Healing at Home: A CRNA’s Mission to Elevate Pain Management Care in Saipan

Annie Trusso, DNAP, CRNA, NSPM-C, grew up under the warm, tropical sun of Saipan, where the rhythms of island life and close-knit communities formed the backdrop of her childhood. While her journey as a Certified Registered Nurse Anesthetist (CRNA) initially took her far from Saipan’s shores, she returned home with a mission: to blend advanced nurse anesthesiology knowledge with the intimate, compassionate care that reflects the spirit of Saipan.

Trusso had always envisioned returning home and, after earning her CRNA credentials from Georgetown University, a fateful email from a chief anesthesiologist in Saipan had her flying back to use her expertise to make an impact in her community. As a CRNA and AANA member since 2017, she practices independently, using the full scope of her expertise. Her team initially consisted of three physician anesthesiologists and one other CRNA alongside Trusso. 

“Professionally, I have the CRNA career that I have always wanted,” said Trusso. “I remember a time growing up where there was only one anesthesiologist on the island. There were services we needed that weren’t accessible or available—we just didn’t have the staff. It’s incredibly fulfilling to be a part of the stability of Saipan’s hospital system and to provide these services that my community needs and deserves. A lot of people here have never heard of CRNAs before. I think our actions and our ability to provide good care speaks for itself.” 

Now in her fifth year of practice, Trusso says that CRNAs make up the majority of her anesthesiology department. From facilitating the introduction of labor epidurals to educating future nurses, she exemplifies a dedication to her people and to the nurse anesthesiology profession. Throughout her years practicing, Trusso has been at the forefront of pioneering a new standard of care in her homeland. 

“I love that I get to have a special relationship with my patients that I never got to have before. These are patients I get to see over and over—they’re part of my community and there’s added trust between us,” said Trusso. “There’s a deep sense of fulfillment in being able to care for my people as a native.” 

As a small island, Saipan faces some limitations in its ability to provide medical care. To combat this, hospitals in Saipan have a Medical Referral Program that sends patients off island to receive the care they need. When Trusso found out her hospital was cutting the program for patients with chronic pain, she sought out a fellowship in advanced pain management from the University of South Florida that would not only expand her professional horizons, but also allow her to bridge the gap in care Saipan needed. 

“I knew that if I didn’t start doing pain management, patients weren’t going to have many other options,” said Trusso. “These are my people—they know me, and I know them. They rely on their bodies for their livelihoods. I did not want them to have to suffer, but I didn’t think it was appropriate to do pain management procedures when my knowledge was so limited. 

She continued, “I knew that doing a pain management fellowship would allow me to treat these patients. I remember thinking, if there was something I could do, I needed to do it. I wrote up a proposal for the hospital CEO saying that Saipan has this need, and I can meet it. I’m from here and I don’t plan on leaving—I’m a good investment and I know I can grow this into something that’s very helpful to our community. Luckily, she believed in me.” 

At that time, Trusso didn’t know the full potential of what she could accomplish with her fellowship. She recalls feeling like a “whole other world got unlocked” and finding a new passion in pain management. As Saipan’s only pain management provider, Trusso is now facing the daunting task of opening the country’s first pain management clinic. 

“It’s really exciting. During my fellowship, I thought, wow, I can really make a career out of this, and here I am building this clinic,” said Trusso. “But it’s also come with a lot of frustration at times. Nobody really knows about pain management here, so nobody knows what I’m doing. Trying to convey the importance and breadth of pain management can be tricky… Also, I also still do anesthesia. I can’t just leave it—there’s almost 50,000 people on this island, so it’s a little overwhelming to balance pain management and anesthesia.” 

“My whole reason for doing the fellowship in the first place was to increase access to care. To give my people the opportunity to receive the procedures they need to gain back their functionality—their lives,” said Trusso. “It’s hard and frustrating, but I’m excited. My husband once asked, why are you doing all this? Because I have to. No one else is doing it. All of this feels like a reflection on me as a clinician, as a CRNA, as a pain management provider, and as a person in this community. I just have to get it done, and make sure it’s done well.” 

Trusso’s dedication as a CRNA is rooted in a profound understanding of the unique needs and challenges faced by Saipan. Expected to open in mid-September 2024, Trusso’s new pain management clinic aims to provide safe, effective care that aligns directly with the island’s healthcare needs. In her journey from Saipan to advanced medical centers and back, Trusso exemplifies the spirit of giving back and the power of community. Through her expertise and compassionate care, she is poised to ensure that Saipan continues to receive exceptional medical care built on local values.