At National Jewish Health, the clinical responsibilities of Certified Registered Nurse Anesthetists (CRNAs) are both diverse and comprehensive, offering an engaging and challenging practice environment. As part of a fully autonomous CRNA-led practice model, CRNAs play a critical role in managing a wide range of anesthesia services for high-acuity outpatient procedures. The hospital specializes in minimally invasive diagnostic and therapeutic procedures, primarily within the areas of gastroenterology (GI) and pulmonology. CRNAs in this role are responsible for delivering anesthesia for procedures such as colonoscopies, esophagogastroduodenoscopies (EGDs), bronchoscopies, thoracentesis, and interventional pulmonology procedures.
The patient population at National Jewish Health is unique and requires a high level of expertise from its anesthesia providers. Many patients come from across the country, seeking treatment for unresolved respiratory and GI issues, often after visiting multiple specialists. This dynamic patient population presents CRNAs with an opportunity to work on cases that are both medically complex and clinically stimulating, requiring advanced anesthesia techniques and vigilant perioperative management.
CRNAs at National Jewish Health are fully integrated into the procedural workflow, performing pre-anesthetic assessments, administering anesthesia, and monitoring patients throughout their procedures. The pre-anesthesia evaluation process includes a thorough review of the patient’s health history, physical assessment, and coordination with attending physicians to ensure a comprehensive approach to patient safety. The CRNAs are responsible for selecting and administering appropriate anesthetic agents and monitoring patients' vital signs throughout the procedure, ensuring stable hemodynamics and effective pain management. CRNAs are also proficient in airway management and the administration of both non-invasive and invasive monitoring modalities, making their role indispensable during high-acuity procedures.
The practice environment is collaborative, with CRNAs working closely with gastroenterologists, pulmonologists, and anesthesiologists. While CRNAs operate with full autonomy, there is collaborative oversight from attending anesthesiologists, particularly in complex or high-risk cases. The hospital’s focus on patient safety and clinical excellence is supported by this teamwork, ensuring that all patients receive the highest standard of care during their procedures. Additionally, CRNAs provide critical emergency responses, including airway management and basic or advanced cardiac life support techniques, in situations where rapid intervention is necessary.
National Jewish Health’s procedure rooms are equipped with state-of-the-art technology, and CRNAs have access to cutting-edge monitoring and anesthesia delivery systems. The hospital uses the Epic electronic medical record (EMR) system, allowing for seamless documentation and communication between providers. This ensures that all aspects of patient care, from pre-operative assessments to post-operative recovery, are meticulously tracked and integrated into the patient's medical record.
A key feature of the CRNA practice at National Jewish Health is the diverse caseload, which primarily includes high-acuity patients requiring bronchoscopies and GI procedures. The facility performs 300 to 350 procedures per month, with an emphasis on bronchoscopy and interventional pulmonology. Each week, CRNAs handle approximately 15 to 20 bronchoscopies and a growing number of GI cases due to the expansion of the hospital's GI practice. In addition to traditional procedures like colonoscopies and EGDs, CRNAs may also assist with the placement of stents and other therapeutic interventions. The hospital has recently added two new GI specialists to its team, further increasing the volume and variety of cases handled by CRNAs.
While the majority of the procedures are outpatient, the patients’ underlying conditions often make them more complex than typical outpatient cases. Many patients require specialized sedation and anesthesia management due to pre-existing respiratory or cardiovascular conditions, making this a highly specialized environment for CRNAs. The complexity of the cases ensures that CRNAs are consistently engaged in providing high-level clinical care, which can be both rewarding and challenging.
For CRNAs interested in expanding their skills and focusing on specific areas, there are opportunities for specialization in areas such as interventional pulmonology and cardiology, as these service lines continue to grow. National Jewish Health is committed to providing continuous professional development, and CRNAs have the opportunity to engage in advanced practice areas that align with their career goals. The facility is also a teaching hospital, providing potential opportunities for those interested in education or mentoring the next generation of CRNA professionals.
CRNAs at National Jewish Health are entrusted with a broad scope of clinical responsibilities in a high-acuity, fast-paced environment. The diverse range of cases, the complexity of the patient population, and the opportunity to work autonomously make this position ideal for experienced CRNAs seeking a challenging yet rewarding role. The collaborative environment, combined with the hospital’s commitment to innovation and clinical excellence, ensures that CRNAs are well-supported in delivering exceptional patient care.