The history of Nurse anesthesia is a long and storied one full of success and trial. Nurse anesthetists have proven their worth across the battlefields of the world and throughout the health care centers of America. I am proud to be called a Nurse anesthetist and dedicate this web site to the advancement of its practitioners and students.
Nurse anesthetists are advanced practice registered nurses who have been providing quality anesthesia services in the United States for nearly 150 years. The longevity and growth of the specialty can be attributed directly to nurse anesthetists’ commitment to excellence and Patient safety and their willingness to provide services when and where needed, and the provision of those services at reasonable cost.
History of Nurse Anesthesia Practice
Certified Registered Nurse Anesthetists (CRNAs) working in collaboration with surgeons, physician anesthesiologists, and other qualified healthcare professionals administer more than 32 million anesthetics to patients each year in the United States, according to the American Association of Nurse Anesthetists (AANA) 2009 Practice Profile Survey. CRNAs practice in every setting in which anesthesia is delivered: traditional hospital surgical suites and obstetrical delivery rooms; critical access hospitals; ambulatory surgical centers; the offices of dentists, podiatrists, ophthalmologists, plastic surgeons, and pain management specialists; and U.S. military, Public Health Services, and Department of Veterans Affairs healthcare facilities. When a nurse anesthetist administers anesthesia, it is recognized as the practice of nursing; when administered by an anesthesiologist, it is recognized as the practice of medicine. Regardless of whether their educational background is in nursing or medicine, all anesthesia professionals give anesthesia the same way.
According to a 1999 report from the Institute of Medicine, anesthesia care is nearly 50 times safer than it was in the 1980s. Numerous outcomes studies have demonstrated that there is no difference in the quality of care provided by CRNAs and their physician counterparts.
Caring for the Nation
CRNAs have long been the primary anesthesia professionals in rural America, enabling healthcare facilities in these medically underserved areas to offer obstetrical, surgical, and trauma stabilization services. In some states, CRNAs are the sole providers in nearly 100 percent of the rural hospitals. Additionally, nurse anesthetists have been the main providers of anesthesia care to U.S. military personnel on the front lines since WWI, including current conflicts in the Middle East. Nurses first provided anesthesia to wounded soldiers during the Civil War.
Early in their history, nurse anesthetists were challenged by lawsuits claiming they were illegally practicing medicine. Landmark decisions in Kentucky (1917) and California (1936) established that they were, in fact, practicing nursing, not medicine. Today, more than 44,000 CRNAs and nurse anesthesia students practice in all 50 states, providing anesthesia services to all segments of the population including substantial numbers of Medicare, Medicaid, public employee, veteran, and indigent patients.
The AANA and its members advocate for changes to the nation’s healthcare system which increase anesthesia patient safety and affordability of anesthesia services, maximize patient access to care, support patients’ rights to receive care from the providers of their choice, and ensure nurse anesthesia educational opportunities. The nurse anesthesia profession also supports public and institutional policy, which enables maximum utilization of CRNAs and their ability to work within their full and legal scope of practice. Their record of patient safety is excellent.
Nurse anesthetists are educated at the graduate level in programs that encompass both academic and clinical study in the specialty of anesthesia. Based on their sophisticated body of knowledge, CRNAs are licensed and certified to practice anesthesia. In addition, they must meet the requirement of recertification every two years. Because of their qualifications, CRNAs are eligible to receive reimbursement for their services directly from Medicare, Medicaid, the Civilian Health and Medical Program of Uniformed Services (CHAMPUS), and a multitude of private insurers and managed care organizations. Legislation passed by Congress in 1986 made nurse anesthetists the first nursing specialty to be accorded direct reimbursement rights under the Medicare program.
About the AANA
The AANA is the sole professional association for the nation’s nurse anesthetists. More than 90 percent of all U.S. nurse anesthetists, including CRNAs and nurse anesthesia students, belong to the association. Founded in 1931, the AANA has issued educational and practice standards and guidelines, developed and implemented a certification and mandatory recertification program, and developed a nationally recognized program for accreditation of nurse anesthesia educational programs. Since 1975, credentialing of nurse anesthesia educational programs and the certification/recertification of nurse anesthetists has been a function of the AANA autonomous multidisciplinary councils. The AANA is actively involved in the development of federal and state healthcare policy, and offers consultation and data sources regarding CRNA practice to both public and private entities.