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Advanced Practice Provider Spotlight: Certified registered nurse anesthetist shares perspective on caring for diverse patients

Advanced practice providers (APPs) play an integral role in meeting the needs of Penn State Health’s increasingly diverse patient populations. With their advanced training and credentials, these professionals expand access to high-quality care, build trust with patients and are a valuable aspect of patients’ overall experience.
Advanced practice providers (APPs) play an integral role in meeting the needs of Penn State Health’s increasingly diverse patient populations. With their advanced training and credentials, these professionals expand access to high-quality care, build trust with patients and are a valuable aspect of patients’ overall experience.

Posted April 11, 2023 by Penn State Health News


Prolung Ngin, a certified registered nurse anesthetist (CRNA) at Penn State Health Milton S. Hershey Medical Center, said she was inspired to become a health care practitioner at a young age when she was her mother’s interpreter during her doctor’s visits and hospitalizations. Her family had fled Cambodia as political refugees and settled in the United States, where Ngin said she admired the doctors and nurses who cared for her mother. That motivated her to learn to care for her mother and others as well.


Ngin studied to become a nurse at Villanova University near Philadelphia and planned to become a pediatric critical care nurse practitioner. Part of her pediatric critical care transport training involved performing advanced airway management in the operating room. Her interactions with other CRNAs piqued her interest in pursuing certification in the field, which she said were a natural fit with her experience in pediatric critical care and transport.

A CRNA specialty, Ngin added, “allows a marriage of advanced critical care skills, the technical skills, advanced knowledge and skill sets required to take of care of patients in a variety of settings.”

After graduating from the nurse anesthesia program in 2010, Ngin began working at Hershey Medical Center, where she said she enjoys providing care to its diverse patient population.


ADDRESSING DIVERSITY CHALLENGES IN THE FIELD

Diversity in the nurse anesthetist field was challenging when she was enrolled in the anesthesia program at Villanova, Ngin said. At that time 85% of the students were white, 14% were Asian and there was no Black or Latino representation in the program. She compared those statistics to the current composition of CRNAs at Penn State Health, which is predominantly white, with 6% Asian and 8% Black CRNAs but no Latino representation.


Reflecting on the impact of diversity in her field, Ngin shared that she feels socially isolated from time to time and “invisible” as a minority female. Because English is her second language, she experiences occasional microaggressions, she said.


While there is always room for improvement, “I think it’s been very positive that there is a systemwide push for inclusion and diversity at Penn State Health,” Ngin said. “By doing this, we are meeting the need of our growing diverse patient population. I think we are moving in a good direction.”


One way Penn State Health is helping to meet the needs of its diverse patients is by being flexible with its medical processes, allowing families to be a part of their child’s care in the hospital. She also noted the health system’s effort to address language barrier challenges through certified interpreters, appreciating different cultural beliefs and traditions and providing equitable care to all, no matter their socioeconomic background.


The best approach to addressing diversity issues, Ngin said, is by “leaders and educators continuing to promote a culture of acceptance, understanding and empathy toward diverse individuals, staff and patients.”


HOW TO BECOME A CRNA


After CRNAs earn a bachelor’s degree, become a registered nurse and gain experience in critical care, they must also earn either a doctorate in nursing practice or in nurse anesthesia practice and pass a national board certification exam before obtaining a license to practice in their state.


PATIENT CARE RESPONSIBILITIES

  • Administering anesthesia before, during and after surgery

  • Monitoring a patient’s response to anesthesia

  • Educate patients before and after they receive anesthesia

The advance practice providers at Penn State Health include certified registered nurse practitioners, physician assistants, certified registered nurse anesthetists, certified nurse midwives and clinical nurse specialists. Rigorously trained and credentialed, APPs work collaboratively with other health care providers to offer patients the highest level of care possible. This is the second feature in our APP Spotlight series. See the March APP Spotlight feature on nurse practitioners.

If you're having trouble accessing this content, or would like it in another format, please email Penn State Health Marketing & Communications.

