Policy Library

The philosophy of the NAP evolves from and is congruent with that of UB and the SON. Anesthesiology is viewed as a specialty practice appropriate to both nurse and physician anesthetists. It is built on the strong generic educational foundation of the respective disciplines; namely, baccalaureate nursing education and medical education.

The specialty is most frequently characterized as an essential service in facilitating secondary and tertiary levels of care, and as such, cuts across practice specialties in such a manner as to require enhanced competency as a generalist while having special knowledge and skill in providing specialty-specific services. Graduate students within the NAP apply theory and research findings utilizing the nursing process and decision-making skills in relation to clients, family, communities, and organizations. Role development consists of extending the professional socialization process to include the evaluation and critique of professional norms in relation to current practice and the needs of a changing society. Role development includes the further cultivation of behaviors consistent with professional ethics and comportment. 

Graduate education in this advanced practice specialty builds on the knowledge and competencies of baccalaureate education in nursing and provides for the attainment of advanced knowledge of nursing and related theories and their application to advanced nursing practices. It provides the student with the opportunity to develop the leadership skills and expertise needed for the assumption of complex, specialized roles that are essential to the provision of nursing care as an advanced practitioner, as well as for participation in research, administration, and nursing education as a mentor and preceptor.

This area of study is designed to prepare Nurse Anesthetists within the framework of doctoral preparation for advanced practice nurses. Graduates will be competent practitioners able to provide comprehensive care to patients of all ages with a variety of medical problems that require anesthesia services as part of their health care. Students will gain a broad base of knowledge in the biophysical and behavioral sciences on which to develop expertise in the anesthesia management of patients in the perioperative, resuscitative and ventilatory support phases of care, and in the anesthesia management of patients requiring such management in non-surgical settings.

The scope of practice for which these practitioners will be prepared is defined to encompass nursing functions for which they bear independent responsibilities and collaborative functions with physicians and consulting specialists. The elements of anesthesia services are viewed as having both a nursing and medical component. The Nurse Anesthetist is prepared to perform both types of functions and to recognize those situations where patient requirements are beyond their individual competence necessitating consultation and/or referral.

This program is designed to provide the graduate with those requirements for award of the Doctor of Nursing Practice degree and eligibility for the writing of the certification examination offered by the National Board for the Certification of Nurse Anesthetists (NBCRNA). As such, the student will be required to meet all requirements of the Graduate School, UB, the State University of New York, for award of the degree, and all requirements of the NBCRNA for eligibility to write the certification examination. Such requirements include all common learning experiences and all required courses.

At the conclusion of this program of study the graduate will demonstrate knowledge, skills, and competencies in patient safety, peri-anesthetic management, critical thinking, communication, and the professional role.

1. Graduates will assure patient safety by:

a. Being vigilant in the delivery of patient care.

b. Refrain from engaging in extraneous activities that compromise vigilance while providing direct patient care (e.g., “texting”, reading, emailing, “surfing the web”, etc.)

c. Protecting patients from iatrogenic complications.

d. Participating in the positioning of patients to prevent injury and assure optimal physiologic functioning.

e. Conducting a comprehensive and appropriate equipment check.

f. Utilizing standard precautions and appropriate infection control measures.

2. Graduates will provide individualized perioperative management by:

a. Providing care throughout the perianesthetic continuum.

b. Preparing the patient and family psychologically for anesthesia and surgery or other medical intervention.

c. Using a variety of current anesthesia techniques, agents, adjunctive drugs, and equipment while providing anesthesia.

d. Administering general anesthesia to patients of all ages and physical conditions for a variety of surgical and medically related procedures.

e. Providing anesthesia services to all patients, including trauma and emergency cases.

f. Administering and managing a variety of regional anesthetics.

g.  Functioning as a resource person for airway and ventilatory management of patients.

h. Possessing current advanced cardiac life support (ACLS) recognition.

i. Possessing current pediatric advanced life support (PALS) recognition.

j. Delivering culturally competent perianesthetic care throughout the anesthesia experience.

k. Performing a comprehensive history and physical assessment.

