CRNA Week Takes on New Meaning Amid COVID

It’s safe to say our 2021 National CRNA Week commemoration really is like no other before it. Because of the global pandemic caused by COVID-19, all of us have had to confront personal and professional challenges we never thought we’d have to face.

Even now, more than 10 months after this health-care crisis began, response and recovery efforts continue.

But one thing is certain in these uncertain times: I’ve never been prouder to be a Certified Registered Nurse Anesthetist (CRNA) than I am today, and I’ve never been more honored to stand by your side as president of the Pennsylvania Association of Nurse Anesthetists (PANA).

In the most ordinary situations, surgery and anesthesia can be intimidating or frightening. CRNAs provide families comfort and reassurance by never leaving their loved one’s side. When this pandemic separated families in crisis, our promise to be there for every heartbeat, every breath took on a whole new meaning.

Because of our advanced education and hands-on training, CRNAs are uniquely qualified to care for critically ill patients who are suffering because of this respiratory pandemic. Many CRNAs have been serving as frontline health-care workers, fulfilling critical roles inside and outside the operating room during this crisis.

In May, when the state granted a temporary waiver to suspend the CRNA supervision requirement, healthcare facilities jumped at the chance to tap into nurse anesthetists’ unique skillset --- and we rose up to meet the challenge.

By allowing CRNAs to practice to the fullest extent of their education and training, not only are more people familiar with what we do, but our work during this crisis has availed more physicians to provide hands-on care, expanded the capacity of both CRNA and physician providers, and augmented the state’s health-care system to continue to meet the growing demands of this pandemic. Our work affects lives.

This crisis still requires an all-hands-on-deck approach. Our health-care systems are still challenged to function above capacity. As long as response and recovery efforts continue, CRNAs will remain a critical part of the solution as “Experts You Trust. Care You Count On,” our theme this week.

On behalf of PANA, I want to extend my heartfelt gratitude to each and every CRNA and student who has stepped up during these difficult times to represent our profession so honorably and serve patients and families so faithfully. If ever there was a time to commemorate what we do, then 2021 National CRNA Week is the time to do it.

Please be safe. And again, thank you for all you do.

Matt McCoy, DNP, CRNA

President

Pennsylvania Assn of Nurse Anesthetists

PANA Members Discuss What Blanket Waiver During Pandemic Really Means

Blanket waiver removing physician supervision requirement benefits health-care facilities, patients during pandemic

The Pennsylvania Association of Nurse Anesthetists achieved a significant victory for the profession in May when Gov. Tom Wolf announced a temporary blanket waiver removing the physician supervision requirement for certified registered nurse anesthetists (CRNAs).

The waiver has been hugely important as part of the state’s response to the health-care crisis caused by COVID-19. Advanced practice nurses like CRNAs can finally practice to the fullest extent of their education and training.

That avails more physicians to provide hands-on care. It expands the capacity of both CRNAs and physician providers. It augments the state’s health-care system to continue to meet growing demands during this pandemic. And it ensures patients get the best care.

But what has this waiver really meant for CRNAs, health-care facilities and the patients we serve? Here are some firsthand accounts from CRNAs on the frontline. (Please note that the names of the CRNAs and their facilities have been removed to ensure their anonymity and protection in the workplace.)

“I work in a critical access hospital and since the governor removed the supervision requirement, the anesthesiologists are now running their own room and I’m working in another room with my surgeon --- which means we are able to provide two times the services!”

“We at our local Hospital started a COVID response team in conjunction with the ER and ICU. We responded to all COVID intubations, put in an arterial line, a central line, and intubated the patients. We also helped manage vent settings/unstable patients as needed.”

“My hospital told our anesthesiologists that they will be taking their own assignment and that the CRNAs will work alone until we get caught up on elective surgeries. Many of our anesthesiologists resigned because they don’t want to give anesthesia.”

