Education

Nurse anesthesia programs are between 24 to 36 months in length (average 28) and provided on a Masters degree level.   In addition, there are Doctorate programs (Nursing Doctorate or Doctor of Nursing Practice) at several universities.   All programs require you to be a registered nurse, and have a four year college degree in science or nursing (BSN), and at least one year of acute care nursing experience before entry.  Acute care is usually defined as intensive care, coronary care, emergency/trauma, etc.  In addition, applicants must meet the qualifications of the graduate school (GRE, GPA, required course work).  Because most programs have far more qualified applicants than available spaces, successful candidates usually have several years of experience in nursing in addition to specialized education in nursing or other health disciplines.  For new applicants, it is important that you meet the qualifications of the graduate college, in addition to any specific requirements of the anesthesia school.   Graduate college requirements may include a minimum score on GRE exams (e.g. 1000+), and possibly a 400 or graduate level statistics course.   Anesthesia school requirements usually include recent college level math, physics, chemistry, and anatomy.   It is important to contact the schools you are interested in, and gather any specific information necessary for your preparation.

Nurse anesthetist Helen Lamb, a leader in nurse anesthesia and past AANA president, performs the anesthesia for Dr. Evarts A. Graham, a renown chest surgeon.   She establised the School of Anesthesia at Barnes Hospital, St. Louis, Missouri, in 1929.   In addition, she performed the anesthetic for the first successful pneumonectomy.

Scope of Practice

The nurse anesthetist can work for a hospital, out-patient surgery center (surgery, dental, podiatrist), in a group practice, or they can practice independently.   CRNAs will work in collaboration with your surgeon, dentist or podiatrist, or on an anesthesia team with an anesthesiologist, to provide anesthesia care.  Laws governing the degree of physician collaboration or supervision will vary state to state.   Most often, the patient can expect to receive their anesthetic from an anesthesia care team, with the CRNA and anesthesiologist working together to provide your care.   CRNAs can administer anesthesia in all types of surgical cases, applying all the accepted anesthetic techniques - general, regional, local, or sedation.  The exception is "pain medicine," which is usually practiced by anesthesiologists.  Others become clinical instructors, school directors, or department supervisors.  Working hours vary according to practice, but in many cases, exceed 40 hours per week.   Salaries exceed most nursing specialties, depending on location and experience.

"U.S. Army Nurse Corps, 1901-1951. Nurse anesthetists find a wide variety of practice in U.S. Army hospitals. The Army Nurse Corps offers a 12-month course in anesthesiology leading to certification by the American Association of Nurse Anesthetists." Postcard, circa 1951 - 1952, courtesy of the Zwerdling Nursing Archives.

In the Military, CRNAs provide a critical peacetime and wartime skill.   During peacetime, they provide the majority of anesthesia services for the retired service member, active duty military and their dependents.  CRNAs function as the only licensed independent anesthesia practitioners at many military treatment facilities, including Navy ships at sea.   They are also a leading provider of anesthesia for the VA and Public Health medical facilities.  During wartime, they are usually the primary anesthesia provider at forward positioned medical treatment facilities (like MASH units), and they play a key role in the education and training of nurses and technicians in the care of trauma patients.  In addition, CRNAs have provided the majority of anesthesia services in every U.S. war during the 20th century.  They have lost their lives in war, have been POWs, and have been in the heat of battle.  Such is the case for Second Lieutenant Mildred Irene Clark, CRNA, BA, who provided anesthesia for casualties from the Japanese bombing of Pearl Harbor.

Nurse anesthetist administering general anesthesia at U.S. Naval Hospital, Oakland, California.  She appears to be supplimenting the anesthetic with sodium pentothal.

U.S. Army nurses following release from Japanese POW camp, with AANA member Annie Mealer, CRNA, among the group.	LTC David R. Fletcher, CRNA, USAF, NC, assist in evacuation of patients at Quang Tri, Vietnam, 1968.

In the earily 60's, the United States Army starting increasing their number of male CRNAs.   The first all male class graduated from Walter Reed General Hospital, Washington, D.C., in May 1961.  They were given the nickname "Ethernauts."   This trend continued in order to fulfill an overall military need in the escalating Vietnam conflict.   In 1966 there was a specific military order to draft male nurses to serve in Vietnam.  Two nurse anesthetists lost their lives in Vietnam, First Lieutenant Kenneth Shoemaker, Jr., CRNA, and First Lieutenant Jerome Olmsted, CRNA, both assigned to 67th Evacuation Hospital in Qui Nhon.

"Ethernauts" recieve their diplomas in 1961 from hospital commander and course directors.

Go here for an Air Force information site on CRNAs in the USAF.

Surgery at Dyess Air Force Base, Abilene, Texas, circa 1957 to early 60's. Anesthetist in lower right corner.

There are 36,000 members in the American Association of Nurse Anesthetists.  This includes certified, recertified, and student members.  The American Society of Anesthesiologists boast a membership of 42,330.   However, in the membership breakdown (2007), 26,093 were active practicing members, and the others where made up of honorary, researchers, residents and medical students, retired members, etc.

King George V Hospital, London, 3rd floor theatre, Dr. Barrington Ward and Mr. Perkins (Actual photograph with a postcard back).	This is the same hospital, but is the 4th floor theatre with "Dr. Morison operating." as per note on back of card.
Postcards, circa 1916, courtesy of the Zwerdling Nursing Archives

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Copyright © 1998-2008 Thomas J. Evans, CRNA, MS