3. Graduates will demonstrate their critical thinking skills by:

a. Applying best knowledge to practice in decision-making and problem solving.

b. Providing nurse anesthesia care based on evidence-based and research evidence.

c. Performing a preanesthetic assessment and formulation of a comprehensive anesthesia care plan for patients whom they are assigned to administer anesthesia, utilizing patient history, physical examination, laboratory, radiologic, and additional diagnostic data.

d. Identifying and taking appropriate action when confronted with anesthetic equipment-related malfunctions.

e. Interpreting and utilizing data obtained from noninvasive and invasive monitoring modalities.

f. Calculating, initiating, and managing fluid and blood component therapy.

g. Recognizing and appropriately responding to anesthetic complications.

h. Passing the Council on Certification of Nurse Anesthetists’ (CNAA) certification examination in accordance with CCNA policies and procedures.

4. Graduates will demonstrate professional communication skills by:

a. Effectively communicating with all individuals influencing patient care.

b. Utilizing appropriate verbal, nonverbal, and written communication in the delivery of perianesthetic care.

5. Graduates will embrace the professional role of the nurse anesthetist by:

a. Participating in activities that improve anesthesia care such as quality review and/or clinical research.

b. Functioning within appropriate legal requirements as a registered professional nurse, accepting responsibility and accountability for his or her practice.

c. Interacting on a professional level with integrity.

d. Teaching others.

e. Participating in continuing education activities to acquire new knowledge and improve his or her practice.

f. Recognizing their responsibility to actively participate in state and/or national professional associations.

g. Demonstrating knowledge of wellness and chemical dependency in the anesthesia specialty through completion of content in wellness and chemical dependency.

In order to be eligible to take the national certification examination offered by the National Board on Certification and Recertification of Nurse Anesthetists (NBCRNA), all program requirements defined by University at Buffalo, School of Nursing, Nurse Anesthetist program must be completed.

The NBCRNA has requested that students and faculty be advised of the following:

The Content of the Certification Examination, and each of its items, is proprietary and strictly confidential. The unauthorized retention, possession, copying, distribution, disclosure, discussion, or receipt of any examination question, in whole or in part, by written, electronic, oral, or other form of communication, including but not limited to emailing, copying or printing of electronic files, and reconstruction through memorization and/or dictation, before, during, or after an examination, is strictly prohibited…(and) subject to disciplinary action such as revocation of certification…and may subject the responsible individuals to legal action resulting in monetary damages.

Disciplinary Actions Based on Unethical Behavior, Questions of Academic Integrity or Documented Evidence of Cheating
Applicants for certification by the National Board on Certification and Recertification of Nurse Anesthetists (NBCRNA) applicants for certification must certify that they have never been dismissed from a nurse anesthesia educational program, or had any disciplinary action including probation taken against them, for unethical behavior, questions of academic integrity or documented evidence of cheating. If the applicant cannot so certify, he or she must provide full documentation of the reasons for such disciplinary action with sufficient specificity to resolve the matter to the Council’s satisfaction. If the Council finds that the applicant poses a risk to the integrity of the certification examination, or to the public health, the applicant will not be granted eligibility to take the certification examination.

It is imperative that the program faculty be made aware of changes in a student’s physical well-being which may preclude their participation in program activities. Students unable to be present at an assigned activity must notify the Nurse Anesthetist Clinical Residency Coordinator. In addition, students must also notify the Clinical Site Coordinator of the site to which they are assigned, prior to the scheduled start of assigned activities. Students may not alter their assigned clinical schedule without written pre-authorization from the Clinical Residency Coordinator and the Clinical Site Coordinator.  This includes changing the number of clinical days attended.

All clinical absences will be rescheduled prior to the end of that rotation. Any absence not rescheduled can result in a lower grade or potentially failure of that clinical course. All students are expected to be in clinical approximately 36 hours per week. Clinical course syllabi may adjust hours for each course. If a student chooses not to go to clinical due to weather, it is still the expectation that those hours will be made up prior to the end of the rotation.

