Q&A with Nurse Anesthetist, Debbie Malina, CRNA, MBA, DNSc

Read About Our March 3rd Live Blog with the American Association of Nurse Anesthetists interviews nurse anesthetist, Debbie Malina, CRNA, MBA, DNSc. Debbie has worked in a variety of practice settings as well as in clinical instruction. She is currently serving as President-elect of the American Association of Nurse Anesthetists.

Below she talks about what it takes to be successful in nurse anesthesia.

Q: How did you get started in nursing?

I started out working in a nursing home as a nurse's aide in high school, and that's how I got interested in nursing. At the very beginning of my career, I first practiced as a Licensed Practical Nurse (LPN). [Short Code Error: type value must be either online or ground] should be full partners with physicians and other health care professionals in the United States, not necessarily working under them or for them. We really need to step up to the plate and be able to work to our fullest potential. Further in 2010, two new studies confirmed beyond a shadow of a doubt the remarkable safety and cost effectiveness of nurse anesthesia care. In 2009, California became the 15th state to opt-out of the Medicare physician supervision requirement for nurse anesthetists, and in 2010, Colorado followed suit and became the 16th state.

Nurse anesthetists have been the main providers of anesthesia care to U.S. Military personnel since World War I, and right now, in Afghanistan and Iraq, nurse anesthetists are the primary people who are there in the operating theatre providing anesthesia. Also, we were the first nursing specialty to get reimbursement from Medicare. We can bill Medicare directly.

Q: What do you see for the future of nurse anesthesia?

The future is bright for nurse anesthesia in the United States. There are more than 42,000 CRNAs and student nurse anesthetists who are members of the AANA, and that's about 92 to 93 percent of all practicing nurse anesthetists. There are probably about 45 thousand nurse anesthetists practicing in the country right now. Without a doubt there will be a greater need for anesthesia professionals such as CRNAs as millions of previously uninsured Americans enter the health care system thanks to health reform, and as the economy starts to turn around and people who have been putting off elective surgeries become financially capable of having these procedures done.

Q: What exactly is the schedule like for a CRNA?

It really depends on your practice setting. CRNAs who work in trauma centers and obstetrical units in general work 24-hour shifts. They go in at 7 a.m., and they're there until 7 a.m. the next morning. They do get downtime there to rest, and generally work two-24 hour shifts per week. But, there are CRNAs there to provide service 24/7/365. In some settings, people work eight-hour shifts, Monday through Friday. In other settings, people work 10-hour shifts or 12-hour shifts.

Q: Any other recommendations for aspiring CRNAs?

If you are accepted into a nurse anesthesia program, it is full-time. You cannot work, so you are dedicated for that 24 to 36 months to going to school to become a nurse anesthetist. The curriculum is rigorous. You do classroom as well as OR time - you don't stop. As a student you don't necessarily get out at 3 p.m. every day. You don't necessarily just put in 40 hours. The time commitment is significant. Be prepared for that, and be prepared to not have an income. Even though loans are available, those student loans in general will not cover all of your living expenses. I think people have to be aware of that and have to be prepared for that - whether you're living off savings, getting loans from other avenues, or having a spouse supporting you.

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