Rich History Defines CRNAs, America’s Original Anesthesia Experts

By Laura Wiggins, DNP, CRNA

🔹🔹🔹National CRNA Week debuted as an annual commemoration in 2000 as a way to celebrate our nation’s Certified Registered Nurse Anesthetists and nurse anesthesia students. But the history of our profession stretches back generations.

Nurse anesthesiology traces its origins to 1863, when nurses eased the suffering of wounded soldiers in the Civil War. Since then, nurse anesthetists have been the main providers of anesthesia care to U.S. military personnel on the front lines and remain the primary anesthesia providers in austere combat theaters.

Today, there are nearly 66,000 CRNAs and nurse anesthesia students nationwide, including more than 3,700 in Pennsylvania.

🔹In times of transition and strife, people look to nurses—and, more specifically, highly trained CRNAs—to bridge the gaps of care, offer compassion to those who need help, and ensure the safety of patients during their most vulnerable times. You bring the art and science to the practice of anesthesia, and the work you do to serve our profession so honorably and your patients so faithfully ultimately enhances the patient’s experience.

🚧 In today’s environment, with health-care overhauls, organizational mergers and changes, redesigned care systems, and fluctuating payment models and costs, patients can rely on CRNAs who demonstrate as the foundation of their practice these core values—integrity, accountability, trustworthiness, and community service. You should be proud of what you do.

As we transition through a global economic crunch and continue to emerge from the global pandemic, enhancing our personal emotional intelligence and well-being is becoming an increasingly essential component of our practice. Having self-awareness, self-regulation, empathy, motivation, and empowerment skills, combined with these other core values, will only strengthen our ability to care more compassionately for our patients.

I am confident in the direction of our association and profession. CRNAs are leaders. We have been there from the beginning, as military necessities on the front lines of our nation’s wars, and we continue to build the teams necessary to serve, because we have the backbone, drive, and fortitude to fight, protect, and defend our patients, our communities, and our nation.

🩺 Looking back at the last 160 years, CRNA history is nursing history. It’s women’s history. It’s our nation’s history. So, let’s celebrate our rich past, but let’s not overlook our promising future. With your passion and commitment to our profession, America’s original anesthesia experts will continue to build trust, show compassion, provide stability, and create hope in the health-care system adjusting, adapting, and overcoming with finesse and grace.

😷 Thank you for all you do—and happy CRNA Week, Pa.! PANA would love to join in YOUR celebration of our profession, so if you're on social media, you can tag @panacrna on Instagram, Facebook and Twitter.

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PANA PRESIDENT: Enhanced Leadership, Increased Engagement, Mentorship Key to Growing Profession

PRESIDENT’S MESSAGE:

Laura Wiggins, DNP, CRNA

Lt. Col. (R), U.S. Air Force

It is a pleasure and honor to be assuming the role of President of the Pennsylvania Association of Nurse Anesthetists (PANA). I am looking forward to serving the membership in the upcoming year. There certainly is no shortage of work to do.

Our Government Relations Team and Government Relations Director, Jessica Poole, are confronting several issues in Harrisburg. I attended a meeting there Oct. 27 with the Department of State and the Bureau of Professional and Occupational Affairs on behalf of PANA and our members. During this meeting, they discussed the antiquated PALS system and license renewals within the state of Pennsylvania. PANA is trying to determine how our new title designation will be processed through this system, or any other system the state develops. We learned several things at this meeting, but the most important thing is not to delay renewing any licenses. Get them done as soon as you receive notification because there will be obvious growing pains in activating a new system and removing the old PALS system.

As your new PANA President, I am setting the following goals for our association:

• Enhance the leadership of the board of directors;

• Increase member engagement; and

• Mentor our future leaders

I think as CRNAs we are experts at patient care and clinical competence. I feel that we are sometimes lacking in the leadership realm. I hope to improve on this within our board by encouraging participation in the AANA Leadership Summit and offering other leadership training throughout the year. Advocacy continues to be one of our main priorities, especially during an election year. We need to be out in front, meeting with our legislators and forming long-lasting relationships with legislative aides, legislators and lobbyists to solidify our position on various health-care issues that will present themselves within the coming year. Leadership in this area is a priority and necessity. We are fully expecting legislation to be re-introduced in the next session, which begins in January 2023, to license anesthesiologist assistants (AAs) for the first time in Pennsylvania. The connections and relationships we form now with lawmakers will be extremely important in helping us maintain our position and will help us with gains in propelling the profession forward.

I also hope to increase member engagement by communicating with members directly on issues that affect our profession. PANA’s Communications Director, Sarah Trau, will help facilitate this huge undertaking. She will be working with the team at Ceisler Media & Issue Advocacy to make sure our members are in the know and kept informed. My hope is that as we increase engagement, more members will participate in district events and other educational activities and political action committee (PAC) events.

Finally, mentoring our future leaders is extremely important in ensuring the ongoing success and trajectory of the profession. Please encourage student involvement at every level of participation! I am motivated and encouraged by the excitement and enthusiasm of the SRNAs we have on the PANA board. Hopefully, their enthusiasm is contagious and will be felt by all of the members in the coming months.

I remain committed to helping this profession succeed in this time of uncertainty. With change there is always room for opportunity. Advancing our profession is worth the fight. If you have any ideas or suggestions for upcoming PANA events or want to know how to contact your legislators, please don’t hesitate to contact me. I am looking forward to working with all of you and serving this association.

