A Conversation with Former AANA President Juan Quintana

It has been nine years since you were the AANA President. How has the nurse anesthesiology profession landscape changed since then in terms of opportunity for leadership in the healthcare space, advocacy, and interest in the profession among nurses.

Amazing that nine years have passed since I took the gavel! It was an honor to represent this association, and I will always fondly remember it.

As always, healthcare continues evolving in ways many could foresee: Many years ago, we determined that anesthesia utilization was increasing while the number of potential retirees and continued reimbursement issues were a very real problem. Well, here we are, and issues are now exacerbated by the lack of legal muscle to enact permanent change within our government.

It is interesting and sad that it took a cataclysmic event, the COVID virus, to show in an indisputable fashion our expertise, adaptability, and innovative capacity. Through this tragic event, we advanced our profession in a manner that many of us in leadership had been unable to do for decades through advocacy. We clearly discerned that when the government needs Certified Registered Nurse Anesthetists (CRNAs) also known as nurse anesthesiologists or nurse anesthetists, they are willing to move mountains to utilize us.

Today, opportunities abound! Compared to pre-COVID days the gates have opened wide, and any industrious and innovative CRNA can engage in a multitude of business and leadership roles. From start-ups to well established businesses, the healthcare community is begging for CRNA leaders to educate themselves and step up. Of course, obstacles still exist but access to care, practicality, and pragmatism have eroded many old norms. Many practices have broken down false barriers, increasingly permitting CRNAs to practice to the top of their scope AND advertise as such. Salaries increasingly reflect the true value of CRNA services. All the while patient care has continued to improve, much to the chagrin of our other anesthesia colleagues.

In the meantime, the visual explosion of CRNAs in leading roles intubating, starting central lines, adjusting ventilator settings, and addressing patients’ needs has had an amazing uptick effect on RNs interested in joining our profession. Administrators, ER docs, nurses, and techs echo the same refrain, “I didn’t know they could do all that!”  Well folks we can, and we do, and we do it incredibly well.

When you were elected AANA president, did you plan to convene a Diversity and Inclusion Task Force, and why did you think the Diversity Task Force was necessary?

Engaging and working within the AANA at the state and national level provides huge insight into what is fantastic and functional and what is not. Weaknesses in the armor become apparent. One issue which became apparent to me, as an individual who is not part of the majority, was the lack of representation of minorities not only in anesthesia leadership but in the anesthesia community.

How could the anesthesia community understand me and my culture if they had never experienced it? My very good friend Wallena Gould, EdD, CRNA, FAANA, FAAN, and I had multiple conversations on the need for the make-up of the anesthesia community to better influence the association, thereby exposing it to diverse cultures.

Not only is diversity, equity, and inclusion (DEI) an imperative for minorities, but it should also seek to address for example, financial equity for women in the anesthesia workplace. It was during those engaging conversations that I knew I would encourage the AANA Board of Directors to move forward with the DEI Committee as a permanent part of our association. The Diversity Task Force showed us the possibilities and the energy arising from discussions. The committee was the obvious next step.

What did you specifically want the DEI Task Force to research and review?

Our objectives were multiple: all leading to understanding how addressing DEI would and could impact our association. Fortune 500 companies were espousing DEI, could we benefit from this focus as well? What advantage did they gain from having a diverse workforce and interacting with it? Why did our association NOT reflect the minority make-up of the nation creating an isolationist cultural environment? We were however, more closely reflecting male /female percentages as opposed to nursing in general. Why were minorities not interested in nurse anesthesia? How could our association take advantage of this untapped resource?

We planted a seed and then with arduous work, a little hope, and a prayer we waited for it to grow, and it has GROWN. Today we see doctorly prepared CRNAs taking leadership positions, influencing the AANA, sharing various presentations with topics that range from caring for the transgender patient to understanding cultural norms of different cultures.

What shape would you like diversity, equity, and inclusion to take in the nurse anesthesia profession today?

While we have made incredible strides in our association, we have miles to go.  Corporate America, fearing legal reprisals, is pulling away from DEI even in the face of the benefits it brought to the workplace. Today, we as healthcare providers can not only become more engaged with patients of diverse cultures, but we can also be the voice of minority patients who still face racial disparities in healthcare.

What is the business case for diversity, equity, and inclusion?

An online study highlights what DEI brings to the workplace, “According to research from the Diversity Wins: How Inclusion Matters report by McKinsey & Company, there are three fundamental indicators of inclusion in the workplace: equality, openness, and belonging. Equality refers to fairness and transparency in pay, recruitment, promotion, and access to resources. Openness refers to a workplace culture where people are treated with respect and without bias, discrimination, or microaggressions. And belonging refers to a sense of community that encourages people of all backgrounds to feel free to share their insights and talents—and to know that their input is valued by coworkers, managers, and their organization.”  What business in their right mind does not want this type of criteria as part of their company dogma?!!

Do you have any advice for residents and/or CRNAs who are in the early stages of their career?

1. First and foremost, remember there is nothing that you cannot do. In the beginning you may not do it as proficiently as another but given time you will be amazing.
2. Focus on your priorities. There are many distractions. If you cannot identify your goals clearly, your chance of success is limited.
3. Finally, note that the road you travel will be considered by some “impossible.” However, it is always important to note that dreams and successes are made of IMPOSSIBLITIES.