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Jax Daily Record Monday, Jan. 21, 200812:00 PM EST

Jacksonville's unsung medical professionals

by: David Ball

by David Ball

Staff Writer

University of North Florida student Lori Cross deals with challenging classroom assignments like most students. Well, her’s may be a bit more challenging.

Her classroom: an operating room at UF Shands Jacksonville. Her assignment: to use a precise mixture of chemicals to render a patient unconscious, monitor that patient’s breathing, heart-rate and other vital signs during a procedure and then bring the patient back to consciousness without them ever feeling a thing or remembering what happened.

Cross is a student registered nurse anesthetist (SRNA), a member of the first class at the UNF Nurse Anesthesia Program and one of hundreds of students learning this highly technical and sought-after medical trade in a handful of colleges and hospitals across the state.

“We always say that nurse anesthetists are the world’s best kept secret,” said Cross, a registered nurse since 1993. “Even as a nurse, they don’t teach you in nursing school about nurse anesthesia. I worked in an (operating room) setting for years before I learned about them.”

According to the American Association of Nurse Anesthetists (AANA), nurse anesthetists have provided anesthesia care to patients for more than 125 years, and they currently administer nearly 27 million anesthetics each year in the U.S.

The AANA reports that certified registered nurse anesthetists (CRNA) are the primary anesthesia providers in rural America, enabling health care facilities in medically under-served areas to offer obstetrical, surgical and trauma stabilization services. In some states, CRNAs are the sole providers in almost all rural hospitals.

Yet, many feel nurse anesthetists aren’t as well recognized as their M.D. counterparts, anesthesiologists, although they provide virtually the same patient care and often work in teams to provide cost-effective and efficient services.

This week marks the eighth annual National Nurse Anesthetists Week, with 2008’s theme being “Nurse Anesthesia: The Professional Quality You Expect, the Personal Care You Deserve.” The theme was penned by a student at the Wolford College Nurse Anesthesia Program in Naples, Fla.

Shands Jacksonville is promoting the week with an informational booth set up at the hospital and staffed by students at UNF’s Nurse Anesthesia Program, said Assistant Program Director Tammy Carroll.

“Part of our goal is to promote the practice of anesthesia by nurse anesthetists, because it’s not only a physician-based science or mode of care,” said Carroll. “Certainly, we like the idea of being able to educate with regards to who’s doing anesthesia.”

Anesthesiologist Dr. Robert Redfern, acting chairman of the anesthesiology department at Shands, said the weeklong recognition is deserved for a group of professionals reaching the pinnacle of the nursing science.

“It’s a team approach. I will have two or three different rooms that I supervise with a nurse anesthetist assigned to each room,” said Redfern. “We come up with the anesthesia plan together, and we participate together in the more critical part of putting them to sleep and waking them up.”

Redfern said some hospitals, such as Baptist Jacksonville, rely more heavily on anesthesiologists and utilize nurse anesthetists in a limited role, mostly for epidural anesthesia in labor and delivery. Whereas in some hospitals and clinics, nurse anesthetists are the only providers.

“The argument for the M.D. is they do have better medical background and training,” he said. “But I take a different approach, that two sets of eyes, skilled eyes, on a patient are better than one. It’s like the airline pilot and co-pilot approach.”

As for the particular skills of the students from the UNF program, Redfern said they are among the best he’s seen.

“We’ve had other SRNA classes here from the University of Alabama and Florida International University, and these students (from UNF) are certainly on par if not better than other programs,” said Redfern, who is also an associate professor with the UNF program.

To apply for the program, nurses must have two years experience in critical care settings as well as very high GPAs and scores on the graduate record examinations (GRE).

More than 100 applied to UNF’s first class in August 2006, and that field was narrowed to about 50 who were interviewed and ultimately 20 who were accepted. That first class will graduate in December 2008.

“It was brutal, obviously,” said Cross of the application and interview process. “You have to think on your toes and you have to be able to withstand the pressure of the interview. But I believe part of the purpose is they want people in this program who are dedicated.”

The entire class scored above the national average in a nurse anesthesia assessment in October, and Carroll said it shows the quality of the students that, even though not yet licensed nurse anesthetists, are already having an impact on Jacksonville’s medical community.

“I can tell you our standards are high, because it is our profession,” said Carroll, a CRNA since 2004. “Most of us practice as well as teach. We believe in the quality of the profession as much as the quality of the program.”

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