After what its leadership called “careful consideration,” and with the support of physician leaders and surgeons, Watertown Regional Medical Center has shifted to a comprehensive certified registered nurse anesthetist (CRNA) structure in its anesthesia department.

This is a switch that has been occurring nationally — away from anesthesiologists who are exclusively medical doctors. It has been met, in some quarters, with opposition.

“CRNAs have been providing high-quality anesthesia services at our hospital, and other hospitals across the country, for years,” Richard Keddington, CEO of the medical center, said Monday. “Following evidence-based best practices, these highly trained medical professionals bring essential skills and expertise to rural and medically under-served communities, allowing patients to access critical care when and where they need it.”

According to WRMC, it will continue to have an anesthesiologist on staff who works collaboratively with the CRNAs.

Information provided by the hospital stated that CRNAs are trained to administer every type of anesthesia to all types of patients in any healthcare setting where anesthesia is delivered.

According the website for the American Association of Nurse Anesthetists, CRNAs have been providing anesthesia care to patients in the United States for more than 150 years.

“CRNAs collaborate with surgeons, anesthesiologists, dentists, podiatrists and other qualified healthcare professionals to deliver safe, high-quality and cost-effective patient care in virtually every healthcare setting,” the AANA site stated.

CRNAs are advanced practice registered nurses who administer approximately 43 million anesthetics to patients each year in the United States.

“In some states,” the AANA said, “CRNAs are the sole anesthesia professionals in nearly 100% of rural hospitals, ensuring patient access to obstetrical, surgical, trauma stabilization and pain management services.”

CRNA services include pre-anesthesia evaluation, administering the anesthetic, monitoring and interpreting the patient’s vital signs, and managing the patient throughout surgery.

“Today’s ever-changing healthcare environment presents unique challenges for hospital administrators and executives, policy-makers and healthcare providers alike,” the AANA stated, “especially when it comes to ensuring patient access to safe, high-quality and cost-effective anesthesia care.”

In 2005, Wisconsin became the 14th state in the country to opt out of the physician-supervision requirement, making the decision that CRNAs, who are certified as advanced practice nurse providers, legally can provide care without the supervision of a physician.

“Patients who require anesthesia for surgery, labor and delivery, or any other procedure, can count on a CRNA to stay with them throughout their procedure, advocate on their behalf, and provide safe, high-quality care,” Keddington said. “With this approach, we are continuing to meet patients’ unique needs while making care more affordable and accessible for our community.”

Another hospital in the area that uses CRNAs for anesthesia is Fort HealthCare. A check with that hospital’s website indicated there are at least nine CRNAs on staff who administer anesthesia.

Keddington said the WRMC is “extremely confident” in its ability to continue delivering safe, high-quality care to the community.

“We would like to recognize the talented and dedicated CRNAs who have been providing quality care to WRMC patients for years,” he said, “and we thank them for their continued effort in advancing our mission of making communities healthier.”

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