Photo courtesy of American
Associaton of Nurse Anestheists
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| Nurse
anesthetists are among the most highly sought-after
health professionals today, benefiting from a higher
profile in the field and a growing workload. |
As a certified nurse anesthetist in rural Nebraska,
Steve Wooden, MS, CRNA, travels quite a bit. But he
doesn't always hit the road.
Instead, his services are in such high demand in remote
areas of the state, he takes to the cockpit of his private
plane to pilot himself to various operating rooms.
"I do a lot of traveling, as much as 100 miles
or more to do a case or two. Without CRNAs, small hospitals
would have a hard time providing surgery services, or
even staying in business," said Wooden, of Anesthesia
Services of Nebraska in Broken Bow.
On a typical day, Wooden may administer anesthetic
for a toddler's spinal tap, fly to another town for
a major surgery or for a birth, and head back to Broken
Bow to give a local or spinal analgesia for a patient's
chronic back pain.
Nurse anesthetists are among the most highly sought-after
health professionals today, benefiting from a higher
profile in the field and a growing workload. CRNAs administer
about 65 percent of the anesthetics given in this country
each year, working collaboratively with physicians to
care for patients before, during and after surgery.
The percentage of anesthesia given by CRNAs has increased
from about 49 percent in 1971.
Why the surge in demand? CRNAs are cost-effective providers
of anesthesia service at a time when numbers of inpatient
and outpatient surgeries are rapidly increasing, reported
Allied Consulting Inc., a Texas professional staffing
firm. With a concurrent nationwide shortage of anesthesiologists
and managed care's imperative to reduce costs, CRNAs
represent a savings to hospitals.
"We perform [a lot of] the same clinical functions
as an anesthesiologist," said Rodney Lester, Ph.D.,
CRNA, nurse anesthesia division director and associate
professor of clinical nursing at the University of Texas-Houston
Health Science Center School of Nursing. "Day surgery
and short surgical procedures have increased, so a CRNA
may be able to do 10 to 12 anesthetics per day as opposed
to six or seven. We have enough CRNAs to take care of
everyone, but patients for elective surgeries may have
to wait a little later in the day."
About 80 percent of CRNAs work as partners in care
with anesthesiologists, while the remaining 20 percent
function as sole anesthesia providers collaborating
with surgeons and other licensed physicians. In anesthesia
care teams, anesthesiologists provide medical direction
for up to four CRNAs, and CRNAs typically administer
the anesthetics and remain in the operating room with
the patient the entire time.
The ratio of anesthesiologists to CRNAs is set by the
hospital or surgery center, based on the sickness of
the patients and the amount of manpower the institution
can afford, Lester said.
The demand for CRNAs, particularly in rural communities,
has produced an 11 percent vacancy rate for CRNA job
positions, according to a recent study by the American
Association of Nurse Anesthetists. Allied Consulting
reported it conducted more searches for CRNAs in 2002
than for any other type of health care professional.
"This is a tough market for recruiting. CRNAs
can literally go anywhere they want to go," said
Larry Hornsby, CRNA, president of Anesthesia Solutions,
which staffs both CRNAs and anesthesiologists for a
hospital in Mobile, Ala. "If someone is burned
out with late hours at a large hospital, they can go
to an ambulatory center across town, and salaries are
increasing."
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