Nurse Anesthesia, 5e
Since the publication of the last edition of this textbook, we lost our mentor and dear friend John F. Garde. Without his encouragement and guidance, our anesthesia career paths would have been much different and no doubt much less rewarding. John encouraged the publication of the first edition of this text, two decades ago, as an important milestone in the evolution of the specialty of nurse anesthesia. He felt it showcased the breadth and depth of nurse anesthetists’ contributions to research and clinical care. John transmitted his enthusiasm for the unique role of nurse anesthetists to everyone he encountered. He believed that anesthesia excellence was manifest when a clinician made a difference in the everyday lives of patients. He was without question the most consequential nurse anesthesia leader of his time. We reprint the foreword he wrote for the first edition of this textbook in his honor.
John J. Nagelhout
Karen L. Plaus
FOREWORD FOR NURSE ANESTHESIA, FIRST EDITION
As a new century dawns, nurse anesthetists continue to provide the highest quality anesthesia services to their patients. To put this into perspective, consider that nurse anesthetists safely and compassionately administered anesthesia throughout the entire last century and even prior to that. The writings of Alice Magaw, published between 1899 and 1906, provide a noteworthy benchmark. Magaw detailed the use of chloroform and other anesthesia with the open-drop technique in more than 14,000 surgical cases without a single fatality attributable to anesthesia. She was the first nurse anesthetist to publish articles on the practice of anesthesia and was considered “the mother of anesthesia” during a time when surgeons selected nurses to specialize in anesthesia to provide greater safety for patients requiring anesthesia. Many pharmacologic and technologic changes in anesthesia have occurred, however, since those noble beginnings. The chapter titles of this textbook serve as an atlas to this expanded knowledge base: “Clinical Monitoring in Anesthesia,” “Anesthesia Equipment,” “Pharmacokinetics,” “Inhalation Anesthetics,” “Intravenous Induction Agents,” “Local Anesthetics,” “Opioid Agonists and Antagonists,” and “Neuromuscular Blocking Agents, Reversal Agents, and Their Monitoring,” to name a few. Look at the specialty components of anesthesia contained in this book: Cardiac Anesthesia; Respiratory Anesthesia; Thermal Injury and Anesthesia; Trauma Anesthesia; Outpatient Anesthesia; Regional Anesthesia; Anesthesia for Ophthalmic Procedures; Anesthesia and Orthopedics; Anesthesia for Ear, Nose, Throat, and Maxillofacial Surgery; Anesthesia and Laser Surgery; and the list goes on. The continuum for practice in the twenty-first century is that of professionals learning anew how to ensure the best possible care for their patients.
When Agatha Hodgins and other nurse anesthetist pioneers gathered in a classroom in the anesthesia department of the University Hospital of Cleveland on June 17, 1931, they established what was to become the American Association of Nurse Anesthetists (AANA). This group sought to place better qualified people in the field, to keep those already in nurse anesthesia abreast of modern developments, and to give protection and recognition to this group of professionals.
When the AANA values statement was adopted in 1995, it was not surprising that it reflected this earlier philosophy. The AANA values the following:
• Its members and the advancement of the profession of nurse anesthesia
• Quality service to the public through diverse practice settings based on collaboration and personal choice
• Integrity, accountability, competence, and professional commitment
• Scientific inquiry and contributions to the fields of anesthesiology, nursing, and related disciplines
• Participation in the formation of healthcare policy.
These value statements are supported by knowledgeable practitioners ever in pursuit of their craft
Nurse Anesthesia is a textbook that builds on a formidable knowledge base and draws on the expertise of CRNAs and other professionals practicing in today’s fast-paced, ever-changing environment. I look upon this volume as a means to demonstrate the profession’s growth and encourage CRNAs and student nurse anesthetists to read it and reflect upon the dynamic field they have chosen.
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