Legislator’s grandmother, a CRNA, lives life of caring

When state Representative Aaron Bernstine was a boy, he had it better than most.

“Grandmothers are always the best at fixing bumps and bruises,” he said. But Rep. Bernstine’s grandmother, Stella Rybka, was a certified registered nurse anesthetist, so she was able to “fix it a little bit better.”

Mrs. Rybka was born and raised in New Castle, Pa., and began her career as a registered nurse (RN) at Jameson Hospital. When the hospital, in need of anesthetists, offered to train staff members to become nurse anesthetists, she leapt at the opportunity, a response that was very much in character for her.

“She always talked about the importance of continuing education and striving to make yourself better,” Rep. Bernstine recalled. “No matter what you do, it’s about continuing to get better, which I know is a strong focus of PANA. It’s about continued improvement in your vocation.”

The spirit of constant betterment that Mrs. Rybka exemplifies so well is very much alive in the new generation of CRNAs in Pennsylvania. The commonwealth currently is home to more than 3,000 CRNAs and is one of the top states for CRNA students nationwide, with 12 university-level nurse anesthetist programs spread across the state.

Mrs. Rybka developed her interest in anesthesia during her RN training when she was working in an operating room and became “fascinated” by the work being done by the anesthetists. While the intellectual challenges of her craft were important to her, at the end of the day it all came down to one thing: her passion for caring for her patients.

“I just loved all my patients,” she recalled. “And not only because they were all asleep at the time,” she joked. Being able to be there for her patients and console them during difficult times in their lives “gave [her] a sense of fulfillment.”

According to Rep. Bernstine, this dedication to caring for others has extended beyond Mrs. Rybka’s career.

“My aunt has multiple sclerosis and is bedridden,” he said. “To this day, my grandmother provides exceptional care to my aunt, which is why my aunt is in the good health that she is in. I know that her training has been extremely helpful in that regard. Every day I thank God that she had that training and care in her heart to continue treating my aunt.”

Currently, there is no definition for “certified registered nurse anesthetist” under Pennsylvania’s Professional Nursing Law, which means that highly-trained, hardworking, exceptionally dedicated professionals like Mrs. Rybka are not fully recognized for the high level of care that they provide. Pennsylvania is one of only four states that fail to recognize CRNAs in this manner.

Rep. Bernstine has signed on as a co-sponsor of House Bill 719, which will grant professionals like Mrs. Rybka who do what she describes as “the wonderful work of being an anesthetist,” the level of recognition they have earned. A companion measure (S.B. 274) already has passed the Senate and currently is under review by the House Professional Licensure Committee.

“Anytime that we can go out and be supportive of people, like the members of PANA, who are working hard every day and putting food on the table for their families, I’m excited to do that,” Rep. Bernstine said. “We all know that a stronger PANA means a stronger community.”

About Professional Designation Legislation

CRNAs are highly-skilled advance practice nurses who ensure the highest level of care and pain management for patients. As the hands-on providers of anesthesia care, CRNAs practicing 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; and pain management centers.

Yet, Pennsylvania remains one of just four states that do not recognize certified registered nurse anesthetists. Under the state’s Professional Nursing Law, there is no official definition for “certified registered nurse anesthetist,” meaning these professionals are recognized only as registered nurses (RNs). Two companion measures --- S.B. 274 in the Senate and H.B. 719 in the House --- would change that and formally recognize certified registered nurse anesthetists as “CRNAs” under Pennsylvania statute.

Nurse anesthetists like Shirley Gordner forged the way for CRNAs today

Pennsylvania now has more than 3,000 certified registered nurse anesthetists and ranks among the top states for CRNA students nationwide, with 12 university-level nurse anesthetist programs spread across the state. But things were much different when Shirley (Kishbaugh) Gordner graduated in the mid-1950s.

Shirley was among just three student nurse anesthetists who comprised the first class at Williamsport Hospital and, in 1954, successfully completed examinations for membership in the American Association of Nurse Anesthetists (AANA).

It was uncharted territory then. The hospital had only received AANA’s certification for the 16-month nurse anesthetist course the previous year. At the time, Williamsport Hospital in Lycoming County was the only hospital in central Pennsylvania to even host a school for anesthetists. The other options were 90 miles away in Harrisburg or 80 miles north along the New York border in Sayre, distances made all the longer by rural routes.

Today, CRNAs are recognized for their rich history and well-established traditions. But it was trailblazers like Shirley who helped to establish the culture of safe, responsible anesthesia care that continues to this day.

For Shirley, who in 1952 became a registered nurse, a requirement for AANA membership and certification even today, becoming a nurse anesthetist was the next step in a health-care career that would span nearly half a century.

After receiving her certification, she stayed on at Williamsport Hospital for a few months and put her anesthesia training to use for patients there. But professional and personal changes meant a move.

Shirley moved to Berwick in Columbia County, where she would spend most of the next 20-plus years as an operation recovery room nurse and an emergency room nurse and another two decades as the head nurse for a beloved private practice doctor on Berwick’s West End.

Her husband, Carl, an Air Force veteran, worked mornings maintaining HVAC systems at Wise Foods, the makers of Wise Potato Chips. Shirley, still devoted to caring for others, worked for a time at Berwick Hospital on the second shift, from 3 p.m. to 11 p.m., as the couple raised two sons.

Whatever they had to do, they did. Carl worked at the plant for 40 years before retiring. Shirley retired in 1992. She passed away in 2014. Carl survives, as do their two sons.

According to family, although her time as a nurse anesthetist was short, the achievement she felt for being among the first in her class was something she held dearly and spoke of fondly. And that desire to provide the best care possible carried with her throughout her career.

As a tribute to his mother, her youngest son, state Sen. John R. Gordner (R-Columbia), has introduced legislation (S.B. 274) that would formally recognize nurse anesthetists as “CRNAs” under Pennsylvania statute. He grew up experiencing her love for the profession.

“She really enjoyed spending time with patients, listening to them, getting to know them,” Sen. Gordner said. “For as long as she worked, she was always an old-school nurse. There were no 10-minute appointments. She used to say that you can learn a lot more about a patient by listening than by being just diagnostic. She was very personable, and that came out in how she did her job.”

Because of his mother’s work, Sen. Gordner has been a long-time champion of nurse anesthetists. He was a featured speaker at the Pennsylvania Association of Nurse Anesthetists’ spring symposium in Hershey in May 2015, when he was awarded PANA’s prestigious Leadership Award.

“I probably wouldn’t be a state legislator today without my mother having all the connections she had and being so beloved in the community,” Sen. Gordner said.

Now, as Senate Majority Whip, one of the highest-ranking positions in the state Senate, Sen. Gordner is set to help finish something his mother started by making sure more people are aware of nurse anesthetists and the work they do.

Currently, there is no definition for “certified registered nurse anesthetist” under the state’s Professional Nursing Law, meaning these professionals are recognized only as registered nurses. Pennsylvania remains one of just four states that do not recognize CRNAs in this manner.

Sen. Gordner’s professional designation bill would remedy that and formally recognize CRNAs for the advanced training and education they undergo and the skills they administer to help patients — skills that Shirley (Kishbaugh) Gordner spent a lifetime perfecting.

This piece was originally posted on Medium.com.