A nurse anesthetist (or a certified registered nurse anesthetist (CRNA)), is someone who has completed graduate-level education and has been board certified in anesthesia. They are capable of administering anesthesia under the oversight of an anesthesiologist, surgeon, dentist, podiatrist or other qualified healthcare professional. These advanced practice registered nurses are given a high degree of independence and respect.
A nurse anesthetist (not to be confused with an anesthesiologist assistant) is a specialist within the profession of nursing. They administer anesthesia for all types of cases, in collaboration with physicians and healthcare professionals, from the simplest to the most complex of surgeries. They can be found in many venues, including traditional hospitals, delivery rooms, dentists' offices, ambulatory surgical centres, pain management clinics and battlefields. They are independently licensed health professionals, and are often the sole providers of anesthesia services that offer surgical, obstetrical, and trauma stabilization services in rural hospitals and areas where it would otherwise not be possible. Outside of the operating room, a nurse anesthetist can provide services in other areas, such as lithotripsy units, MRI units, and cardiac catheterization labs. As well, many CRNAs perform administrative functions for the departments of anesthesia, such as personnel and resource management, quality assurance, financial management, and risk management.
A nurse anesthetist (or CRNA) administers anesthesia and anesthesia-related care in four general categories:
The nurse anesthetist must monitor the patient closely to make any adjustments that are needed in medication dosing. Evaluation of the patient’s blood pressure, heart rate, and other measurements help determine the effectiveness of the anesthesia. The nurse anesthetist is also responsible for maintaining the patient’s airway. This is usually accomplished through the use of an intubation tube. The tube allows the nurse anesthetist to protect and control the airway, thus ensuring that the patient is breathing effectively. They must be able to identify and manage emergency situations, and can initiate and participate in cardiopulmonary resuscitation that involves tracheal intubation, ventilation, airway maintenance, and the management of fluid, blood, electrolyte and acid-base balance.
Some nurse anesthetists hold credentials in fields such as respiratory care or critical care nursing, and some choose to specialize in obstetric, neurosurgical, pediatric, dental or cardiovascular anesthesia services.
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The nurse anesthetist can work in a hospital, outpatient surgery clinic, or office-based surgery centre. The environment is clinical and filled with high-tech equipment. The nurse anesthetist will work with other health care members including surgeons, nurses, and operating room technicians. The sterile environment requires the use of masks, gloves, and other personal protective equipment, and the operating room is kept cold to reduce bacteria.
A nurse anesthetist can expect to view live surgical procedures, blood and other body fluids and unpleasant smells. During intubation the nurse anesthetist must insert the intubation tube into the lungs of the patient. They must be comfortable performing this and other medical procedures. In addition, they must meet with and educate patients regarding what to expect from anesthesia before a procedure.
Work hours can vary significantly depending on the normal workload of the institution. Most nurse anesthetists can expect to work between 6am and midnight. They also need to be on call and available at the hospital within 30 minutes, in the event that a patient must have emergency surgery.
An nurse anesthetist is a nurse with extra training (typically two years) in the field of anesthesiology, and has the ability to administer anesthesia. In most surgery centres and hospital settings, they work under the supervision of a board certified anesthesiologist. An anesthesiologist is a physician who has gone through medical school, internship, and then an accredited residency training program in a US hospital.
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