User:Trystian13/Nurse anesthetist

In the United States, Certified Registered Nurse Anesthetists (CRNA) have provided anesthesia care in the United States for more than 150 years. During this time, anesthetics were applied by a trained surgeon under the supervision of a doctor. Now that anesthesiology has specialized as its own field, nurse anesthetists are used in all 50 states. Currently, CRNAs can practice independently in 16 states, meaning they can practice their specialty without the supervision of a licensed anesthesiologist. Nurse anesthetists use the registered term "Certified Registered Nurse Anesthetist" (CRNA) and are educated to doctorate or master's level. CRNAs account for approximately half of the anesthesia providers in the United States and are the main providers of anesthesia in rural America, U.S. military, Veteran’s Administration, medically underserved communities, and to maternity patients. 49,000+ nurse anesthetists administer approximately 43 million anesthetics to patients each year. CRNA’s are trained to administer every type of anesthesia. The CRNA credential came into existence in 1956 and approximately 40% of nurse anesthetists are male. CRNAs can work completely alone or in teams with other nurses and physicians. CRNAs work in an array of medical settings, but usually work in operating rooms, emergency rooms, intensive care units, cardiac care units, or outpatient surgical clinics.

History
During the 1800s, anesthesia was practiced by surgeons and nurses. However, in 1910, physicians started to push for laws enforcing anesthesia practice to become solely their job and not nurses. There were three lawsuits against nurse anesthetists in 1917, 1919, and 1936. In 1936, nurse anesthetists established the American Association of Nurse Anesthetists (AANA), which would establish the master level education system for a nurse anesthetist. The name, "Certified Registered Nurse Anesthetist" was first officially introduced in 1956, with CRNAs still practicing only under a medical professional. However, in 2001 Medicare removed a federal law stating that nurse anesthetists can only practice anesthesia under medical supervision. This allowed CRNAs to practice anesthesia without the supervision of a physician and the federal government would still pay for anesthesia. Now, the power to decide whether CRNAs practice without supervision lies upon the states laws or hospital policy.

Education & Salary
In order to become a nurse anesthetist, an individual must first complete their Bachelor of Science in Nursing (BSN), then complete the master's degree at an accredited educational program. More than 111 programs exist in the United States. In order to enter the nursing program, candidates must have the following:


 * 1) a degree in Bachelor of Science in Nursing (BSN)
 * 2) registered nurse certification
 * 3) at least one year as a working nurse in an intensive care unit (ICU)

The masters program is about 2-3 years, and includes lectures and clinical hours in anesthesia. The exam for the certification is determined by a board, called the National Board of Certification and Recertification of Nurse Anesthetists (NBCRNA). The exam includes content from lectures which are based on the exam, like anatomy, physiology, pathophysiology, pharmacology, applied chemistry, biochemistry, physics, equipment, instrumentation, technology, basics of anesthesia, advanced principles of anesthesia, and professional issues. For the clinical requirements, a nurse is required to have over 550 cases of anesthesia performed and over 1,694 hours of clinical experience as well. During the clinical hours of practice, a nurse must always be under supervision by a CRNA or anesthesiologist. Upon graduating the masters program, nurses must then pass the national board examination to become a CRNA. In total, it takes about 7-10 years to become a CRNA (includes all secondary edcuation).

CRNA salaries are amongst some of the highest in the medical field. Depending on the state and their area of work, CRNAs can make more than $200,000 a year. The top 5 highest salaries by city and state in 2019 are as follows :


 * 1) Wyoming: $243,310
 * 2) Montana: $239,380
 * 3) Oregon: $234,750
 * 4) Wisonsin: $233,600
 * 5) California: $227,290

A major factor in salary is years of experience for CRNAs, with more than a $100,000 range. Entry level CRNAs make on average $120,581, while senior CRNAs with more than 6 years of experience can earn $220,557. Another factor in salary is the area of employment. CRNAs that work in outpatient care centers are amongst the highest paid, while CRNAs in health practitioner offices are among the lower end of pay, at about $169,140.