W‑2 PRN

Full details

Working under an Attending Anesthesiologist, the per diem Nurse Anesthetist provides care to patients before, during and after anesthesia, using experience and judgment to plan and carry out assigned goals across a range of tasks. The role reports to the Attending Anesthesiologists, calls for a degree of creativity and independent latitude, and includes taking a turn at setting the daily schedule for case coverage.

Candidates need to be graduates of an accredited nurse anesthesia school and hold current CRNA certification with proof on file, along with experience in anesthesiology that the Chairman or Director of Anesthesiology finds acceptable, typically one to two years. Applicants also need a degree from an accredited program, completion of required clinical rotations, one year of acute care nursing experience, a valid New York State nursing license, and certification from the Council on Certification of Nurse Anesthetists, which is renewed every two years. Newly graduated nurse anesthetists have twelve months to meet certification standards. Basic computer skills in Microsoft Word, internet use and research tools are expected, as are strong written and verbal communication abilities.

Together with the Attending Anesthesiologist, the Nurse Anesthetist completes a thorough pre-anesthesia assessment, obtains and reviews relevant test results, and discusses the findings with the Attending. The Nurse Anesthetist confirms that informed consent has been obtained from the patient or legal guardian, reviews anesthetic options and risks after speaking with the Attending, and records the consent in the medical record. A patient-specific anesthesia plan is developed with the Anesthesiologist, drawing on the assessment, problem analysis, the planned procedure, patient and surgeon preferences, and current anesthesia principles.

Anesthesia is induced and maintained under Attending supervision. The Nurse Anesthetist continually watches the patient's response to anesthesia and surgery, promptly reports significant changes to the Attending, and acts as needed to keep the patient physiologically stable. Monitoring covers ventilation (including tracheal intubation confirmation, end-tidal carbon dioxide, and spirometry and pressure readings), oxygenation through observation, pulse oximetry and arterial blood gases when indicated, cardiovascular status through ECG, heart sounds, blood pressure and heart rate, temperature in pediatric general anesthesia and other cases when indicated, neuromuscular function when blocking agents are given, and patient positioning and protection. Any omitted standard must be documented with the reason on the anesthesia record. The Nurse Anesthetist stays with the patient until another qualified provider assumes care.

Responsibilities also include complete, accurate and timely charting of all anesthetic interventions and patient responses, and a handoff of care to other qualified providers that protects continuity and safety. Before use, the Nurse Anesthetist inspects the anesthesia machine, monitors and equipment under institutional guidelines, records that this was done, and uses safety measures against fire, explosion, electrical shock and malfunction, including disconnection and oxygen supply alarms during mechanical ventilation. Infection precautions protect the patient, the nurse anesthetist and other staff.

The role involves taking part in departmental quality review and self-evaluation, adopting new techniques, presenting cases at departmental Grand Rounds, upholding patient rights, assisting with research as an anesthesiologist directs, and supervising and teaching Student Registered Nurse Anesthetists when appropriate.