Nursing Notes

July 19, 2010

Cool job: Working to keep ‘hiccups’ out of surgery

Here’s an article from the great state of Oklahoma.  There is alot of good things to be said for that state, and this article only proves that they are more forward thinking than others.

I know that I, personally, do not wish to pursue this avenue of nursing, but I think others may want to take a real look at this opportunity.  Nursing is about to become the linchpin of healthcare, finally.  It’s taken quite a long time, but it seems that finally the population at large is beginning to see the benefit of a well-trained nurse in the hierarchy of health care.

Please enjoy this article and don’t forget to visit the original site to leave comments.


CRNAs are very valuable assets to health care teams, said Gary Loving, interim associate dean of academic programs at the University of Oklahoma College of Nursing.


Published: July 18, 2010

When he describes his life’s work, Don Mordecai talks about takeoffs, landings and airways. But he’s not a pilot. He’s an advanced practice nurse who administers anesthesia to hospital patients.


More Info

Career spotlight

Certified Registered Nurse Anesthetist (CRNA)
• History: Nurses have administered anesthesia since the Civil War; formal education for the profession was introduced in 1887 at what is today the Mayo Clinic.

• Demographics: 41 percent of CRNAs are men, compared with 10 percent of RNs overall.

• Education: A master’s degree in advanced nursing; doctorates will be required of students entering programs on or after Jan. 1, 2022. Current programs run 24 months to 36 months and combine academic education in pharmacology, chemistry, bio-chemistry, anatomy, physiology and pathophysiology with an average of 1,595 hours of clinical experience.

• Accredited programs: 108 nationwide including several in Texas; Oklahoma has none.

• Prerequisites: Bachelor’s degree in nursing and at least one year of experience in critical care, an emergency department or operating room.

• Certification: After passing national board certification licensure, CRNAs are required to complete 40 continuing education hours every two years.

• Median annual salary nationwide: $158,000, according to the American Association of Nurse Anesthetists (AANA). Malpractice insurance, which sometimes is paid by employers, runs between $7,000 and $10,000 annually.

• Necessary traits: Good coordination, critical thinking, detail-oriented, ability to remain calm in pressure situations, vigilance.

• More information: and

“Just like takeoff and landing is the most important part of a pilot’s job, the most important parts of mine are induction, or the start of an anesthetic, and emergence, when a mask or tube is removed,” said Mordecai, who practices at the VA Medical Center in Muskogee. That’s when patients’ airways are the most vulnerable, he said.

According to an Institute of Medicine report, anesthesia is nearly 50 times safer than it was in the 1980s, with about one death in every 250,000 to 300,000 cases. The dramatically lowered risk is thanks mostly to better drugs and technology that monitors oxygen and carbon dioxide during surgery, Mordecai said.

“But with anesthesia, you can never take any case lightly,” he said. “No matter how good you are, there can be hiccups.”

President of the Oklahoma Association of Nurse Anesthetists (OANA), Mordecai is among some 500 health professionals in the state and 44,000 nationwide who are certified registered nurse anesthetists (CRNAs).

Nationwide, about 80 percent work as partners in care with physician anesthesiologists, while 20 percent are self-employed sole providers who work and collaborate with surgeons and other licensed physicians. In largely rural Oklahoma, that’s roughly 50-50.

CRNAs are very valuable assets to health care teams, said Gary Loving, interim associate dean of academic programs at the University of Oklahoma College of Nursing.

“They have a long documented history of providing safe care,” Loving said. Studies, he said, show there’s no difference in patient outcomes whether anesthesia is provided by a physician anesthesiologist or nurse anesthetist.

CRNAs administer roughly 70 percent of anesthesia in the state, said Victor Long, government relations chair of the OANA and a self-employed nurse anesthetist who practices in Lindsay, Purcell, Oklahoma City and Norman.

“In rural areas, it’s more like 85 percent,” Long said. Forty-one counties in Oklahoma have no anesthesiologists; only CRNAs, he said.

State law requires a CRNA’s anesthesia to be supervised by a licensed medical doctor, osteopathic physician, dentist or podiatrist where timely on-site consultation can be made, Long said. In negligence cases, the overseeing doctors aren’t necessarily held liable; it depends on the case.

According to the American Association of Nurse Anesthetists, 40 states don’t require supervising physicians and 15 also have opted out of the Medicare requirement for supervision.

Nurse anesthetist Dennis Bless practices in Minnesota, which is one of those states.

But the bylaws of the Minneapolis hospital where he works require physician supervision.

“But I’m the one in the room with the patient,” said Bless, Region IV director of the AANA. “There’s no anesthesiologist in there with me. So I have to be able to react to any severe reactions or airway issues. It’s minute to minute, beat to beat.”

Like Bless, Mordecai finds his career very rewarding.

“I have the opportunity to interact with patients and provide a quality service,” he said. “And they thank me for it.”

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1 Comment »

  1. Doh! I was domain shopping at and went
    to type in the domain name: http://nursingtrends. and
    guess who already had it? You did! haha j/k. I was about to shop
    for this domain name but realized it was taken
    so I thought I’d come check it out. Awesome blog!

    Comment by — August 8, 2013 @ 1:32 am | Reply

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