Episode 182

Professional Roles & Leadership for Nurse Anesthesia w. Dr. Melissa Eisenhauer, University of Evansville Nurse Anesthesia Program

Oct 30, 2024

Professional Roles & Leadership for CRNA Cover Photo

Join the Free CSPA Community!

Connect with a network of Aspiring CRNAs, Nurse Anesthesia Residents, practicing CRNAs and CRNA Program Faculty Mentors here: https://www.cspaedu.com/community

From understanding the rich history of nurse anesthesia to learning how to advocate for the profession, Dr. Eisenhauer offers invaluable insights that will help you stand out in your career as a nurse anesthetist. In today’s episode of the CSPA podcast, Dr. Melissa Eisenhauer, CRNA and educator, takes you on a journey through the essential leadership skills and professional roles that every aspiring CRNA needs to succeed.

You’ll learn why leadership is crucial in anesthesia, how to get involved in professional organizations like the AANA, and why advocacy matters—both for your patients and your career growth. This episode also covers leadership opportunities within national committees and the steps to stay involved and proactive in the nurse anesthesia community.

Whether you’re just beginning your CRNA journey or looking to enhance your leadership skills, this episode provides actionable takeaways to empower you on your path to success. Gain clarity on your next steps as a future CRNA, and learn how to shape your career into a leadership role in this dynamic field. Let’s dive in!

Need Interview Prep Help In A Hurry? Fast-Track Your CRNA School Interview Prep with our CRNA Interview Crash Course! https://www.cspaedu.com/4wotmlds

Get access to application & interview preparation resources plus ICU Educational Workshops that have helped thousands of nurses accelerate their CRNA success. Become a member of CRNA School Prep Academy: https://cspaedu.com/join

Get CRNA School insights sent straight to your inbox! Sign up for the CSPA email newsletter: https://www.cspaedu.com/podcast-email

Book a mock interview, resume or personal statement critique, transcript review and more: www.teachrn.com

Watch the episode here

 

Listen to the podcast here

Professional Roles & Leadership for Nurse Anesthesia

Hello, future CRNA. Welcome back to CSPA podcast. Today we’re going to dive into professional roles and leadership for nurse anesthesia. This topic today is going to be brought to you by Dr. Melissa Eisenhower through the University of Evansville.

Dr. Melissa Eisenhower, DNP, CRNA began her nursing career with an associate’s degree from Kentucky Westland College in ’97, and then she earned her BSN from Murray State University in ’99, driven by her passion for nurse anesthesia. She graduated from Murray State University in 2002 and for 17 years she worked as a CRNA servicing rural facilities across western Kentucky.

In 2019, she became the founding administrator for the Doctor of Nursing Anesthesia Practice Program at the University of Evansville, leading the program to accreditation in 2021. Dr. Eisenhower is a strong advocate for the profession serving as President of the Indiana Association of Nurse Anesthetists, and contributing to state organizational Development Committee of the American Association of Nurse Anesthetists.

Outside her work, she enjoys traveling, time at the beach, being with her two children and she’s also recently married, so sending a huge congratulations and sincere gratitude for sharing your knowledge with soon-to-be-CRNAs.

A note to our readers: Dr. Eisenhower refers to a PowerPoint throughout her presentation- if you’d like to view this, you can watch today’s episode on YouTube above. Thank you! 

A Brief History of Nurse Anesthesia

Hello, my name is Dr. Melissa Eisenhower from the University of Evansville Nurse Anesthesia Program in Evansville, Indiana. And today I just want to talk to you a little bit about how to develop your professional role and leadership skills if you are looking to go to anesthesia school, which I believe most of you are, so let’s get started.

I think before we can truly get into the development of the role of a CRNA and how to lead in the field, I think it’s important for us to take a quick look at the history of the profession- and we do, as nurse anesthetists, have a very storied history. In the photo on this slide, you’ll see Alice Magaw. Alice Magaw was dubbed the “Mother of Anesthesia” by Dr. Charles Mayo. Her leadership in what was considered a new field in her time drew more widespread attention than that of any member of the Mayo Clinic apart from the Mayo Brothers themselves.

