Courtesy
of Maj. J. Benjamin Campbell
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Maj. J. Benjamin Campbell, a CRNA from
Hot Springs, Ark., and a member of the Army Reserve
for 18 years, recently spent 90 days in Baghdad,
and in 2002 served with his wife, Lt. Col. Mary
Jane Campbell, as the sole anesthesia providers
at Eagle Base in Bosnia.
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They may be the most unheralded heroes in military
history. Most outside the medical profession are unfamiliar
with their work. Yet the military depends upon them
to treat casualties from the frontlines to military
hospitals back home.
| Pain
Professionals |
| Certified
registered nurse anesthetists administer 65 percent
of the 26 million anesthetics given to patients
each year in the United States. CRNAs are also
the sole anesthesia providers in more than 65
percent of rural hospitals.
CRNAs provide anesthetics to patients in collaboration
with surgeons, anesthesiologists, dentists, podiatrists
and other qualified health care professionals.
CRNAs practice in every setting in which anesthesia
is delivered, including traditional hospital surgical
suites and obstetrical delivery rooms; critical
access hospitals; ambulatory surgical centers;
the offices of dentists, podiatrists, ophthalmologists
and plastic surgeons; and U.S. military, public
health services and Veterans Administration health
care facilities.
Anesthesia administered by a CRNA is recognized
as the practice of nursing, while anesthesia administered
by an anesthesiologist is recognized as the practice
of medicine. CRNAs, as advanced practice nurses,
have a high degree of autonomy and made a median
annual income of $113,000 in 2001, based on an
American Association of Nurse Anesthetists membership
survey.
Forty-five percent of the nation’s 30,000
CRNAs are men vs. 5 percent in the nursing profession.
There are 88 nurse anesthesia educational programs
in the United States that range from 24 to 36
months. All programs include clinical training
in university-based or large community hospitals.
Source: American Association of Nurse Anesthetists
Scott Williams
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They’re certified registered nurse anesthetists
and they’ve provided the bulk of anesthesia to
American troops in the war against Iraq, as well as
during the first Gulf war.
Throughout U.S. military history, nurse anesthetists
have provided the bulk of anesthesia services, beginning
as far back as World War I, said Ira Gunn, MLN, CRNA,
a retired Army nurse anesthetist from El Paso, Texas.
“Nurse anesthetists do a good job and they’re
more accessible to the military services,” said
Gunn, who at 76 has become a historian on military nurse
anesthetists.
Nurses became involved in administering anesthesia—discovered
in 1846—from almost the very beginning, when the
Mayo brothers began training them to administer it in
the late 1800s, Gunn said.
“It started pretty much with individual surgeons
getting a nurse and training that nurse to do anesthesia
and then that nurse training more nurses,” she
said.
The U.S. military branches began training nurse anesthetists
at the beginning of the 20th century. By the time World
War II started, there were 287 fully trained anesthesiologists
in the United States and 17 times as many nurse anesthetists,
Gunn said.
“So nurse anesthetists became the primary provider
of anesthesia in World War II,” she said. Nurse
anesthetists outnumbered anesthesiologists in Vietnam
by a 4-to-1 ratio, Gunn said, and that ratio has continued
to hold up throughout the military branches.
Commanding presence
The American Association of Nurse Anesthetists, founded
in 1931, reported that the Pentagon released statistics
in May that indicate that 364 CRNAs and 77 anesthesiologists
were deployed as part of the recent war against Iraq.
By October, those numbers had dropped to 167 CRNAs and
46 anesthesiologists deployed from all military branches.
Why do CRNAs outnumber anesthesiologists to such a
great degree in military service?
“The income as a military officer isn’t
very attractive to anesthesiologists,” Gunn said,
“and [many] nurse anesthetists get training in
the military service.”
That’s how Maj. Adrienne Hartgerink, MSN, CRNA,
RN, received her training as a nurse anesthetist. Hartgerink,
38, is a 16-year veteran of the U.S. Air Force and is
stationed at Langley Air Force Base in Virginia.
She began her Air Force career as a registered nurse
in the intensive care unit at Langley’s hospital.
After eight years, she decided she wanted a new challenge
and the ability to make decisions on her own.
“As a nurse anesthetist, you have a lot of autonomy,
a lot of independent practice, and I like the excitement
of it, too,” she said. “I like the OR setting
in general. I find it fascinating, so that’s kind
of what drew me to it.”
To become a nurse anesthetist, she attended the Uniformed
Services University of the Health Sciences in Bethesda,
Md., where she met her future husband, Brad, a nurse
anesthetist in the U.S. Navy. The military paid for
her and her husband’s schooling and paid them
a salary while they attended school, she said.
In return for her 27 months of schooling, Hartgerink
had to give the military
4 1/2 years of service, including a five-month stint
in the Philippines in 2002. Her husband has been deployed
five times.
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