91AV

The mission of the School of Nurse Anesthesia is to provide an academic environment which allows students to master the intellectual and technical skills necessary to become competent in the safe conduct of anesthesia. This is accomplished by providing a select group of experienced, graduate level nurses with the highest level of didactic, simulation lab, and clinical site experiences. 91AV's graduate nurse anesthetists develop life-long scholarship, critical thinking skills, and professionalism needed to become compassionate, patient-centered Certified Registered Nurse Anesthetists in solo practice or within anesthesia care teams.

Behavioral Outcomes
Upon completion of this educational program, the student shall demonstrate, to the satisfaction of the faculty, specific competencies expected of graduates.  These competencies identify knowledge and skills necessary for competent entry-level practice of nurse anesthesia.  Upon completion of the program, the graduate will:

1. Perform an anesthetic-related history and physical exam.
2. Formulate and discuss a comprehensive anesthetic care plan for a given patient based on the pre-anesthetic assessment and Physical Status Classification I-VI.
3. Implement and evaluate anesthesia management plans, procedures, and critical decision-making skills  during the anesthetic management of the patient.
4. Demonstrate proficiency in technical skills necessary to deliver anesthesia care.
5. Evaluate the postoperative course of a patient.
6. Perform resuscitation of the newborn infant, child or adult, if necessary.
7. Function as a team leader for cardiovascular and/or pulmonary emergencies.
8. Provide first echelon care, maintenance, and troubleshooting of all anesthesia equipment.
9. Critically analyze published data in the field of anesthesia and apply new evidence in technology, pharmacology, and techniques to patient care.
10. Develop interpersonal behaviors consistent with that of a health care professional.

Certified Registered Nurse Anesthetists (CRNA's), as Advanced Practice Registered Nurses, have been providing anesthesia care in the United States of America for over 150 years. Currently, there are approximately 48,000 CRNA's in the country with more than 2,200 students graduating per year.

CRNA's are anesthesia specialists who safely administer approximately 34 million anesthetics to patients in the United States each year. As advanced practice nurses, they can serve in a variety of capacities in daily practice, such as a clinician, educator, administrator, manager and researcher.

• CRNA's administer anesthesia for all types of surgical cases, using all anesthetic techniques and practice in every setting in which anesthesia is delivered, from university-based medical centers to free-standing surgical facilities and offices.
• CRNA's are the primary anesthesia providers in almost 100% of rural hospitals in the United States, affording 1/4th of the population access to anesthesia care.  CRNAs provide a significant amount of the anesthesia in inner cities as well.
• CRNAs are qualified and permitted by state law or regulations to practice in every state in the nation.

The School of Nurse Anesthesia at the 91AV has been an involved in nurse anesthesia education since 1970, serving as an academic affiliate for hospital-based certificate nurse anesthesia programs. In 1988, we initiated a program leading to the Master of Science in Nurse Anesthesia. In 1993, the 91AV MSNA program became the sole authority of the education of nurse anesthesia students and the last hospital-based program in Maine closed.

Two-Phase Program

At 91AV, we offer a 27-month two-phase program.

The first phase is conducted on our historic Westbrook College of Health Professions Campus, situated in the picturesque coastal city of Portland.  The first eight months of study consists primarily of didactic instruction in basic sciences and anesthesia taught by our CRNA and basic science faculty. Included within this 8 month didactic curriculum is instruction using state-of-the-art simulation labs which prepare students for their clinical curriculum.

The second phase of the curriculum entails clinical training based at our hospital affiliates for a period of 19 months.  Didactic instruction continues during the clinical phase through web-based courses in advanced principles of anesthesia, as well as periodic lectures, seminars, and simulation held on campus. The School has contractual relationships with over 32 hospitals located in New England and as far away as Nevada, which offer our students a varied and diverse clinical education experience.

