When seconds count, CRNAs are there

National CRNA Week kicked off Jan. 21 as a way to remind patients, families, medical professionals and others: “Every Breath. Every Beat. Every Second. WE ARE THERE!”

As usual, PANA is taking it a step further, stretching National CRNA Week into a month-long campaign to introduce Pennsylvanians to the highly skilled professionals behind the mask --- the men and women who are by their side during surgical procedures, from open-heart surgery to routine outpatient procedures.

CRNAs are the face of anesthesia care in Pennsylvania. There are more than 3,000 CRNAs and CRNAs-in-training in the commonwealth, providing hands-on anesthesia care in every setting: hospital operating and delivery rooms; ambulatory surgical centers; the offices of dentists, podiatrists, ophthalmologists, and plastic surgeons; and pain management centers.

It’s time to take off that mask and help our patients know who we are and what we do. The role of a CRNA requires intensive training and education and nurse anesthesia is a high-responsibility career. CRNAs provide anesthesia care for millions of patients each year. Nurse Anesthetists are most frequently the first responders to intraoperative emergencies, acting quickly with expert knowledge and skill in the care of our patients.

The average nurse anesthetist completes 9,000 clinical hours of training when you combine the clinical ICU experience as a RN required to enter CRNA training, the clinical experience obtained in an undergraduate nursing curriculum and the clinical anesthesia training in a nurse anesthetist program. That’s impressive. Our high level of education and clinical experience contributes to our capable, vigilant care of each patient.

CRNAs are the primary providers of anesthesia care in rural America, enabling health-care facilities in these medically underserved areas to offer obstetrical, surgical, pain management and trauma stabilization services. We’re battle tested, too, serving as the main providers of anesthesia care to U.S. military personnel on the front lines since World War I. CRNAs remain the primary anesthesia providers in austere combat theaters.

CRNAs are proud of their safety record and career. And that’s why this month, we are encouraging patients, families, medical professionals and others to learn more about the professionals behind the mask and appreciate the work we do. Because when it matters, nurse anesthetists are by your side for every breath, every heartbeat, every second. WE ARE THERE!

Jodie Szlachta, CRNA, Ph.D., is the President of the Pennsylvania Association of Nurse Anesthetists (PANA).

Are you a CARVED CRNA?

If you have attended a business meeting or heard me speak on some occasion since 2012, you probably have heard the question: Are you a CARVED CRNA? CARVED is an acronym I use to describe the consummate, professional CRNA. It goes beyond the characteristics that describe the Pennsylvania CRNA who delivers expert anesthesia care on a daily basis to our commonwealth’s patients. At the end of the day, you drive to a home in a car to a life that you would not have achieved without the opportunities availed to you by the professional activism outlined in this message. You may think of this as a checklist to determine if you are doing your part for the profession.

C is for Communicate: We communicate with each other and operating room professionals to exchange information about anesthesia techniques, employment opportunities, and family life. The CARVED CRNA turns the conversation outward to meet with hospital administrators, legislators, and the community to describe who we are and what we do. Communication fosters relationships that pay dividends when important decisions are made in the boardrooms and voting chambers across the state.

A is for Attend: We all need to attend in-services and meetings to maintain our certifications. Meetings at vacation locations are appealing, but those meetings will not give you specific information about state and national professional issues. The CARVED CRNA attends professional meetings such as the AANA Midyear Assembly and Leadership Academy, the PANA Spring or Fall Symposia and PANA’s Lobby Day. Can you consider alternating your meeting years to attend a quality, substantive, state meeting on even years and vacation meetings on odd years? The “meatier” meetings grant Continuing Education credits, and they equip you to reach out to those beyond the operating room.

R is for Read: Most CRNAs are familiar with reading. We all had to do it to get through training. It can’t stop there! The CARVED CRNA goes deeper to get familiar with practice issues and policy in your facility and on the state and national levels. Reading the newsletter, e-mails from AANA and PANA, and related social media posts give you information on current professional events.

V is for Vote: Hopefully, many CRNAs vote in the U.S. presidential elections. The CARVED CRNA votes in AANA’s and PANA’s annual elections, too. Unlike the U.S. voting system, AANA and PANA do not have an Electoral College. EVERY vote counts! PANA pledges to have full ballots with competitive candidates for each officer and trustee position.

E is for Educate: Many CRNAs educate SRNAs in the operating room. The CARVED CRNA, prepared with readings and information from attending quality professional meetings, will be able to educate others about our practice. State policies pertinent to CRNA practice in Pennsylvania that you can find on the web through any search engine include: “PA Code Chapter 21,” “PA Code Chapter 123,” and “PA Code Chapter 555.” PA Code Chapter 21 describes our scope of practice, and is part of the State Board of Nursing Regulations. PA Code Chapter 123 is part of the Department of Health’s hospital regulations that describes CRNA practice in our state’s hospitals. PA Code Chapter 555 describes practice in our state’s surgicenters. These are great places to start educating yourself.

Finally, D is for Donate: Most CRNAs probably donate to charity. In addition to charity, the CARVED CRNA donates to PANA and AANA political action committees, or PACs. Relationships are important in politics, but money helps to support the election of candidates who share our issues, and PACs are the way to achieve that. If each of Pennsylvania’s CRNAs donated $10 per month to PANA-PAC through an automatic monthly payment, we would be doing our part to empower PANA to influence legislative activity in Harrisburg.

In the coming months, there will be more information from PANA to participate in ballot nominations, to visit your legislator in your local legislative district, and to vote in the annual PANA elections. The new year promises to deliver new and exciting challenges and opportunities for our profession. Can you resolve to get involved? PANA is prepared to help you become the consummate professional, the CARVED CRNA.

Thank you for supporting the VHA Initiative!

Pennsylvania’s CRNAs and SRNAs made sure their voices were heard during a 60-day comment period for the U.S. Veterans Health Administration (VHA) rulemaking to authorize Full Practice Authority for CRNAs and APRNs working within the Department of Veterans Affairs’ (VA) health-care system.

VHA received 167,000 comments nationally, which was 25 times more than any the agency had received since it instituted online comment submission in 2006. Beyond a doubt, this is a topic of keen interest to veterans, their families, and the American public.

We would also like to thank everyone who took the time to write a letter to their local paper about this issue. Anesthesiologists were also active letter writers in opposition to this rule and we were able to respond to many of their letters while also publishing letters proactively to push out our messages. Together we were able to have letters published in the following areas of the state:

• Allentown Morning Call

• Easton Express Times (Lehigh Valley Live)

• Pittsburgh Post-Gazette

• Scranton Times Tribune (two letters: July 19th, July 20th)

• West Chester Daily Local

• Wilkes-Barre Times Leader

All of us at PANA are so proud of the work so many of you put into advocating so strongly for this initiative. It could be months before the U.S. Veterans Health Administration announces its final rulemaking. You can be sure we’ll keep you posted. Thank you again.

Ann Culp, CRNA, DNP

PANA President

Derek A. Reckard, CRNA, MSN, PHRN

PANA Federal Political Director