A new program to increase the number and diversity of nurse anesthetists provides a launchpad for aspiring CRNAs
Travel nurse Mya Williams, RN, had applied to half a dozen nursing anesthesia programs, advancing to final-round interviews multiple times.
Yet even after years of building her credentials and qualifications, Williams couldn’t gain admission to one of the limited number of highly competitive advanced degree programs for certified registered nurse anesthetists (CRNA).
“You start to believe it’s a sign to not pursue this career,” said Williams.
A mentor told her about a different approach: a new program at Case Western Reserve University’s Frances Payne Bolton School of Nursing, known as the Leadership Excel and Achievement Program (LEAP). The one-year preparatory program is designed as an introduction to content in a traditional three-year CRNA doctoral program, including chemistry, physiology and pathophysiology, and preparing scholarly work.
“It provides opportunity for nurses deserving of a chance to prove themselves,” said Williams, who enrolled as a member of LEAP’s first cohort in 2021.
Upon completing the LEAP certificate, Williams gained admission into one of the program’s 11 partnering CRNA programs around the country. Her first choice was close to her Cleveland home—at Case Western Reserve University, where she is in her first year.
“The program prepared me for the rigors of graduate school,” said Williams, who has started her clinical rotations at Summa Health in Akron. “It’s provided a foundation for my next career—and the confidence and hope to get there.”
Meeting the need
Demand for CRNAs will increase by nearly 50% by the end of the decade, according to the U.S. Bureau of Labor Statistics. Now in its second year, LEAP has attracted positive attention for demonstrating an inventive way forward for a field that’s in need of thousands of new professionals, but with relatively few doctoral programs to train them.
The field also needs more diversity in its ranks. Only 11% of nurse anesthetists are people of color, according to the Diversity in Nurse Anesthesia Mentorship Program.
LEAP aims to create a more equitable CRNA workforce, said Sonya D. Moore, DNP, CRNA (GRS ’16, nursing), director of LEAP and the nurse anesthesia Doctor of Nursing Practice program at Frances Payne Bolton School of Nursing.
Like Williams, many students joining LEAP have been denied entry into doctoral programs—despite stellar resumes, qualifications and recommendations, Moore said. Several are from communities that are underrepresented in the CRNA field.
“We have interviewed students for LEAP and think ‘Why are they not in CRNA programs?’” Moore said. “Even with competitive applicant pools, we can’t understand why they are not accepted.”
But, Moore, also an assistant professor of nursing, continued, “It’s through no malicious intent that advanced nursing programs end up with classes that often look the same, and this creates a lack of diversity in the field, year after year.”
While there are similar preparatory programs for medical-school hopefuls, LEAP is the only one of its kind for qualified nurses who aspire to become CRNAs and are seeking another route into an accredited program.
“It’s a very well sought-out profession—really drawing the cream of the crop of nurses,” said Kimberly Rodriguez, DNP, CRNA, LEAP’s faculty coordinator. “We are providing another on-ramp for nurses who have shown they have what it takes to enter the field.”
The program is proving to be a success. In the first pilot year, all nine students earned the one-year certificate and are enrolled in CRNA programs around the country. Enrollment in its second cohort more than doubled. Hundreds of nurses have applied to join each year.
What’s more, the program also expanded its coalition of partner institutions, including Columbia University, Emory University, the Medical University of South Carolina and University of Arizona. Each agrees to accept two LEAP students each year. (Students must meet the requirements of all partner CRNA programs to gain admission to LEAP.)
“There is a lot of weight on our shoulders as the first class,” said Williams, “but we are honored to help Dr. Moore’s dream become a reality.”
Repaying opportunity in kind
Growing up in East Cleveland, Moore was attracted to nursing anesthesia after shadowing a CRNA through a high school STEM program.
“When I looked at medical professions, nursing and anesthesia seemed to be the best of all worlds,” said Moore, “combining science, technology and the human aspect of caring.”
Still, if not for influential mentors along the way, key opportunities may have not been available to her. Throughout her education, Moore was often the only minority in her advanced nursing courses. In her career as a CRNA and as a faculty member, Moore continually noticed an unacceptable homogeneity in the field.
“It’s important to make diverse individuals aware of the profession,” she said. “As a nursing leader, I knew I needed to put myself out there to help others be successful.”
This message resonated with Earl Pirante, RN, a cardiothoracic intensive care nurse at University of Chicago Medical Center, who learned of LEAP from Moore during her presentation at a virtual conference.
Originally from the Philippines, Pirante worked as an intensive care (ICU) nurse in the capital city of Manila and in Abu Dhabi, United Arab Emirates—hoping to build experience to work in the U.S. and, eventually, to earn an advanced nursing degree.
“Because of immigration issues, there weren’t enough visas, so I waited for 10 long years,” said Pirante, who moved to the U.S. in 2018 with his wife (also a nurse) and their young daughter. “For me to become a nurse anesthetist, it’s my family’s dream, too.”
Even with a decade-plus of ICU experience, multiple advanced certifications and graduate electives to bolster his qualifications, Pirante knew gaining admission into a CRNA program would be difficult, given that his education and professional experiences largely took place outside of the U.S. This past summer, he joined LEAP’s second cohort.
“The program is giving me—an immigrant, a minority—a chance,” he said. “The professors recognize the cultural competency I bring to my work that helps me better understand patient perspectives and the care they need.”
Now in his first year at Columbia, Marco Oliveros, RN, often looks back at lecture notes taken in his LEAP classes—particularly in anesthesia pharmacology. (Like anesthesiologists, CRNAs can order diagnostic tests and prescribe medicine, though must work under the supervision of a board-certified physician in some states.)
“I would do it over again, in a heartbeat,” said Oliveros, originally from the Philippines. “I have not met a CRNA unhappy with the career choice they made.”
Loving the work
Most LEAP students are nurses living and working throughout the U.S. Classes and didactics are mostly held online.
“It’s already making me a better nurse in the ICU,” said Khadijat Badejo, RN, a LEAP student who works at Cook County Hospital in Chicago. “It’s allowing me to be more knowledgeable of the pathology in my patients and have a deeper understanding of their treatments. I am building off the knowledge I already have.”
LEAP cohorts also meet in person. Toward the end of the academic year, a skills-training and patient simulation workshop will bring students together at Emory University School of Medicine in Atlanta.
Mentorship and professional socialization are also an emphasis of the program. In early spring 2023, the LEAP cohort will gather at the American Association of Nurse Anesthesiology Mid-Year Assembly to network with leaders in the field.
“Becoming a CRNA changes your life,” said Moore. “With the security and autonomy the career provides, the trajectory of families and communities can be changed—another reason why it’s important to help the profession reflect the wider world.”
She added, “And when you love the work you do, you thrive—and have a duty to lift up others, too.
This article appears in the Fall/Winter 2022 issue of Forefront Magazine.