History

Surgical anesthesia, first demonstrated in 1846, is widely regarded as nineteenth-century America’s greatest gift to medicine. Paired with the rise of professional nursing and the principles of asepsis, it opened the door to modern surgery — but only once it could be given safely. Early anesthetics were often administered by medical students more interested in watching the operation than in the patient breathing under the mask, and deaths from asphyxiation followed. Surgeons needed anesthetists whose sole devotion was the patient’s safety. Nurses — intelligent, vigilant, and focused entirely on the patient — proved ideally suited to the work, and in the 1880s the first advanced nursing specialty, nurse anesthesia, was born.

California produced early pioneers of its own. Alta Alice Miner Bates — the namesake of the Berkeley hospital — opened her own sanatorium for women and infants in 1905, serving as its administrator, chief anesthetist, and director of its nurse training program. Over a career spanning more than fifteen years, she administered upwards of 14,000 anesthetics.

As nurses established themselves in anesthesia in the early twentieth century, organized opposition arose from physician anesthetists — and California became the principal battleground. In 1928, Adeline Curtis, a nurse anesthetist practicing at the Johnson-Wickett Clinic in Anaheim since 1921, received a letter from the state Board of Medicine accusing her of practicing anesthesia illegally. She spent years, and her life savings, fighting back. Her persistence produced a 1933 opinion by Attorney General Ulysses S. Webb confirming that no California law barred nurses from administering anesthetics, and the controversy ultimately led to a California Supreme Court decision affirming that anesthesia is part of the practice of nursing.

Curtis carried the warning up and down the state — and out of that campaign, in 1931, thirteen charter members founded the California Association of Nurse Anesthesiology: the first state association of its kind in the country.

Sophie Gran Winton, a nurse anesthetist decorated for her service in France during the First World War, was installed as CANA’s first president. In 1935 the association affiliated with the newly formed National Association of Nurse Anesthetists — today the American Association of Nurse Anesthesiology (AANA). Membership grew from those thirteen founders to roughly five hundred in the 1950s, stabilizing near one thousand through the 1970s. Since then, the association has grown substantially, with over three thousand nurse anesthetists now practicing in the state.

Through decades of educational meetings, a widely read bulletin, and sustained advocacy in Sacramento and Washington, D.C., CANA has helped secure the independent, respected scope of practice that California CRNAs hold today — and has kept nurse anesthesiologists at the center of the answer to the state’s and the nation’s health care needs.