Any unreported absence from assigned clinical activity will be considered unprofessional behavior and will result in a lower grade for the course in which the unreported absence occurred. The first offense of an unreported absence will result in a written warning placed in the student’s file. A second unreported absence will result in a mandatory meeting with the Nurse Anesthetist Clinical Residency Coordinator and the Program Director, and a developmental plan put in place. If the developmental plan is not followed by the student, dismissal from the program will occur.  School closure does not automatically imply no clinical, unless contacted by program administration. Please make every attempt to attend your assigned clinical site.

A Typhon event request needs to be submitted for any excused absences and time off requests (including illness and mental health). You will be notified via email if your request is approved or denied.

Nurse anesthesia graduate students will be granted time during the Clinical Residency component to renew or obtain Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), or Pediatric Advanced Life Support (PALS) if needed and also to attend one (1) anesthesia review course.  Nurse anesthesia graduate students must seek and receive written approval from the Clinical Residency Coordinator one month prior to scheduling these activities/courses.

For each clinical course (e.g., NAN 601), all students will receive one day off for clinical to use as they see fit. Other than acute illness, students must give at least 24 hours’ notice to use the time off. Unless approved by the Clinical Site Coordinator and the Clinical Residency Coordinator a maximum of two days per clinical course can be utilized. Due to the flexibility in scheduling, personal days will not be approved during the following rotation assignments: ECMC trauma call and MFS OB evenings. Requests for personal days will not be approved during these rotations unless previously approved by the Clinical Site Coordinator and the Clinical Residency Coordinator. Students who do not use their day off in that clinical course will be allowed to roll it over to the next clinical course.

Program requirements adhere to student time commitment requirements as defined by the Council on Accreditation of Nurse Anesthesia Educational Programs. Because of the intensive nature of this program, students will find it difficult to maintain employment. Academic and/or clinical learning obligations may not conflict with non-academic and/or clinical learning obligations. Students may not be involved in employment activities within six hours prior to clinical assignment as a nurse anesthetist graduate student. At no time, may a student be permitted to be employed as a nurse anesthetist by title or function, unless such students are already Certified Registered Nurse Anesthetists (CRNAs) enrolled in the Program.

Patient confidentiality at the facilities used by the University at Buffalo, State University of New York School of Nursing is considered to be of primary importance. In addition to each facility policy, a federal law called the Health Insurance Portability and Accountability Act (HIPAA) requires patient health information to be kept confidential. Patients and their families have a right to deal with their health information use in a private and secure manner, trusting that their privacy will be maintained. In order to protect this right to confidentiality and to comply with federal and state laws, students must agree to hold all information (including, but not limited to, patient names, their medical information, and relevant agency information) gained through their clinical assignments at any facility used by the University at Buffalo, State University of New York School of Nursing in strictest confidence. Confidentiality includes, but is not limited to, not discussing patients or their medical conditions with persons who do not have a need to know and not removing any documents with individually identifiable patient data from the facility. Students need to understand the terms of this Confidentiality Policy and agree to abide by the above requirements. Students also need to understand that any breach of a patient’s confidentiality may result in disciplinary action against them and possible removal from the clinical site to which they have been assigned.

Students may not remove any patient identifying data from any patient care agency.

Students enrolled in the Nurse Anesthetist Program, School of Nursing, University at Buffalo are required to meet HIPAA training requirements as defined by the School of Nursing and/or each clinical site.

During the Summer I, Fall I and Spring I semesters, students will follow the University calendar. Students in the Clinical Residency component of the program will receive a two-week inter-semester break between the Fall II and III and Spring II and III semesters, respectively. Program plans are provided to students during their first semester and should be followed accordingly.  

Students holding commissions in the Armed Services of the United States and having Reserve training obligations will be granted time to meet those obligations to the extent of two weeks per year.  Monthly drills must be accomplished on the student's own time.  Such students should notify the CRNA Program Coordinator of their military obligation upon enrollment within the program for purposes of projecting necessary arrangements.

The Patient Simulation Center (PSC) of the Nurse Anesthetist Program in the School of Nursing, established in 1997, employs advanced simulation technology in the form of a full-body, computer controlled mannequin to support the delivery of specific clinical education to nurse anesthetist graduate students and others involved in the delivery of surgical or resuscitative care. The Center includes an operating room with advanced monitoring and gas delivery systems. The Center provides opportunities for students and clinicians from multiple disciplines for basic and advanced training in anatomy, physiology, pharmacology, acute management of rare or critical events, and crisis resource management. The Center is located in Wende Hall, B03.