With successful completion of the 27 month program, students are awarded a Master of Science degree in Nurse Anesthesia. The graduate is then qualified to take the National Certifying Examination.  Upon successful completion of the exam, the graduate becomes a Certified Registered Nurse Anesthetist capable of practicing in all 50 states. To date, 100 percent of our students have passed the certifying examination in their first year post-graduation and 100 percent have successfully obtained employment.

The School of Nurse Anesthesia is accredited by the Council on Accreditation (COA) of Nurse Anesthesia Educational Programs, a specialized accrediting body recognized by the Council on Post-secondary Accreditation and the U.S. Department of Education. The School of Nurse Anesthesia is accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs through the spring of 2021.  The Program received the full 10-year accreditation length in June 2011.

The MSNA curriculum is designed so that students are based on 91AV's Portland campus for the first eight months (two semesters) of the program. The majority of the basic science didactic courses are offered during this period. The remaining 19 months of the program are clinically-based, with an emphasis on advanced coursework, clinical training, simulation lab experiences, and completion of a capstone project. All students are required to complete the entire curriculum with passing grades. 

Clinical Training

Upon completion of the didactic portion of the program, the students move on to the 19-month clinical portion of the curriculum. The primary focus is clinical anesthesia training. The clinical experience obtained will be of the width and breadth necessary for the student to achieve clinical competency in anesthesia. This is accomplished through affiliations at various clinical sites.

Each student will participate in a minimum number of cases and techniques. The Council on Accreditation of Nurse Anesthesia Educational Programs has set minimum standards for clinical experience that each student must achieve prior to graduation from the program in order to qualify for the National Certifying Examination.  All of the surgical specialties are available, including hands-on training in regional anesthesia techniques. Specialty experiences (i.e. neurosurgery, open-heart surgery, high-risk obstetrics) when not available at primary hospital affiliation sites, will be obtained from rotations at other medical facilities.

All types of anesthesia techniques and the latest agents are available for student learning. Students are able to obtain experience in general anesthetics, intravenous agents, invasive line placement, and regional anesthesia including spinal, epidural, and peripheral nerve blocks. Students are required to rotate to CRNA-only sites to gain this valuable experience.

Clinical Affiliates

Please refer to the school website for a list of clinical sites currently utilized by the School of Nurse Anesthesia.

Graduation Requirements

In order for a student to graduate, the following criteria must be met:

1. Satisfactory completion of all didactic material.
2. Satisfactory completion of clinical experience as required by the school and the Council on Accreditation of Nurse Anesthesia Educational Programs.
3. Satisfactory completion of stated 91AV School of Nurse Anesthesia behavioral objectives.
4. Completion of twenty-seven actual months in program.
5. Evaluations must be completed and signed.
6. All clinical records must be completed and submitted to the Anesthesia School Administrative staff.
7. Completion of the capstone project.
8. All fees must be paid in full.
9. All library books must be returned.
10. A current RN license and ACLS, PALS, BLS Certifications must be on file.

WCHP Academic Policy

The Department of Nurse Anesthesia, the Westbrook College of Health Professions, and the 91AV are committed to offering a quality Nurse Anesthesia education program that complies with the evaluative criteria of the Council on Accreditation of Nurse Anesthesia Educational Programs (COA). The program provides learning experiences to enable graduates to achieve the outcomes required for the practice of Nurse Anesthesia.  Please refer to the WCHP Graduate Program Progression Policies and Procedures for detailed description of academic standards.

PROGRAM COMPLETION TIMELINE

Students are expected to complete 27 actual months in the program.

RULES OF CONDUCT WHILE ON AFFILIATION AT CLINICAL SITES

Success in the Nurse Anesthesia profession requires certain behavioral attributes including but not limited to personal commitment and hardiness, empathy, discipline, honesty, integrity, personal regard for others, the ability to work effectively with others in a team environment, and the ability to address a crisis or emergency situation in a composed manner.  Adherence to these attributes requires a high level of maturity and self-control, even in highly stressful situations.  During the clinical phase, students must conduct themselves in a highly professional manner consistent with the patient care responsibilities with which they will be entrusted.  Failure to adhere to these standards (noted below) or comply with the Clinical Rotation Policies will result in a disciplinary action ranging from a written warning to discharge from the program (depending upon the violation and the circumstances surrounding the offense).

