英语角——美国专业化的麻醉护士(转帖)

xiaoxiaoma

美国麻醉学科的特点是有一只专业的麻醉护士队伍。他们人数众多，远远超过麻醉医生的人数，担负繁重的临床麻醉工作。这些麻醉护士中，男性占到50％，首先需要获得科学学士的学位，经过29个月的专科培训才可能获得麻醉护士的证书。麻醉护士的职业发源于1956年，现在覆盖整个美国，越是偏远的地方越是麻醉护士多见。麻醉护士开始每年的收入平均是6万美金。随后或者协会证书后可以拿到10－15万美金，这比麻醉医生每年20－50万元的收入差别还是相当大的。因此许多医院也乐于聘请麻醉护士。
Nurse anesthetist is a growing specialty
It's a nursing specialty that nurses are proud to say dates back to the battlefields of the Civil War. As the first professional group to administer anesthesia services in the United States, nurse anesthetists are considered the first clinical nursing specialty, according to the American Association of Nurse Anesthetists Web site.
Today, more than 30,0000 certified registered nurse anesthetists, a certification that began in 1956, work on teams with medical doctors at hospitals across the country providing anesthesia services to 27 million patients each year, according an AANA report in 2005. Dr. Thomas Bladek, chairman of the department of anesthesiology at St. Vincent's Medical Center in Bridgeport, said the hospital employs 18 full-time CRNAs and 12 full-time board certified anesthesiologists. "Certified registered nurse anesthetists have been around for quite some time," said Bladek, recalling how St. Vincent's had three CRNAs when he joined the hospital in the 1960s. "Virtually every hospital has them in operating rooms, some have more than others. "The more rural the hospital, the more CRNAs are employed," he said. CRNAs are usually under the direct supervision of medical doctors, he said, although in some areas they are in independent practices. At St. Vincent's, both CRNAs and medical doctors are in the operating rooms administrating anesthesia, except for open heart surgeries and major surgical cases that require intense monitoring, when only MDs are allowed, Bladek said
"This practice is different in other hospitals," he said. Across town at Bridgeport Hospital, CRNAs are allowed in high-risk surgeries, including heart surgeries, but always with a medical doctor, said Nancy Moriber, director for the Bridgeport Hospital and Fairfield University certified registered nurse anesthetist program, one of three in the state. "In most hospitals, nurse anesthetists work in a team approach. Every patient has a minimum of two anesthesia providers. That has always been my choice of practice," said Moriber. The road to becoming a CRNA is a long and intense one. It may be a job not everyone is familiar with and with the current nursing shortage that only promises to get worse, it's a growing specialty that is attracting a growing number of both men and women. "It's a 29-month program and the candidates [for the program] must be registered nurses with a bachelor of science in nursing and a minimum of one year of critical care experience," said Moriber, noting that candidates must have a GPA higher than 3.0. There are 104 CRNA programs nationally, she said, graduating more than 2,000 students each year, and across the board, these programs have to turn people way. Each Bridgeport Hospital/Fairfield University class takes 12 students per year and is always full, said Moriber, 42, who received her CRNA from Columbia University in New York in 1990 when she was 24, a relatively young age. Most students in the program are between 27 and 35 or in their late 40s or 50s, she said. Graduates receive a master's degree in nursing in addition to the certification. It is also one nursing specialty that attracts a high number of men — about 50 percent of CRNAs are men, she said. In general, only 4 percent of nurses are male. The pay is also a draw, said Moriber. While a new registered nurse may expect $60,000 in salary, a CRNA can make between $100,000 and $150,000, she said. But, it is still less than what an anesthesiologist commands, which is between $250,000 and $500,000 a year, she said. Bridgeport Hospital employs 34 CRNAs. With one medical doctor supervising two to four CRNAs, this team approach can help lower medical bills, Moriber said. "Nurses produce safe care at a reduced cost," she said. For Moriber, the high-pressure job was always appealing. "I thrive on stress," she said. "I like the patient contact, the one-on-one; you have control of the patient. I look at it as caring for the patient while someone else is doing the curing." Starting with the pre-op interview to waking the patient in recovery, CRNAs work on all types of cases, including orthopedics, neurosurgery, vascular surgery, ob/gyn cases and general surgery, providing epidural and spinal anesthesia when needed, said Donna Nunno, a CRNA at St. Vincent's. A nurse for 17 years before going back to school for her CRNA, Nunno, 39, graduated from the CRNA program at the Hospital of St. Raphael's in New Haven in 2006, earning a master's degree in biological science/anesthesia. The Milford resident said she became interested in the specialty while working as a nurse in St. Vincent's intensive care unit. The training she got was similar to a doctor's residency, she said. "It's very intense. We do on-call and work many hours," she explained. "It's a great clinical experience at St. Raphael's. The first year was just academics to get my master's then 17 months of clinical training and testing for boards." There are oral comprehensive boards and national boards to take to become licensed, she said. On the job, she works a rotating schedule with three, 12-hour shifts a week, she said. "We always have supervision, from beginning to end," she said. [The doctors] will come in frequently to check on how things are going and offer advice as needed. We have a very close working relationship." Nunno agrees it's a growing profession and finds that patients are very open to it. "There are some people who don't know what an anesthetist is, but I never met anyone who felt uncomfortable [with me]," she said. "They know we work with the doctors." Contact the Fairfield University and Bridgeport Hospital Nurse Anesthesia program at 384-3054. For information on the Hospital of St. Raphael School of Nurse Anesthesia, call 789-3351. The New Britain School of Nurse Anesthesia may be reached at (860) 224-5612
（转自瑞金麻醉网）

genine

都是美金啊，现在大的医院也招麻醉护士，合同制吧，那收入太低了，中国就是....................

赵征华

麻醉护理职业是一个不断发展和完善的行业，不光是在美国如此，中国的麻醉护理事业也正在寻求完善之路。虽然我刚来到佛山第一人民医院实习，但以明显感觉到这里的麻醉护理培训已臻完善。在这实习是我的荣幸！

赵征华

2# genine 相信中国会慢慢重视这个职业！