Nurse anesthetist
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Nurse-Anesthetist administers a local anesthetic to an injured Marine prior to surgery aboard USS Kearsarge
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A nurse anesthetist or anesthetic nurse is a nurse who specializes in the administration of anesthesia. 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 90% of the 45,000 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. Worldwide, in the UK and former commonwealth countries the term anesthetist is used for physicians only. It is the British version for a US anesthesiologist. In order to get into this graduate program, one must obtain a BSN degree in nursing, as well as complete their boards and get a license. Graduate programs generally require individuals to have at least a 3.2 GPA in their undergraduate degree. The next step is to have two years experience in a critical care unit, for example the ICU.
Nurse anesthetists have been providing anesthesia care in the United States for 150 years. According to the American Association of Nurse Anesthetists, nurse anesthetists are the oldest nurse specialty group in the United States. Additionally, in testament to the profession’s roots, today’s nurse anesthetists remain the primary anesthesia providers to U.S. service men and women at home and abroad.
Among the first American nurses to provide anesthesia was Catherine S. Lawrence. Along with other nurses, Lawrence administered anesthesia during the American Civil War (1861–1865). The first "official" nurse anesthetist is recognized as Sister Mary Bernard, a Catholic nun who practiced in 1877 at St. Vincent's Hospital in Erie, Pennsylvania. There is evidence that up to 50 or more other Catholic sisters were called to practice anesthesia in various mid-west Catholic and Protestant hospitals throughout the last two decades of the 19th century. The first school of nurse anesthesia was formed in 1909 at St. Vincent Hospital, Portland, Oregon. Established by Agnes McGee, the course was seven 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 third 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.
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