Opportunities

Nurse Anesthesia is the best kept secret in health care. Since the 1800s, nurse anesthetists have played significant roles in developing the practice of anesthesia. Currently more than 26,000 Certified Registered Nurse Anesthetists (CRNAs) provide cost effective, quality patient care essential to American’s health care system. Today, almost all anesthesia services in the United States are provided by physician anesthesiologists and/or certified registered nurse anesthetists (CRNAs). However, the services of these providers are not evenly distributed across the rural-urban continuum of populations. Nearly one quarter of all Americans reside in non-metropolitan areas, according to the 2000 census and this is projected to increase by approximately 1% per year (Census, 2001). Studies have shown that rural Americans share several common characteristics to include; an overall less healthy status, a higher incidence of chronic disease morbidity and traumatic injury and physical, economic and cultural barriers to healthcare access. Certified registered nurse anesthetists have historically rendered the majority of anesthesia services to these rural residents. Over 97% of all practicing nurse anesthetists are members of the American Association of Nurse Anesthetists (AANA).

The maldistribution of specialty physicians across the United States has directed much attention to the roles of advanced practice nurses inclusive of CRNAs, especially but not exclusively in rural America. Economic incentives stress the importance of a proper physician/non-physician mix to assure quality cost effective health care for all.

National data analyzed in our Department has been stratified geographically according to the US Department of Agriculture database, "Rural-Urban Continuum Codes for Metro and Non-metro Counties." It reveals that 81.4% (21,706) of all CRNAs reside in metropolitan counties and that 18.6% (4,957)reside in non-metro counties. The national distribution of physician anesthesiologists differs, in that 91.6% (31,194) reside in metropolitan areas and only 8.4% reside in non-metro counties.

An Office of Technology Assessment report (1990) asserted that CRNAs were especially important to small rural hospitals that wish to provide basic surgical services but cannot support or attract physician anesthesiologists, yet the national supply of CRNAs appears to be in decline. In 1990, the Department of Health and Human Services reported in a congressionally mandated study, that 1500 to 1800 CRNA graduates per year would be needed to meet societal demands by the year 2010. Today there are approximately 90 nurse anesthesia programs still graduating around 1500 CRNAs per year and these graduates are highly sought after professionals.