6 Challenges That CRNAs Face in Their Profession

CRNAs play a crucial role in the health-care profession, and there are numerous benefits to the occupation. But there are also many challenges that CRNAs face in their profession. Current issues like burnout, staffing shortages, and training barriers are some of the responsibilities nurse practitioners face in their practice.

In our guide, we’ll take a closer look at the CRNA role, the responsibilities, what it takes to become one, and the current and future problems.

What Is a CRNA?

A Certified Registered Nurse Anesthetist (CRNA) has an essential job in anesthesiology. Surgeons and physicians administer anesthesia to a patient through intravenous drugs or inhaled gasses before performing surgery or a medical procedure so that they don’t feel pain.

The CRNA works with the anesthesiologist throughout the procedure. Some of the tasks a CRNA will do include:

  • Developing an anesthesia plan
  • Educating the patient on the anesthesia plan and procedure
  • Physically assessing the patient
  • Preparing the patient for the procedure
  • Assisting in the administration of the anesthesia
  • Supporting, positioning, and monitoring the patient during the procedure
  • Monitoring the patient post-procedure

As you can see, a CRNA has many serious responsibilities that will determine the well-being of the patient and the result of the surgery or medical procedure. While an anesthesiologist may develop a big-picture treatment plan for many patients, the CRNA is responsible for the daily tasks and monitoring of patients.

Where Do CRNAs Work?

CRNAs can work in any health-care facility that performs medical procedures or surgeries requiring local or general anesthesia. CRNAs work in:

  • Hospitals
  • Surgical clinics
  • Outpatient care centers
  • Doctor’s offices
  • Emergency rooms
  • Military facilities

How Do You Become a CRNA?

Joining the CRNA profession is a long and challenging process that can take nearly a decade of schooling, training, and working. First, an individual must become a Registered Nurse (RN) before becoming a CRNA.

Therefore, they must first obtain a degree in nursing or an associate degree and pass the National Council Licensure Exam to get an RN license. It typically takes two to four years for an individual to begin schooling and eventually obtain an RN license.

Once licensed, an RN will work to gain experience, typically for about a year, before entering a postgraduate nursing program. A CRNA postgraduate program will usually take two to three years, although some accelerated curriculums are faster by a few months.

After years of courses and clinicals, the individual can take the certifications exam from the National Board of Certification and Recertification for Nurse Anesthetists. Once passed, they receive their license.

The Benefits of Becoming a CRNA

As anyone can see, it takes a lot of commitment to become a CNRA, so what are the benefits of joining the profession? CRNAs are a growing career, and industry experts expect the demand for their skills and training to grow in the coming years.

Good Wages

There’s no doubt that some choose the CRNA profession because it’s one of the best-paying nursing jobs available. Various factors affect individual wages, but the median salary in the profession is around $180,000.

In more rural states and areas, like Wyoming or Idaho, demand is high for CRNAs, so the salary increases even more. The top wage for CRNAs hovers around $270,000 a year, so there’s a payoff for those years of school and training.

In Demand

The anesthesiology field already has a strong demand for capable and effective CRNAs, and industry experts predict that demand will continue to increase in the coming years. The US is an aging population, which means there’ll be a more significant proportion of older people in the coming years.

An aging population means more chronic conditions and comorbidities—ailments that require more surgical procedures and anesthesia. Over the next decade, CRNAs will be one of the most in-demand jobs in the health-care industry, which will lead to higher wages and better benefits.

Autonomy

Although CRNAs work hand-in-hand with anesthesiologists, they enjoy a lot of autonomy in their daily tasks and responsibilities. They don’t do their job with a supervisor breathing down their neck all day— they perform the bulk of the work on their own in many cases.

Many CRNAs say that one of their favorite parts of the job is the leeway they have to make decisions about treatment and patient monitoring. But is being a CRNA stressful? Like most health care professions, it is more physically and emotionally demanding than many other jobs.