1. Creating or contributing to situations that jeopardize patient safety. 
2. Students are expected to follow all policies in the Student Code of Conduct section of the 91AV Handbook.  Unethical behavior such as academic dishonesty, falsifying logs or medical records is considered a violation of the Program’s standards of conduct. 
3. Respect the confidentiality of patients and fellow students.  One is not permitted to discuss any patients by name outside the clinical encounter situation.  Students should not discuss other students with preceptors.  For academic presentations, all identifying data , including name, initials, date of birth and facility where seen will be omitted.
4. Unauthorized possession, use, copying, or distribution of hospital records or disclosure of information contained in such records to unauthorized persons.
5. Use, distribution, or unauthorized possession of intoxicating beverages or drugs on hospital premises or reporting to work under the influence of intoxicants.
6. Unauthorized absence from the Anesthesia Department during regularly scheduled clinical hours.
7. Failure or refusal to follow instructions of a duly assigned preceptor including refusal to accept clinical assignment.
8. Use of vile, intemperate or abusive language, or acting in a disrespectful manner to any employee, supervisor, patient, or visitor.
9. Any disorderly conduct on hospital premises.
10. Creating or contributing to unsanitary conditions.
11. Theft, fraud, or unauthorized use of property belonging to the hospital, patient, or visitor.

CLINICAL PRACTICUM COURSE EXPECTATIONS

To successfully complete each clinical practicum course, students must achieve a grade of  A or B.    Details regarding clinical practicum expectations will be detailed in the Student Clinical Practicum Handbook and/or course syllabus.  Briefly speaking, clinical progression will be monitored during each clinical practicum.  If students are not meeting clinical objectives, they will be placed on Probation.   
  
If a student is placed on a 30- day Probationary Status, they will continue with the clinical objectives scheduled for that level.  The student will communicate with program faculty and clinical faculty to develop a remediation plan based on their clinical evaluations, clinical faculty feedback and/or program faculty findings.  The plan will include strategies for improvement of clinical performance. 

At the end of the 30-day Probation Status, the student’s performance will be re-evaluated by the program faculty. If they are successful, they will resume their clinical practicum at the same level their peers are at and return to good standing. If progress continues to be unsatisfactory, the student will receive an 'F' for the course and be dismissed from the program.    

Students may be placed on a second 30-day probation period for additional (unresolved or newly identified) performance issues.  The process described above would apply for this as well.  Students are granted a maximum of two (2) probationary periods not to exceed 60 days total.  If additional (newly identified) performance issues continue to occur after a student has been granted (2) probationary periods, the student would be immediately dismissed.

ESSENTIAL TECHNICAL STANDARDS

Principles:
Nurse anesthesia education requires that accumulation of scientific knowledge be accompanied by the simultaneous acquisition of specific skills and professional attitudes and behavior. Nurse Anesthesia school faculties have a responsibility to society to matriculate and graduate the best prepared nurse anesthetists, and thus admission to this program has been offered to those who present the highest qualifications. The essential technical standards presented in this document are pre-requisite for matriculation, subsequent promotion from year to year, and ultimately graduation from the 91AV School of Nurse Anesthesia. These standards pertain to all matriculated students. All required courses in the curriculum are necessary in order to develop essential skills required to become a competent nurse anesthetist.

The faculty is committed to fostering relationships with its candidates that encourage human and professional growth. Its policies and procedures attempt to reflect this commitment to proactive and supportive communication.

Nonetheless, it is imperative that all candidates recognize that the primary responsibility for a successful nurse anesthesia education, both in and outside the classroom, rests with the individual. Candidates, including candidates with disabilities, must have the capacity to manage their lives and anticipate their own needs. The School has incomplete influence in helping students achieve these personal adaptations. Situations can arise in which a candidate’s behavior and attitudes resulting from a disability or other personal circumstances represent a secondary problem which impairs the candidate’s ability to meet the School’s standards, even after implementation of all reasonable accommodations have been made by the School.

