Inside the Role: What It Is a CRNA?

When it comes to surgical procedures, childbirth, and critical care, certified registered nurse anesthetists (CRNAs) play a vital—but often behind-the-scenes—role in patient care. As advanced practice nurses who specialize in anesthesia, CRNAs are responsible for administering anesthesia, monitoring patients during procedures, and ensuring safe, pain-free experiences in a variety of medical settings.

But, their responsibilities go far beyond the operating room. Here, Jeff Cichocki, CRNA at Fort HealthCare, breaks down what a CRNA is, the scope of their practice, and how they’re helping to shape the future of healthcare.

How Does a CRNA Differ from a “Regular” Anesthesiologist?

The key difference between a CRNA and an MD anesthesiologist lies in their educational paths. MD anesthesiologists complete undergraduate studies, medical school, and a residency program focused on anesthesia. In contrast, CRNAs first earn a bachelor’s degree in nursing, then gain at least two years of critical care experience before entering a three-year anesthesia program.

Upon completion, CRNAs graduate with a Doctor of Nursing Anesthesia Practice (DNAP) or a similar doctoral degree. Both are highly trained, but their routes to practice reflect different healthcare backgrounds—nursing for CRNAs and medicine for anesthesiologists.

“If you ask various groups of anesthesia providers, everyone will tell you there are differences. But, in the day-to-day practice, they are minimal. We do everything here at Fort HealthCare that an anesthesiologist would do at other hospitals. We do bread and butter type surgeries,” notes Cichocki. “We don’t do bigger cases, like transplants, some trauma, open heart surgery, and neuro cases. We leave those to an MD anesthesiologist because their training often includes fellowships in those specialties. But, in the day-to-day practice of elective surgeries, there is very little difference.”

A Much-Needed Specialty: Obstetrics

At Fort HealthCare, all CRNAs are specially trained to handle obstetric (OB) anesthesia, including administering epidurals and providing anesthesia for C-sections. They also play a critical role in caring for premature newborns, including resuscitation and stabilizing infants for transfer to a neonatal ICU when necessary. Their expertise ensures comprehensive OB care comparable to that offered in larger hospitals.

“Ultimately, we don’t take care of that patient start to finish, meaning until their discharge, because we don’t have a neonatal ICU. But, we take care of the moms, comprehensively, including epidurals or spinals, as well as pain management, which is kind of the latest and greatest thing for anesthesia and CRNAs,” shares Cichocki.

Using Nerve Blocks as a Strategic Approach to Pain Management

Over the past 5–10 years, healthcare providers have worked to reduce reliance on opioids for post-surgical pain management due to their risks and long-term consequences. In response, Fort HealthCare has developed a comprehensive, ultrasound-guided nerve block program. By targeting specific nerves based on the surgical site—similar to how a dentist numbs part of the mouth—CRNAs can effectively manage pain in areas like the arm, shoulder, or knee, helping patients recover more comfortably with fewer opioids.

“As a practice and as a group, we are probably eighty percent opiate free. If patients still have pain, we do give them pain relief medications,” assures Cichocki. “But, we try really hard to use the nerve blocks and local anesthetics to reduce or eliminate narcotics, which cause so many problems for people.”

Partnerships with Academia Optimize the Future of Healthcare

About six to seven years ago, Fort HealthCare partnered with the University of Wisconsin–Oshkosh’s nurse anesthesia program to offer senior-level students intensive training, particularly in their high-volume, advanced nerve block program. After successfully hosting UW students—even through the challenges of COVID—Fort HealthCare expanded its educational partnerships to include Marquette University students as well.

Now, with a strong reputation for clinical education and nerve block expertise, Fort HealthCare is also being considered as a clinical site for Edgewood College’s new anesthesia program in Madison. These partnerships reflect Fort HealthCare’s commitment to shaping the future of rural medicine and CRNA training.

“Not every hospital or program is doing it, especially like we’re doing it,” shares Cichocki. “Edgewood has reached out with an interest, as their program is online and students at the senior level are already asking if we have an interest in taking on a third institution in training. I feel fairly confident we can provide that to them because of the number of blocks that we’re doing every day. We offer the ability for these students to get the repetition and experience. And, to some degree, a comfort level taking care of these patients. I think this collaboration is great on both sides.”