Nurse Anesthetist: Your Pain Relief & Anesthesia Administering Specialist

Most people see a nurse anesthetist when they have surgery or a procedure that requires anesthesia or deep sedation. Nurse anesthetists are often the sole anesthesia providers in rural hospitals, and are the main provider of anesthesia to United States military personnel.

A nurse anesthetist will see you before your surgery or procedure for a preoperative evaluation of your physical condition and your readiness for surgery. After that, you may not see or be aware that the nurse anesthetist is caring for you. However, he or she will be overseeing your care both during and after surgery until you leave the recovery room.

You may also see a nurse anesthetist during childbirth, for other painful conditions, or if you have a critical illness or injury that affects your airway or breathing.

A nurse anesthetist may care for you under the following situations:

• You have an acute or chronic pain condition.

• You have life-threatening condition or injury that requires critical care in an intensive care unit (ICU).

• You need surgery or a procedure that requires anesthesia or deep sedation.

• You are in labor and delivery and request pain relief or anesthesia such as an epidural.

A nurse anesthetist treats conditions and diseases including:

• Acute pain conditions including postoperative pain, pain after an injury, or pain with a medical illness

• Childbirth including pain relief with painkillers (analgesia), local anesthesia for episiotomy, regional anesthesia (epidural, spinal, or combined spinal-epidural), and general anesthesia for urgent or emergency cesarean section delivery

• Chronic pain conditions including cancer, arthritis, back and neck injury, migraine, shingles, AIDS, and phantom limb pain following amputation

• Life-threatening conditions or injuries that threaten the airway or breathing including traumatic injuries, heart attack, stroke, brain injuries, shock, respiratory failure, severe infections, coma, and multiple system organ failure

• Outpatient procedures requiring anesthesia or sedation including gastrointestinal endoscopy, radiological imaging (such as an MRI), cardiac pacemaker or defibrillator placement, heart catheterization, and electroconvulsive therapy

• Surgeries requiring sedation and/or anesthesia including elective surgeries, semi-elective surgeries, emergency surgeries, trauma surgeries, and exploratory surgeries

A nurse anesthetist can order or perform a wide variety of diagnostic and screening tests including:

• Imaging tests including X-rays, ultrasounds, computed tomography (CT) scans, and magnetic resonance imaging (MRI)

• Laboratory tests including blood tests, urine tests, pregnancy tests, liver function tests, kidney function tests, and blood typing

• Organ function tests including electrocardiograms (EKGs) and pulmonary (lung) function tests

A nurse anesthetist can order or perform various procedures and treatments including:

• Anesthesia management including sedation, inhaled anesthetics, intravenous anesthetics, muscle relaxants, narcotics, and other pain medications

• Critical care procedures including intravenous catheterization or central line placement, tube placements, organ support, and emergency life support procedures

• Pain management including medications, injections, nerve blocks, and electrical stimulation

• Recovery procedures including reversing anesthesia and support while you regain consciousness

• Vital sign and critical life function management including controlling your breathing, heart rate, and blood pressure with medications and devices

The requirements for becoming a nurse anesthetist include:

• Completion of a Bachelor of Science degree in nursing or other appropriate baccalaureate degree

• Licensure as a registered nurse (RN)

• Completion of an accredited nurse anesthesia educational program, which is usually a master’s degree or higher

• Passage of a national certification examination administered by the National Board of Certification and Recertification for Nurse Anesthetists (or its predecessor). The credential earned is called Certified Registered Nurse Anesthetist (CRNA).

A nurse anesthetist must recertify every two years to maintain his or her professional credentials. This includes meeting practice requirements and completing at least 40 continuing education credits.
A nurse anesthetist can choose to earn board certification in certain specialty nursing and practice areas, such as critical care nursing, emergency nursing, and respiratory care. Certifications generally require additional training and passage of an examination. A nurse anesthetist can also pursue extra training and other credentials in a subspecialty through a variety of organizations, or specialize by focusing all or most of his or her practice in a certain area. Specialized areas include pediatric, obstetric, cardiovascular, plastic, dental or neurosurgical anesthesia.

In most cases, your surgeon or other specialist will select the nurse anesthetist who will give you anesthesia during surgery. However, nurse anesthetists perform and monitor many procedures that you schedule in advance. Therefore, you may be able to request a specific nurse anesthetist if you work with your surgeon beforehand. When considering a specialized nurse anesthetist, ask him or her to provide details about the type of training, education, and experience he or she has in the specialty or subspecialty.