Individuals are expected to use good judgment and wear clothing that is appropriate for a professional setting. Individuals should adhere to a minimum of business casual dress and remember that Graduate Registered Nurse Anesthesia Students are representing themselves, the UB Nurse Anesthesia Program, as well as the Nurse Anesthesia profession.

All UB School of Nursing Students in clinical courses are required to obtain the official ID badge approved by the School of Nursing and issued by the UB Card Office. This identification badge must be worn at all times in the clinical area. In the clinical setting, it is expected that Lab coats will be worn for all activities outside the operating room suite. Students are required to purchase a minimum of one (1) Nurse Anesthetist Program lab coat embroidered with the student’s name (for use in patient care areas) and a minimum of one (1) pair of School of Nursing Patient Simulation Center (PSC) scrubs (required for use in the Patient Simulation Center, and not for use in patient care areas) at the UB Medical Bookstore. The lab coats and scrubs will be ordered by October 1 of the first semester within the Nurse Anesthetist Program. The program does not order the scrubs and lab coats for the students. Students will order these as a cohort.

A professional headshot is required prior to the start of clinical residency (NAN 601/NAN 598). It is a requirement that all students wear business formal attire and a lab coat for this photo. Students are encouraged to sign up for a portrait session when offered by the School of Nursing.

In online social networks, the lines between public and private, personal and professional can be blurred. Just by identifying yourself as a representative of the UB School of Nursing, Nurse Anesthesia Program, you are creating perceptions about the Program, the profession, and your expertise. Be sure that all content associated with you is consistent with your abilities and the UB SON’s reputation. Be mindful of what you post about clinical sites, preceptors/other anesthesia providers, coursework, faculty, and always protect the private information that our patients entrust with us.

Remember that what’s put on the internet is discoverable and shareable. Future employers often search applicants’ social media presence. Always be respectful and professional.

Program office equipment is not available for student use. 

*Clinical Residency courses (NAN  601-606, NAN 598, NGC 728-729) provide students with approximate 28 to 36-hour per week experiences respectively. Students will be assigned in the clinical area 4 days per week during the Spring of Year II (i.e., to fulfill the requirements of NAN603 and NGC728 in support of DNP project development), and 3 days per week in the Fall of Year III (i.e., to fulfill the requirements of NAN 605 and NGC729 in support of DNP project implementation). Students assigned an on-call rotation are scheduled for no more than 36-hours per week. Students are never scheduled with less than a 10-hour rest period between scheduled clinical shifts.

**(4-8 hour clinical days and 4-sim days)

NAN 543 Principles of Anesthesia 1 – A study of the mathematical, chemical, and physical principles as they find application in anesthesiology nursing practice. (3 cr)

NAN 544 and 544L Principles of Anesthesia 2 – A continuation of Principles of Anesthesia 1 with a focus upon the scientific bases of anesthesiology nursing practice as they derive from such topics as health assessment, electricity, biochemistry, physiology, biologic hazards, mechanisms of anesthesia, and principles of safe practice. (3 cr)

NAN 545 Principles of Anesthesia 3 – The focus of this course is to prepare the graduate student nurse anesthetist to develop a comprehensive knowledge base from which they can prepare and execute an evidence-based anesthesia plan of care in the following areas: cardiovascular system, respiratory system, nervous system, and regional anesthesia. This course will integrate principles learned in Pathophysiology, Pharmacotherapeutics, Health Assessment, and Principles of Anesthesia 1 and 2. (3 cr)

NAN 546 Principles of Anesthesia 4 – This course is a continuation of Principles of Anesthesia 1 through 3. It provides the nurse anesthesia student with the opportunity to focus on evidence-based anesthesia management of: patients with altered hepatic, renal, gastrointestinal, endocrine, and genitourinary function; the geriatric patient; the pediatric patient; the obstetric patient. This course is built upon principles of anatomy, physiology, pathophysiology, biochemistry, physics, and research. It requires the student to plan for nurse anesthesia care, which is grounded in these principles. (3 cr)