She was the first to really draw attention to nurses performing anesthesia. Back in the 1930s, George Cry, a physician, he is known as one of America’s greatest surgeons, renowned for his research in the treatment of surgical shock and he was a staunch supporter of nurses, even choosing a lady named Agatha Hodgins to be his personal anesthetist. He was known to say that he felt that the movement of nurse anesthesia was one of the most beneficial movements we had seen in the whole field of operative surgery.

He felt that Agatha Hodges was brilliant, called her a woman of vision, so it was very fitting that she was elected the honorary president of the National Association of Nurse Anesthetists in 1933. The NANA or National Association of Nurse Anesthetists actually started June 17th, 1931 in Cleveland, Ohio, but they did not hold their first meeting until 1933 in Milwaukee; there were 120 individuals in attendance and that’s when Agatha Hodgins was elected the honorary president.

The AANA, COA and NBCRNA

There are three primary professional organizations in nurse anesthesia. We’ve got the American Association of Nurse Anesthesiology. You’ll see on the slide I have an old logo there that still says American Association of Nurse Anesthetist, but we are now known as the American Association of Nurse Anesthesiology or AANA. There’s the Council on Accreditation of Nurse Anesthesia Educational Programs or what we call the COA, and the National Board of Certification and Recertification for Nurse Anesthetists or the NBCRNA.

The American Association of Nurse Anesthesiology or AANA, is the single professional organization in the United States that truly represents the interest of CRNAs in the country. Its mission is to promote full scope of practice for CRNAs and to promote healthcare policy that supports nurse anesthesia practice. It is based in Rosemont, Illinois, and then we also have a federal government affairs office in Washington DC.

In the late 1920s, forty four CRNAs from twelve states agreed to form the National Association of Nurse Anesthetists, which we talked about previously. They made an effort to affiliate with the American Nurses Association, but that affiliation actually never happened. So we just moved forward over the years, until we eventually became the AANA and again, Agatha Hodgins was the first president of the AANA. 

AANA Objectives

Objectives of the AANA are to promote continual high quality patient care. We always want to advance the science and art of anesthesiology. We want to develop and promote educational standards in the field of nurse anesthesia, promoting standards of practice in the field of nurse anesthesia. We aim to facilitate effective cooperation between the nurse anesthetist, physician, anesthesiologist, and other members of medical professions; this is because we do work very closely with all professions within our healthcare system, the nursing profession, hospitals, the hospital association, and then those agencies that represent communities of interest in nurse anesthesia.

The AANA encourages publishing of scientific journals, bulletins and other publications that are pertinent to the objectives of the Association. They help to maintain informational and statistical data for reference and assistance in matters that pertain to our profession and clinical practice issues. They provide lots of opportunities for continuing education, and then they provide us as members with direction pertaining to governmental policies and governmental affairs that are of importance to anesthesia and anesthesia providers.

There are many benefits and services to members if you are a paid member of the AANA, they do their best to keep us aware of any issues that may be going on behind the scenes. In addition to that, they help us to keep the public aware of the profession of nurse anesthesia. They provide support regarding business and clinical practice issues, government affairs activities. 

They provide support for neuroanesthesia education quality and patient safety continuing education activities and they will actually record our class A continuing education credits. They provide support for research. There’s the AANA bookstore and resource center. The website itself has just a wealth of resources for its members, a online services, and then there’s the AANA insurance services area that offers members reasonable pricing for liability insurance and other types of insurance.

CRNA Conferences

We have several national meetings annually. Why is that important? Why do we need to go to meetings? People talk about being busy and not wanting to attend something else, no time to sit through another lecture…but it is really important to attend these meetings and it’s easy to become involved. The mid-year assembly is probably one of our largest and most important meetings each year. It’s held annually in Washington DC, usually in April.

CRNAs have the opportunity to come together, meet together, and then separate as state delegations to meet with their elected national congressional delegation. They get to really just be able to directly lobby our federal legislative agenda to our legislators.

Discussions include healthcare reform, federal policies and laws affecting healthcare cost assessment and quality. When we arrive in Washington D, the first couple of days of that mid-year assembly meeting is time to just prepare us as CRNAs on issues and how to best talk with our congressional members and staff when we do have those face-to-face meetings.

