Mount Sinai Careers

Chief Certified Nurse Anesthetist

New York, New York

Job Description

The Chief Certified Registered Nurse Anesthetist (CRNA) is an advanced practice nurse with the responsibility and accountability for the management of the nurse anesthesia program, which is part of the Department of Anesthesia. The Chief CRNA will also be responsible for the administration of the nurse anesthesia practice as well as assuming responsibility for the monitoring and management of patients before, during and after anesthesia, under the supervision of an Attending Anesthesiologist.

Duties and Responsibilities:
1. Supervises the clinical and professional activity of the CRNAs in their practice.
2. Serves as a role model for advanced nursing practice.
3. Completes the hiring process in conjunction with Nursing Recruitment for new staff.
4. Identifies retention strategies to create a stable and satisfying work environment.
5. Monitors and evaluates the performance and productivity of the CRNAs.
6. Performs disciplinary proceedings if necessary, inclusive of termination for cause.
7. Facilitates an environment of professional growth and development.
8. Collaborates with members of the health care team.
9. Conducts documentation reviews of the OR record.
10. Participates in performance improvement activities.
11. Identifies, responds to, and investigates potential and actual risk management issues.
12. In conjunction with Attending Anesthesiologist, performs a thorough and complete pre-anesthesia assessment. Responsible for obtaining and reviewing relevant tests and discussing findings.
13. Obtains and/or verifies that an informed consent has been obtained for the planned anesthetic intervention from the patient or legal guardian. Discusses anesthetic options and risks with the patient and/or legal guardian after discussion with
14. Attending Anesthesiologist. Documents in the patient’s medical record that informed consent was obtained.
15. Formulates a patient-specific plan for anesthesia care in conjunction with the Anesthesiologist. The plan is based upon comprehensive patient assessment, problem analysis, anticipated surgical or therapeutic procedure,
16. patient and surgeon preferences, and current anesthesia principles.
17. Induces anesthesia under the supervision of an Attending Anesthesiologist and maintains anesthesia at required levels. Assesses continuously the patient’s response to the anesthetic and/or surgical intervention and must
18. immediately notify the Attending Anesthesiologist of significant changes in the patient’s condition and intervenes as required, under the supervision of an Attending Anesthesiologist to maintain the patient in a satisfactory physiologic condition.
19. Monitors the patient’s physiologic condition as appropriate for the type of anesthesia and specific patient needs.
20. Monitors ventilation continuously. Verifies intubation of the trachea by auscultation, chest excursion, and confirmation of carbon dioxide in the expired gas. Continuously monitors end-tidal carbon dioxide during controlled or assisted ventilation.
21. Uses spirometry and ventilatory pressure monitors.
22. Monitors oxygenation continuously by clinical observation, pulse oximetry, and if indicated, arterial blood gas analysis.
23. Monitors cardiovascular status continuously via electrocardiogram and when appropriate, heart sounds.
24. Records blood pressure and heart rate.
25. Monitors body temperature continuously on all pediatric patients receiving general anesthesia and when indicated, on all other patients.
26. Monitor neuromuscular function and status when neuromuscular blocking agents are administered.
27. Monitors and assesses the patient positioning and protective measures.
28. The omission of any monitoring standards shall be documented and the reason stated on the patient’s anesthesia record. The CRNA shall be in constant attendance of the patient until another qualified health care provider has accepted
29. the responsibility for care.
30. Maintains complete, accurate, and timely documentation of pertinent information on the patient’s medical record. Must document all anesthetic interventions and patient responses.
31. Transfers the responsibility for care of the patient to other qualified providers in a manner that assures continuity of care and patient safety.
32. Adheres to appropriate safety precautions, as established within the institution, to minimize the risk of fire, explosion, electrical shock and equipment malfunction.
33. Documents on the patient’s medical record that the anesthesia machine and equipment were checked.
34. Inspects the anesthesia machine prior to use, and monitors according to established guidelines. Checks the readiness, availability, cleanliness, and working condition of all equipment to be utilized in the administration of the anesthesia care.
35. Monitors oxygen concentration continuously with an oxygen supply failure alarm system.
36. Takes precautions to minimize the risk of infection to the patient, the Nurse Anesthetist, and other healthcare providers.
37. Collaborates with members of the healthcare team in the development and ongoing review of policies, procedures & standards of care for designated patient population.
38. Participates in the ongoing review and evaluation of quality and appropriateness of anesthesia care as a member of the Department of Anesthesiology. Evaluation shall be performed based upon appropriate outcome criteria and reviewed on an ongoing basis.
39. Participates in a continual process of self-evaluation and strives to incorporate new techniques and knowledge into practice.
40. Engages in clinical teaching for the health care team.
41. Participates in departmental Grand Rounds, presenting cases as appropriate, with other CRNA staff.
42. Respects and maintains the basic rights of patients.
43. Promotes an environment that is sensitive to cultural diversity and is open and responsive to the diverse backgrounds and experience of others.
44. Participates in research projects.
45. Oversees and participates in the preceptorship of Student Registered Nurse Anesthetists by CRNA staff.