Pa. Should Utilize Nurse Anesthetists in COVID-19 Response

Pennsylvania Association of Nurse Anesthetists

FOR IMMEDIATE RELEASE

CONTACT: Kurt Knaus, P: 717-724-2866

E: kurt@ceislermedia.com

Pa. Should Utilize Nurse Anesthetists in COVID-19 Response

Public affairs TV program to spotlight role of nurse anesthetists in pandemic

HARRISBURG (April 17, 2020) --- As the COVID-19 pandemic continues its spread in Pennsylvania, certified registered nurse anesthetists are uniquely qualified to provide care for critically ill patients, according to the Pennsylvania Association of Nurse Anesthetists. Yet, these frontline health-care workers remain an untapped resource for fulfilling critical roles outside the operating room during this crisis.

PANA President Angelarosa DiDonato and PANA Federal Political Director Laura Wiggins outlined the work of CRNAs and the challenges they face during a taping of the statewide public affairs TV program, “Pennsylvania Newsmakers,” which is set to begin airing this weekend.

PHYSICIAN SUPERVISION: Pennsylvania still requires physician supervision of a CRNA. However, under the directive of President Donald Trump, the Centers for Medicare and Medicaid Services removed the national physician supervision requirement and encouraged states to allow CRNAs to practice to the fullest extent of their education and training to best care for patients during this crisis.

States like New York, West Virginia, Maine, Michigan, New Jersey, Arizona and others already have acted to remove barriers, allowing them to better utilize all available health-care providers without risking patient safety. PANA has been urging Gov. Tom Wolf and his administration to lift the requirement in the commonwealth.

“This is a respiratory pandemic,” DiDonato said. “CRNAs often work with patients’ airways and perform intubations and other procedures. Our education and clinical experience make us central to any response. We want to do all we can to help.”

Removing the supervision requirement of CRNAs in Pennsylvania will avail more physicians to provide hands-on care, expand the capacity of both CRNA and physician providers, and augment the state’s health-care system to meet the growing demands of this pandemic.

PERSONAL PROTECTIVE EQUIPMENT: Like other frontline health-care workers, personal protective equipment (PPE) is crucial for CRNAs, and the shortage of some material has been alarming --- especially after guidance came from the federal government that during shortages, any facial covering, even a bandanna, would be better than nothing.

To help protect its members, PANA, which represents more than 3,700 CRNAs and students in Pennsylvania, invested $40,000 to purchase 1,000 masks for CRNAs who need them, or for those who may have been working in facilities where PPE was limited or quantities were diminishing, especially in high-need areas.

The masks, which are being sourced and manufactured in part through Ifft Enterprises in Evans City in western Pennsylvania, have been innovatively designed after extensive review of a variety of mask prototypes used by health- care professionals. The masks are reusable and feature a filter, with three replacements.

Each CRNA must request the mask individually. The manufacturer then ships the masks directly to the CRNA. But PANA is underwriting the full cost --- both manufacturing and shipping.

“We are proud of the work CRNAs are doing to respond to this crisis and remain committed to doing all we can as an association to keep CRNAs healthy and safe so they in turn can keep patients healthy and safe,” Wiggins said.

PROFESSIONAL DESIGNATION: Pennsylvania is one of just two states that fails to formally recognize CRNAs in some form. Because there is no definition for “certified registered nurse anesthetist” under the state’s Professional Nursing Law, CRNAs are recognized only as registered nurses, not as CRNAs. That brings logistical and financial burdens, and it continues to inhibit our full response to this health-care pandemic.

In response to COVID-19, many CRNAs want to contribute more in the facilities where they work but can’t. Likewise, hospitals and other health-care institutions want to use CRNAs to their fullest capacity but can’t. Many of these facilities feel restricted by the way the state licenses CRNAs and will not allow nurse anesthetists to provide advanced, critical care services, even though it is within their education, training, clinical experience and scope of practice --- meaning this valuable health-care resource remains untapped during a time of crisis.

There are other challenges as well. Pennsylvania nurse anesthetists who serve in the military must secure designation in another state to provide anesthesia in the armed services. They cannot assist on rapid response teams in states affected by natural disasters because they lack formal credentials. And, after receiving training in Pennsylvania, many nurse anesthetists relocate to states with full credentialing, contributing to the state’s “brain drain.”

Bipartisan measures have been introduced in both chambers to recognize nurse anesthetists as “CRNAs” under Pennsylvania statute, with one bill (S.B. 325), sponsored by Sen. John R. Gordner (R-Columbia), receiving Senate approval last year. The legislation remains under consideration in the House Professional Licensure Committee.

Results of a recent statewide public opinion poll shows that two-thirds (67%) of Pennsylvania voters support professional designation for certified registered nurse anesthetists, including those who identify as Republican (59%), Democrat (75%) and Independent (62%).

“Broad support like this should give lawmakers the confidence they need to advance this measure and finally provide CRNAs with professional designation,” DiDonato said.

“Pennsylvania Newsmakers” is one of the state’s premier politics and public policy television talk shows. The program runs statewide. For more information or to view the program, visit: www.newsmakerstv.com.

For more information about CRNAs 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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