Anesthesiology And Nursing

Who would have thought that a small carbon based organic compound such as ether
would spawn a new field of medical specializations, changing the history of
medicine for ever. Ether was discovered in 1275 by a Spanish chemist named

Raymundus Lullius,(Evans,1995,p 1). It was his discovery that allowed William E.

Clark to use ether as an anesthetic for the first time in 1842. He administered
the ether on a dental patient for Elijah Pope as he performed a dental
extraction on Miss Hobbie,(Evans,1995.p 1). This was the first step in the
creation of the field of anesthesia. This new technology was quickly put to use
to relieve pain in all areas of medicine, and its use was seen in hospital
operating rooms, dentists' offices and battle fields. This new practice in
medicine was primarily taken on by the physicians of that time. This new method
added to a doctors routine of operating on patients, this proved to be to taxing
on the doctor as well as their patients. The added burden of administering the
anesthetics along with doing the operation and resuscitation of the patient
safely was too much for the doctors. This fact was proven by the increase in
mortality rates of patients put under by doctors who administered their own
anesthetic. The increasing mortality rates forced the medical proffesion to
demanded a change in how anesthesia was given. It was thought that the person
administering the anesthetic should do that and only that during an operation.

This would free up the physicians so that they could concentrate on the
operation at hand. The remaining question was, who do we get to administer the
anesthesia? This person would have already be trained in some aspect of the
medical field and demonstrate good critical thought and good cognitive
reasoning. The doctors only needed to look up from the operating table and to
their assistants in health care CRNA 3 to get their answer, it was the nurse.

From that moment on the first specialization in clinical nursing was born and
those in that specialty were named nurse anesthetists,(Thatcher,1952,p11). The
earliest documentation of anesthetic care given to a patient by a nurse was the
work done by Sister Mary Bernard in 1887. She was a catholic nun who worked at
the St. Vincent hospital in Erie Pennsylvania,(Thatcher,1952,p 12). The nurse
anesthetists of that time were trained by physicians at first, but as time went
on the nurses took a more active role in the study and research of anesthetics
and eventually surpassed their teachers in the field of anesthesiology. This
advance led to role reversal, where the teacher became the student and the
student became the teacher. By 1909 the first formal educational program
designed for nurse anesthetists was started at St. Vincents Hospital in Portland

Oregon,(Evans,1995,p 3). Upon graduation from the school, the nurse anesthetists
were placed in all sorts of settings. Most impressive were the teaching
positions held by nurses in the medical schools of that time. They became the
primary instructors of anesthetic to medical students. The nurse anesthetist
also held positions in the battlefields. During World War One, the American
nurse anesthetist was the primary health giver to troops in the European
theaters of combat. While at war the American nurses influenced other foreign
nurses and that led to the spread of nurse anesthetists throughout the world.

With the wars came a sharp increase in the demand of anesthetists, and this in
turn increased the number of institutions needed for training and broadened the
criteria for educating the nurses. By the end of war it was evident that the
nurse anesthetist was an invaluable profession that had established itself as
one of the most important of all in medicine. With all of this growth and
evolution it became necessary that the profession of nurse anesthetists needed
to have some structure and governance. On June 17, 1931 the American Association
of Nurse Anesthetists CRNA 4 (AANA), wasformed and held its first meeting. From
that point on the nurse anesthetist had a new name, they were also known as

Certified Registered Nurse Anesthetist, (CRNA). Up until World War Two,
anesthesia was considered a nursing specialty. This fact was credited in 1942
when the ratio of CRNA's to anesthesiologists(M.D.) was seventeen to one. Those
statistics stayed relatively the same until the sixties,(Evans,1995,p 3). The
construction of criteria and guidelines for CRNA programs has been the
responsibility of the AANA and government organizations. Together they also
created the criteria that was necessary for schools to follow to keep their
accreditation and licensure of practicing anesthetists,(AANA,1998,p 3). The CRNA
of today is