History of the Nurse Anesthetist

Nurse anesthetists have been providing anesthesia care in the United States for nearly 150 years. One of the first American nurses to provide anesthesia was Catherine Lawrence, who administered it during the American Civil War. The first “official” nurse anesthetist was Sister Mary Bernard, a Catholic nun who practiced in 1887 at St. Vincent’s Hospital in Erie, Pennsylvania.1

1 Fosburgh, L., & Koch, E. (1995, April). The AANA Archives: Documenting a distinguished past [Imagining in Time column]. Journal of the American Association of Nurse Anesthetists, 63(2), 88-93. Retrieved from


Moving from an RN Degree to a DNP Degree

There are 184 DNP Programs currently enrolling students with 101 programs in the planning stages·   

At schools of nursing across the United States, 184 DNP programs are currently enrolling students; an additional 101 DNP programs are in the planning stages.

·    DNP programs now exist in 40 states plus the District of Columbia. States with more than five programs include Florida, Massachusetts, Minnesota, New York, Pennsylvania, and Texas.

·    From 2010 to 2011, the number of students enrolled in DNP programs increased from 7,034 to 9,094. During that same period, the number of DNP graduates increased from 1,282 to 1,595.

Lisa Chism's Middle-Range Spiritual Empathy Theory

Lisa has also developed a nursing theory, called Chism’s Middle-Range Spiritual Empathy Theory,” to explain the relationship between nurses’ spiritual care perspective and their expressions of spiritual empathy. Lisa set out to demonstrate how a middle-range theory was developed and tested through research that “examined relationships between nurse-expressed empathy and two patient outcomes: patient-perceived empathy and patient distress.”[i]

[i] Olsen, J., & Hanchett, E. (1997, Spring). Nurse-expressed empathy, patient outcomes, and the development of a middle-range theory. Journal of Nursing Scholarship, 29(1), 71-76.


Increasing Collaboration Across Departments

Laurie Hartman continuously watches for opportunities to increase collaboration between floors, departments, and units. She encourages her APNs to take on new roles and pushes them to address difficult issues. By encouraging her APNs to grow and expand their limits, she gives them permission to challenge established boundaries, identify “stretch” goals, and achieve organizational goals. She works to eliminate such statements as “We never do it that way” or “That won’t work.” She empathizes with her team’s perspective while challenging them to explore alternative methods for change.

Healthcare Practices and Nurse Practitioners

Principles surrounding the medical home model include a personal physician for each individual; a physician-directed medical practice; a process designed to take care of the whole patient with coordinated care, quality, and safety; enhanced prevention; and adequate provider payments.3 The ideal medical home health system consists of multiple providers, each communicating with and accountable to each other, to coordinate and deliver high-quality care. In the medical home model participating physicians are paid a per-member-per-month care management fee in addition to regular fee-for-service payments.

3 Backer, L. A. (2007, September). The medical home: An idea whose time has come . . . again. Family Practice Management, American Academy of Family Physicians. Retrieved from


How Proactive Care Builds Trust

Caring theory demonstrates that when nurses care about their patients, they react more quickly to their patients’ needs.17 Identifying and responding to the patient’s needs without being asked sends a powerful message—a message that the nurse really cares. When a nurse goes into a patient’s room, introduces herself, explains her role, calls the patient by his or her preferred name, and sits with the patient and the family for five minutes, the patient begins to trust the nurse.

17 Tonges, M., & Ray, J. (2011, September). Translating caring theory into practice: The Carolina care model. JONA, 41(9), 374-381.


Increasing Education Regarding Antibiotics

Nurse Practitioners (NPs) now represent about 9 percent of all nurses, and their numbers continue to grow. Moving into more chronic care treatment and management represents the next step for these highly educated professionals. NPs can help fill the gap of primary care formerly provided by primary care physicians, freeing primary care physicians to attend to the more complicated illnesses formerly requiring a specialist’s attention. Utilizing healthcare professionals to their highest level of education and training will help enable us to meet the needs of our patients today and in the future.

Too High Cancer Death Rates in Appalachia

Women living in Appalachia are vulnerable to dying of cervical and breast cancer because many avoid the screening programs that could identify these diseases in the early stages, when treatment can be effective. Despite government subsidies to educate and enroll women in screening programs throughout high-risk areas, the rate at which women are screened is inadequate.1 Focus groups and surveys reveal that rural women gain most of their information about cancer from family, neighbors, and friends rather than from health professionals. 

1 Grube, W. (2010, January 1). Talk and Backtalk: Negotiating Cervical Cancer Screening among Appalachian Women in West Virginia. Dissertations available from ProQuest. Paper AA134227. http://repository.upenn/dissertations/AA13414227


Earning Sacred Trust at Hospice of Michigan

Hospice treats the person rather than the disease. It focuses on patients and their families, to help all concerned make the crucial decisions about quality, rather than length, of life. That said, patients and their families are truly the best advocates for determining the type of care they receive and which options are best for their particular condition. But they need to prepare themselves to advocate effectively by reading the medical literature, questioning the sources of the information they are given, continuing to be skeptical, and always asking probing questions of their healthcare providers.[i]

[i] Brawley, O. W., & Goldberg, P. (2011). How We Do Harm: A Doctor Breaks Ranks about Being Sick in America. New York, NY: St. Martin’s Press. ISBN 978-0-67297-3. Kindle download.


Reassuring the Doubters: From Clinic to Private Care Model

By definition, a certified nurse-midwife (CNM) is an advanced practice nurse (APN) who has specialized education and training in both nursing and midwifery. CNMs function as primary healthcare providers for pregnant women, most often relatively healthy women, whose pregnancies are considered uncomplicated (not "high risk") and whose babies are not at risk.[i] But CNMs do much more than deliver babies; they address maternity care, promote healthy living, counsel women for family planning and contraceptive use, conduct gynecologic procedures, treat infertility issues, detect and treat breast problems, and address osteoporosis and menopausal concerns.


[i] Wikipedia. Retrieved from


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