CRNAs Respond to COVID-19 Pandemic

As our country and the commonwealth continue their aggressive measures to stem the spread of the coronavirus (COVID-19), Pennsylvania’s certified registered nurse anesthetists (CRNAs) are taking action to ensure public health and safety.

As the hands-on providers of anesthesia care, operating safely in every setting where anesthesia is administered, CRNAs, like so many other health-care professionals, are on the frontline. That makes the profession a critical part of the national response.

“CRNAs hold leadership positions in their institutions of care and help to create policy about how best to protect fellow providers and patients,” said Angelarosa G. DiDonato, DNP, CRNA, president of the Pennsylvania Association of Nurse Anesthetists (PANA). “Our top priority is always public health and safety.”

As a precaution, many Pennsylvania hospitals are choosing to cancel elective cases requiring anesthesia, except where a condition is emergent or urgent and essential to the health of the patient. All decisions are made in consultation and coordination with patients and surgical teams.

CRNAs also are changing the way they work with patient airways, as COVID-19 is a respiratory illness that is characterized by mild to severe symptoms, including fever, cough, shortness of breath, and breathing difficulties.

The American Association of Nurse Anesthetists (AANA) is providing resources to support CRNAs as they develop strategic steps for managing patients with expected or confirmed infection. These tips go beyond meticulous hygiene and strict environmental cleaning and disinfection procedures to intubation and aerosolization techniques.

Excellence in care, safety, and continuous improvement of care are hallmarks of the anesthesia profession.

In Pennsylvania, the Department of Health is reporting new cases daily, which means everyone has a role to play. Remember these simple tips to protect yourself, your family and your community:

• Wash your hands often with soap and water for at least 20 seconds.

• Clean and disinfect frequently touched objects and surfaces.

• Avoid touching your eyes, nose and mouth.

• Avoid crowds and stay home, even when no exhibiting signs and symptoms.

• If you must work or be in public, follow guidelines for social distancing (stay six feet others).

Thank you for all you do always, but especially in times of crisis like we face together today. Be smart and be safe. Don’t hesitate to contact PANA with questions.

Nurse Anesthetists in Pa. Ensure Patient Safety, Help to Control Rising Health-care Costs

Pennsylvania Association of Nurse Anesthetists

CONTACT: Kurt Knaus; P: 717-724-2866; E: kurt@ceislermedia.com

Nurse Anesthetists in Pa. Ensure Patient Safety,

Help to Control Rising Health-care Costs

HARRISBURG (Jan. 20, 2020) --- Pennsylvania ranks among the top draws nationally for certified registered nurse anesthetists (CRNAs) and students, with 13 highly rated nurse anesthetist programs serving every corner of the commonwealth and helping to sustain one of the largest contingencies of professionals in the country.

This week marks CRNA Week in Pennsylvania, when patients, hospital administrators, health-care professionals, policy-makers, and others learn more about CRNAs and the work they do to keep patients safe and help reduce the cost of health care. The week-long celebration runs in conjunction with the 21st annual National CRNA Week from Jan. 19 to Jan. 25.

“Surgery and anesthesia can be intimidating,” said Angelarosa G. DiDonato, DNP, CRNA, president of the Pennsylvania Association of Nurse Anesthetists (PANA). “That’s why it’s so important for people to understand the vital role CRNAs play as a patient advocate. We stay with our patients for every heartbeat and every breath, administering their anesthetics and watching over their vital signs. We never leave their side.”

Pennsylvania is recognized as a leader in anesthesia education and training, with 13 programs spread throughout Allegheny, Columbia, Erie, Lackawanna, Lehigh, Montgomery, Philadelphia, Westmoreland and York counties. (For a full list of programs, visit www.PANAforQualityCare.com and click “Resources.”)

CRNAs are the hands-on providers of anesthesia care, operating safely in every setting where anesthesia is administered, including hospital operating and delivery rooms; ambulatory surgical centers; the offices of dentists, podiatrists, ophthalmologists, and plastic surgeons; pain management centers and more.

The nation’s 54,000 CRNAs and student registered nurse anesthetists safely and cost-effectively provide more than 49 million anesthetics each year. PANA itself represents more than 3,700 CRNAs and students across the state --- one of the largest contingencies in the country.

The role CRNAs play in Pennsylvania’s and the nation’s health-care system is expansive.

CRNAs are the main providers of anesthesia care in rural communities and medically underserved areas, delivering essential health care and preventing gaps in services. CRNAs also are battle-tested, serving on the front lines since World War I as the main providers of anesthesia care to U.S. military personnel in austere combat theaters.

With advanced degrees and a high level of education and clinical experience, CRNAs are able to deliver the same safe, high-quality anesthesia care as other anesthesia professionals but at a lower cost, helping to control the nation’s rising health-care costs.

Because of their training and experience, numerous medical studies show there is no statistical difference in patient outcomes when a nurse anesthetist provides treatment. In fact, these studies by nationally recognized health-care policy and research organizations prove that CRNAs provide high-quality care, even for rare and difficult procedures.

That’s because CRNAs are with the patient throughout the entire procedure. Anesthesiologists, on the other hand, may have several cases to attend to simultaneously, or they may be somewhere else handling another response.

