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The role of Certified Registered Nurse Anesthetists in the United States

Abstract

Certified Registered Nurse Anesthetists (CRNAs) have been providing anesthesia care in the United States (US) for nearly 150 years. Historically, anesthesia care for surgical patients was mainly provided by trained nurses under the supervision of surgeons until the establishment of anesthesiology as a medical specialty in the US. Currently, all 50 US states utilize CRNAs to perform various kinds of anesthesia care, either under the medical supervision of anesthesiologists in most states, or independently without medical supervision in 16 states; the latter has become an on-going source of conflict between anesthesiologists and CRNAs. Understanding the history and current conditions of anesthesia practice in the US is crucial for countries in which the shortage of anesthesia care providers has become a national issue.

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Notes

  1. Certified Registered Nurse Anesthetists (CRNAs) at a Glance. Available at: http://www.aana.com/ataglance.aspx

  2. Historical Resources. Available at: http://www.aana.com/Resources.aspx?id=2049

  3. Medicare and Medicaid Programs; Hospital Conditions of Participation: Anesthesia Services. Available at:http://www.gpo.gov/fdsys/pkg/FR-2001-11-13/html/01-28439.htm

  4. Accredited Nurse Anesthesia Programs. Available at: http://webapps.aana.com/AccreditedPrograms/accreditedprograms.asp?State=all

  5. The National Board on Certification and Recertification of Nurse Anesthetists (NBCRNA). Available at: http://www.nbcrna.com/

  6. American Association of Nurse Anesthetists. Education of Nurse Anesthetists in the United States; At a Glance 2008. Available at: http://www.aana.com/BecomingCRNA.aspx?ucNavMenue-TSMenueTargetID=18&ucNavMenuTargetType=4&ucNavMenu-TSMenuID=6&id=1018

  7. Scope and Standards for Nurse Anesthesia Practice. Available at: http://www.aana.com/uploadedfiles/resources/practice_documents/scope_stds_nap07_2007.pdf

  8. Questions and Answers: A Career in Nurse Anesthesia. Available at: http://www.aana.com/BecomingCRNA.aspx?id=110&linkidentifier=id&itemid=110

  9. Occupational Employment and Wages, May 2009: 29-1111 Registered Nurses. Available at: http://www.bls.gov/oes/2009/may/oes291111.htm

  10. Occupational Employment and Wages, May 2009: 29-1061 Anesthesiologists. Available at: http://www.bls.gov/oes/current/oes291061.htm#(5).

  11. Abouleish, AE, Stead SW, Cohen NA. Myth or Fact? Nurse Anesthetists Cost Less Than Anesthesiologists. ASA Newsletter 2010;74 (Dec): 31-34. Available at: http://viewer.zmags.com/publication/8de38f6e#/8de38f6e/32

  12. The American Academy of Anesthesiologist Assistants. Available at: http://www.anesthetist.org/

  13. The Japanese Society of Anesthesia. Available at: http://www.anesth.or.jp/english/tips.html

  14. Australian Society of Anesthesia. Available at: http://www.anzca.edu.au/news/bulletin/bulletin-oct

  15. Grogono AW: Anesthesiology Recruitment. Available at: http://www.grogono.com/nrmp/

  16. Australian and New Zealand College of Anaesthetists. Available at: http://www.anzca.edu.au/news/bulletin/bulletin-oct

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Acknowledgments

The authors thank Christine M. Heiner, BA (Scientific Writer, Department of Anesthesiology/Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA) for her editorial assistance with the manuscript. The authors also thank Richard Henker, Ph.D., CRNA, FAAN (Professor and Interim Chairman, Acute/Tertiary Care Department, University of Pittsburgh School of Nursing, Pittsburgh, PA, USA) for his review of the manuscript.

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Correspondence to Tetsuro Sakai.

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Matsusaki, T., Sakai, T. The role of Certified Registered Nurse Anesthetists in the United States. J Anesth 25, 734–740 (2011). https://doi.org/10.1007/s00540-011-1193-5

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  • DOI: https://doi.org/10.1007/s00540-011-1193-5

Keywords

  • Nurse anesthetists
  • United States
  • Anesthesia practice