Nurse Anesthetist's Practice In Many Delivery Models Of Care Nurse anesthetists across the nation have administered anesthesia to people for a century and a half -- long before it became a doctor specialty. Conventional training occurred in military or hospital-based programs ranging from some months to even years in length. Surgeons strongly supported Certified Registered Nurse Anesthetists (CRNA) practice rights and abilities, and continue to do so. Dr. George Crile, Cleveland Clinic Foundation's founder and general surgeon was targeted in 1912 by physicians in Ohio, via the state's Attorney General and Medical Board, owing to his advocacy of nurse anesthetists. Dr. Crile, together with the Lakeside Hospital he worked in, was threatened with physician payment and hospital appropriation finance withdrawal, for his support of nurse anesthetist training and employment. Following a lengthy struggle that lasted 5 years, the doctor and his hospital tasted victory in their nurse anesthetist advocacy. Crile's leading nurse anesthetist, Agatha Hodgins, who held the post since 1908, founded the National Association of Nurse Anesthetists, which later went on to become AANA (American Association of Nurse Anesthetists). In this time, there were other lawsuits and sanctions against individuals who trained or employed nurse anesthetists in the states of California, Kentucky, Pennsylvania, and New York (Malina & Izlar, 2014).

Scope of CRNAs and APRNs

According to Massie (2014), the "tipping point" for the nation's healthcare delivery system, which represents a moment of critical period, or threshold, has arrived. The idea appears to be so simple: Employ CRNAs as well as APRNs (advanced practice registered nurses) to their utmost practice scope and provide cost-effective,...

The IOM's (Institute of Medicine) 2010 report justifies precisely that. It advises APRNs to carry out practice to their training/education's full extent ("The Future of Nursing: Leading Change, Advancing Health - Institute of Medicine," 2010).
CRNAs administer over 32 million general and local anesthetics per annum to patients in the U.S. By collaborating with healthcare providers such as surgeons and physician anesthesiologists, they practice in all settings wherein anesthesia is administered: conventional hospital, obstetrical delivery, and surgical suites; critical access clinics; ambulatory surgical facilities; healthcare facilities affiliated to the Veteran Affairs Department, U.S. military, and Public Health Services; and offices of podiatrists, dentists, plastic surgeons, pain management professionals, and ophthalmologists. Irrespective of practice arrangement and setting, research has repeatedly confirmed these anesthetists' exceptional safety record. In medically underserved parts of the country (e.g. rural communities), CRNAs play the role of primary anesthetist. The presence of these professionals enables healthcare facilities and hospitals to provide trauma stabilization, obstetrical, and surgical services to individuals who would otherwise have to travel far to access essential care. The sole anesthesia providers are CRNAs in virtually every rural hospital for some states. Bearing in mind these professionals' history of guaranteeing…