Health Care Team (HCT)

Certified Registered Nurse Anesthetists are master’s prepared advanced practice nurses who provide anesthesia to patients in every practice setting, and for every type of surgery or procedure. They are the sole anesthesia providers in two-thirds of all rural hospitals and the main providers of anesthesia to expectant mothers and to men and women serving in the U.S. Armed Forces.

Certified Registered Nurse Anesthetists provide anesthesia in collaboration with surgeons, anesthesiologists, dentists, podiatrists, and other qualified health care professionals.

The typical day-to-day activities of a Certified Registered Nurse Anesthetist include:

• performing and documenting a pre-anesthetic assessment and evaluation of the patient, including requesting consultations and diagnostic studies; selecting, obtaining, ordering, and/or administering pre-anesthetic medications and fluids; and obtaining informed consent for anesthesia
• developing and implementing an anesthetic plan
• selecting and initiating the planned anesthetic technique, which may include general, regional, and local anesthesia and intravenous sedation
• selecting, obtaining, or administering the anesthetics, adjuvant drugs, accessory drugs, and fluids necessary to manage the anesthetic, to maintain the patient’s physiologic homeostasis, and to correct abnormal responses to the anesthesia or surgery
• selecting, applying, or inserting appropriate non-invasive and invasive monitoring modalities for collecting and interpreting patient physiological data
• managing a patient’s airway and pulmonary status using endotracheal intubation, mechanical ventilation, pharmacological support, respiratory therapy, or extubation
• managing emergence and recovery from anesthesia by selecting, obtaining, ordering, and/or administering medications, fluids, or ventilatory support in order to maintain homeostasis, to provide relief from pain and anesthesia side effects, or to prevent or manage complications
• releasing or discharging patients from a post-anesthesia care area, and providing post-anesthesia follow-up evaluation and care related to anesthesia side effects or complications
• ordering, initiating, or modifying pain relief therapy through the utilization of drugs, regional anesthetic techniques, or other accepted pain relief modalities, including labor epidural analgesia
• responding to emergency situations by providing airway management, administering emergency fluids or drugs, or using basic or advanced cardiac life support techniques

The functions listed above are a summary of Certified Registered Nurse Anesthetist practice and are not intended to be all-inclusive. A more specific list of functions and practice parameters is detailed in the American Association of Nurse Anesthetists’ Scope and Standards for Nurse Anesthesia Practice.

In order to practice as a Certified Registered Nurse Anesthetist, the practitioner must be licensed and certified. CRNA credentials cannot be used until a graduate of an accredited nurse anesthesia program has passed the initial certifying exam offered by the Council on Certification of Nurse Anesthetists. In order to continue practicing as a Certified Registered Nurse Anesthetist, recertification must be obtained every two years. In order to become recertified, Certified Registered Nurse Anesthetists must participate in a minimum of 40 hours of approved continuing education every two years, document substantial anesthesia practice, maintain current state licensure, and certify that they have not developed any conditions that could adversely affect their ability to practice anesthesia.

Certified Registered Nurse Anesthetists care for all patient populations ranging from the premature infant to the elderly, and for all types of surgical and diagnostic procedures.

This varies according to the specific needs of the patient. As soon as the need for anesthesia services is determined, the Certified Registered Nurse Anesthetist may become involved in a patient’s care.