Anesthesia in Rural American

¶ … competition increasing in every field including nursing, it is not desirable for any professional nurse to just be content with a bachelor's degree in Nursing. It should be noted here that as the subspecialties and subfields are evolving with betterment and improvement in the field of nursing and healthcare, the responsibility of the nurses is being further increased with respect to their professional competence. After my attaining my bachelor's degree in nursing, I would now like to go on to become a Certified Registered Nurse Anesthetics, for which I would like to explore the universities that are offering this program. As a part of this paper, I would include some of the top universities where I plan to apply and get in to complete my degree as a certified nurse anesthetic. However, there are some aspects that I need to consider before applying to these universities, pertaining to the cost and availability of seats.

Why CRNA?

Many would question as to what is the main inspiration for going for CRNA. A nightmare like surgery has been converted into a miracle just because of anesthesia as it has made all surgeries pain-free and this treatment easy for the patients as well as the doctors. It is important to note here that nurse anesthetics are one of the first healthcare providers that decided to dedicate a special department for anesthesia back in the 1800s. The role of nurses in anesthesia started when nurses would give anesthesia to the wounded soldiers who would get injured during the Civil War. In today's world where the field of healthcare has improved several-folds since the 1800s, Certified Registered Nurses Anesthetics are mastered nurses that have been prepared in this advanced field and these nurses have the privilege to enjoy a greater degree of professional respect and autonomy because of the delicacy of the field they have specialized in. Among the several roles of CRNAs, the provision of anesthesia to patients in almost every practice setting is including in the most important ones. It is quite interesting to note here that nurses are prepared for different types of procedures and surgeries as the type and duration of anesthesia varies according to the procedure being done. Another reason why CRNAs are being valued is that they are the only providers of anesthesia in hospitals in the rural settings and are the sole providers of anesthesia to males as well as the females that are serving in the Armed Forces of the United States (Aana.com, 2014).

The first CRNA was acknowledged as an advanced professional nurse in the year 1956. In the United States alone, CRNAs are known to safely administer above 34 million anesthetics to patients every year, being anesthesia professionals, according to the Practice Profile Survey carried out in the 2012 by the American Association of Nurse Anesthetics.

As it has already been mentioned above, CRNAs are considered to be the sole primary providers of anesthesia in rural American settings and it is because of them that healthcare facilities are not being compromised in these areas where surgical, obstetrical, trauma stabilization and pain management services are to be provided to the deserving patients. In some states of the country, CRNAs are named as being the only providers of anesthesia in almost all of the rural hospitals.

According to a report that was published in the year 1999 by the Institute of Medicine, the advancement in anesthesia care has been improved about 50 times as compared to what it was in the 1980s. Several studies have concluded that there is no compromise in the quality of healthcare that is provided by the CRNAs when compared with their physician counterparts in the field.

Apart from the primary responsible anesthetic professionals in the rural settings, CRNAs also have the responsibility to provide anesthesia to the patients in collaboration with anesthesiologists, surgeons, dentists, podiatrists and other qualified healthcare professionals. The administration of anesthesia by a nurse anesthetist is considered to be a recognized and acknowledge part of the nursing practice; meanwhile when it is safely administered by an anesthesiologist it is considered to be a part of practice of medicine. Irrespective of the professional background, whether anesthesia is being administered by a doctor or a nurse, anesthesia professionals are trained in the same way when it comes to the administration and provision of anesthesia (Bankert, 1989).

In the year 2001, the federal physician supervision rule pertaining to nurse anesthetics was changed by the Centers for Medicare and Medicaid Services since they were now allowed to opt out of the requirement of the facility reimbursement by state governors. CRNAs could opt out of this requirement, which applied to ambulatory surgical centers as well as hospitals, by fulfilling three criteria that included the consultation of the nursing issues and state boards of medicine with respect to the issues relevant to access and the quality of anesthetic services being provided in the state, the determination of opting out of this facility in compliance with the state law and the determination that opting out will be in the best interest of the citizens of the state. Up till now, the number of states that have opted out of this federal supervision requirement has gone up to 17, with Kentucky being the most recent one (April 2012).

According to the national statistics, the average of malpractice premium for CRNAs that were self-employed was around 33% lower than as compared to the average in the year 1988. Direct reimbursement rights were given to the nurse anesthetics, which made the first nursing specialty to get these rights under the Medicare program in the country. Approximately 47,000 nurse anesthetics of the country that includes student registered nurse anesthetics and the CRNAs have become members of the AANA, which accounts for more than 90% of nurse anesthetics in the United States. More than 40% of nurse anesthetics are male nurses, as compared to the less than 10% of the nursing profession as a whole (Grade, 1996).

Requirements to become a CRNA

As with any professional degree, there are some prerequisites for becoming a CRNA. In order for a nurse to become a CRNA, he or she would require a Bachelor of Science in Nursing degree or any other degree that would be equivalent to a bachelorette degree. The nurse who wishes to become a CRNA would require a current license as a registered nurse. Nurses need to get a certificate or experience letter of a registered nurse in emergency care setting of at least one whole year. It is required for the nurses to acquire a graduate degree with at least a master's degree from an anesthesia educational program that is recognized by the law. As of the year 2013, 113 accredited nursing anesthesia educational programs were being run in the United States that made use of over 2,200 working clinical sites, out of which 16 programs were awarding a doctoral degree to become eligible for practice. The duration of nursing anesthesia programs ranges from 24 to 36 months, depending upon the institutional requirements of different universities. These programs include clinical training in large community hospitals or university-based hospitals. Following graduation of the aforementioned degrees, nurse anesthetics need to pass the national certification examination to become a CRNA.