|Competencies||Administration of anesthetics and the elimination of pain|
|Varies by country|
A nurse anesthetist (also CRNA or nurse anesthesiologist) is an advanced practice nurse who administers anesthesia for surgery or other medical procedures. They are involved in the administration of anesthesia in a majority of countries, with varying levels of autonomy.
A survey published in 1996 reported that there were 107 countries where nurses administer anesthesia in some form, and a further nine countries where nurses act as assistants in the administration of anesthesia. Depending on the local system of healthcare, they participate only during the operation itself, or may also be involved before and after (for preanesthetic assessment and immediate postoperative management). In some localities, nurse anesthetists provide anesthesia to patients independently; in others they do so under the supervision of anesthesiologists.
The International Federation of Nurse Anesthetists was established in 1989 as a forum for developing standards of education, practice, and a code of ethics. Delegates from 35 member countries participate in a World Congress every few years.
In the United States
In the United States, nurse anesthetists are called Certified Registered Nurse Anesthetists (CRNAs) or nurse anesthesiologists. CRNAs account for approximately half of the anesthesia providers in the United States and are the main providers of anesthesia in rural America. Historically, nurse anesthetists in the United States have been providing anesthesia care to patients since the American Civil War and the CRNA credential came into existence in 1956. CRNA schools issue a master's or doctorate degree to nurses who have completed a program in anesthesia, which ranges from 2–3 years in length. By 2025 the Council on Accreditation, the organization which accredits Nurse Anesthesiology programs requires all graduating CRNA to be doctorate prepared.
Scope of practice limitations and practitioner oversight requirements vary between healthcare facility and state, with 20 states and Guam granting complete autonomy as of 2021. In states that have opted out of supervision, the Joint Commission and CMS recognize CRNAs as licensed independent practitioners. In states requiring supervision, CRNAs have liability separate from supervising practitioners and are able to administer anesthesia independently of anesthesiologists.
Over 92% of CRNAs in the US are represented by the professional association The American Association of Nurse Anesthesiology (AANA). The AANA recommends that CRNAs use the titles "nurse anesthesiologist" and "Certified Registered Nurse Anesthesiologist" as synonyms for "nurse anesthetist" and CRNA. Groups representing anesthesiologists and other medical doctors, such as the American Medical Association and American Society of Anesthesiologists, oppose the use of this phrase to describe CRNAs and call it misleading.
- American Association of Nurse Anesthesiology. "Accepted titles for CRNAs" (PDF). AANA.com.
- "Definition of NURSE ANESTHESIOLOGIST". www.merriam-webster.com. Retrieved 2021-09-16.
- McAuliffe, M. S; Henry, B (1996). "Countries where anesthesia is administered by nurses". AANA Journal. 64 (5): 469–79. PMID 9124030.
- McAuliffe, M. S; Henry, B (1998). "Survey of nurse anesthesia practice, education, and regulation in 96 countries". AANA Journal. 66 (3): 273–86. PMID 9830854.
- International Federation of Nurse Anesthetists (2007). About IFNA... Retrieved May 23, 2007, from http://ifna-int.org/ifna/page.php?16
- Daughettry, Lindsay (2010). "Is There a Shortage of Anesthesia Providers in the United States?". Rand Health. Retrieved September 30, 2018.
- "CRA Fact Sheet".
- Council on Accreditation of Nurse Anesthesia Educational Programs. "Requirements to Practice as a Nurse Anesthetist in the United States". www.coacrna.org.
- "Position Statements – Council on Accreditation". Retrieved 2021-09-12.
- "Archived copy" (PDF). Archived from the original (PDF) on 2018-08-04. Retrieved 2018-08-03.CS1 maint: archived copy as title (link)
- Joint Commission on Accreditation of Healthcare Organizations. "Standards Revisions Related to the Centers for Medicare & Medicaid Services (CMS)" (PDF). Archived from the original (PDF) on 2018-08-04. Retrieved 2018-08-03.
- Gene Blumenreich. "A Surgeons Responsibility for CRNAs" (PDF). www.aana.com. Archived from the original (PDF) on 2018-08-04. Retrieved 2018-08-03.
- American Association of Nurse Anesthetists (2013). "Scope of Nurse Anesthesia Practice" (PDF). www.aana.com. Archived from the original (PDF) on 2018-08-04. Retrieved 2018-08-03.
- Gene Blumenreich. "Legal Briefs: Captain of the Ship Doctrine" (PDF). www.aana.com. Retrieved 2018-08-03.
- Matsusaki T, Sakai T (2011). "The role of certified registered nurse anesthetists in the United States". Journal of Anesthesia. 25: 734–740. doi:10.1007/s00540-011-1193-5. PMID 21717163.
- Andy Nghiem, AMA: Anesthesiologists that aren't licensed shouldn't refer to themselves as such, Patient Daily (July 31, 2020).
- Christine Sexton,Nursing Board Signs Off On 'Anesthesiologist' Title, News Service of Florida (August 20, 2020).