Jorge Alvarez is a 3rd year student at Villanova University Nurse Anesthesia Program at Villanova University, where he will graduate in December 2022. He won the Pennsylvania Association of Nurse Anesthetists’ 2022 Student of the Year Award. The upcoming celebration of National Hispanic Heritage Month allowed him to reflect on the path he has taken to reach his goal of becoming a Certified Registered Nurse Anesthetist (CRNA):


“This Hispanic Heritage Month I am reflecting on the journey that, in a few short months, will lead me towards my career as a CRNA. My mother brought us to the U.S. from the Dominican Republic when I was eight years old. As a single mother, she worked multiple jobs to make ends meet so that my sister and I would have a chance at a better education and life than she did. My mom set a strong example of what work ethic means and how your attitude and perseverance contribute to your success. I keep my heritage alive by honoring my family’s sacrifices for their children, always remembering our humbling beginnings, and the privilege that it is to have an opportunity at higher education. As Hispanic SRNAs and CRNAs, we are united as one extended family. My hope for the future of anesthesia in PA is that we continue to bring representation to the profession so that we may reduce stereotypes while simultaneously validating and inspiring other Hispanic and underrepresented youths along the way.”

🩺💙 For additional #HispanicCRNA stories in our#HispanicHeritageMonth blog series, click here.


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SUPPORTING DESIGNATION LEGISLATION IN PENNSYLVANIA

Re: CRNA Professional Designation Legislation: S.B. 325 (Gordner)

October 1, 2019

Dear Senator/Representative:

Pennsylvania has more nurse anesthesia graduate programs than any other state in the U.S., attracting students from across the country to study in Pennsylvania to become certified registered nurse anesthetists (CRNAs). Many choose the highly competitive Villanova University Nurse Anesthesia Program, which is administered in partnership with the Crozer Chester Medical Center.

Pennsylvania remains one of just two states that fail to formally recognize CRNAs in statute or provide licensure as a CRNA. There is no definition for “Certified Registered Nurse Anesthetist” under the state’s Professional Nursing Law, and there is no title designation for CRNAs and they are recognized only as registered nurses, not as CRNAs. This ignores the lengthy advanced education and training, required to become a CRNA.

Fortunately, in the final days of legislative session before the General Assembly adjourned for summer 2019, the state Senate approved a measure (S.B. 325) introduced by Sen. John Gordner that would formally recognize CRNAs under PA state law. This is the second consecutive legislative session that the measure passed the Senate. We are urging the House to do the same, immediately.

Nurse anesthetist programs like Villanova’s have seen firsthand the challenges our students and graduates face without title recognition in Pennsylvania. Many graduates opt to relocate to other states where CRNAs can practice to their full scope of their education and training. Without formal designation as a CRNA, our graduates who relocate to other states can wait as long as six months to become credentialed. In the absence of title recognition or CRNA license reciprocity, other state boards must verify that the graduates have met their state requirements to be licensed appropriately, which delays our graduates’ ability to work. Retention of these advanced professionals in Pennsylvania should be a priority for our commonwealth because of the outstanding health services that they provide thus improving the health and welfare of PA residents.

Nurse anesthetists must graduate with a minimum of a master’s degree from a nurse anesthesia accredited program, complete greater than 2,000 hours of clinical experience in anesthesia practice and pass a national certification exam in order to practice. The average nurse anesthetist completes 9,000 clinical hours of clinical training, including the clinical ICU experience as an RN required to enter CRNA training, the clinical experience obtained in an undergraduate nursing curriculum, and the clinical anesthesia training in a nurse anesthesia program. CRNAs are required to be nationally certified and must be recertified every four years, meeting strict continuing education standards.

Lack of title recognition in PA presents significant barriers for CRNAs in Pennsylvania who are active military personnel or who volunteer in emergency response teams. Pennsylvania CRNAs who are active military have to secure CRNA licensure in another state to serve as a CRNA in an active duty role of the armed forces. This is unacceptable because it adds additional fees and continuing education requirements to maintain licensure in another state to be eligible serve in our military. Nurse anesthetists have been the primary 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. Yet, Pennsylvania’s battle-tested CRNAs are at a distinct disadvantage without CRNA licensure in Pennsylvania. Pennsylvania CRNAs cannot assist as part of emergency response teams in other states because they lack CRNA title designation in Pennsylvania, which diminishes the role our commonwealth can play in aiding states affected by hurricanes, floods or other natural disasters.

The CRNA graduates from Villanova University / CCMC Nurse Anesthesia Program are highly-qualified clinicians who are recruited across the country. CRNAs have been providing superior anesthesia care for more than 150 years and empirical evidence demonstrates there is no difference in the quality of anesthesia care when provided by CRNAs or physicians, independently, or together in a team model.

The CRNAs in Pennsylvania need title recognition and we urge you to both support S.B. 325 and urge immediate action by the House of Representatives.

Sincerely,


Donna S. Havens, PhD, RN, FAAN

Connelly Endowed Dean and Professor

Villanova University

M. Louise Fitzpatrick College of Nursing

Copyright © 2025 Pennsylvania Association of Nurse Anesthetists

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