NAN 547 Principles of Anesthesia 5 – A continuation of Anesthesia 1 through 4, this course addresses evidence-based specialty topics in anesthesia care with emphasis on anesthesia for patients having emergency, orthopedic, otolaryngologic, ophthalmic, dental, and oral surgery, as well as patients in outpatient settings, drug or alcohol abusers, and patients with burns or trauma, plasmas, oncology, hematologic disorders. (3 cr)

NAN 598 Introduction to Nurse Anesthesia Practice – This course provides clinical experience within a simulated environment for nurse anesthetist graduate students. Employing simulation techniques, this course provides the graduate student with the opportunity to develop the skillset to support the transition into patient care activities. (2 cr)

NAN 601 Nurse Anesthetist Clinical Practicum 1 – Nurse Anesthetist Clinical Practicum 1 provides clinical experience for nurse anesthetist graduate students. This experience focuses upon the development of beginning competencies in the assessment and management of patients who require anesthesia care. Students are given the opportunity to develop their clinical judgment in collaboration with appropriate health care providers. This preceptorship offers the student a structured environment in which to develop clinical skills. (6 cr)

NAN 602 Nurse Anesthetist Clinical Practicum 2 – Nurse Anesthesia Clinical 2 provides clinical experience for nurse anesthetist graduate students. This experience focuses upon the development of beginning competencies in the assessment and management of patients who require anesthesia care. Students are given the opportunity to develop their clinical judgment in collaboration with appropriate health care providers. This preceptorship offers the student a structured environment in which to develop clinical skills. (8 cr)

NAN 603 Nurse Anesthetist Clinical Practicum 3 – Nurse Anesthetist Clinical Practicum 3 provides clinical experience for nurse anesthetist graduate students. This experience focuses upon the development of beginning competencies in the assessment and management of patients who require anesthesia care. Students are given the opportunity to develop their clinical judgment in collaboration with appropriate health care providers. This preceptorship offers the student a structured environment in which to develop clinical skills. (6 cr)

NAN 604 Nurse Anesthetist Clinical Practicum 4 – Nurse Anesthesia Clinical 4 provides clinical experience for nurse anesthesia students to develop advanced competencies in the assessment and management of patients requiring anesthesia care. The opportunity to refine clinical judgment is provided in collaboration with appropriate health care providers. (8 cr)

NAN 605 Nurse Anesthetist Clinical Practicum 5 – Nurse Anesthesia Clinical 5 provides clinical experience for nurse anesthesia students to develop advanced competencies in the assessment and management of patients requiring anesthesia care. The opportunity to refine clinical judgment is provided in collaboration with appropriate health care providers. (6 cr)

NAN 606 Nurse Anesthetist Clinical Practicum 6 – Nurse Anesthesia Clinical 6 provides clinical experience for nurse anesthesia students to develop advanced competencies in the assessment and management of patients requiring anesthesia care. The opportunity to refine clinical judgment is provided in collaboration with appropriate health care providers. (8 cr)

NAN 672 Clinical Pharmacology of Anesthetic and Adjunctive Drugs - Clinical application of pharmacology to anesthesia with emphasis on an evidence-based application of pharmacological principles inherent to the administration of anesthesia. (3 cr)

NAN 711 Current Topics in Anesthesia I - This course is designed to provide nurse anesthetist graduate students with a forum for the presentation of case studies in anesthesia care, investigation of current evidence-based trends in anesthesia care, and analysis of current issues (regulatory, clinical, legal, safety-related, or political) in anesthesia practice. (1 cr)

NAN 712 Current Topics in Anesthesia II - This course is designed to provide nurse anesthetist graduate students with a forum for the presentation of case studies in anesthesia care, investigation of current evidence-based trends in anesthesia care, and analysis of current issues (regulatory, clinical, legal, safety-related, or political) in anesthesia practice. (1 cr)

NAN 713 Current Topics in Anesthesia III - This course is designed to provide nurse anesthetist graduate students with a forum for the presentation of case studies in anesthesia care, investigation of current evidence-based trends in anesthesia care, and analysis of current issues (regulatory, clinical, legal, safety-related, or political) in anesthesia practice. (1 cr)

