Location: New York,NY, USA
Description The Nurse Anesthetist is an advanced practice nurse (CRNA). Within this role, under the supervision of an Attending Anesthesiologist, the CRNA, administers monitors and manages patient care before, during and after anesthesia. Responsibilities Responsible To Designated Attending Anesthesiologists/ Vice President, Nursing and Chief Certified Registered Nurse Anesthetist for performance appraisals and scheduling Responsible For The performance of pre-anesthesia assessment, induction and maintenance of and emergence from anesthesia, monitoring of the patient's physiological condition and performance of clinical intervention as necessary, under the supervision of an Attending Anesthesiologist. Principal Duties and Responsibilities Clinical Practice 1. In conjunction with Attending Anesthesiologist, performs a thorough and completed pre-anesthesia assessment. Responsible for obtaining and reviewing relevant tests and discussing findings with the Attending. 2. Obtains and/or verifies that an informed consent has been obtained for the planned anesthetic intervention from the patient or legal guardian. Discusses anesthetic options and risks with the patient and/or legal guardian after discussion with Attending Anesthesiologist. Documents in the patients' medical record that informed consent was obtained. 3. Formulates a patient-specific plan for anesthesia care in conjunction with the Anesthesiologist. The plan is based upon comprehensive patient assessment, problem analysis, anticipated surgical or therapeutic procedure, patient and surgeon preferences, and current anesthesia principles. 4. Induces anesthesia under the supervision of an Attending Anesthesiologist and maintains anesthesia at required levels. Assesses continuously the patient's response to the anesthetic and/or surgical intervention and must immediately notify the Attending Anesthesiologist of significant changes in the patient's condition and intervenes as required, under the supervision of an Attending Anesthesiologist to maintain the patient in a satisfactory physiologic condition. 5. Monitors the patient's physiologic condition as appropriate for the type of anesthesia and specific patient needs. * Monitors ventilation continuously. Verifies intubation of the trachea by auscultation, chest excursion, and confirmation of carbon dioxide in the expired gas. Continuously monitors end-tidal carbon dioxide during controlled or assisted ventilation. Uses spirometry and ventilatory pressure monitors. * Monitors oxygenation continuously by clinical observation, pulse oximetry, and if indicated, arterial blood gas analysis. * Monitors cardiovascular status continuously via electrocardiogram and when appropriate, heart sounds. * Records blood pressure and heart rate. * Monitors body temperature continuously on all pediatric patients receiving general anesthesia and when indicated, on all other patients. * Monitors neuromuscular function and status when neuromuscular blocking agents are administered. * Monitors and assesses the patient positioning and protective measures. The omission of any monitoring standards shall be documented and the reason stated on the patients anesthesia record. The CRNA shall be in constant attendance of the patient until another qualified health care provider has accepted the responsibility for care. 6. Maintains complete, accurate, and timely documentation of pertinent information on the patients' medical record. Must document all anesthetic interventions and patient responses. 7. Transfers the responsibility for care of the patient to other qualified providers in a manner that assures continuity of care and patient safety. 8. Adheres to appropriate safety precautions, as established within the institution, to minimize the risk of fire, explosion, electrical shock and equipment malfunction. Documents on the patients' medical record that the anesthesia machine and equipment were checked. 9. Inspects the anesthesia machine prior to use and monitors according to established guidelines. Checks the readiness, availability, cleanliness, and working condition of all equipment to be utilized in the administration of the anesthesia care. When the patient is ventilated by an automatic mechanical ventilator, monitors the integrity of the breathing system with a device capable of detecting a disconnection by emitting an audible alarm. Monitors oxygen concentration continuously with an oxygen supply failure alarm system. 10. Takes precautions to minimize the risk of infection to the patient, the Nurse Anesthetist, and other healthcare providers. Professional Practice 1. Participates in the ongoing review and evaluation of the quality and appropriateness of anesthesia care as a member of the Department of Anesthesiology. Evaluation shall be performed based upon appropriated outcome criteria and reviewed on an ongoing basis. 2. Participates in a continual process of self-evaluation and strives to incorporate new techniques and knowledge into practice. 3. Participates in departmental Grand Rounds, presenting relevant cases as appropriate. 4. Respects and maintains the basic rights of patients. 5. Promotes an environment that is sensitive to cultural diversity and is open and responsive to the diverse backgrounds and experience of others. 6. Assists in research projects as directed by an anesthesiologist. 7. Participates in the instruction and supervision of Student Registered Nurse Anesthetists (SRNAs). Administrative Practice 1. Collaborates with members of the health care team in the development, implementation and ongoing review of policies, procedures and standards of care for a designated patient population. 