addition, candidates are required to have a minimum of one year of full-time nursing experience in an acute care setting, such as medical intensive care unit or surgical intensive care unit. Following the acute care experience, applicants apply to a Council on Accreditation (COA) accredited program of nurse-anesthesia. Education is offered on a masters degree or doctor degree. Program length varies from 24 to 36 months. Many programs require entrance prerequisites similar to medical schools (pre-med courses) and up to two years of acute care experience. The didactic curricula of nurse-anesthesia programs are governed by the Council on Accreditation (COA) standards and provide students the scientific, clinical, and professional foundation upon which to build sound and safe clinical practice. Clinical residencies afford supervised experiences for students during which time they are able to learn anesthesia techniques, test theory, and apply knowledge to clinical problems. Students gain experience with patients of all ages who require medical, surgical, obstetrical, dental, and pediatric interventions. In addition, many require study in methods of scientific inquiry and statistics, as well as active participation in student-generated and faculty-sponsored research.
Resources:
Nurse Anesthetist: Training, Learning, History
How Long Does it Take To Become a Nurse Anesthetist?