“Yes, we have provided a CRNA from our department for 24-hour coverage of the COVID units to act as an NP to help assess patients, place lines, and act as extenders for the critical care intensivists in our county. The chief in my group was able to use the supervision waiver for us to work outside of the OR and in the OR without supervising anesthesiologists.”

“The orthopedic surgeons at my hospital have always wanted an ologist available. That has all changed. The CRNAs are working alone and our ologist was given the option of working in a room or taking time off unpaid.”

It’s clear: Gov. Wolf’s decision to issue that temporary blanket waiver and remove the physician supervision requirement for certified registered nurse anesthetists is making a real difference.

The waiver was included in an executive order that the governor signed to protect health-care practitioners for good-faith actions taken in response to this crisis, and it remains in effect for the duration of the governor’s disaster proclamation, which gives him broad powers to manage this public health emergency.

The proclamation was renewed for 90 days in early June. Lawmakers challenged the extension. But state judges sided with the governor. That means the proclamation remains in place for at least two more months. As long as the governor’s disaster proclamation remains in place, so does his blanket waiver removing the physician supervision requirement for CRNAs.

Stories like these from our CRNAs prove that this policy shouldn’t just be implemented during a pandemic, but instead be permanent to ensure patient health and safely and to give greater options to health-care facilities to provide the best care to those in need.

Military CRNAs Lead the Fight against COVID-19

Certified registered nurse anesthetists (CRNAs) are battle-tested providers, joining all our military’s medical personnel deployed in the fight against COVID-19.

Nurse anesthetists have been the main providers of anesthesia care to U.S. military personnel on the front lines since World War I, and remain the primary anesthesia providers in austere combat theaters. In fact, CRNAs most commonly are the only anesthesia providers in the military’s forward surgical teams.

It is no wonder then that CRNAs are back on the frontline and on active duty fighting against the global COVID-19 pandemic. CRNAs provide high-quality, safe care, even in the most stressful and emergent situations.

In America’s epicenter of the viral infection, the anesthesia department at the Javits New York Medical Station (JNYMS) consisted of 27 CRNAs who worked with medical providers from the U.S. Army, Navy and Air Force, addressing the health-care crisis striking New York City.

Among those at JNYMS was U.S. Navy Cmdr. Joe K. Blair, CRNA, MS, NC. Blair is a 2005 graduate of the Allegheny School of Anesthesia/La Roche College School of Nurse Anesthesia in Pittsburgh, and was featured in a video showcasing the military operations of CRNAs working at the medical station:

“It has been noted frequently what a difference the CRNAs have made in the care the patients have received in the ICU,” Blair said. “Our vast ICU experience with our current anesthesia training made us supremely adapted to function in the capacity that we took on in this situation.”

The Pennsylvania Association of Nurse Anesthetists and all of our CRNAs and students salute Cmdr. Joe K. Blair and the military medical professionals like him from all of the uniformed services who are bravely and proudly serving our country in its national response to COVID-19.

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Jamaica-native, U.S. Army Reserve Capt., supports Temple University Health health care workers​

PHILADELPHIA, PA, UNITED STATES

04.29.2020

Video by Master Sgt. George Roach

Defense Department Support to FEMA COVID-19

U.S. Army Reserve Capt. Yakeba Allison, certified registered nurse anesthetist (CRNA), attached to Urban Augmentation Medical Task Force 352-1, is supporting Temple University Health health care workers in the fight against COVID-19 in Philadelphia, Pa., April 29, 2020. UAMTF 352-1 is augmenting civilian medical staff at six Philadelphia-area medical facilities in support of the Department of Defense COVID-19 response. U.S. Northern Command, through U.S. Army North, is providing military support to the Federal Emergency Management Agency to help communities in need. (U.S. Army video by Staff Sgt. Adrian Patoka, 22nd Mobile Public Affairs Detachment)

For more information on this story, please contact 1st Lt. Kara Crennan at kara.crennan.1@us.af.mil