The School’s obligation and mission is to provide an academic environment which allows candidates to master the intellectual and technical skills necessary to become competent in the safe conduct of anesthesia. It does this by providing a select group of experienced, graduate level nurses with the highest level of didactic education, simulation lab and clinical site experiences. Our graduates develop life-long scholarship, critical thinking skills and professionalism needed to become compassionate, patient-centered anesthesia providers in solo practice or within anesthesia care teams. Therefore, all applicants, regardless of disability, will be held to the same admission standards, with reasonable accommodations if needed.

Recommendations:

1. No otherwise, qualified individual will be denied admission to the School of Nurse Anesthesia based solely upon a disabling condition.
2. Candidates with disabilities applying to the School of Nurse Anesthesia will be expected to have achieved the same requirements as their non-disabled peers.
3. Matriculation into the School of Nurse Anesthesia assumes certain levels of cognitive, emotional, and technical skills. Nurse anesthetist candidates with disabilities will be held to the same fundamental standards as their non-disabled peers. Reasonable accommodations will be provided to assist the candidates in learning, performing and satisfying the fundamental standards, so long as the candidate provides timely, comprehensive documentation establishing the candidate’s disability status and need for reasonable accommodation.
4. Reasonable accommodations that facilitate candidate progress will be provided but only to the extent that such accommodation does not significantly interfere with the essential functions of the School of Nurse Anesthesia, fundamentally alter the program, or significantly affect the rights of other candidates.
5. The School, under the law, is obligated to provide all reasonable accommodations that will eliminate or minimize the barriers disabled candidates may face in the process of successfully completing the requirements for graduation from the 91AV’s School of Nurse Anesthesia.

Abilities and Skills:
A candidate for this program must have abilities and skills of five varieties including observational skills; communication skills; fine and gross motor skills; intellectual skills: conceptual, integrative and quantitative abilities; and behavioral and social/emotional attributes.

I. Observational Skills
The candidate must be able to acquire a defined level of required information as presented through demonstration and experiences in the basic sciences and anesthesia courses including, but not limited to, information conveyed through labs and simulated anesthesia exercises. Furthermore, a candidate must be able to observe a patient accurately, at a distance, and close at hand, acquire information from written documents and visualize information as presented in radiographic images and patient monitors. The candidate must have visual and hearing acuity, including use of depth perception and peripheral vision; hearing normal and faint body sounds (blood pressure and heart sounds) and hearing auditory alarms on monitors and anesthesia delivery systems. Such observation and information acquisition necessitates the functional use of visual, auditory and somatic sensation while being enhanced by the functional use of other sensory modalities.

In any case where a candidate’s ability to observe or acquire information through these sensory modalities is compromised, the candidate must demonstrate alternative means and/or abilities to acquire and demonstrate the essential information without reliance upon another person’s interpretation of the information. The university will provide appropriate reasonable accommodations to foster the student’s ability to meet these standards, so long as the student registers with 91AV Disability Services.
 
II. Communication Skills
The candidate must be able to effectively and efficiently communicate using verbal, written, and reading skills, in a manner that demonstrates sensitivity to patients, their families and all members of the health care team.  A candidate must be able to accurately elicit information, describe a patient’s change in mood, thought, activity and status. He or she must also demonstrate established communication skills using traditional or alternative reasonable means that do not substantially modify the standard.

III. Fine and Gross Motor Skills
The candidate must be able to, with or without the use of assistive devices, but without reliance on another person, interpret x-ray and other graphic images and digital or analog representations of physiologic phenomenon (such as EKGs).