NAN 714 Current Topics in Anesthesia IV - This course is designed to provide nurse anesthetist graduate students with a forum for the presentation of case studies in anesthesia care, investigation of current evidence-based trends in anesthesia care, and analysis of current issues (regulatory, clinical, legal, safety-related, or political) in anesthesia practice. (1 cr)

NAN 718 Professional Aspects of Nurse Anesthesia I - This course is the first in a series of two one-credit courses designed to provide a basis for professional socialization to nurse anesthesia practice. The role of the nurse anesthetist is examined from the perspective of specialty-specific philosophical bases of caring, professionalism, scope of practice, standards of care in anesthesia practice, the role of professional organizations, legal and regulatory issues in anesthesia practice, and malpractice. (1 cr)

NAN 719 Professional Aspects of Nurse Anesthesia II - This course is the second in a series of two one-credit courses designed to provide a basis for professional socialization to nurse anesthesia practice. The role of the nurse anesthetist is examined from the perspective of the specialty-specific role within a complex healthcare environment, practice options and designs, employment and entrepreneurial options, specialty-specific ethical considerations, and personal growth as a professional within the specialty, within nursing, and within society. The course will address issues of substance abuse and highlight the role of peer assistance initiatives and resources. (1 cr)

NAN 721 Anesthesia Crisis Resource Management 1 – The first in a series of two one-credit courses, this course provides nurse anesthetist graduate students with an introduction to the principles of crisis resource management and evidence-based techniques within an advanced, high-fidelity simulation environment. (1 cr)

NAN 722 Anesthesia Crisis Resource Management 2 – The second in a series of two one-credit courses, this course provides nurse anesthetist graduate students with continuing involvement in crisis resource management and evidence-based techniques within an advanced, high-fidelity, simulation environment. (1 cr)

Throughout their clinical residency experience, students acquire cognitive, affective and psychomotor skills integral to anesthesia nursing practice. During this clinical practicum, students are afforded the opportunity to plan and administer all types of currently accepted general and regional anesthetic techniques to a variety of patients ranging in medical and surgical acuity. At all times while in the clinical environment, students are supervised, instructed, counseled, and evaluated by nurse and/or physician anesthetist clinical preceptors. Students should prepare for each clinical day by researching and reading about their patients’ conditions, medications, and planned procedures (based on available information/schedules), formulating an individualized Plan of Care (see page 28-29) for each patient. Throughout their residency, students function at levels of expectation that derive from their level within the Clinical Residency ranging from I-VI. The “Achievement Level Guidelines” detail the differences in expected achievement as students progress in the program. Students receive both verbal and written feedback on a daily basis from their clinical preceptors via the “Daily Progress Report." Students have access to these reports at the clinical sites on a daily basis and are encouraged to read them often. Students will receive formative and evaluative input from the Clinical Site Coordinator during the clinical practicum on an “as needed” basis. Students will receive a “Summative Evaluation of Clinical Performance” from the Clinical Site Coordinator (See pages. Students have the opportunity at this time to offer written self-evaluative comments on their progress. Students are responsible to schedule and meet with Clinical Coordinators to discuss their clinical rotation and clinical performance prior to the last day of that rotation. The student is to receive a “Summative Evaluation of Clinical Performance” at the end of respective rotations.  The student receiving the evaluation should self-evaluate/provide comments and sign the evaluation at the time of this meeting.  After completion of the clinical rotation each student should complete an evaluation of the clinical site. This summative evaluation will reflect student performance of this rotation.

The Program Director and Clinical Residency Coordinator meet with Clinical Faculty at Clinical Coordinators meetings where the progress of each student is discussed.

Students earn a grade for NAN 601 through NAN 606 based on their overall performance within the Clinical Site(s) during the semester or session in which they are enrolled. The grade for NAN 603 taken during the Spring Semester will be based on work done during the Spring Semester, as well as work done during the two week time period immediately preceding the resumption of didactic instruction for the Spring Semester.  

Clinical events that will lead to dismissal from the program

Students who receive an unsatisfactory evaluation during a clinical rotation will be given the option to accept the evaluation or ask for a review to be done by the program director and clinical coordinator.

