Nurse anesthetists' organization celebrates 75 years

When you're strapped to a table and bordering on unconsciousness, it's good to know someone is in your corner.

More specifically, someone is stationed next to you watching out for every aspect of your well-being -- a nurse anesthetist.

Certified registered nurse anesthetists are this week celebrating 75 years as an organization -- the American Association of Nurse Anesthetists -- but they have been comforting patients in surgical settings since the Civil War.

Nurse anesthetists do more than administer anesthesia prior to surgery, says Suzanne Dufek, a certified nurse anesthetist at Southeast Missouri Hospital.

"A nurse anesthetist becomes a patient's ears and eyes," Dufek said. "It's our responsibility to keep the patient safe, to be their voice. We become their advocates.

"We are responsible for giving fluids, monitoring urine output and blood loss, plus giving antibiotics. We replace fluids as needed. There's a lot of things we watch as they sleep."

Nurse anesthetists work with surgeons in hospitals, with podiatrists and dentists. They're vital to military medical services. They ease the fears of surgical patients and lessen the pain of childbirth. Perhaps most importantly for some patients is that nurse anesthetists help them feel like they have some control in a scary situation.

Nurse anesthetists and anesthesiologists do basically the same thing. Anesthesiologists learn their profession in medical school, said Eric White, a nurse anesthetist at Saint

Francis Medical Center. Nurse anesthetists are trained in an accredited nurse anesthesia program. Both serve residencies at varying lengths of time. Anesthesiologists often are given supervisory duties. Both local hospitals have nurse anesthetists and anesthesiologists. In smaller rural hospitals, nurse anesthetists work under the supervision of a physician.

White said he shadowed nurse anesthetists before he became one.

"I was amazed by the care given to the patient," he said. "They were able to care for a patient before surgery by allowing him to go to sleep, be pain-free during the procedure and at the end be able to wake up quickly and ask if it was over. It was amazing how in charge they were of every aspect of care, and it turned me on to the profession."

Dufek said she was a nursing student in South Dakota searching for a specialty when one of her teachers said if he could live his life over he would be a nurse anesthetist. Dufek didn't know what a nurse anesthetist was then, but the remark intrigued her so she looked into it. Like White, she spent some time with a nurse anesthetist and "that sealed it for me," she said.

Technology has made the practice easier. The pulse oximeter, the little clamp that fits on the tip of a patient's finger, monitors the oxygen level during surgery. "When this came out the safety went up considerably because we are now able to see a drop in oxygen long before a patient's color changes," Dufek said.

Before the pulse oximeter was invented, Dufek said, nurse anesthetists had to monitor a patient's lip and nail bed color. By the time they showed any difference, she said, a patient could be in danger.

New gases have made anesthesia safer for the patient, Dufek said, and can result in sedation at different levels, from a light sedation where a patient may be conscious of what is going on to a deep unconsciousness that requires the anesthetist to help the patient breathe and closely monitor his vital signs -- and levels of sedation in between.

White and Dufek agree that patients put a great deal of trust in their nurse anesthetists.

"That's not something we take for granted," White said. "We don't take that responsibility lightly. I think that's one of the best things about it. We actually care for a patient in a highly specialized way."

That responsibility, Dufek said is the most rewarding aspect of the job.

"It's knowing that you are given that trust, and you get the patient through a very scary time in their life, you make sure they are safe and when they wake up you have accomplished a goal for them," she said.

lredeffer@semissourian.com

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