The ability to participate in basic diagnostic and therapeutic maneuvers and procedures (e.g. palpation, auscultation) is required. It is also essential for a candidate to possess the gross motor skills sufficient to provide a full range of safe and effective care to patients. These include the ability to move within confined spaces, reach above shoulders, bend, stoop, squat, stretch and to reach below the waist. Fine motor skills are necessary to perform psychomotor skills such as picking up objects, grasping, pinching with fingers (intubations, manipulating a syringe, starting IVs), twisting and squeezing.

Physical stamina sufficient to complete the rigorous course of didactic and clinical study is required. In addition, physical endurance and strength is a requirement in order to tolerate training during an entire shift (including overtime or call), standing for long periods of time and sustaining repetitive movements (performing CPR, positive pressure ventilation, etc). Candidates must be able to provide hands-on patient care such as lifting, pushing and pulling excessive weight to position patients, pick up and carry children, ambulate patients and transfer anesthetized patients from stretchers and beds. When transporting patients to patient recovery areas, the candidate is required to move not only the patient's weight but also the heavy bed.
The candidate is required to carry heavy equipment and supplies, sit for long periods of time on stools with and without any back support, twist and turn to visualize monitors and the surgical field and possess the strength and flexibility to assist in the restraint of combative patients. In addition, the candidate must be able to move quickly to respond to emergencies. At all times the ability to administer care to patients in a safe manner is paramount.
 
IV. Intellectual Skills - Conceptual, Integrative and Quantitative Abilities
The candidate must be able to measure, calculate, reason, analyze and synthesize information in a timely fashion. In addition, the candidate must be able to comprehend three-dimensional relationships and to understand the spatial relationships of structure. Problem-solving, the critical skill demanded of nurse anesthetists, requires all of these intellectual abilities. These problem-solving skills must be able to be performed in a precisely limited time demanded by a given clinical setting. In addition, the candidate must be able to adapt readily to changing environments and deal with unexpected activities.

V. Behavioral and Social/Emotional Attributes
Candidates must possess the emotional health required for full utilization of their intellectual abilities, the exercise of good judgment, the prompt completion of all responsibilities attendant to the diagnosis and care of patients, and the development of mature, sensitive and effective relationships with patients.
Candidates must be able to tolerate physically taxing workloads and to function effectively under stress. They must be able to adapt to changing environments, to display flexibility and to learn to function in the face of uncertainties inherent in the clinical problems of patients. They must be able to measure, calculate, reason, analyze and synthesize information effectively in a precisely limited time demanded by a given clinical setting, while under stress, and in an environment in which other distractions may be present.
Compassion, integrity, concern for others, interpersonal skills, self reflection, emotional intelligence, interest, and motivation are all personal qualities that will be assessed during the admissions and educational processes.

Upon completion of this educational program, the student shall demonstrate, to the satisfaction of the faculty, specific competencies expected of graduates.  These competencies identify knowledge and skills necessary for competent entry-level practice of nurse anesthesia.  Upon completion of the program, the graduate will:

1. Perform an anesthetic-related history and physical exam.
2. Formulate and discuss a comprehensive anesthesia care plan for a given patient based on their preoperative assessment and Physical Status Classification I-VI.
3. Implement and evaluate anesthesia management plans, procedures, critical decision-making skills during the anesthetic management of the patient
4. Perform and utilize appropriate technical skills during the anesthetic management of a patient. 
5. Evaluate the postoperative course of a patient. 
6. Perform resuscitation of the newborn infant, child or adult, when necessary. 
7. Function as a team leader for cardiovascular and/or pulmonary emergencies. 
8. Provide first echelon care, maintenance, and troubleshooting of all anesthesia equipment.
9. Critically analyze published data in the field of anesthesia and apply new evidence to technology, pharmacology, and techniques to patient care.
10. Develop interpersonal behaviors consistent with that of a health care professional.  

Transfer Credit

There is no transfer credit awarded to students in the Nurse Anesthesia program.

Advanced Placement

There is no advanced placement.

Experiential Learning

No credit will be awarded to students for experiential learning.