A group of nurses, nurse anesthetists and healthcare workers talking in a group together while at a conference

Leadership Roles for CRNA: The AANA Annual Congress is a full five days of amazing networking and learning opportunities.

Annual Congress of course, is held each year, it usually lasts about five days in early to mid August, always in a major metropolitan city. I’m super excited because the 2025 Annual Congress is going to be held in Nashville, Tennessee, which is just a couple of hours for me. So I will definitely be there. Large attendance and usually includes over a thousand students. There are a lot of activities for students including the College Bowl.

There’s a student luncheon, there are mentoring opportunities for students and the networking is just amazing. This meeting includes a opening ceremonies. There’s general business session bylaws, hearing scientific sessions and workshops, focus sessions, concentrating on special issues, their exhibits, receptions. It is really a full five days of just amazing networking opportunities and learning opportunities.

Leadership opportunities and committee involvement are huge within our profession and there are countless opportunities to become involved. We at one point had a leadership summit annually, it was one of our annual meetings; now beginning this fall that former leadership summit is being replaced with leadership bootcamps at the AANA headquarters in Rosemont, Illinois. Those will be held for state presidents and presidents elect to really just do exactly what the title says, bootcamps to help train these individuals, giving them a strong foundation in state leadership and how to best guide and direct the membership in their state.

There are numerous elected and volunteer committees within the AANA that offer opportunities for involvement, development of leadership skills, insight into how the association is run. But the one thing that I always tell my students and that I encourage everyone to really, really think about is that we stand on the shoulders of giants in this profession.

I can think of, we talked about Alice McGall, we talked about Agatha Hodges, Nancy Bruton, Marie Sandy, Marie Ette, Jackie Rolls, and those are just to name a few right off the top of my head. These individuals have done so much hard work over the years. They got us to where we are today.

And so getting involved and staying involved today is the only way to carry on the work of those before us. And so I really, really always push these leadership opportunities with my students and getting involved on committees. I myself have served on a national committee. I was on the State Organizational Development Committee. I learned so much. It was a wonderful opportunity for me. There are opportunities for student involvement on national committees as well, and then it just really, really lays that foundation for involvement.

What is the NBCRNA?

Once you graduate and become a CRNA, we move on to the National Board of Certification and Recertification for nurse anesthetists. Now, it’s important to note that these professional organizations that I’m talking about, they are separate. They’re individual organizations. We all try to work together, but these are separate organizations with different goals.

So the NBCRNA represents the community of interest involved in the process of certifying and then recertifying CRNAs every few years. They formulate the requirements, guidelines and prerequisites for certification and the eligibility to take that national certification examination that you will take after graduation from an accredited program.

They actually administer the NCE, evaluate performance on that and grant initial certification to those individuals who successfully complete the certification exam. They formulate and adopt the criteria for eligibility for recertification based on the CRNA’s participation in those continuing education activities and recognized activities that show that we are professionally proficient. They then continue to formulate and adopt those criteria for recertification requirements as recommended by one of those committees that we talked about, the AANA Continuing Education Committee. 

The Council on Accreditation of Nurse Anesthesia Educational Programs

Now we’ll move on to the Council on Accreditation of Nurse Anesthesia Educational Programs or the COA. It’s one I’ve become extremely familiar with since becoming a program director in 2019. The COA actually represents the community of interest involved in the accreditation process of nurse anesthesia educational programs.

Their purpose is to advise, formulate and adopt standards, guidelines, procedures and criteria for accrediting nurse anesthesia educational programs. Their big responsibility is to ensure the public that our educational programs are high quality and that we remain compliant with sets of minimum educational performance standards.

One important thing to note, because you’re involved with CRNA School Prep Academy and you’re looking into anesthesia schools, you may already be aware that all accredited programs must have transitioned to a doctoral degree for entry into practice by January 1st, 2022. So after the year 2015, the COA no longer considered master’s degree programs for accreditation. So all programs now are doctoral degree for entry into practice.

State Nurse Anesthesiology Associations

State organizations are extremely important because your state Nurse Practice Acts determine how CRNAs can practice in their particular state. So becoming involved with your state organization and familiarizing yourself with your state’s Nurse Practice Acts will give you a solid understanding of your practice and responsibilities where you live and work.

