National Nurse Anesthetist Week is an annual celebration recognizing the valuable role of the anesthetist. Each year, 43 million patients place their trust in more than 50,000 anesthetists and student anesthetists across the country. In honor of the MEDNAX family of more 1,800 anesthetists in 15 states, we are excited to profile several CRNAs whose dedication to their work inspire us.
Ray is Chief CRNA at REX Hospital for American Anesthesiology of North Carolina in Raleigh. He has been a CRNA for 25 years.
I began my career in health care in 1970 at a tuberculosis sanatorium. In 1976, I earned my certificate to practice nursing in New York and moved to North Carolina to work at Duke University. I finished my undergraduate degree in 1982 and my anesthesia training in 1991, with the help of an educational program offered by Raleigh Anesthesia Associates and the Navy Reserve Primus Program.
Inspiration to become a CRNA
“When the opportunity arose to study anesthesia, I decided to pursue it. I was looking for a challenge and had pretty much been involved with everything at the staff nurse level at the medical center.”
Challenges and rewards
I’ve been a CRNA for a long time and have faced my share of challenges over the years. However, my work is more administrative now. The best rewards come from team building, and refining the internal processes that make our practice so successful. Once you reach our size—a fairly large practice—you realize our success is dependent on a well-functioning team, not any one individual. One of the most satisfying aspects of my job is bringing young practitioners in and providing them an environment where they can develop their potential as future leaders. I also have an opportunity to work with student nurse anesthetists. Watching them grow professionally as they progress through the program, and seeing the contribution they make to the department, is very gratifying.
Training tomorrow’s leaders
For the last 26 years our practice has had a successful partnership with the Raleigh School of Nurse Anesthesia. In addition to their didactic education at the University of Greensboro, they rotate through a number of local hospitals—including REX—for clinical practice and specialty work. In the summer of senior year they begin “Independent Practice”. During this period, they have the opportunity to work semi-autonomously under the supervision of a CRNA and an anesthesiologist. We have partnered with the school so that the students who are coming to work for us are assigned to us during this phase of their education. This enables our practice to complete much of the orientation work normally completed by a new graduate from another program; it just occurs while our students are still in school. In addition, the work the students complete during “Independent Practice” trends to build self-confidence and makes for a more seamless transition to full-time employment as a CRNA.”
“At this point in my career, I would say it is the unique administrative innovations we have completed over the past several years. We started an Anesthesia Safety Program called AHRO based on principles that other high reliability organizations employ, such as the airline and nuclear power industry. Our success with this initiative proved very successful, and has led to wider adaptation of this program. We began organizing and storing our clinical procedure manuals and other resources in the cloud so that our practitioners could access them at anytime from anywhere, using their smart phones or iPads. Most recently, our company’s HRO Program has adopted this initiative. We also have an extraordinary employee evaluation tool with innovative EXCEL features, which we have been asked to share with other anesthesia departments within the MEDNAX family. It is now posted on the MEDNAX HRO share file.”
“We have a great practice environment, which is accepting of new learners, innovative by nature and guided by the principles of participatory management. We practice team anesthesia. Our anesthesiologists, CRNA, students and anesthesia techs work in tandem to do a remarkable job of delivering great care to a large number of patients on a consistent basis. We offer opportunities to grow in a number of different areas through our Clinical Specialist Program, which allows our staff to participate and often lead new initiatives for the practice. Our specialists manage the cloud-based work, help lead our conversion to an EMR, run the staff conference schedule, and educate us on new procedures or processes we are being asked to perform. They are the ‘go-to people for their areas’. Administratively, we see our goal as facilitators of their growth, which by definition adds value to our practice. It’s an exciting place to work!”
Advice for aspiring CRNAs
“I recommend that anyone considering entering this field shadow a CRNA. The shadow experience will help them see the various roles of the anesthesia team in action, and give them the clearest idea of what we do for a living. At our practice, we work with young people all the time—some as young as 18 who are trying to decide if nurse anesthesia is the right career for them. The start of that growth process is really terrific to watch.”