Dr. Kevin Hitt (left) and students (from left) Stacey George of Pontotoc, Amanda Hoffman of Myrtle, Greg Parham of Tupelo and Summer Palmer of Pontotoc.
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Certified registered nurse anesthetists (CRNAs) are some of the most highly sought-after health professionals and, therefore, some of the most difficult to recruit.
North Mississippi Medical Center (NMMC) is helping meet this challenge by “growing” their own.
“We realized how difficult it was to recruit CRNAs to Tupelo, and affiliating with a training program was one way to do this,” said Dr. Kevin Hitt, a board-certified anesthesiologist who serves as clinical site coordinator, noting that when Mississippi’s only CRNA training program closed in the 1980s, the shortage became even more acute. “Because of the number and complexity of surgical cases we do at North Mississippi Medical Center, our students are very highly clinically trained and can go anywhere to work. Fortunately for us, many of them choose to stay here.”
Qualifying as a CRNA is no easy task. Students must first have a bachelor’s degree in nursing and at least one year of critical care experience. Grades and experience are crucial, as universities accept only 15 to 25 students every year.
NMMC first became a CRNA training site in the early 1990s by affiliating with the University of Alabama at Birmingham. The hospital became a training site for the University of Tennessee (UT) at Memphis in 2000, and for UT-Chattanooga in 2003. Even though out-of-state tuition is more than double that for Tennessee residents, Mississippi subsidizes the cost because there is no such training program in the magnolia state.
Summer Swinney of Booneville, one of the first students who trained in Tupelo and chose to stay, had joined NMMC in 1998 as a registered nurse after earning an associate’s degree from Northeast Mississippi Community College. With the intention of becoming a certified nurse practitioner, she continued to work in Tupelo while completing her bachelor’s degree from the University of North Alabama and her master’s degree from Delta State University. But then her plans changed.
“At that time, the market was kind of flooded with nurse practitioners, and there was a shortage of CRNAs,” she explained.
Two years later, Swinney returned to NMMC with her CRNA credentials. Today, she helps Hitt coordinate the hospital’s CRNA training program and serves as liaison for the 10 current students, five of whom will graduate this August and another five who will graduate next August.
Nuts and Bolts
CRNA training is part classroom, part clinical experience. Students spend the first three months on the UT-Chattanooga campus in intense classroom instruction. For the remainder of their junior year, they spend two days each week in class and the remaining time working alongside CRNAs and anesthesiologists. Thanks to NMMC’s distance learning technology, students “attend” class with their cohorts 300 miles away in Chattanooga. They meet together in a hospital classroom equipped with videoconferencing equipment that allows them to join discussions and ask questions. The students have even taught their Chattanooga classmates from the Tupelo classroom.
As training progresses, students spend less time in the classroom and more time gaining clinical experience. With patients needing anesthesia services in the hospitals’ 35 surgical suites, plus the Electrophysiology Lab, Endoscopy Lab, Radiology Department and Women’s Hospital, students have ample opportunity to gain clinical experience.
According to Hitt, NMMC is one of the few places where students can get everything they need at one training site.
“To gain certification, students must have a certain number of various types of cases,” Swinney added. “Our students consistently have the highest number of cases in their class.”
UT-Chattanooga students are required to perform at least 550 anesthetics before graduation; NMMC seniors have each already completed more than 1,400 cases. Because of NMMC’s high number of open-heart procedures, students routinely log more than 60 each, far surpassing the required minimum of five.
The summer after their junior year, CRNA students begin taking call at NMMC. This experience further prepares them to think on their feet because, unlike scheduled cases, with call they never know what types of cases to expect.
“Our anesthesia staff is highly motivated, very professional and dedicated to what they do. The students add to that,” Hitt said. “The CRNAs we train ourselves are able to go seamlessly from being a student to being an employee. They know the staff, they know the routine and they have ties to this area. It’s definitely an asset to patient care.”
Students Respond
Greg Parham of Tupelo, who will graduate in August, started his NMMC career in 1992 as a certified biomedical technician, primarily installing and repairing medical equipment. He became so enamored with the anesthesia equipment that he embarked on a new career path, enrolling in nursing school in 1994.
“Greg really has a passion for anesthesia,” Hitt said. “Once he made up his mind to become an anesthetist, he let nothing stand in his way.”
With a wife and three small children, Parham admits he probably could not have pursued his goal if the training had not been offered in Tupelo.
“To pack up my family, sell a house and move my children to new schools,” he said, “I just don’t think I could have done it.”
Unlike Parham, Amanda Hoffman of Myrtle knew all along she wanted to become a CRNA. After earning her nursing degree, she worked for two years in NMMC’s Critical Care Unit. For her, a career in anesthesia provides autonomy and variety.
“No patient is the same,” she said, “and we work all types of cases. It’s certainly never boring.”
Stacey George of Pontotoc, who will graduate in 2008, finds anesthesia work very rewarding.
“I’m at Women’s Hospital right now, and the patients there are so happy to see us come to put in an epidural,” she said. “It’s so rewarding to be able to help people in this way.”
Summer Palmer of Pontotoc, another 2008 candidate, worked in NMMC’s Critical Care Unit for four years before returning to school. Both George and Palmer are married to law students at the University of Mississippi and are thankful they could pursue anesthesia training close by.
Statewide Accolades
Betty Macias of Petal, president of the Mississippi Association of Nurse Anesthetists, has worked at NMMC with Tupelo students and calls the training program “excellent.”
“In fact, NMMC is actually a clinical practice site affiliated with a university for post graduate education in nurse anesthesia,” she said, noting that when training programs were closed in the 1980s, CRNA was an additional “certification” beyond the nursing licensure.
“However, since the 1990s, the entry level for a CRNA is at the master’s level — and there is much discussion of a nursing doctorate entry in the future,” Macias pointed out. “In Mississippi, as in most states, CRNAs are considered nurse practitioners in anesthesiology.”
August 2007
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