6 Challenges CRNAs Face

It’s not all positive for CRNAs, though. There are still many challenges that CRNAs face in their profession, from staffing shortages to education barriers and more.

Burnout

CRNA burnout is real, and it’s perhaps the biggest challenge that CRNAs face is the mental and physical fatigue from the job. Burnout is not exclusively a CRNA problem—the entire medical profession deals with this dilemma, which the COVID-19 pandemic worsened.

According to the American Association of Nurse Anesthesiology, four out of every 10 CRNAs reported high levels of occupational burnout during the pandemic. Burnout amongst CRNAs means that more people are likely to change careers, retire, or make mistakes on the job due to physical or mental fatigue. The causes of burnout varies, but one culprit is a CRNA shortage.

Nurse Shortage

One of the principal reasons for burnout amongst CRNAs and the entire industry is the nursing shortage. A shortage of nurses was a problem for many areas of the health-care industry before the pandemic, and COVID-19 exacerbated the challenge.

Over the next decade, the health-care industry expects to have a shortage of nurses in numerous professions, including CRNAs. More nurses are leaving voluntarily or retiring, and because the education and training of CRNAs is such a long and arduous process, many people worry that there won’t be enough trained professionals to fill the gaps left open.

Increase Demand

While this shortage is occurring, there’s also an increase in demand for CRNAs. Many rural or impoverished communities are trying to expand their health-care capabilities, and CRNAs play an essential role.

But are there enough CRNAs to fill these roles? That’s one of the significant challenges facing the profession in the next decade.

Education and Training Barriers

As we laid out, it takes many years of schooling and training for an individual to become a CRNA. They have many crucial responsibilities, so education is necessary, but it presents a considerable barrier to growing the profession. After all, many people don’t have the time or money to spend six or eight years working toward becoming a CRNA.

Significant Responsibilities

Every day, a CRNA works with patients that could be facing life-or-death circumstances, depending on the setting and the medical procedure. Anesthesia can present many severe problems to a patient’s health if there are mistakes, which is why CRNAs and anesthesiologists undergo so much training and education. But it’s no doubt a challenge for CRNAs to have such drastic responsibility almost every day at work.

Malpractice Lawsuits

Nobody, not even a CRNA, is perfect. In fact, the issues nurse practitioners face happen in most other health care professions. CRNAs make mistakes like everyone else, but when errors happen, they can result in dire consequences, leading to malpractice lawsuits. Everyone working in the medical profession has to deal with malpractice claims, and CRNAs are no different.

That’s why CRNA liability insurance is necessary for all CRNAs to protect their careers and financial lives. Liability coverage ensures that CRNAs have a fair chance and won’t lose their career over a mistake. Contact us for a quote regarding malpractice insurance. To learn more about CRNA burnout, shortage, and other challenges, explore our blogs.

How To Reduce Risk as a Nurse Practitioner

A nurse practitioner is an essential job in the health care industry with many responsibilities, but with those responsibilities comes risk. Nurse practitioners play a critical role in providing patient care and improving health outcomes. However, with this important role comes significant responsibility, including the need to mitigate risks that can lead to medical errors, malpractice claims, and other adverse outcomes. Medical malpractice claims are part of working in healthcare, so to help, we’ve put together a guide on the duties, malpractice claim reasons, and how to reduce risk as a nurse practitioner.

What Is a Nurse Practitioner?

Nurse practitioners occupy a vital role in the health care industry, and even if you don’t visit the doctor often or remember it, you’ve probably interacted with one before. They operate in a middle ground between physicians and nurses, taking on more primary care responsibilities than a registered nurse.

Nurse practitioners are helpful in regions with a high volume of patients or a low number of physicians. They can take some of the load off of physicians by administering primary care to more manageable patients and fill in communities where there aren’t many physicians for the residents.

Interesting Stat: Americans make over a billion visits to nurse practitioners every year.

Responsibilities of a Nurse Practitioner

A nurse practitioner has many responsibilities, with about 70 percent of them providing primary care for patients. In many areas in the country, a nurse practitioner is the closest thing to a physician a community can offer.