2. Evaluates and documents the patient care outcomes for the Department of Anesthesia and influences Departmental changes in staffing, patient assignment and standards of care. 3. Participates in the identification of performance improvement indicators and develops quality improvement programs with the health care team. 4. Participates in risk management activities including the identification and communication of risk in a timely manner. 5. Responds to budgetary constraints and incorporates financial principles into program development, patient care activities and allocation of resources. 6. Formulates trends and identifies potential problems in the delivery of patient care in the perioperative setting and implements action plans and educational programs for faculty and staff. Qualifications Bachelors of Science degree in Nursing Master's Degree in Nursing with a specialization in nurse anesthesia preferred or a graduate of an accredited program in Nurse Anesthesia. Minimum of one year of nursing in an intensive care setting Name: Neonatal Resuscitation Program Certificate (Required Depts.: L&D, NICU) Issuing Authority: American Heart Association Name: PALS (Required Depts.: ED; PACU; IR; Peds ICU, and APNs Pediatric Oncology) Issuing Authority: American Heart Association Collective bargaining unit: NYSNA-SLW Employer Description Strength Through Diversity The Mount Sinai Health System believes that diversity, equity, and inclusion are key drivers for excellence. We share a common devotion to delivering exceptional patient care. When you join us, you become a part of Mount Sinai's unrivaled record of achievement, education, and advancement as we revolutionize medicine together. We invite you to participate actively as a part of the Mount Sinai Health System team by: Using a lens of equity in all aspects of patient care delivery, education, and research to promote policies and practices to allow opportunities for all to thrive and reach their potential. Serving as a role model confronting racist, sexist, or other inappropriate actions by speaking up, challenging exclusionary organizational practices, and standing side-by-side in support of colleagues who experience discrimination. Inspiring and fostering an environment of anti-racist behaviors among and between departments and co-workers. At Mount Sinai, our leaders strive to learn, empower others, and embrace change to further advance equity and improve the well-being of staff, patients, and the organization. We expect our leaders to embrace anti-racism, create a collaborative and respectful environment, and constructively disrupt the status quo to improve the system and enhance care for our patients. We work hard to create an inclusive, welcoming and nurturing work environment where all feel they are valued, belong and are able to advance professionally. Explore more about this opportunity and how you can help us write a new chapter in our history! About the Mount Sinai Health System: Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 43,000 employees working across eight hospitals, more than 400 outpatient practices, more than 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time - discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it. Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients' medical and emotional needs at the center of all treatment. The Health System includes approximately 7,400 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high Honor Roll status, and are highly ranked: No. 1 in Geriatrics and top 20 in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report's Best Children's Hospitals ranks Mount Sinai Kravis Children's Hospital among the country's best in several pediatric specialties. The Icahn School of Medicine at Mount Sinai is ranked No. 14 nationwide in National Institutes of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek's The World's Best Smart Hospitals ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally. The Mount Sinai Health System is an equal opportunity employer. We comply with applicable Federal civil rights laws and does not discriminate, exclude, or treat people differently on the basis of race, color, national origin, age, religion, disability, sex, sexual orientation, gender identity, or gender expression. We are passionately committed to addressing racism and its effects on our faculty, staff, students, trainees, patients, visitors, and the communities we serve. Our goal is for Mount Sinai to become an anti-racist health care and learning institution that intentionally addresses structural racism. EOE Minorities/Women/Disabled/Veterans Compensation The Mount Sinai Health System (MSHS) provides a salary range to comply with the New York City Law on Salary Transparency in Job Advertisements. The salary range for the role is $124.6832 - $124.6832 Hourly. Actual salaries depend on a variety of factors, including experience, education, and hospital need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.Bachelors of Science degree in Nursing Master's Degree in Nursing with a specialization in nurse anesthesia preferred or a graduate of an accredited program in Nurse Anesthesia. Minimum of one year of nursing in an intensive care setting Name: Neonatal Resuscitation Program Certificate (Required Depts.: L&D, NICU) Issuing Authority: American Heart Association Name: PALS (Required Depts.: ED; PACU; IR; Peds ICU, and APNs Pediatric Oncology) Issuing Authority: American Heart Association Collective bargaining unit: NYSNA-SLWResponsible To Designated Attending Anesthesiologists/ Vice President, Nursing and Chief Certified Registered Nurse Anesthetist for performance appraisals and scheduling Responsible For The performance of pre-anesthesia assessment, induction and maintenance of and emergence from anesthesia, monitoring of the patient's physiological condition and performance of clinical intervention as necessary, under the supervision of an Attending Anesthesiologist. Principal Duties and Responsibilities Clinical Practice 1. In conjunction with Attending Anesthesiologist, performs a thorough and completed pre-anesthesia assessment. Responsible for obtaining and reviewing relevant tests and discussing findings with the Attending. 