When Michigan Medicine needed more providers to take on cardiac cases, Certified Registered Nurse Anesthetists (CRNAs) were up for the challenge.
Previously, open-heart cases within the Michigan Medicine system — which includes the University of Michigan Hospital — had been done exclusively by physician anesthesiologist residents, said Marcy Julvezan, CRNA, an assistant chief nurse anesthetist. She oversees the cardiovascular center as one of her primary sites.
The University of Michigan handles many high-acuity cardiac cases that many other facilities won’t do, she said. The need for more providers was critical.
“Our physician anesthesiologist residency program had a decrease in numbers, and our cardiac cases were increasing. We knew there was going to be a need for CRNAs to begin doing these cases,” Julvezan said.
In March of this year, she learned CRNAs would start doing cardiac cases July 1. Along with chief nurse anesthetist Sheila Kellogg, MS, CRNA, Julvezan was instrumental in the creation of the 13-CRNA team that now handles cardiac cases.
“We were always told, ‘You’ll never be doing cardiac cases here because they’re restricted to residents.’ We’re thrilled the tides changed,” Julvezan said.
Photo credit: Ali Cotner, CRNA. Pictured left to right, front row: Aaron Varghese, Meghan Pydyn, Cassie Zell, Samantha Spotts, Seema John. Back row: Jason Beaudoin, Darlene King, Mark Cashen, Robert Carter, Ian Kain, Alicia Williams, Derrick Denny, Jasprit Dulat.
CRNAs are highly educated and trained anesthesia experts who provide safe, effective, efficient, and compassionate care. They safely administer more than 50 million anesthetics to patients each year in the United States and practice in every setting in which anesthesia is delivered, including operating rooms and obstetrical delivery rooms; the offices of dentists, podiatrists, ophthalmologists, plastic surgeons; and pain management specialists; and in the U.S. military. They’re also the only anesthesia professionals with critical care experience prior to beginning their anesthesia education.
“CRNAs have a specialized skill set,” Julvezan said. “They stood ready, able, and willing to provide the full range of anesthesia services specifically needed by cardiac patients.”
Several CRNAs on the 13-member team had previous critical care cardiac experience and had done cardiac cases before as CRNAs at other facilities, some of them for decades. That made them the perfect fit to fill the need for providers at the hospital. Ahead of beginning to work on the cardiac team, the CRNAs received additional training, were credentialed to place central lines, and quickly got up to date on the latest education in the heart world.
Meghan Pydyn, CRNA, was the first nurse anesthetist in the hospital’s history to take part in a heart transplant surgery.
“I came from a strong cardiac background, so I took the challenge and provided the best care that I could,” she said. “I was very proud to be the first CRNA at my hospital to be part of a heart transplant surgery.”
Pydyn said she didn’t realize how groundbreaking it was for her to be part of the surgery until afterward.
“For the CRNAs to get our feet wet in this area is a big deal for our profession. Previously, only physician anesthesiologists and residents participated in these surgeries. When I started to think about it that way, it really made me proud of our group for taking on this specialty.”
Julvezan credited the anesthesia faculty at the University of Michigan for being extremely supportive of CRNAs taking on these cases. “Without the support of the entire team, this would have never worked.”
“I know every day I go to work, I provide the best care that I can to my patients,” Pydyn said. “It does feel good to get recognized for it because a lot of times, patients don’t know about us. They research and choose their surgeons, but they might not know who’s behind the drape taking care of them throughout their procedure. I’m happy to be there for my patients providing their anesthesia.”