Coronavirus Q & A: Erik Rauch DNP, CRNA, NSMP-C
As the nation continues to be on stay-at-home orders amid the COVID-19 pandemic, we asked USF College of Nursing’s Erik Rauch, BSN ‘03, DNP ‘11, assistant professor and the chief CRNA at Bayfront Health St. Petersburg, to share what he’s seeing from the front lines.
Describe what it’s like on the front lines from a nurse anesthetist’s perspective.
This health care crisis is unlike anything we’ve ever seen. There are so many uncertainties revolving around it, but certified registered nurse anesthetists (CRNAs) are uniquely prepared for this since we come from a critical care background and have a special expertise in airway management.
The front lines of any war are a scary place to be for anyone, especially when there’s not enough protective equipment for everyone. Right now CRNAs are struggling to find enough N-95 masks to properly protect them while managing the airways for patients with suspected/positive COVID-19. Despite those challenges, it’s truly an honor to be a nurse anesthetist right now, and having the opportunity to use your unique skillsets to give back and literally save lives daily during this pandemic.
How has this public health crisis changed your job?
The public health crisis dramatically changed my job. Many nurse anesthetists spend most of their days providing safe anesthesia care to those patients having surgery. But as a result of COVID-19, essentially all elective surgery has been canceled across the nation.
The focus for anesthesia providers has shifted to more of a critical care setting. I now go to the hospital expecting to play a larger part in the ICUs where we are beginning to see suspected/positive COVID-19 patients show up in need of our expertise. Within the next few weeks as Florida hits its peak of COVID-19 patients, I expect my job to become an around-the-clock full-time job providing advanced practice care in the ICUs at my local hospital.
What are the challenges ahead?
The largest concern right now is that the ICUs at many if not all of our local hospitals will be at maximum capacity due to COVID-19. CRNAs across the nation are stepping up and deploying to other hospitals as needed to help fill the critical care provider shortage. There has never been a greater time for hospitals to recognize and tap into the potential services that CRNAs have to offer. However, if Florida comes to the point where we are at maximum capacity in our ICUs, it will most likely need to remove regulatory barriers that currently prevent CRNAs from providing care at the top of their licensure and training. Otherwise, they won’t be able to provide these vital services in the capacity that will be needed at that time. Multiple other states around the country and the Center for Medicaid and Medicare Services (CMS) have already temporarily removed these regulatory barriers in a proactive effort to combat the disease.
Experts have discussed how the COVID-19 virus could likely come in waves, with another wave in the fall. What should health care providers be doing now to prepare?
Health care providers should be taking all the lessons we have learned during this current wave to be better prepared for a possible second wave in the fall. One of the biggest needs will be to stock up on personal protective equipment (PPE) so that we’re not in a shortage when it’s so desperately needed.
Having highly trained critical care/airway experts on the front lines like CRNAs isn’t that helpful if they are getting exposed, becoming ill, or needing quarantine as a result of lack of proper protection. State legislators should also look at improving regulatory conditions for advanced practice providers beyond just a temporary status. Having advanced practice providers able to work at the top of their licensure and training is a key component long term to ensuring patients receive the care that they need during even the most vulnerable times.
What are your nurse anesthesia students learning from this pandemic experience?
Nurse anesthesiology students are seeing how important their training and skill sets will be in the future. They fully understand why we train them to be autonomous anesthesia providers. Because in a situation like this where all hands are on deck, they will be needed to provide autonomous care at the top level of their licensure regardless of what state they go and practice in after graduation. At USF we are fortunate to have some of the best resources and faculty in the country to be able to provide that level of expert training.
Story by Elizabeth L. Brown, USF College of Nursing
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