Certified Registered Nurse Anesthetist (CRNA) Mt Sinai Hospital FT Days

The certified registered nurse anesthetist is an advanced practice nurse (CRNA). Within this role under the supervision of an Attending Anesthesiologist the CRNA administers monitors and manages patient care before during and after anesthesia.

Clinical Practice

conjunction with Attending Anesthesiologist performs a thorough and completed pre-anesthesia assessment. Responsible for obtaining and reviewing relevant tests and discussing findings with the Attending.

and/or verifies that an informed consent has been obtained for the planned anesthetic intervention from the patient or legal guardian. Discusses anesthetic options and risks with the patient and/or legal guardian after discussion with Attending Anesthesiologist. Documents in the patients medical record that informed consent was obtained.

a patient-specific plan for anesthesia care in conjunction with the Anesthesiologist. The plan is based upon comprehensive patient assessment problem analysis anticipated surgical or therapeutic procedure patient and surgeon preferences and current anesthesia principles.

anesthesia under the supervision of an Attending Anesthesiologist and maintains anesthesia at required levels. Assesses continuously the patients response to the anesthetic and/or surgical intervention and must immediately notify the Attending Anesthesiologist of significant changes in the patients condition and intervenes as required under the supervision of an Attending Anesthesiologist to maintain the patient in a satisfactory physiologic condition.

the patients physiologic condition as appropriate for the type of anesthesia and specific patient needs.

* Monitors ventilation continuously. Verifies intubation of the trachea by auscultation chest excursion and confirmation of carbon dioxide in the expired gas. Continuously monitors end-tidal carbon dioxide during controlled or assisted ventilation. Uses spirometry and ventilatory pressure monitors.

* Monitors oxygenation continuously by clinical observation pulse oximetry and if indicated arterial blood gas analysis.

* Monitors cardiovascular status continuously via electrocardiogram and when appropriate heart sounds.

* Records blood pressure and heart rate.

* Monitors body temperature continuously on all pediatric patients receiving general anesthesia and when indicated on all other patients.

* Monitors neuromuscular function and status when neuromuscular blocking agents are administered.

* Monitors and assesses the patient positioning and protective measures.

omission of any monitoring standards shall be documented and the reason stated on the patients anesthesia record. The CRNA shall be in constant attendance of the patient until another qualified health care provider has accepted the responsibility for care.

complete accurate and timely documentation of pertinent information on the patients medical record. Must document all anesthetic interventions and patient responses.

the responsibility for care of the patient to other qualified providers in a manner that assures continuity of care and patient safety.

to appropriate safety precautions as established within the institution to minimize the risk of fire explosion electrical shock and equipment malfunction. Documents on the patients medical record that the anesthesia machine and equipment were checked.

the anesthesia machine prior to use and monitors according to established guidelines. Checks the readiness availability cleanliness and working condition of all equipment to be utilized in the administration of the anesthesia care. When the patient is ventilated by an automatic mechanical ventilator monitors the integrity of the breathing system with a device capable of detecting a disconnection by emitting an audible alarm. Monitors oxygen concentration continuously with an oxygen supply failure alarm system.

precautions to minimize the risk of infection to the patient the Nurse Anesthetist and other healthcare providers.

Professional Practice

in the ongoing review and evaluation of the quality and appropriateness of anesthesia care as a member of the Department of Anesthesiology. Evaluation shall be performed based upon appropriated outcome criteria and reviewed on an ongoing basis.

in a continual process of self-evaluation and strives to incorporate new techniques and knowledge into practice.

in departmental Grand Rounds presenting relevant cases as appropriate.

and maintains the basic rights of patients.

in research projects as directed by an anesthesiologist.

in the instruction and supervision of Student Registered Nurse Anesthetists (SRNAs).

Administrative Practice

with members of the health care team in the development implementation and ongoing review of policies procedures and standards of care for a designated patient population.

and documents the patient care outcomes for the Department of Anesthesia and influences Departmental changes in staffing patient assignment and standards of care.

in the identification of performance improvement indicators and develops quality improvement programs with the health care team.

in risk management activities including the identification and communication of risk in a timely manner.

to budgetary constraints and incorporates financial principles into program development patient care activities and allocation of resources.

trends and identifies potential problems in the delivery of patient care in the perioperative setting and implements action plans and educational programs for faculty and staff.

NYS RN with BSN and Masters Degree in nurse anesthesia current ACLS ACLS and PALS and CRNA certificate.

Collective bargaining unit: NYSNA-MSH

NYSNA at Mount Sinai Hospital 389 - CRNA Anes - MSH Mount Sinai Hospital