As part of primary care, nurse practitioners are responsible for:

  • Ordering, performing, and analyzing lab work and x-rays
  • Prescribing and administering medications
  • Diagnosing and treating chronic conditions (diabetes, infections, physical ailments, etc.)
  • Educating patients on healthy lifestyle choices
  • Managing overall patient care

That’s just a brief description of the duties a nurse practitioner can perform in their role. It also varies in the facility, other staff, and specialty they practice.

Areas Nurse Practitioners Practice

A nurse practitioner has a broad set of skills that apply to almost any specialty in healthcare. Some of the most popular practices nurse practitioners specialize in include:

  • Acute care
  • Adult health
  • Family health
  • Oncology
  • Pediatrics
  • Emergency

Do Nurse Practitioners Get Sued?

Can you sue a nurse practitioner? Although nurse practitioners may not have the same responsibilities for patient care as physicians, they’re still liable for their well-being, and patients can hit them with a medical malpractice claim. Nurse practitioners make up a small portion of malpractice claims, but they’ve been steadily rising since the early 1990s.

In a study analyzing malpractice claims between 1990-2019, nurse practitioners have steadily been named in a more significant percentage of lawsuits, even though paid malpractice claims have fallen by more than half in roughly the same period.

In 2019, 420 malpractice claim payments were made on behalf of nurse practitioners—the highest number on record. But, considering there are over 350,000 nurse practitioners in the country, it’s not exactly typical for one to get sued.

Cost of a Medical Malpractice Claim Against Nurse Practitioners

There may be a relatively low number of paid medical claims against nurse practitioners, but they’re still noteworthy and worth taking preventive measures against. The average cost of a paid claim against a nurse practitioner is over $350,000.

If you don’t have professional liability insurance for nurse practitioners, the cost of paying the claim could significantly hamper your finances and limit your career. Like anything else, it’s better to be safe than sorry with insurance.

Common Reasons for a Malpractice Claim Against a Nurse Practitioner

Since nurse practitioners perform so many duties and have so many responsibilities, the reasons for the malpractice claim can vary. However, most of the malpractice claims against nurse practitioners fall under the following categories, ordered from most common to the least common:

  • Diagnosis errors
  • Treatment errors
  • Failure to diagnose
  • Medication-related allegations (over-prescribing, ignoring medication allergies, etc.)
  • Delay in diagnosis
  • Delay in treatment

Medication-related allegations and errors have risen the most due to the ongoing opioid epidemic that damaged many parts of the country. In the previous decade or so, medication allegations have nearly doubled. Because nurse practitioners are responsible for prescribing drugs like opioids in many cases, they can be held accountable in some instances of addiction.

Medication Administration

The opioid epidemic has been one of the most significant and damaging developments in the healthcare industry in the 21st century. The over-prescribing of an opioid is a common complaint filed against nurse practitioners. However, such claims typically focus on the manufacturers and sellers rather than the physicians and nurse practitioners.

Medication-related allegations aren’t limited to just overprescribing. Sometimes the incorrect amount is prescribed to a patient, or a nurse practitioner prescribes them a drug they’re allergic to. Some claims are as simple as the wrong medication being administered to the wrong patient—basic errors that can slip through the cracks.

Diagnosis Errors

There are different kinds of negligence that can affect nurse practitioners and other clinicians. The most common malpractice complaint against nurse practitioners is diagnosis errors. As most nurse practitioners administer primary care, this means ordering tests, analyzing, and coming up with a diagnosis.

They’re rare, but mistakes happen, and sometimes an X-ray is misread, or a diagnosis takes too long, and it’s too late to give adequate treatment.

Risk Reduction Strategies for Nurse Practitioners

There’s a risk for nurse practitioners, but there are ways to reduce risk as a nurse practitioner against medical malpractice claims. Risk reduction strategies often come down to open communication with the patient and proper documentation.

