IntroductionWatchful Care: A History of America’sNurse Anesthetists by Marianne Bankert depicts the history of the nurseanesthetist profession and nurse pioneers who helped to create the field over150 years ago. According to the Association of Nurse Anesthetists, CertifiedRegistered Nurse Anesthetists (CRNA) administer approximately 43 millionanesthetics per year in the United States. CRNA’s are able to practice in alltypes of settings where anesthesia is used such as, “traditional hospitalsurgical suites and obstetrical delivery rooms; critical access hospitals;ambulatory surgical centers; the offices of dentists, podiatrists, ophthalmologists,plastic surgeons and pain management specialists; and United States military,Public Health Services, and Department of veterans Affairs healthcarefacilities” however, this was not always the case (AANA, 2017). CRNA’s were thefirst anesthesia providers in the United States during the American Civil War,however it has been an ongoing struggle since then for CRNA’s to establishtheir autonomy in anesthesia practice and leadership.Nurse Anesthesia PioneersAnesthesia was first discovered in theUnited States and due to the unwillingness of physicians to administeranesthetics; nurses were placed in the forefront of the specialty profession.
Oneof the first nurses who took on anesthetic duties was discovered to be SisterMary Bernard who was a Catholic nun practicing in 1877 at St. Vincent’sHospital in Erie, Pennsylvania. Her influence expanded and other Catholic nunsbegan to train in anesthesia.
Nurses administering anesthesia developed into “Undoubtedlya prevailing practice in many Catholic hospitals” (Bankert, 1989, p. 25). Sincethen the field grew to include 52,000 CRNA’s and student registered nurseanesthetists just in the United States and 115 accredited nurse anesthesiaprograms across the country (AANA, 2017). One of the most well known nurseanesthetists was Alice Magaw, who was a revolutionary part of the CRNAprofession and helped pave the path for nurse anesthesia education.
Numerousreports were published based on her experiences in anesthetic techniques andskills while working with Dr. Charles Mayo, a renowned surgeon during the1800’s, giving her the title of “Mother of Anesthesia”. Alice MaGaw helpedspread her knowledge to medical professionals all over the world and heranesthetic influence was greatly valued (Bankert, 1989, p.
28). One of hermajor accomplishments was her expertise of safe administration using open dropinhalation method of anesthesia with ether and chloroform. Magaw stressed theuniqueness of each patient’s needs and her work helped attain success for CRNAsacross the country.
She helped to change perspectives of many people as to whatnurses are capable of however, some still “Denied the nurse anesthetistcontribution to the founding of the field” (Bankert, 1989, p. 38). Catherine S. Lawrence was among one ofthe first American nurses to provide anesthesia during the Civil War (1861-1865),however it wasn’t until years later in 1877 that Sister Mary Bernard wasidentified (Ray & Desai, 2016). Some of the pioneering anesthesia nurseswere trained by surgeons and it was not until 1909 when Agnes McGee opened thefirst school of nurse anesthesia in Portland, Oregon along with St.
John’sHospital, Springfield, Illinois (1912), The New York Post Graduate Hospital inNew York City 1912, and Long Island College Hospital Brooklyn, New York 1914 (Bankert,1989, p. 43). Nurse Anesthetists began to establish their presence in the FirstWorld War in aiding wounded men that were depending heavily on their skill,however it did not come without a price. Challenges Faced in the Profession”As nurses were building theirreputation, Actions were being taken to legislate them out of existence” (Bankert,1989, p. 57). Dr.
Francis HoefferMcMechan who was an encouraging force in physician anesthesia, believed thatthe profession of anesthesia was solely for physicians and “There was again adenial of any contribution on the part of nurse anesthetists. Nor will McMechaneven utter their name, only the denigrating label, “technicians” (Bankert,1989, p. 59). He took legal action against nurse anesthetists in the 1920’s toabolish the presence of nurse anesthetists and their care of patients.
In 1911in New York, one of the first challenges to the nurse anesthetists right toadminister anesthesia was challenged and the validity of nurse anesthetistscame into question by the counsel for New York State Medical Society. In thisyear they had a great setback when it was declared that the administration ofanesthesia by nurses was in violation of the law. Action was also taken in Ohioagainst the nurse anesthesia program and that no one other than a physicianwould give anesthesia. Another legal challenge that nurse anesthetists werefaced with was when the Louisville Society of Anesthetists rallied that onlymedical physicians can administer anesthetic. A Louisville surgeon named Dr.Louis Frank and his nurse anesthetist Margaret Hatfield appealed the motion andwon, which was a great feat for the profession. It was said “In the future nomember of the American Association of Anesthetists shall instruct anyundergraduate nurse or orderly in the art of anesthesia, with the intention ofgranting them a certificate or diploma qualifying them as competentanesthetists (Bankert, 1989, p.
64). ConclusionThe American Association of nurse Anesthetistswas formed in 1931 and today represents more than 52,000 CRNA’s and studentregistered nurse anesthetists nationally. It is a professional organization toprovide quality education, develop and train nurse anesthetists to provide thesafest patient care. Nurse anesthesia has advanced over a long period of timeand the pioneering nurses helped pave the way for the professions survivaltoday.
CRNA’s play a very strong role in anesthesia care and the healthcaresystem depends on them greatly to provide safe patient care. One of the mostimportant issues CRNA’s face today is to be able to practice in full autonomy.A study from 2010, states that, “Anesthesiologists and CRNAs areinterchangeable. They can perform the same set of anesthesia services, includingrelatively rare and difficult procedures such as open heart surgeries and organtransplantations, pediatric procedures, and others” (Hogan, Seifert, Moore,& Simonson, 2010). CRNA’s have had the ability to practice autonomouslychallenged to this day.
Certified Registered Nurse Anesthetists are vastlyeducated medical professionals who are able to administer anesthesia in a safemanner to the same extent as anesthesiologists and allowing them to practice totheir full capacity is vital to the healthcare field. ReferencesAmerican Association of NurseAnesthetists. (2018).
Retrieved January 21, 2017, from https://www.aana.com/about-us. Bankert, M. (1989). Watchful care: a history of Americas nurse anesthetists. ParkRidge, IL: American Association of Nurse Anesthetists.
Desai, S.P., MD.
, Ray, W.T., PhD. (2016).The History of the Nurse Anesthesia Profession. Journal of Clinical Anesthesia, 30, 51-58. Retrieved January 21,2018, fromhttps://www.sciencedirect.
com/science/article/pii/S0952818016000076#bb0250.Hogan, P.F., Moore, C.S., Seifert, R.F.
, &Simonson, B.E. (2010, June). CostEffectiveness Analysis of Anesthesia Providers. Retrieved January 21, 2017,from https://pdfs.semanticscholar.org/4d38/f200e19696557e367e482bb33615ea80111c.pdf