Duluth News Tribune OpEd

https://www.duluthnewstribune.com/opinion/columns/6870606-Statewide-View-Nurse-anesthetists-provide-critical-care-during-and-beyond-COVID-19

2/3/21

Every one of us has been asked to make sacrifices and change behaviors to save lives during this tragic COVID-19 pandemic. Those on the front lines — physicians, nurses, paramedics, certified registered nurse anesthetists, and other specialists — have literally been asked to risk their lives to help others live.

According to the American Association of Nurse Anesthetists, health care facilities have tapped Certified Registered Nurse Anesthetists, or CRNAs, to leverage our unique skills during this crisis. CRNAs play a crucial role in providing life-saving critical care for patients impacted by COVID-19. CRNAs are qualified to provide this vital care because of our education, licensure, and certification.

These men and women have been by the bedsides of many of the sickest patients in intensive-care units across the state, intubating COVID patients and providing emergency airway support. In addition, CRNAs are the main providers of anesthesia care in most Minnesota counties.

On Jan. 24-30, we celebrated CRNA Week in Minnesota and across the country, a commemoration of the more than 1,900 CRNAs in our state who provide anesthesia care, ventilator support, and advanced patient assessments to Minnesotans across diverse health care settings.

CRNAs have been providing anesthesia care to patients in the U.S. for more than 150 years. CRNAs are highly educated and bring experience in nursing to their practice: Nurses must attain seven to eight years of education, training, and work experience before they can become a CRNA. As advanced-practice registered nurses, CRNAs practice with a high degree of autonomy and professional respect.

Beyond expertise in providing anesthesia, CRNAs assist with the placement of invasive lines and monitors, administer deep levels of sedation not normally managed in ICUs, and assess patients who require advanced pulmonary support, which has been a key component in treating COVID patients for better breathing support.

CRNAs provide anesthesia in collaboration with surgeons, anesthesiologists, dentists, podiatrists, and other qualified health care professionals in every setting where anesthesia is delivered. Whether administered by an anesthesiologist or CRNA, all anesthesia is delivered the same way. Anesthesia is significantly safer for patients today than ever before, and studies have shown there is no difference in the quality of care provided by CRNAs and physician counterparts.

One key benefit of CRNA-delivered anesthesia is that it is the most cost-effective anesthesia-care model. With health care costs continuing to rise, finding ways to improve patient access to safe, quality care without overburdening the system is a huge challenge. CRNAs provide the same safe, high-quality care as other anesthesia professionals but at a lower cost.

In rural parts of our state and country, CRNAs are the primary providers of anesthesia care, and we provide access to anesthesia care that many people would not otherwise have in Greater Minnesota. This essential service has been underscored during the pandemic, as rural health care facilities struggled to keep up with patients needing care.

Additionally, CRNAs provide the majority of anesthesia care in the Veterans Administration and U.S. military. Historically, nurses first provided anesthesia on the battlefields of the American Civil War. During World War I, nurse anesthetists became the main providers of anesthesia care to wounded soldiers. Today, CRNAs continue to be the primary providers of anesthesia care to U.S. military personnel on the front lines, navy ships, and aircraft-evacuation teams around the globe.

Every day, in every health care setting, CRNAs collaborate with members of patient-care teams and fill roles beyond administering anesthesia. We are responsible for patient safety before, during, and after anesthesia. We monitor and sustain a patient’s critical life functions during surgery. We analyze situations and respond quickly during emergencies. And we bring a special spirit of caring to our work that is unique to nurses.

As the surge of COVID-19 patients needing emergency care has begun to stabilize, and as most front-line workers are on their way to being vaccinated, there is a glimmer of hope — but also a moment of reflection.

CRNAs are essential in the critical care continuum and should be included in leadership and executive roles as well as planning discussions and policy development.

Every breath, every beat, every second: we are there.

Eric Swanlund is president of the Minnesota Association of Nurse Anesthetists and works at the Minneapolis VA Medical Center. He wrote this for the News Tribune.