Surgical anesthesia was discovered in 1846, and was soon recognized as the greatest American contribution to medicine of the nineteenth century. Anesthesia, together with the emergence of professional nursing and the discovery of the principles of asepsis, brought forth the age of modern surgery. But the wonder of anesthesia was soon overshadowed when its dangers became apparent. Patients died from asphyxiation because, initially, anesthesia was poorly administered by student physicians who had more interest in learning surgery than administering an anesthetic. In order for the public to trust that surgery was safe, surgeons would need capable anesthetists who were devoted solely to the safe care of patients under anesthesia. It was felt that nurses were well suited to this job because they were intelligent, vigilantly attentive to patients, and would accept a subordinate role to the surgeon. Thus in the 1880’s, the first advanced nursing specialty was born, nurse anesthesia.
The first advanced practice specialty in nursing began in the northeast United States (U.S.) in the 1880’s. As a nursing practice, nurse anesthesia blossomed in the Mid-West during the 1880s and ten years later was well established across the country. Together with the advent of professional nursing and the discovery of the principle asepsis, nurse anesthesia ushered in the age of modern surgery.
Ms. Alta Alice Miner Bates (for whom the community hospital in Berkeley is named) was a prominent early California anesthetist who opened her own “Sanatorium” for women and infants in 1905. She served as the facility’s administrator, chief anesthetist, and director of her own nursing training program. The December 1955 CANA bulletin reported that Ms. Bates was the first graduate of a nurses training program in Eureka and the “first woman in the bay area to become an outstanding anesthetist.” Ms. Bates administered over 14,000 anesthetics in a career that lasted over 15 years.
As nurses gained a foothold in the anesthesia profession during the early years of the twentieth century, organized opposition to nurse anesthesia arose from physician anesthetists. California was to become a major battleground for this conflict. The fight would give rise to the first state association of nurse anesthetists in the country and lead to a California Supreme Court decision affirming that anesthesia is a part of the practice of nursing.
Ms. Adeline Curtis, a nurse anesthetist who had been working in Anaheim at the Johnson-Wickett Clinic since 1921, received a letter from the California Board of Medicine in 1928, informing her that she was practicing anesthesia illegally. Ms. Curtis would end up spending years and her life savings seeking legal advice. It was Ms. Curtis’s efforts that resulted in an Attorney General’s opinion authored by Ulysses S. Webb in 1933, stating there was no law in California forbidding nurses from administering anesthetics. Ms. Curtis continued her activism by traveling around the state informing her colleagues of the threat to nurse anesthesia practice. This lead to the formation of the California Association of Nurse Anesthesiology (CANA) in 1931 with Ms. Sophie Gran Winton, a nurse anesthetist decorated for her valorous service in France during World War I, installed as the first president.
In 1935, the California Association affiliated with the newly formed National Association of Nurse Anesthetists (NANA), the predecessor of the current American Association of Nurse Anesthetists (AANA). From thirteen charter members, CANA grew to approximately five hundred in the 1950s and then stabilized at about one thousand throughout the 1970s. Since the time of its inception, CANA has remained the voice and leader for CRNAs in California.
Because of CANA’s continuous efforts to conduct regular educational meetings, produce a widely read news bulletin, participate in legislative activities in both Sacramento and Washington D.C., and due to its committed activism to making positive legislative, regulatory, and professional gains, CRNAs today enjoy an independent and respected scope of practice providing quality health care for Californians, and are an integral part of the answer to California and the nation’s health care crisis.
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