State organizations are formed by members who live and work in that particular state. They’re recognized by the board of directors as a duly incorporated entity. They are responsible for organizing their own committees for electing state officers and handling their own financial affairs. They’re supported financially by state membership dues, which the AANA collects.

Part of your membership, each individual who pays for an AANA membership, part of that comes back to the state as your state dues. Members from state associations maintain contact with the national office. We provide the national office each year with a list of our new officers, committee members, bylaws, things of that nature. I think it’s important to get to know your state organization board of directors.

Professional Roles & Leadership for Nurse Anesthesia w. Dr. Melissa Eisenhauer, University of Evansville Nurse Anesthesia Program Share on X

As a five-year member of the Indiana Board of Directors, I can tell you there are limitless opportunities for involvement. When I came to the state of Indiana, I joined the board that first year that I came here in 2019 as an at large director; I remained in that seat as an at large director for three years. I was then elected to the president elect seat and have been the president in this 2024 fiscal year. My presidency will end in October when we have our fall meeting, and I will remain on the board in a non-voting capacity for the next year as the immediate-past president.

So there are so many opportunities, committees, program development for state meetings, things like that for involvement. I can tell you that your board of directors in your state, they want to hear what the membership wants. They want to hear what issues you want to fight for, what do you want us to talk to legislators about when we go to our state capitol buildings?

I highly encourage you to get involved with your state organization, find out who’s on your board and ask how you can help, because I promise you there are ways you can help advocacy. Obviously because I have served on the board, I have served on committees. I am a staunch advocate for the profession, both at the state and national level.

Advocating for the CRNA Profession

So who advocates for us in our profession? Well, these organizations that we’ve just been talking about, they are all in place to assure that we have individuals on our side to fight for our practice rights, to ensure that our anesthesia programs are of the highest quality and to assure that our certification standards are maintained.

How can we then advocate for our patients? Well by maintaining our certifications, by continuing education opportunities, by networking and continually learning and being the best clinicians and practitioners that we can be.

It’s always my hope for those of you who are embarking on this educational journey that you grasp one crucial aspect of professional advocacy, and this is something I share with every student that comes through our program and specifically when they take our professional role in leadership development course. You must be able to safely administer an anesthetic and be a competent and vigilant provider before you can advocate for the right to provide that care. You’ve got to be able to walk the walk before you can talk the talk.

That’s one of the big things with advocacy, you’ve got to know what you’re doing before you can go out and fight for the right to do it. So anyone can go out and advocate for this amazing profession, but you have to know how to safely do what you’re fighting to do before you understand how to truly fight for it. So that’s where our anesthesia training programs come in and keeping curriculum strong and robust; making sure that our clinical preceptors are strong and working with our students daily, providing feedback that helps us to help our students.

Leadership Development for CRNA

Leadership is an integral part of graduate education and the development of the professional role of the CRNA. Within the Professional Role in Leadership Development course at the University of Evansville, I utilize the Quantum Leadership Creating Sustainable Value in Healthcare textbook. 

If you’re looking to become a CRNA, I want you to not only become an excellent clinician, but a strong leader of change in your community and then that will carry over into the profession as a whole. One of the quotes that I like in the Quantum Leadership textbook says, “The hardest thing is not to get people to accept new ideas. It is to get them to forget old ones.” That was from John Maynard Cains.

This current generation has seen the development of fiber optics, virtual universities with online classes, cloning and custom DNA based treatment modalities… I could go on and on. There’s so many more things than we would even have time to discuss. Changes are often coming so fast that we can’t often fully comprehend how these changes might affect us.

For instance, I think society really is truly just starting to understand the impact of social media on our beliefs, knowledge, communication, business and politics. I mean, we wake up in the morning and the first thing we do is click on some form of social media, and that’s kind of where we get our news, and it’s probably different when we wake up in the morning than it was when we went to bed the night before. It can be really overwhelming and difficult to keep up with that.

The key point here is that communication technology has created a world without boundaries. Often we have to learn to create our own self-limiting boundaries in a way that will produce balance among those conflicting demands of our lives. We are all pulled in so many directions.

