Job Description

The Certified Registered Nurse Anesthetist (CRNA) functions under this Nurse Anesthetist job description approved by the Interdisciplinary Practice Committee (IDPC). In collaboration with the attending physicians in the Department of Anesthesiology, and through implementation of standardized procedures, this CRNA is responsible for selecting and administering anesthesia to pediatric and adult patients undergoing surgical procedures in the operating room (OR), or to patients undergoing diagnostic or therapeutic procedures outside the OR under the supervision of a physician after the order for anesthesia has been written. Specific functions pertaining to the Department of Anesthesiology are established by the CRNA and his/her supervising physician(s), and approved by the appropriate medical and nursing administrators, IDPC, the Credentials and Privileges Committee, the Stanford Hospital and clinics (SHC) medical executive committee and the SHC Board Credentials, Policies and Procedures Committee. Functions: 1. A CRNA may provide only those medical services which he/she is competent to perform, and which are consistent with the CRNA's education, training and experience, and which are performed under the supervision of an anesthesiologist who is responsible for the patient's care for by the CRNA. 2. A CRNA shall consult with the anesthesiologist regarding any tasks, procedure or diagnostic problem which the CRNA determines exceeds his/her level of competence. 3. Scope of practice of the CRNA: Obtains complete histories and performs pertinent physical exams with assessment of normal and abnormal findings on patient's, according to written standardized procedures. Performs all requests and evaluates diagnostic studies as indicated upon evaluation of the patient, according to the written standardized procedures. Orders, obtains and administers pre-anesthetic and anesthetic agents, and adjuvant drugs for administration through general, regional or local techniques, according to written standardized procedures. Performs designated procedures after demonstrated competency, according to the written standardized procedure Obtains informed consent, as indicated. Evaluates patient to identify apparent or potential difficulties with airway control, if indicated. Discusses anesthesia and/or treatment plan based on identified assessments and physical findings. Explains tests, procedures and disease processes to patient's and their family's, as indicated. Obtains, prepares and uses all equipment, monitors, supplies and drugs use for administration of anesthesia and sedation techniques, performs and orders safety checks as needed. Observes, monitors and records vital signs, respiratory stability, adequate gaseous exchange, types of fluids and/or blood loss evaluation and replacement and other critical parameters. Inserts invasive monitoring lines for an anesthetic and for interpretation of physiologic data. Performs all aspects of airway management. Recognizes abnormal patient response during anesthesia, selecting an implementing corrective action and requesting consultation whenever necessary. Provides airway management, administration of emergency fluids and drugs, and uses basic or advanced life support techniques. eeps the surgeon/proceduralist and responsible anesthesiologist informed of patient's condition as needed. Documents anesthetic in accordance with legal and regulatory requirements; records type of anesthetic used. Evaluates patient response during emergence from anesthesia and instituting pharmacological or supportive treatment to insure patient stability during transfer. Performs post-anesthesia follow-up and evaluation of patient's response anesthesia in the recovery room, taking appropriate corrective actions in requesting consultation when indicated. Communicates with assigned anesthesia faculty member, as needed, before, during and after surgery. Performs designated procedures after demonstrated competency and according to the written standardized procedures were applicable. Ensures compliance with legal, regulatory, and clinical policies and procedures. Performs other duties assigned.

Qualifications

Education: 1. Master's or doctoral degree in nursing from an accredited college or university. 2. Graduate of a CRNA program accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs (COA). Licensure/Certification: 1. Licensure is a Registered Nurse (RN) in the State of California. 2. Certifications as a Certified Registered Nurse (CRNA) in the State of California. 3. National Board Certification as a Certified Registered Nurse Anesthetists (CRNA) from the National Board of Certification and Recertifications for Nurse Anesthetists (NBCRNA). 4. Certification in Basic Life Support (BLS) from the American Heart Association (AHA). 5. Certification in Advanced Cardiac Life Support (ACLS) from the American Heart Association (AHA). Supervision: 1. Supervision is provided by the supervising/sponsoring anesthesiologist with clinical privileges at SHC or designated attending physicians in the Department of Anesthesiology. Standardized procedures, approved by the supervising physician(s) and the IDPC, are a mandatory mechanism of supervision. 2. The CRNA will receive a formal annual performance evaluation by the Lead Advanced Practice Provider (Lead APP) or supervising manager/director with input from the Lead APP, supervising physician(s) and/or physician delegates, APP peers, and the supervising manager/director. Ongoing professional practice evaluation (OPPE) also occurs through tracking of a performance indicators.