Department of Anesthesia

JDWNRH
Job Description of a Nurse Anesthetist

Anesthesia is the production of the unconscious state or neural blockade to produce conditions
allowing surgical procedures. Often it includes complete muscles paralysis, cardiac and
respiratory support, e.g. endotracheal intubation and ventilation.
The nurse anesthesia job description and responsibilities include a number of activities, most of
them completed with minimum supervision by anesthesiologists. As they become more trusted
and experienced, they may be given both complete independence plus responsibility for patient
care. Therefore, as advanced practice registered nurses, Nurse Anesthetists practice with a high
degree of autonomy and professional respect.
In collaboration with surgeons, anesthesiologists, dentists, podiatrists, and other qualified
healthcare professionals, Nurse Anesthetists are responsible for patient safety, reduction of risk
of anesthesia in addition to quality of care. The Nurse Anesthetist administers anesthesia and
anesthesia-related care in four general categories: 1) Preoperative anesthetic preparation and
evaluation, 2) Anesthesia induction, maintenance and emergence, 3) Post operative anesthesia
care and 4) Perianesthetic and clinical support functions.

Patient Assessment The Nurse Anesthetist will perform a pre-anesthetic assessment and
evaluation of the patient and talk with them about their procedure. They may refer the
patient to other specialists if they have conditions that might affect the anesthesia
experience. The consultations and diagnostic studies may be obtained as required along
with the preanesthetic medications and fluids.

Anesthesia Plan This plan notes the various medical conditions to be aware of for
anesthesia and recommends the type and levels of anesthesia for the procedure. There
will be notes about what to watch for during the procedure and specific actions for
recovery room personnel to take. A thorough blood investigation will be ordered and
patient conditions optimized prior to surgery.

Patient Preparation The Nurse Anesthetist will help prepare the patient for their
procedure and the anesthesia. They may put in the needed IVs or check that they are
ready for use. They will set up all the monitoring devices to check blood pressure, ECG,
SPO2, pulse and temperature of the patient.

Anesthesia Preparation and Administration All of the needed anesthetics,

accompanying drugs and IV fluids will be requisitioned and made ready to be used in the
operating room. The Nurse Anesthetistwill administer all anesthetics,adjuvant drugs,
accessory drugs, and fluids necessary to manage the patient under anesthesia, to maintain
the patient's physiologic homeostasis, and to correct abnormal responses to the anesthesia
or surgery accordingly. As the procedure comes to a close, the Nurse Anesthetist will
bring the patient out of the anesthesia safely and prepare them for transfer to the recovery.

Follow Up The patient will be monitored while in recovery for any adverse effects from
the anesthesia. The Nurse Anesthetist will make sure that all patient documentation
regarding the anesthesia is updated and accurate.

Emergency Management The Nurse Anesthetist will promptly react to an emergency

with the standard procedures as outlined by the practice in which they work. They are
responsible for the patients airway, administration of emergency drugs and fluid
management, and any basic or advance life support measures they are called on to do.

Airway Management--- Managing a patient's airway and pulmonary status using

endotracheal intubation, mechanical ventilation, pharmacological support, respiratory
therapy, or extubation in OR,ICU and Emergency Department.

Pain Management --- Ordering, initiating or modifying pain relief therapy, through the
utilization of drugs, regional anesthetic techniques, or other accepted pain relief
modalities, including labor epidural analgesia.

Administrative Duties Nurse Anesthetists perform administrative functions for

department of anesthesia. The services provided by the anesthetists are extremely
important to the overall functioning of an anesthesia department and directly affect the
efficiency and quality of service provided. These functions include personnel and
resource management, financial management, quality assurance, risk management and
continuing education. The Nurse Anesthetist will be responsible for other aspects of their
practice such as patient record management, inventory and restocking, and patient
scheduling as well.

Clinical Support Services outside OR- The Nurse Anesthetist also provides clinical
support services outside of the operating room, such as CT/MRI units, ICU, Emergency
Department and wards. These services include providing consultation, implementation of
respiratory and ventilatory care, as well as identifying and managing emergency
situations, initiating or participating in cardiopulmonary resuscitation which involves
airway maintenance, ventilation, tracheal intubation, pharmacologic support,
cardiopulmonary support, and management of blood, fluid, electrolyte and acid-base

balance. The sedation is also often administered in small children for MRI and CT scan
under our close observation and monitoring.

Nurse Anesthesia Providers have the following clinical privileges,

1. General Anesthesia including but not limited to:

Pre-operative evaluation
Preoperative, perioperative and postoperative patient management.
Administration of Intravenous agents.
Administration of Inhalation agents.
Administration of Intramuscular agents.

2. Regional Anesthesia including but not limited to:

Topical and Infiltration anesthesia.

Spinal anesthesia.
Caudal anesthesia.
Thoracic and Lumbar Epidural anesthesia.
Upper and Lower Extremity neural blockade.
Field Blocks.
Other peripheral blocks.

3. Others Types of Anesthetic Care:

Pain management
Moderate to deep sedation techniques.
Intravenous catheter placement.
Placement of Central venous line.
Placement of Intra-arterial catheters.
Management and initiation of mechanical ventilation.
Airway management
ACLS, other Resuscitation techniques.
Fluid, Blood transfusion and autotransfusion techniques.
IV administration of vasoactive and cardiac drugs.
Hypotensive and hypertensive technique.
Interpretation of blood gas.
Ultrasound and fluoroscopy.
Prescriptive authority on medications and investigations.