PREREQUISITE COURSES

Biochemistry is required and must be completed no more than five years prior to enrollment into the Nurse Anesthesia program.  Biochemistry must be completed with a grade of "B" or better, and must be completed by the end of December (or fall term) prior to expected enrollment to be eligible for admissions. The Nurse Anesthesia Program will accept the online biochemistry course offered through as well as many other courses.

Grades for the science courses listed above are used to calculate a cumulative science GPA for the Admissions Committee to review the applicant's foundational science base and to evaluate the applicant's aptitude for the sciences.

ACADEMIC / EXPERIENCE REQUIREMENTS

• Graduation from a regionally accredited baccalaureate or higher degree program in nursing OR graduation from a regionally accredited associate degree program in nursing and completion of a baccalaureate degree in another field 
• Official transcripts from ALL colleges and universities attended must be submitted as part of a complete application
• Proof of current licensure as a registered nurse in your own state at the time of application. Upon acceptance into the program, licensure in the state where clinical experience is obtained will be required.
• A minimum overall cumulative GPA of 3.0, especially in the science and professional courses is highly recommended.
• Applicants are strongly encouraged to "shadow" a nurse anesthetist for at least a day in the operating room prior to application. In addition, to fully grasp the commitment involved in studying to be a nurse anesthetist, it is especially valuable to "shadow" a student registered nurse anesthetist for a day. Neither of these experiences is a requirement for application, but are highly recommended.
• Minimum of one year of experience as a registered nurse in a critical care area (specifically ICU, CCU, CVICU, SICU, MICU, NICU, PICU and Neuro ICU) prior to application to the program. Note: Emergency Room, Recovery Room or Post-Anesthetic Care Unit (PACU) will be considered on a case by case basis but is generally not sufficient as the sole critical care experience.  
• Three references/recommendations, submitted as part of the online application; one reference must be from the applicant's immediate acute care nursing supervisor/manager and must attest to the total length of time the applicant has worked in the acute care setting as a registered nurse.
• Current Advanced Cardiac Life Support (ACLS) Certification
• Current Pediatric Advanced Life Support (PALS) Certification
• CCRN, highly recommended

Note:    Before matriculation, accepted applicants will be expected to obtain a physical examination with proof of up-to-date immunization status to meet all health immunization requirements.  Please visit Student Health Care  for details.

As required by clinical training sites, students will be subject to criminal background checks and drug screens prior to matriculation and periodically throughout the MNA program.

PROCEDURES AND POLICIES

• Applications for admissions are accepted through the 91AV's  only.
• Applications submitted and completed by the posted deadline will be fully considered. Applications submitted and/or completed after the deadline will be reviewed on a space available basis only.
• On-campus interviews are granted to qualified applicants upon invitation by the Admissions Committee, and are required for admission to the program. Interviews will be held in December/January 
• Admissions decisions will be made, by the program Admissions Committee after all interviews are completed. Decision letters will be sent to applicants, from the Office of Graduate and Professional Admissions.
• International applicants and applicants with international degrees must have their transcripts evaluated for degree and grade equivalency to that of a regionally accredited institution in the US. See
• All applicants to 91AV must be able to understand and communicate in English to be admitted to the university. 91AV accepts several methods of English Proficiency, see English Proficiency requirement must be completed at the time of application.

For additional information on the admissions process and requirements, please access the  program website.

Policy exceptions

The Nurse Anesthesia program and the MNA Admissions Committee in collaboration with the Office of Graduate and  Professional Admissions reserve the right to make exceptions to the admissions criteria and to make changes or exceptions to policies and procedures, on a case by case basis, when it deems such a decision is necessary and appropriate.

Tuition and Fees

Tuition and fees for subsequent years may vary. Other expenses include books and housing. For more information regarding tuition and fees, please consult the Financial Information section of this catalog.

Financial Aid

Detailed information and applications are available on request from the Financial Aid Office at the Biddeford Campus. Call 207-283-0170, extension 2342 or by visiting the Financial Aid website.