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Few healthcare professions bear a closer affinity with the men and women of the U.S. Armed Forces than does nurse anesthesia. CRNAs' very profession began on the field of battle well over a century ago. AANA President Frank Maziarski, CRNA, MS, CLNC, is a 20-year Army veteran and past clinical practice chief for the U.S. Army nurse anesthesia educational program. Each year, on the 11th month and day, Americans take special time to remember veterans, and CRNAs pay close heed to this special relationship.
As with the practice of anesthesia itself, the relationship between CRNAs and uniformed personnel begins with vigilance fitting the need. In October 2004, one of America's most highly decorated veterans, Sen. Daniel Inouye (D-HI) underscored the challenges facing both the nurse anesthesia profession and the military, when he said, "Nurse anesthetists are again carrying the load by providing 80 percent of the anesthesia requirements in Iraq and Afghanistan.... In all of the uniformed services, maintaining adequate numbers of active duty and reserve CRNAs is of utmost concern."
The profession begins by recruiting, educating, and certifying a growing supply of nurse anesthetists to meet demand. In May 2003, at the height of the military effort in Iraq, 364 CRNAs and 77 anesthesiologists were deployed as part of Operation Iraqi Freedom. The military services operate three COA-accredited nurse anesthesia educational programs: the Uniformed Services University of Health Sciences in Bethesda, Md.; the Navy Nurse Corps Anesthesia Program, also in Bethesda; and the U.S. Army Graduate Program in Anesthesia Nursing, San Antonio, Texas. In Addition, the services maintain relationships with civilian universities such as Georgetown University in Washington, D.C.
This professional relationship, along with its challenges, extends to the Department of Veterans Affairs (VA). America's Veterans Health Administration (VHA), with a budget in the $30 billion range, is regarded as the largest healthcare system in the United States. Not surprisingly, it is also the largest single employer of CRNAs, with about 500 full-time on staff. Many VA CRNAs are members of the Association of VA Nurse Anesthetists (AVANA), whose president is Carol Craig, CRNA. Yet, a portion of the VA's CRNAs are approaching civil service retirement age. Securing locums services, particularly those of anesthesiologists, is tremendously expensive for the VA. What is the...