VCU meeting the anesthesia needs in Southwest Virginia
In concert with VCU’s educational outreach initiatives, the Department of Nurse Anesthesia, partnering with the Southwest Virginia Higher Education Center in rural Abingdon Virginia under the direction of Dr. Rachel Fowlkes, has developed an innovative and highly effective educational offering to meet the anesthesia needs for citizens of this region.
While among the most scenic regions in the Commonwealth, the health care needs of the rural and medically underserved populations, particularly Appalachians, are tremendous. Appalachians have higher incidences of chronic health conditions, including cancer and heart disease. Appalachia has the highest death rate from lung cancer in the nation and the second highest death rate in the nation for cervical cancer. In addition to cancer, Appalachians have heart disease and black lung. The Virginia Black Lung Association explains that black lung disease is an occupationally-caused, progressive and incurable disease. Black lung disease continues its debilitation of the miner even after employment ends. He or she will eventually die from lung complications or heart disease caused by coal dust exposure.
CRNAs provide critical services in rural areas, but a national shortage creates even greater challenges to providing adequate healthcare services in Appalachia and other medically-underserved areas across the nation. Today, physician anesthesiologists and/or certified registered nurse anesthetists (CRNAs) provide almost all anesthesia services in the United States. However, these health care professionals are not evenly distributed across the rural-urban continuum of populations. CRNAs have historically rendered the majority of anesthesia services to rural residents. The consequences of the CRNA shortage for small hospitals can be dire. Without CRNAs some small hospitals are unable to provide anesthesia services. Some hospitals are forced to cut back on elective surgeries and close some of their operating rooms. Hospitals may have to delay surgeries. Patients may have to travel long distances to access the healthcare services they need, when the local, rural hospital cannot recruit anesthesia providers. According to the American Association of Nurse Anesthetists (AANA), more than two-thirds of all rural hospitals rely heavily on CRNAs to provide anesthesia care and without these advanced practice nurses, some 1,500 facilities would find it difficult to maintain trauma stabilization, surgical, and obstetrical capabilities.
Responsive to these concerns, in 2004, VCU received financial assistance from the Virginia Tobacco Indemnification and Revitalization Commission to establish a CRNA distance learning site in Abingdon. This initiative proposed to recruit critical care nurses from southwest Virginia, offer them a high quality anesthesia education via distance modalities from Richmond in southwest Virginia, in hopes that graduates would remain in the region to meet the healthcare needs of the population. This goal is being met as every graduate from the first 2 VCU classes has chosen to practice anesthesia among the coalfields of Appalachia. In 2005, VCU received additional grant support from the Division of Nursing, Bureau of Health Professions, to sustain and grow this highly effective program. Under the coordination of Assistant Professor Beverly George-Gay, as of Fall 2007, there are 23 graduate students training at 12 hospitals in this state-of-the-art outreach program. The Department of Nurse Anesthesia has established partnerships with established certified registered nurse anesthetists, anesthesiologists, hospital administrators and community leaders in southwest Virginia to bring the shared vision of access to quality anesthesia care in this region of the United States to fruition.
The Department of Nurse Anesthesia, at Virginia Commonwealth University is home to over 90 graduate students and is a preferred destination for faculty and learners alike studying in the specialty. If you are interested in learning more about the Department, please log onto: http://www.sahp.vcu.edu/nrsa/ or call at (804) 828-9808.