 A review will consist of all written documentation including daily evaluations, summative evaluation and any other written communications between clinical coordinators, the student in question, and clinical preceptors. Comments made verbally will not be considered. After a review the program director and clinical coordinator will choose to accept the unsatisfactory evaluation or alter it satisfactory based on the evidence/facts provided. The student will be notified, in writing, of the decision made. If the review is taking place due to a second unsatisfactory evaluation, the student will not be able to continue in clinical until the review is completed and the student will be required to make up any missed time due to the review. A review must be requested within 72 hours of receipt of the summative evaluation. Any request for review after 72 hours will not be considered and the unsatisfactory evaluation will stand.

Students who receive a total of two unsatisfactory evaluations and fail to have them reversed through appeal, at any time during the clinical coursework portion of the program, will be dismissed from the program regardless of overall grade in the course.  

The Clinical Residency component of the Nurse Anesthetist Program consists of NAN 598, and NAN 601 through NAN 606, and NGC 728/729. The Clinical Residency extends from the second Summer through the third Spring of this three-year program of studies. The Clinical Residency provides students with an approximate 36-hour per week experience.

Prior to beginning the Clinical Residency, students in the Nurse Anesthetist Program must successfully completed the following courses:

Students within the Nurse Anesthetist Program are required to successfully complete and maintain training in Basic Life Support, Pediatric Advanced Life Support and Advanced Cardiac Life Support. In addition, graduate students must have them current at the time of graduation from the Program.

Nurse Anesthetist Graduate Students will be required to maintain a dossier for credentialing purposes within the Clinical Residency portion of the Program. Students will be asked to assemble their dossier prior to entering the Residency portion. This dossier will be reviewed by the Clinical Residency Coordinator.

• New York State nursing license
• ACLS/BLS/PALS
• Immunizations (TB (lot # needs to be included)
• History and Physical (some sites require MMR & Hep B titers)
• CV (resume)
• Influenza immunization verification (wearing of mask on campus and at clinical sites if refraining from being immunized)
• Covid -19 vaccine verification

The Clinical Residency consists of two Summer Sessions, two Fall Semesters, and two Spring Semesters. Students will follow the Academic calendar with the exception of a two-week break between the Fall and Spring Semesters during Years II and III of the Program.

Clinical sites are located throughout Western and Central New York State. Students must provide for their own transportation and incidental expenses at the clinical sites. Students must also be aware that some clinical rotations require overnight stays for several days in succession with return to Buffalo for class. It is the responsibility of the student to make the personal arrangements necessary for them to be away from home and manage personal responsibilities during these times. During the winter months when travel may be hazardous, it is expected that the student will make every reasonable effort to be present at the clinical site for their assignment. These efforts may include traveling the day prior to the assigned clinical day if the site is outside of metro Buffalo.

The number of hours of an assigned clinical day varies. The Clinical Residency Coordinator in collaboration with the CRNA preceptor determines the time of completion of the daily assignment. Nurse Anesthetist Graduate Students will not assume an ending time for the clinical day nor should they request an ending time from a Clinical preceptor unless this request is cleared first with the Clinical Director or Program Director.

Under no circumstances is a graduate student to change or adjust his or her assigned clinical schedule without prior approval by the Clinical Residency Coordinator or Program Director. Students cannot make the determination whether make-up time will consist of additional hours or a full day assignment. Only the Clinical Residency Coordinator or Program Director will make this determination. During the Clinical Residency, students also will follow the holiday schedule of the Clinical Site to which they are assigned

The Self-Evaluation Examination (SEE) is administered by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA).

In order to self-assess, assess readiness to successfully sit for the National Certification Examination offered by the NBCRNA, and complete specific course requirements, at prescribed times within the curriculum (i.e., during the Fall II and Fall III semesters while enrolled in Clinical Practica II (NAN602) and V (NAN605) respectively, students are required to sit for the SEE offered by the NBCRNA.

Currently, it is anticipated that the SEE will be taken twice: once in the Spring II semester, and once in the Spring III semester prior to February 1. Plan on registering and paying testing fees in the Fall II and Fall III semesters.

This policy is subject to change as more information is gathered from SEE.

The SEE Student Handbook, SEE Frequently Asked Questions, and Interpretive Guide are available on the NBCRNA website.