2. Obtains and/or verifies that an informed consent has been obtained for the planned anesthetic intervention from the patient or legal guardian. Discusses anesthetic options and risks with the patient and/or legal guardian after discussion with Attending Anesthesiologist. Documents in the patients' medical record that informed consent was obtained. 3. Formulates a patient-specific plan for anesthesia care in conjunction with the Anesthesiologist. The plan is based upon comprehensive patient assessment, problem analysis, anticipated surgical or therapeutic procedure, patient and surgeon preferences, and current anesthesia principles. 4. Induces anesthesia under the supervision of an Attending Anesthesiologist and maintains anesthesia at required levels. Assesses continuously the patient's response to the anesthetic and/or surgical intervention and must immediately notify the Attending Anesthesiologist of significant changes in the patient's condition and intervenes as required, under the supervision of an Attending Anesthesiologist to maintain the patient in a satisfactory physiologic condition. 5. Monitors the patient's physiologic condition as appropriate for the type of anesthesia and specific patient needs. * Monitors ventilation continuously. Verifies intubation of the trachea by auscultation, chest excursion, and confirmation of carbon dioxide in the expired gas. Continuously monitors end-tidal carbon dioxide during controlled or assisted ventilation. Uses spirometry and ventilatory pressure monitors. * Monitors oxygenation continuously by clinical observation, pulse oximetry, and if indicated, arterial blood gas analysis. * Monitors cardiovascular status continuously via electrocardiogram and when appropriate, heart sounds. * Records blood pressure and heart rate. * Monitors body temperature continuously on all pediatric patients receiving general anesthesia and when indicated, on all other patients. * Monitors neuromuscular function and status when neuromuscular blocking agents are administered. * Monitors and assesses the patient positioning and protective measures. The omission of any monitoring standards shall be documented and the reason stated on the patients anesthesia record. The CRNA shall be in constant attendance of the patient until another qualified health care provider has accepted the responsibility for care. 6. Maintains complete, accurate, and timely documentation of pertinent information on the patients' medical record. Must document all anesthetic interventions and patient responses. 7. Transfers the responsibility for care of the patient to other qualified providers in a manner that assures continuity of care and patient safety. 8. Adheres to appropriate safety precautions, as established within the institution, to minimize the risk of fire, explosion, electrical shock and equipment malfunction. Documents on the patients' medical record that the anesthesia machine and equipment were checked. 9. Inspects the anesthesia machine prior to use and monitors according to established guidelines. Checks the readiness, availability, cleanliness, and working condition of all equipment to be utilized in the administration of the anesthesia care. When the patient is ventilated by an automatic mechanical ventilator, monitors the integrity of the breathing system with a device capable of detecting a disconnection by emitting an audible alarm. Monitors oxygen concentration continuously with an oxygen supply failure alarm system. 10. Takes precautions to minimize the risk of infection to the patient, the Nurse Anesthetist, and other healthcare providers. Professional Practice 1. Participates in the ongoing review and evaluation of the quality and appropriateness of anesthesia care as a member of the Department of Anesthesiology. Evaluation shall be performed based upon appropriated outcome criteria and reviewed on an ongoing basis. 2. Participates in a continual process of self-evaluation and strives to incorporate new techniques and knowledge into practice. 3. Participates in departmental Grand Rounds, presenting relevant cases as appropriate. 4. Respects and maintains the basic rights of patients. 5. Promotes an environment that is sensitive to cultural diversity and is open and responsive to the diverse backgrounds and experience of others. 6. Assists in research projects as directed by an anesthesiologist. 7. Participates in the instruction and supervision of Student Registered Nurse Anesthetists (SRNAs). Administrative Practice 1. Collaborates with members of the health care team in the development, implementation and ongoing review of policies, procedures and standards of care for a designated patient population. 2. Evaluates and documents the patient care outcomes for the Department of Anesthesia and influences Departmental changes in staffing, patient assignment and standards of care. 3. Participates in the identification of performance improvement indicators and develops quality improvement programs with the health care team. 4. Participates in risk management activities including the identification and communication of risk in a timely manner. 5. Responds to budgetary constraints and incorporates financial principles into program development, patient care activities and allocation of resources. 6. Formulates trends and identifies potential problems in the delivery of patient care in the perioperative setting and implements action plans and educational programs for faculty and staff.