Effective leaders must be operational experts and problem solvers. Operational experts meaning in our field, we’ve got to be great clinicians. We’ve got to be strong clinicians and know how to operate in our field. Then, to solve problems often very, very quickly, we must be good signpost readers. I’ll come back to that in a minute.

The word "Leadership" in a puzzle that's being put together

Leadership Roles for CRNA: Effective leaders must demonstrate comfort with the journey and provide a framework for leading others.


Anticipate the path of change and then spell it out for those who are moving their own activities, whether they know it or not, in the same direction as real change is taking form. Effective leaders must demonstrate comfort with the journey and provide a framework for leading others through what often feels like chaos and uncertainty in a world of constant change. We must exhibit behavior that exemplifies commitment to sustain our own journey and to coordinate and facilitate the efforts of others to build a desired future.

To be an effective leader, you have to be the stronghold for others, and that can get exhausting and it can be very daunting at times. But again, we stand on the shoulders of giants, and so someone has to carry on those leadership skills and abilities to the next generations. So let’s go back to that stop sign or that signpost reader. A stop sign can be used to illustrate what is potential reality.

When you first see a stop sign, it notifies said driver to stop, but not immediately. The sign is a real object. It’s a reality. It does require a real response, but the driver’s preparation to stop is the first in a chain of actions, but it’s only when they actually arrive at that stop sign that the act of actually stopping becomes real. So seeing the sign and preparing to stop is acting in consonance with that potential reality. Actually stopping at the sign is what represents the actual reality.

What I’m getting at here is, there’s a lot of preparation that goes into that decision-making and that actual full stop, that actual reality. There’s a lot of potential that’s happening before you get to that actual reality and the actual event taking place.

Leaders are agents of change. They are responsible for providing others with a vision of change and ensuring that their response aligns with the demand for change, which in today’s day and age seems pretty constant. Leaders are those who know that the realities pertaining to a change process and they can adapt that process in light of those realities so that the needs of key stakeholders are met and stakeholders can devote their efforts to implementing and sustaining processes.

Before I get into talking a little bit about our program, like I said with that Quantum Leadership textbook, I just wanted to give you a few highlights there and a few of the key takeaways just in the early chapters. So if you want to know more about what happens with Quantum Leadership and Sustaining Value in Healthcare in today’s day and age, well, you’re going to have to come to the University of Evansville and be in my class to find out.

The University of Evansville Doctor of Nurse Anesthesia Practice Program

I mentioned early on that I’m at the University of Evansville, Doctor of Nurse Anesthesia Practice program. Part of this presentation is to kind of talk to you a little bit about our program and what we offer, and we are very excited to be offering this program in Evansville as one of only two programs in the state of Indiana.

Where is Evansville, Indiana? Well, it is the third largest city in Indiana, population of about 118,000. There’s a Tri-state area that we serve, 11 counties in Indiana, 10 counties in Illinois, and 9 counties in Kentucky. That entire catchment area is listed as medically underserved.

There are no nurse anesthesia programs in the state of Indiana within an hour of the University of Evansville, and we are pretty strategically located within about three hours of Nashville, Louisville, St. Louis and Indianapolis. There’s lots of things to do around us and it’s pretty easy to get to some of those bigger cities.

The university itself was founded in 1854. It’s a not-for-Profit Private University with the total enrollment of a little over 2,500. We have a beautiful campus that covers 75 acres and 31 buildings. Some of the services on campus include a full library, a fitness center, intramurals, counseling, health clinic, bookstore, and of course all the students love the Chick-fil-A.

Some quick facts about our program. So we are accredited to offer a Doctor of Nurse Anesthesia practice program by the Higher Learning Commission. We are also, of course, accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs.

The first year of the program is didactic and clinical rotations are incorporated into the second and third years. However, just last year we added two courses for academic credit entitled Preclinical Practicum One and Two that allow students some shadowing opportunities in our three primary clinical sites. This allows students to really orient to those sites prior to beginning clinical rotations. We also hold a clinical bootcamp of sorts within the second preclinical practicum to ensure that students are ready to hit the ground running when their rotations begin.