Be Present With the Patient

A common refrain from patients about nurse practitioners—and physicians, nurses, and other medical professionals—is that they didn’t feel heard or understood. Nurse practitioners typically have a lot of patients, and when the waiting room fills up with anxious patients, it can get distracting and difficult to give everyone the time they need.

But it’s still paramount that nurse practitioners give the patient their full attention. Explain their diagnosis, treatment, symptoms, and medication as plainly to them as possible, and give them adequate space and time to ask questions.

Sometimes, a patient or family member wants to blame someone for a negative outcome, and if they feel they weren’t treated respectfully, they might choose the nurse practitioner.

Keep Thorough Documentation

Proper documentation is vital in health care—every nurse practitioner and medical professional knows this. It can be a chore, but you should never take shortcuts when promptly filling out proper documentation with precise detail.

The documentation gives us a clear, written timeline of the patient’s admittance, symptoms, treatment, tests, and other important information. Since most claims occur years after the patient’s treatment, this information is essential to understanding what happened. When your career and finances are at stake, you’ll be thankful you were as detailed as possible.

Make Personal Notes

Along with the official documentation, it’s not a bad idea to keep a personal log and journal of patient notes handy. In personal notes, you can be more detailed and add more info than may be needed on the patient’s documentation.

Especially if you feel a patient interaction was hostile or antagonistic, it’s a good idea to start keeping notes sooner rather than later, just in case.

Double-Check the Medicine and Patient

Over a day, a nurse practitioner can fill out and administer dozens of medical prescriptions. With such a high volume every day, mistakes are bound to happen—the wrong patient receives the incorrect medicine, or it’s the wrong amount, or even given at the wrong time.

It’s easy to become complacent, but the best advice to avoid these possible critical errors is to do what carpenters do—measure twice and cut once. Always double-check the drug, dosage, and patient to be 100% certain, even if it means losing a couple of minutes every day.

Like other clinicians, nurse practitioners need malpractice insurance. To learn more about the average cost of malpractice insurance, contact Baxter & Associates today.

How To Reduce Risk as a Nurse Practitioner

Why Physician Assistants Need Malpractice Insurance

Medical professionals are some of the most well-educated and highly skilled workers, but that doesn’t mean mistakes don’t happen. That’s why many choose malpractice insurance should something go wrong that leaves them liable.

Like all medical professionals, physician assistants need malpractice insurance, and our explainer will break down the key reasons why.

Nobody’s Perfect

Although highly skilled and educated, physician assistants (PAs) are still human, which means they’re not perfect. PAs make mistakes at work like anyone else at their job, including other medical professionals.

Hospitals and medical facilities ask PAs to do a lot, from ordering tests to examining patients and administering treatments. Even the best PAs can have the occasional slip-up. The difference is that when mistakes happen, there can be dire consequences that result in suffering or even death. Errors are often inconsequential, but PAs need insurance to protect their financial future and career when oversights have more profound effects.

Increased Responsibility

PAs operate in a crucial but unique area of healthcare, performing many of the same duties that would fall to a certified physician. Initially, PAs originated in communities that lacked doctors or were overrun with too many patients for the local physicians to handle.

Over the decades into the 21st century, PAs have taken on more responsibilities to offset shortages in physicians and nurses. With more responsibilities and duties, PAs are often stretched to their limit, making them more susceptible to mistakes.

Claims Are on the Rise

Although they may not be the target for as many malpractice claims as physicians, PAs still get sued and have been named as defendants more often recently. Studies show that between 2017 and 2019, PAs were targeted in malpractice litigation over 200 times every year, which is a substantial increase from earlier figures, which were around 70 in the year 2000.

Malpractice insurance for health professionals like PAs is essential to ensure that their career and financial future aren’t ruined by one mistake and malpractice claim. Monetary compensation for a successful claim can reach six figures, and without proper insurance, PAs and medical professionals can be left to pay that sum themselves.

Clearly, physician assistants need malpractice insurance as much as physicians and medical professionals do. PAs need to ensure their future is protected.