1. Section Editor(s): Thompson, Elizabeth M. MSN, RN, CNOR

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Last September marked 125 years of nurse anesthesia education. Edith Graham was the first professionally educated nurse at St. Mary's Hospital in Rochester, Minn., and taught principles of nursing and nurse anesthesia to the Sisters of St. Francis. Alice McGraw was the second nurse anesthetist at St. Mary's and is known as "the Mother of Anesthesia," a title bestowed upon her by Dr. Charles Mayo due to her many contributions to nurse anesthesia practice. Dr. Mayo and Alice McGraw were recognized for their excellence in surgery and anesthesia.1

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Annually, certified registered nurse anesthetists (CRNAs) in the United States administer more than 32 million anesthetics across all healthcare delivery systems. The practice of nurse anesthetists has changed from the early days of ether administration. I recently had the opportunity to correspond with two CRNAs to get their perspective on the challenges and rewards of their practice.


Providing anesthesia care

Jean Guyer, APRN, CRNA, DNP, is a codirector of nurse anesthesia at Mayo Clinic, Rochester Minn., and has been a CRNA since 1994. She says she finds "satisfaction in helping patients during their health challenges and feels privileged to meet a need during a very vulnerable time for patients as they go through surgery." Even though she is no longer in a direct patient-care role, she states, "There is nothing that can compare with the individualized attention I can give my patients in the operating or procedural room."


Marcia Belau, CRNA, has been practicing as a nurse anesthetist since 1991 and echoes the rewards of working with patients.


"I can safely say that I have always wanted to come to work and provide anesthesia care. Sure, anyone wants to stay home on a pleasant, sunny day. However, even on the nicest summer day, when I have walked through the OR doors and started giving anesthesia, I am 100% on and in my glory."


Perceived challenges in nursing

Nursing disciplines are facing many challenges, including high patient acuity, staffing shortages, rapid change, and complex technology. Dr. Guyer has observed a high demand for CRNA services, as they have the skill and abilities to work in any procedural or surgical setting. Dr. Guyer has noted many significant changes over the past 20 years in nurse anesthesia practice, including the move to rapid-acting medications, providing value to the patient in regards to the cost of their care, and the increasing use of different types of blocks for pain management.


Perioperative team collaboration

Both Dr. Guyer and Belau noted a focus on a multidisciplinary approach to patient care. As Dr. Guyer noted, "I believe the move towards better collaboration between all perioperative team members has had a positive impact on patient outcomes and the quality of care we are providing. We are all focused on the same goal-providing the best patient care experience."


Elizabeth M. Thompson, MSN, RN, CNOR

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Editor-in-Chief Nursing Education Specialist Mayo Clinic, Rochester, Minn. [email protected]




1. Nurse Anesthetist. Nurse Anesthetist: all things nurse anesthesia. 2015. [Context Link]