We are a 36 month year-round curriculum. We have some amazing faculty and staff. We have classes offered on our main campus in Graves Hall and then with physician assistant students at the Stone Family Center for Health Sciences about a mile off of our main campus. We have put together a very state-of-the-art Simulation Lab, offering our students hands-on experiences prior to providing actual patient care.

We purchased a quad system from intelligent ultrasound about a year and a half ago, and we have students performing fast exams. This is Bodyworks Eve, and this is actually another part of the intelligent ultrasound training system where we can train students on point of care ultrasound guided techniques. We’re able to train students on TEE and TTE techniques as well. 

One requirement for students to graduate from a nurse anesthesia program is to carry out a doctoral scholarly project, and that includes dissemination. So these gentlemen (pictured in slideshow) are part of our current senior class and their doctoral scholarly project centered around diversity in nurse anesthesia, and they took part in several workshops. They were part of the Medical Professions Academy, which is part of the Evansville Vanderberg School Corporation with middle school students going and talking to those students about nurse anesthesia and what it actually means to become a nurse anesthetist.

They visited nursing programs and really try to help build a pipeline into the nursing program that would lead in then to nurse anesthesia. Our program is pleased to have developed three primary clinical partnerships. We have Deaconess Health System and Ascension St. Vincent Health System, both here in Evansville, and then the Owensboro Health Regional Hospital in Owensboro, Kentucky that serve as our three primary clinical sites. We also have affiliation agreements with more than 25 clinical sites across Indiana, Illinois, and Kentucky, and we are continuously working to add more sites to our list.

Requirements for application can be found on our website, but you have to have a bachelor of nursing from a regionally accredited school of nursing, unencumbered license to practice nursing. We will talk you through getting an Illinois license prior to starting clinical rotations. Indiana and Kentucky are a compact state, so it’s a little easier there. One full-time year, although we prefer two, years of ICU experience at the bedside within the last five years.

We do require employer verifications, ACLS, BLS and PALS. 3.0 undergraduate, GPA undergraduate courses that we require with a B or better are a basic statistics and chem class, and we do require a couple of different shadowing experiences. There’s a writing prompt on our website, three professional letters of reference, and we do require CCRN for acceptance into our program, and our application can be found on nursing cas.

Certainly. If you have any questions about our program, please reach out. Our program has an operations administrator, Ms. Missy Holt. She is excellent with providing information, setting up visits. We hold open houses quarterly to allow potential applicants to come in and visit our program and kind of show off what we feel we do really, really well.

I wish you the best of luck in your journey. I hope that this discussion on professional development, a little bit of the history of nurse anesthesia, how we got to where we are and why it’s important to continue on that path was beneficial to you. If I can ever be of any help to you, please don’t hesitate to reach out. Thank you for tuning in.

Important Links

Join the Free CSPA Community! Connect with a network of Aspiring CRNAs, Nurse Anesthesia Residents, practicing CRNAs and CRNA Program Faculty Mentors here: https://www.cspaedu.com/community

Get access to application & interview preparation resources plus ICU Educational Workshops that have helped thousands of nurses accelerate their CRNA success. Become a member of CRNA School Prep Academy: https://cspaedu.com/join

Get CRNA School insights sent straight to your inbox! Sign up for the CSPA email newsletter: https://www.cspaedu.com/podcast-email

Book a mock interview, resume or personal statement critique, transcript review and more: www.teachrn.com

Learn More about the University of Evansville Doctor of Nurse Anesthesia Practice Program: https://www.evansville.edu/majors/nurse-anesthesia-program/

Highlights


    Increase your knowledge with our

    Insightful Blogs

    Unleash your curiosity, ignite your creativity, and explore boundless inspiration in our captivating Blog Section.

    FREE CSPA Circle Community!!

    Your new hub for connections, live events, and resources! Rather than relying on the algorithms to show you what you want, join the FREE CSPA Community on Circle and connect with a dedicated network of nurses pursuing CRNA, plus our team of CRNAs and CRNA Program Faculty Mentors.

    We’re so happy you’re joining us! The link to join will be delivered to your email shortly (if you don’t see it, check your spam folder).