A Brief Look at Nurse Anesthesia History.

Text to accompany the AANA History PowerPoint presentation.

1861-1865
Catherine S. Lawrence and other nurses provided anesthesia for surgeons operating on the wounded
during the Civil War (Slide 2)

1887
Sister Mary Bernard, a Catholic nursing sister at St. Vincent's Hospital in Erie, Pennsylvania, was the first
nurse known to have specialized in anesthesia (no slide)

1893
Alice Magaw begins as nurse anesthetist for Dr. Mayo, who would later bestow upon Magaw the title
"Mother of Anesthesia" for her mastery of open drop ether (Slide 3)

1899
Magaw published the first paper by a nurse anesthetist in the Northwestern Lancet (Slide 4)

1909
Magaw's successor, Florence Henderson, continued in her mentor's pioneering footsteps with a paper
she published. Agatha Hodgins, who later would found the National Association of Nurse Anesthetists
(NANA), provided a commentary on Henderson's paper. (Slide 5)

1914-1917
Sophie Winton, Agatha Hodgins and many other nurse anesthetists in volunteer American medical units
provided anesthesia for casualties during World War I (Slides 6-7)

1917
In Frank v South, the Kentucky Court of Appeals ruled that nurse anesthetist Margaret Hatfield was not
engaged in the practice of medicine when she administered anesthesia for surgeon Louis Frank’s cases
(No slide)

1931
Agatha Hodgins, together with 47 nurse anesthetists, founded the National Association for Nurse
Anesthetists (NANA) (Slides 7-8)

1934
In Chalmers-Francis v Nelson, the California Supreme Court affirmed the Superior Court finding for nurse
anesthetists Dagmar Nelson in a ruling that confirmed the legality of nurse anesthesia practice (Slide 9)

1939
NANA became the American Association of Nurse Anesthetists (AANA) (Slide 10)

1941-1945
Second Lieutenant Mildred Clark, who would later become the first nurse anesthetist to serve as Chief of
the Army Nurse Corps, and many other nurse anesthetists provide anesthesia for the wounded in World
War II (Slide 11)

1945
AANA administered its first qualifying (certification) examination (Slide 12)

1945
AANA hires Florence McQuillen, a highly respected CRNA from the Mayo Clinic, to manage the
association. McQuillen served as Executive Director until 1970. (Slide 13)
1952
AANA implemented its program for accrediting nurse anesthesia schools. Helen Lamb had been a
proponent of the accreditation idea since the 1930s. (Slide 14)

1953
Virginia Thatcher's History of Anesthesia with Emphasis on the Nurse Specialist is published. Through the
efforts of the AANA History & Archives Society, the AANA Archives recently made this first history of
nurse anesthesia available on the AANA website (Slide 15)

1956
AANA members adopt the credential Certified Registered Nurse Anesthetist (CRNA) (no slide)

1969
AANA members approved a voluntary continuing education for CRNAs (no slide)

1974
Board of Directors adopts Standards for Nurse Anesthesia Practice (no slide)

1975
The Council of Certification of Nurse Anesthetists (CCNA), the Council on Accreditation of Nurse
Anesthesia Educational Programs, and the Council for Public Interest in Anesthesia were formed. Ira P.
Gunn was the architect of the Council structure (slide 16)

1977
AANA members approved mandatory continuing education for CRNAs (no slide)

1978
The Council on Recertification of Nurse Anesthetists was established (no slide)

1986
-- Congress passed legislation providing CRNAs direct reimbursement under Medicare Part B (no slide)
-- Board of Directors endorsed Harvard Patient Monitoring Standards (no slide)

1989
-- Direct reimbursement for CRNAs under Medicare Part B was implemented (no slide)
-- Guidelines for Obstetrical Epidural Anesthesia Services were implemented (no slide)
-- Marianne Bankert's Watchful Care: A History of America's Nurse Anesthetists is published. Bankert is
presenting the first copy to Sandra Maree, now Sandra Ouellette, who served as AANA's president during
this eventful year (Slide 17)

1996
CCNA administered the certification examination for the first time using computerized adaptive testing (no
slide)

1997
Guidelines for Office-Based Anesthesia for CRNAs were implemented (no slide)

1998
The U.S. Department of Health & Human Services' Health Care Financing Administration (HCFA)
published a proposed rule to defer to the states on physician supervision of CRNAs for Medicare cases
(no slide)

1999
AANA’s Standards for Office Based Practice for CRNAs were adopted (no slide)
2000
HCFA announced it would finalize the rule to defer to the states on physician supervision of CRNAs for
Medicare cases (no slide)

2001
-- HCFA published the final rule to defer to the states on physician supervision of CRNAs for Medicare
cases on the last working day of the Clinton administration (no slide)
-- After two implementation delays, the Center for Medicare and Medicaid Services (CMS, formerly,
HCFA) of the Bush administration published a proposed rule significantly different from the spirit of the
Clinton physician supervision of CRNAs for Medicare cases rule (no slide)
-- John Garde, who served as AANA's Executive Director for more than 17 years, retired. He and Jeff
Beutler completed the near-seamless transfer of power during the fall and early winter (Slides 18-19)