Kristen Simon, MS ‘12, BS ‘06, didn’t always know she wanted to become a certified registered nurse anesthetist.
Before returning to school, she was working as a registered nurse in the medical/surgical unit at the University of Rochester Medical Center. Although she enjoyed her position, she felt stifled. Then, after transferring to the post-anesthesia care unit (PACU), she had a thought to pursue her CRNA education.
“I was starting to think of advancing my practice but wasn’t sure that the nurse practitioner program was right for me,” she explains. “I was honestly unaware of CRNA practice until I worked in the PACU. I credit the CRNAs that worked there, who really encouraged me to apply to UB SON’s nurse anesthesia program. I was really attracted to the autonomy of CRNA practice and the acuity of patient care.”
When the time came to choose a program, she decided to return to UB School of Nursing, where she earned her bachelor’s degree in nursing in 2006. She enrolled in the nurse anesthetist program, which then was a master’s-level degree.
“Most of the CRNAs I worked with were UB grads, so I had a lot of confidence about the program and that I would be successful upon graduation," she says. “Cost was a major consideration for me because I had a mortgage and was already swimming in student loan debt from undergrad.”
During her time in the program, Simon learned the most from her fast-paced clinical rotations.
“It was stressful to learn a new site and work with so many new preceptors and surgeons, but it also gave me a lot of confidence and adaptability once I began working,” she says. “I knew that no matter what was thrown at me, I could navigate through an uncomfortable situation and provide quality care in any setting."
Although Simon completed the program in 2012, she continues her spirit of learning.
“I think it’s interesting how I have changed as a provider over the last nine years,” she says. “You never know when you might pick up a good trick or learn a different way of doing something that improves your own skillset. It’s important to be open to new ideas and never remain static as a clinician.”
Once she completed the nurse anesthetist program, she accepted a position with Niagara Frontier Anesthesia Associates (NFAS), an independent CRNA-only group that covers a wide range of sites in Western New York.
“I was the first new graduate they ever hired,” she says. “I had no intention of going into independent CRNA practice, but where I had planned to work after school put a hiring freeze on CRNAs. One of the partners of NFAS was an associate professor at UB at the time and recruited me to come work for them.”
Most CRNAs in New York State work in an anesthesia care team (ACT) model, which means they are supervised by an attending physician anesthesiologist. Independent CRNAs practice under the supervision of the operating surgeon.
“Independent practice was very challenging for me initially because while I was training I had only ever worked in an ACT environment,” she explains. “Now, I was solely responsible for the preoperative, intraoperative and postoperative care in a fast-paced environment. You have to know your limitations and your resources.
“If I have learned anything, it’s that the craziest scenarios get thrown at you on call when you are all alone with little time to make a decision,” she adds. “I made many phone calls to my colleagues, in the beginning, to make sure I was on the right path. I worked for NFAS for eight years and the experience and skills I gained are invaluable."
During her time at NFAS, the practice welcomed CRNA students to the clinical site to promote independent CRNA practice and provide them with regional anesthesia experience.
"It was really rewarding to see students practice to their full potential and realize that their practice doesn’t have to be limited if they have the ambition to work independently,” she says. “It’s really important that students are exposed to independent practice sites and get experience with regional anesthesia techniques.”
Today, Simon works as a staff CRNA at Noyes Memorial Hospital in Dansville, New York.
The rural hospital also includes an Ambulatory Surgery Center in Geneseo, New York. Between the two sites, there are five full-time CRNAs, two full-time MD anesthesiologists, one half-time MD and some per diem CRNA coverage. CRNAs work independently at both sites.
Shortly after joining the team, the chief CRNA approached her about bringing CRNA students to Noyes.
“Mark Evans [the chief CRNA] had been advocating to bring student registered nurse anesthetists to Noyes for years, but was unable to get traction. He became chief CRNA just before I came on board. I was a clinical coordinator at my previous job, and I plan to be in that same role here.”
Simon is focused on giving students experiences working in independent practice so that they can also become strong advocates for the profession upon graduation.
“I’m also a member of the AANA and the NYSANA,” she says. “Removing unnecessary barriers to practice should be our main goal, and I think NYSANA’s leadership is doing a lot during this pandemic to show how vital CRNAs are to health care and that we provide equally safe care that can no longer be ignored.”
Published January 22, 2021