Ramey on one-man crusade to find more special nurses

J. Doug Ramey of Kalaheo, who qualifies to carry nearly more initials after his name than there are letters in his name, is coming to a hospital floor near you this week.

A nurse anesthetist at Wilcox Memorial Hospital and Kauai Medical Clinic, he is also a certified registered nurse anesthetist (CRNA) and advanced practice registered nurse (APRN) who is on what sometimes seems a single-minded mission to recruit more nurses into his field.

As president-elect of the Hawaii Association of Nurse Anesthetists (HANA) for 2003-04, and an outer-island representative on HANA’s board for 2002-03, he will be visiting fellow nurses in various facilities around the island this week, which is National Nurse Anesthetists Week.

The week is dedicated to celebrating anesthesia patient safety, but in a career field (nursing) which has general and specialty area shortages (the same is true with doctor anesthesiologists), part of his mission this week is also recruitment, he said.

Nurse anesthetists administer over half of all anesthesia in hospital and clinic settings across the country, but are still sometimes called “America’s best-kept secret in health care,” said Ramey.

Part of his mission is to bring his chosen profession out of that “best-kept-secret” location.

Nurse anesthetists number 117 in Hawai’i, with five on Kaua’i, and their primary jobs are to monitor and care for patients before, during and after the administration of anesthetics.

Anesthesiology has come a long way, baby, from a time a half-century ago when one in 1,800 people died while undergoing anesthetics, to a morbidity rate of around one in 250,000 today, he said.

“Anesthesia is very, very safe now,” with safer agents, better monitors including whole-body monitors, and better training for both nurse anesthetists and anesthesiologists (doctors), Ramey continued.

Those wishing to carry the CRNA designation, for example, go to school nearly as long as doctors must. A combination of education and experience necessary to win the CRNA designation includes:

– A bachelor’s degree in nursing or other appropriate bachelor’s degree;

– A current license as a registered nurse;

– At least one year’s experience in an acute-care nursing setting;

– Graduation from an accredited graduate school of nurse anesthesia, which takes between two and three years and may result in awarding of a master’s degree;

– Successful completion of clinical training at university-based or large-community-hospital settings;

– Successful completion of a national certification examination.

In rural settings like Kaua’i, nurse anesthetists are oftentimes sole providers of anesthesia, though Ramey is quick to point out that the current crop of anesthesiologists (doctors) on the island is “very, very good.”

“Patient safety is, and always has been, the number-one priority for nurse anesthetists,” he said. “We administer to the patient’s physical and emotional needs, offer reassurance and comfort, and stay right by the patient’s side throughout the surgery,” as nurses anesthetists have done for over a century, he continued.

The work can be high-pressure, but CRNAs are paid well, making on average over $100,000 a year both on Kaua’i and the Mainland. Nurse anesthetists are in the first specialized nursing field.

For Ramey, a self-proclaimed “people person,” his job is most rewarding. “This is the best job that I ever had,” he said.

“Nurses are people-friendly people,” and on the job he uses humor, calming techniques, music (his anesthesia cart has a stereo and 100 compact discs), and other means to put patients at ease before putting them to sleep.

Studies have shown music used in operating rooms means less anesthetics have to be used, and result in calmer patients, he said.

There are around 30,000 CRNAs in the United States, getting guidance and direction from the American Association of Nurse Anesthetists.

Ramey has been in Hawai’i since 1994, on Kaua’i since 1995.

“We deliver safe, high-quality anesthesia to patients undergoing surgery and diagnostic procedures in hospitals, surgery centers and doctors offices, and even the labor and delivery unit,” he said.

More information about nurses anesthetists is available at http://aana.com/about/.

Business Editor Paul C. Curtis can be reached at mailto:pcurtis@pulitzer.net or 245-3681 (ext. 224).

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