To ensure optimal experience for student learning, clinical departments participating in this program are expected to afford students opportunity to progressively participate in the full anesthesia management of patients under the tutelage and supervision of the clinical faculty. It is never appropriate for graduate nurse anesthetist students or physician residents to act as the sole agents responsible for the student.

Anesthesia management for the nurse anesthetist student is defined to include the following:

a. Patient interview and assessment, collecting necessary data on which to develop an anesthesia care plan; when data is incomplete and further work up is indicated. Suggestion for such work up will be made to the supervising anesthesiologist.

b. Psychological preparation of the patient for the anesthesia experience including:

• Informing the patient of the general plan for anesthesia, potential risks, and reaching agreement with patient on the overall approach.
• Answering patient questions about his/her anesthesia.
• Giving opportunity for the patient to express verbally or non-verbally, directly or indirectly, any fears and/or anxieties associated with the planned experience.
• Assisting the patient to constructively deal with such fears, anxieties or other concerns.

c. Pharmacologic preparations of the patient to include the suggesting/or ordering (within medically established guidelines) of premedication drugs individualized to meet patient requirements.

d. Providing patient instruction with reference to:

• Need for patient cooperation in planned management.
• Withholding of food and fluid.
• Reduction or elimination of smoking.
• Emptying bladder before coming to anesthesia.
• Precautions relative to ambulation following premedication.
• Activities in the OR that will precede actual anesthesia induction.
•  What to expect during actual induction of general anesthesia or during administration of regional anesthesia.
• What to expect upon emergence.
• Needed patient cooperation in the post-anesthesia period to minimize the risk of anesthesia complications.

a. Applying and utilizing appropriate monitoring modalities for assessing patient responses to anesthesia and surgery.

b. Initiating and managing fluid therapy during the anesthesia and surgical experience, including blood replacement or blood substitute therapy as may be required.

c. Selecting anesthetic agents, techniques and assembling appropriate equipment/supplies necessary to meet patient requirements and assure his/her safety.

d. Administering a physiologically sound anesthetic, creating necessary surgical conditions within the limits of patient tolerance.

e. Monitoring patient responses to anesthesia, position, and surgery, taking appropriate actions as may be required to maintain patient in a proper physiologic balance.

f. Managing emergence from anesthesia within the confines of patient and surgical requirements.

g. Protecting patient from iatrogenic complications.

h. Keeping the surgeon, anesthesiologist and/or other appropriate physicians, informed of the patient's physiological status and any need for their assistance and/or cooperation in attaining or maintaining the patient's physiologic balance.

i. Documenting the care provided along with the patient responses.

a. Providing safe movement and transport of patient between OR and post anesthesia recovery or intensive care.

b. Transferring responsibility for post anesthesia care to qualified personnel, providing necessary psycho-social-physiologic information needed for safe, optimal recovery from anesthesia.

c. Making reoccurring assessments of the patient over a period of 48-72 hours, or longer if indicated, with reference to anesthetic complications and patient satisfaction.

d. Consulting with appropriate nursing personnel about patient care as may be required to minimize risk of complication or to assure early detection.

e. In the event of identification of anesthetic complications, intervening as might be appropriate, including reporting and documenting the problem

f. Reviewing the anesthetic management of the patient for effectiveness of planning and implementation and lessons that can be learned for future considerations.

g. When individual patient response to drugs, anesthetic techniques, etc. have implication for his/her future requirements for anesthesia, discussing these with the patient, impressing upon him/her the need to communicate this information to whomever provides subsequent anesthesia care; insure that such information is documented in his/her current health record. 

All students are required to purchase the Nurse Anesthesia Tracking System for easy, accurate documentation and tabulation of required anesthetic cases/numbers. An orientation to the system will be provided during NAN 598. Data should be entered on a daily basis. Case experiences reported on Daily Progress Reports must be congruent with those reported to Typhon. Any incidences of forgery in Typhon will be considered a breach of academic integrity, and the School of Nursing’s Honor Code. Forgery of clinical hours, cases performed, or procedures done, will lead to a meeting with the clinical coordinator and program director and may result in dismissal from the program