Locations: New York, New York
Categories: Nursing – Advance Practice/ Nurse Practitioner/ CRNA
Ground breaking science. Advancing medicine. Healing made personal.
The nurse anesthetist is an advanced practice nurse (CRNA). Within this role, under the supervision of an Attending Anesthesiologist, the CRNA, administers monitors and manages patient care before, during and after anesthesia. The CRNA is reports to the Designated Attending Anesthesiologists/ Vice President, Nursing and Chief Certified Registered Nurse Anesthetist for performance appraisals and scheduling. They are responsible for the performance of pre-anesthesia assessment, induction and maintenance of and emergence from anesthesia, monitoring of the patients physiological condition and performance of clinical intervention as necessary, under the supervision of an Attending Anesthesiologist.
- In conjunction with Attending Anesthesiologist, performs a thorough and completed pre-anesthesia assessment. Responsible for obtaining and reviewing relevant tests and discussing findings with the Attending.
- 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 Attending Anesthesiologist. Documents in the patient’s medical record that informed consent was obtained.
- 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, patient and surgeon preferences, and current anesthesia principles.
- 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 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.
- Monitors the patient’s physiologic condition as appropriate for the type of anesthesia and specific patient needs.
- 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. Uses spirometry and ventilatory pressure monitors.
- Monitors oxygenation continuously by clinical observation, pulse oximetry, and if indicated, arterial blood gas analysis.
- Monitors cardiovascular status continuously via electrocardiogram and when appropriate, heart sounds.
- Records blood pressure and heart rate.
- Monitors body temperature continuously on all pediatric patients receiving general anesthesia and when indicated, on all other patients.
- Monitors neuromuscular function and status when neuromuscular blocking agents are administered.
- Monitors and assesses the patient positioning and protective measures.
- 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 the responsibility for care.
- Maintains complete, accurate, and timely documentation of pertinent information on the patient’s medical record. Must document all anesthetic interventions and patient responses.
- Transfers the responsibility for care of the patient to other qualified providers in a manner that assures continuity of care and patient safety.
- Adheres to appropriate safety precautions, as established within the institution, to minimize the risk of fire, explosion, electrical shock and equipment malfunction. Documents on the patient’s medical record that the anesthesia machine and equipment were checked.
- 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. When the patient is ventilated by an automatic mechanical ventilator, monitors the integrity of the breathing system with a device capable of detecting a disconnection by emitting an audible alarm. Monitors oxygen concentration continuously with an oxygen supply failure alarm system.
- Takes precautions to minimize the risk of infection to the patient, the Nurse Anesthetist, and other healthcare providers.
- Participates in the ongoing review and evaluation of the quality and appropriateness of anesthesia care as a member of the Department of Anesthesiology. Evaluation shall be performed based upon appropriated outcome criteria and reviewed on an ongoing basis.
- Participates in a continual process of self-evaluation and strives to incorporate new techniques and knowledge into practice.
- Participates in departmental Grand Rounds, presenting relevant cases as appropriate.
- Respects and maintains the basic rights of patients.
- Promotes an environment that is sensitive to cultural diversity and is open and responsive to the diverse backgrounds and experience of others.
- Assists in research projects as directed by an anesthesiologist.
- Participates in the instruction and supervision of Student Registered Nurse Anesthetists (SRNAs).
- Collaborates with members of the health care team in the development, implementation and ongoing review of policies, procedures and standards of care for a designated patient population.
- Evaluates and documents the patient care outcomes for the Department of Anesthesia and influences Departmental changes in staffing, patient assignment and standards of care.
- Participates in the identification of performance improvement indicators and develops quality improvement programs with the health care team.
- Participates in risk management activities including the identification and communication of risk in a timely manner.
- Responds to budgetary constraints and incorporates financial principles into program development, patient care activities and allocation of resources.
- Formulates trends and identifies potential problems in the delivery of patient care in the perioperative setting and implements action plans and educational programs for faculty and staff.
- Certification by the Council of Certification of Nurse Anesthetists required, or qualifying to sit for exam within 12 months of hire. Recertification bi-annually according to the standards of the Council on Recertification.
- Has graduated from an accredited nursing program. Has graduated from a nurse anesthesia educational program accredited by the American Association of Nurse Anesthetists (AANA) Council on Accreditation of Nurse Anesthesia Educational Programs.
- Typical patient care risks from blood borne pathogens and infectious diseases; exposure to latex supplies; may be required to wear protective radiology “aprons” during certain cases.
- Holds a current license in the State of New York as a registered nurse and complies with any applicable state statutory or regulatory requirements concerning such licensure. Successfully completed the AANA Council on Certification of Nurse Anesthetists certification examination. Meets the AANA Council on Recertification of Nurse Anesthetists biennial recertification criteria. Must be insurable by Hospital medical malpractice insurance carrier. Must maintain current certification in BCLS, ACLS, and Infection Control.
- Minimum of one year experience as CRNA preferred, preferably in a tertiary care facility, with demonstrated proficiency at airway management, regional anesthesia, insertion of invasive monitoring, and cardiopulmonary resuscitation.
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