By Heather J. Rankin
As a Certified Registered Nurse Anesthetist (CRNA) I am proud to be part of America’s most trusted profession — advanced practice registered nursing.
I am also profoundly grateful to have a job that allows me to follow my passion: providing anesthesia care to children of all ages — from preterm neonates to college students.
CRNAs are anesthesia professionals who safely administer more than 50 million anesthetics to patients of all ages each year in the United States. We bring to anesthesia care the compassion and dedication inherent in our critical care nursing experience, combined with the highest educational and professional standards and technical skills.
CRNAs who care for pediatric patients work in different practice settings wherever and whenever they require anesthesia, sedation, or pain management: hospital surgical suites, ambulatory surgical centers, critical access hospitals, dentists’ offices, and a range of other settings. Some work in a care team approach that includes CRNAs, physician anesthesiologists, nurse anesthesia residents, and physician anesthesiology residents. Larger medical centers that specialize in pediatrics provide anesthesia throughout the hospital, from the operating rooms to minor procedure and sedation rooms, to radiology suites for MR and CT scans and nuclear medicine, and the intensive care units. Other CRNAs, like Alabama Association of Nurse Anesthetists president Willie Furr, DNP, MSN, CRNA, work as independent CRNAs in rural parts of the state, providing pediatric care for general surgery, ENT, and orthopedic cases. CRNAs are providing care for families with children throughout the state.
Safe, compassionate, care for children
Entrusting a healthcare provider with their child’s safety is one of the most stressful situations a parent can face, and pediatric CRNAs diminish this stress with compassionate interactions with families. Parents can be assured that numerous peer-reviewed studies have shown that CRNAs are safe, high-quality, anesthesia professionals.
Researchers studying anesthesia safety found no differences in care between nurse anesthetists and physician anesthesiologists based on an exhaustive analysis of research literature published in the United States and around the world, according to a scientific literature review prepared by the Cochrane Collaboration, the internationally recognized authority on evidence-based practice in healthcare.
Before becoming certified to enter into practice, a CRNA must graduate with a minimum of a master’s degree from a nurse anesthesia educational program accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs. By 2025, all graduates must have obtained a doctoral degree to be eligible for the national certification exam. Nurse anesthesia educational programs are extremely rigorous and admission is highly competitive. Programs range in length from 24-51 months and must include a variety of clinical settings and experiences. Graduates of nurse anesthesia educational programs have an average of 9,369 hours of hands-on clinical anesthesia experience.
CRNAs are unique among anesthesia providers in that we are required to have of one year of full-time experience as a registered nurse in a critical care setting before being accepted into a program. The average critical care experience of RNs entering nurse anesthesia educational programs is 2.9 years.
Ensuring access to care
CRNAs are cost-effective providers for healthcare systems and patients, and play a critical role in ensuring that families, especially in rural and underserved areas, have access to surgical care and trauma stabilization. CRNAs represent more than 80% of the anesthesia providers in rural counties. Many rural hospitals are critical access hospitals, which often rely solely on CRNAs.
According to a 2010 study published in the journal Nursing Economic$, CRNAs acting as the sole anesthesia provider are the most cost-effective model for anesthesia delivery, and there is no measurable difference in the quality of care between CRNAs and other anesthesia providers or by anesthesia delivery model.
Why we’re here
Some pediatric-focused CRNAs come to the profession with experience in neonatal or pediatric intensive care units, but many, like me, just enjoy working with pediatric patients.
There are days that you laugh with your patients, and there are days that you cry with the patients and families. One of the things that is just amazing about the children who come to the OR is how strong they are, even when they are facing horrible diseases like cancer. They are so resilient, and it is just amazing to see them. And to know that I’m helping a child get better or through a procedure requiring anesthesia brings me great satisfaction and confirmation that I chose an amazing profession.
About the author: Heather J. Rankin, DNP, MBA, CRNA, has been a pediatric CRNA for 15 years and is former president of the Alabama Association of Nurse Anesthetists.