Nurse Anesthetists Balance Independence, Teamwork

Nurse anesthetists administer intravenous drugs and anesthetic gases, manage patients' ventilation, monitor their vital status and wake them when surgery is over. In more than half of Minnesota hospitals, particularly in rural areas, they practice without an anesthesiologist.

By Nancy Crotti, Star Tribune Sales and Marketing

Last update: October 7, 2009 - 12:17 PM

Nurse anesthetists must be appropriately assertive, confident in their skills and work well on a team, according to Rebecca Gombkoto, program director of the Minneapolis School of Anesthesia in St. Louis Park (www.nurseanesthesia.org), one of four such schools in the state.

Educational Requirements

Students must be experienced critical care registered nurses with a bachelor's degree before they may enroll at the Minneapolis School of Anesthesia, a collaboration of seven Twin Cities hospitals and healthcare systems. The school annually accepts 33 students, who spend the first two months exclusively in the classroom and the remaining 25 months in both classroom and clinical settings.

"The students do all types of anesthesia and all types of cases," Gombkoto says. "They get experience in rural hospitals; they get experience in pediatric hospitals and in Level One trauma centers."

Upon graduation and certification by the Council on Certification of Nurse Anesthetists (www.aana.com), certified registered nurse anesthetists (CRNAs) may work in hospitals, same-day surgery centers or dental offices. "We work with surgeons, podiatrists, ophthalmologists, plastic surgeons, dentists and anesthesiologists," Gombkoto says. "The majority of anesthesia that is provided for our military at war is provided by nurse anesthetists."

Ready For Any Procedure

CRNAs provide the anesthesia for whatever types of surgical procedures are assigned to a particular operating room. Brian Thorson, a CRNA at Hennepin County Medical Center in Minneapolis, may work on one to several procedures a day, depending on their complexity and length.

"The anesthesiologist medically directs one to four rooms simultaneously," Thorson explains. "They're physically present at the beginning of the case and remain available throughout. As the nurse anesthetist, I must be able to recognize and manage intra-operative emergencies in collaboration with the anesthesiologist."

Sleeping Patient's Advocate

A past president of AANA, Thorson enjoys the variety of cases and finds patients' gratitude rewarding. "They are very appreciative of the fact that you are with them 100 percent of the time and will be their advocate while they're asleep and be there when they wake up," he says.

Currently, jobs for nurse anesthetists in the Twin Cities are limited, due to the economy, high level of job satisfaction and good compensation, according to Thorson. Local salaries start in the $130,000s. "Nationwide, we still estimate that there is a 12-percent vacancy rate," he says.

"We don't expect this to be long-term," Gombkoto says of the slow job market locally. "Hopefully by next year, it will turn around."

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