CRNAs provide routine anesthesia care but also quickly respond to patient changes and emergencies during surgical and medical procedures, ensuring patient health and safety.

For more information about certified registered nurse anesthetists in Pennsylvania, visit www.PANAforQualityCare.com or follow along on social media via Twitter at @PANACRNA or on Facebook at www.facebook.com/PANACRNA.

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AANA Features PA CRNA: Up to any challenge, one CRNA “does things a little differently”

Published January 6, 2020

By Julie Ciaramella Senior Digital Content Specialist AANA Public Relations and Communications

From an early age, Brett Fadgen, MSN, CRNA, CFRN, knew he wanted a career where he could help people. He also knew he’d have to do things a little differently. Fadgen, a nurse anesthetist at University of Pittsburgh Medical Center (UPMC), was born without the lower portion of his right arm. As far as he knows, he is the only Certified Registered Nurse Anesthetist (CRNA) in the country with one arm. “I do have a disability, but I’m not disabled,” he said. “I may not do a task the same way as others. I can do it just as fast, but I do it differently.” Fadgen uses several adaptive devices, including a second prosthetic hand specifically for intubating. He engineered that prosthetic by having it manufactured as short as it possibly could be, which improved dexterity. “I have to learn how to do things with one hand whereas others learn how to do things with two hands,” he said. He added that for some tasks, he uses a prosthesis, and for others, like spinals and epidurals, he doesn’t. He stressed that whether he uses an adaptive device or not, his work is just like anyone else’s. And when patients ask about his disability, “I tell them I was born without my right arm and explain that I’m going to care for them just like any other nurse anesthetist would do in their pre-op evaluation.”

What Led Him to Nursing When Fadgen was a child, his grandfather suffered an anoxic brain injury after sudden cardiac arrest and needed constant care. Helping care for his grandfather ignited an interest in healthcare that led him to become a paramedic, first with EmergyCare in Erie, Pa., and then with Ross/West View Emergency Medical Services in Pittsburgh. There were many people who inspired and motivated him, he said, including a CRNA he met during his time as a paramedic. This encouragement, coupled with Fadgen’s own desire to learn more in medicine and healthcare, helped change his life and career path. “There was a nurse anesthetist, Francis Feld, who volunteered at the ambulance service, who told me, ‘You can achieve so much in healthcare.’ This enlightened me to look into becoming a nurse,” Fadgen said. Around the same time, Fadgen’s wife, Kathy, an emergency room nurse, encouraged him to go further in his education. He enrolled in Duquesne University’s Second Degree in Nursing program and went on to attend the University of Pittsburgh’s nurse anesthesia program. As a paramedic, and then later as a flight paramedic and a flight nurse, he said he had “a lot of autonomy going into uncontrolled environments with patients experiencing life-threatening conditions.” That changed in nurse anesthesia school. “I was successful when we were required to sedate and paralyze and intubate patients in the field, but when I got to nurse anesthesia school, my technique was non-standard,” he said. “This raised a lot of concerns as to how I can safely and successfully intubate a patient.” In conjunction with his program director, John O’Donnell, Fadgen declared his disability to the school’s Office of Disability Resources and Services, where he learned about opportunities and accommodations provided to him and the school under the Americans with Disabilities Act (ADA). “The ADA supports reasonable accommodation for individuals with disabilities as long as their accommodations are in fact reasonable to the educational institutions and/or employer. In my case, I was permitted to proceed in the program and I was able to be successful by practicing through simulation labs using my prosthetic devices,” he said. He would go to the simulation lab at the University of Pittsburgh’s School of Nursing and practice on his own before working with multiple faculty members, who ensured the way he performed a procedure was appropriate and safe for patients. He would also have to adapt his prosthetics under faculty supervision. “It had to be two faculty members supervising the way I did the procedure,” he said, describing his time in the simulation lab. “Whether it was endotracheal intubation, nasal tracheal intubation, central line access, arterial line, bronchoscopies—all the procedures in the scope of practice of nurse anesthetists.” When it came to using the simulation lab independently, he didn’t always have access to the lab at the School of Nursing. He would use an airway simulation lab he created five years prior with Feld, the nurse anesthetist who worked with Fadgen on the ambulance. After practicing until he became proficient and felt comfortable doing a procedure, faculty and his program director tested him on his skills. While acknowledging that his experience was challenging, Fadgen said after graduation when he was hired by UPMC, people knew him and knew of the adaptive devices he used in the operating room since he’d done his clinical training there. He would still explain to the attending anesthesiologist and CRNAs how he worked and show his colleagues how he performed procedures. Sharing this information enabled them to work more effectively as a team in the event there was a situation where, for example, they were unable to secure an airway. Helping Others Be Successful By sharing his story, Fadgen hopes to help others—both people with disabilities and without disabilities. He wants to help people understand that even though someone may look different or do things differently, that doesn’t mean they can’t do certain tasks. “I think I can help people figure out ways to be successful, as well as help others that do not have physical disabilities understand how people that may look different or are missing an extremity are able to do everything anyone else can who doesn’t have that physical disability,” he said. He also said by sharing what he has done, he wants to give people the motivation to go after their goals. “I want to help motivate people and tell them that anything is possible,” he said. Fadgen’s own story proves just that.