Week #10 as a CRNA Student- Role of Nurse Anesthetist

by admin

Job Description for a Nurse Anesthetist

Now that I am in Week 10 of my CRNA Program, I can better define the role of a nurse anesthetist in the hospital setting…

Of course, there are many other niche services that Certified Registered Nurse Anesthetist’s (CRNA’s) are qualified to provide…BUT, I haven’t had that experience yet so I’ll get back to you when I do.

1. What do you do Before the Case?

  • If it is the day/night before, you should know your assignment.  Many facilities have a web system where you can look up patient information securely from home. Your assignment will (at a minimum hopefully!) include the patient’s name, age, and what type of surgery they are scheduled to have.  Using the patient information you have- you can formulate a plan for anesthesia.  This includes what type of airway you want to use, what type of anesthesia (general, regional, etc.) and what the plans B and C will be.
  • If the patient is an inpatient in the hospital, you can visit them on the floor and complete the Anesthesia Consent Form
  • If the patient has been seen by a preoperative clinic, you will also be able to review these records.
  • The morning of, set up your Operating Room by having your anesthesia gas machine, supplies, and drugs ready.
  • Go see your patient in the preoperative holding area.  Perform last minute assessments, most importantly- NPO status, airway assessment, allergies, and recent drug use (prescription, street, or over the counter).  *Medications taken prior to surgery can effect your anesthesia or drop your blood pressure during the case.  If the patient is receiving a block, it is sometimes done in the preoperative holding area.
  • If you work in a team environment, discuss the anesthesia plan of care with the attending Anesthesiologist.
  • It is fairly common to give Versed in the preoperative holding area for the ride back into the Operating Room.

2. In the Operating Room

  • The happenings in the OR depend on your anesthesia plan but here is a standard rendition: patient is assisted onto the OR table and monitors are applied (EKG, pulse oximetry, etCO2, peripheral nerve stimulator, etc.), patient is preoxygenated/denitrogenated, induction medications are given and an airway is placed.  Once the airway is secure, the anesthesia provider applies additional monitors and places any lines that need to be placed (2nd IV, Arterial Lines, Central Lines, etc.).  *Lines can also be inserted in the preoperative holding area.
  • The surgical team (anesthesia included) preps the patient for surgery by draping and positioning the patient.
  • During the procedure, nurse anesthetists vigilantly monitor vital signs and may give small doses of drugs like phenylephrine, ephedrine, atropine or glycopryrrolate to boost vitals if needed.  Nurse anesthestists also give pain medications, administer inhaled agents, titrate neuromuscular blocking agents (depending on the surgical procedure), and helps with adjusting the OR table for the surgical team.
  • Nurse Anesthestists also maintain adequate perfusion of tissues by replacing fluid losses and blood losses.
  • When the case is completed, Nurse Anesthetists wake the patient up, remove the airway, ensure patient stability, and transfer patient to the Post-Anesthesia Care Unit (PACU).

3. In the PACU

  • Again, the Nurse Anesthetist ensures that the patient is stable, comfortable, and is oxygenating well.
  • Then, report is given to the PACU Nurse.

4.  Back in the OR

  • While the environmental team turns over the operating room for the next procedure, Nurse Anesthetists set up for their next case by performing  a quick recheck of the anesthesia gas machine, ensuring drugs are drawn up and labeled, and that necessary equipment is close at hand.  *Many times, the provider sets up for the next case during a lull in the first case.
  • Then it’s back to preoperative holding to assess the next patient!

 

Any questions??  Post your comments below!

 

 

Get Your FREE audio book that reveals how to dominate the admissions interview!

Previous post:

Next post: