Kenneth Wofford, Ph.D., CRNA, LCDR (USN), is an assistant professor in the graduate school of nursing and nurse anesthesia program at the Uniformed Services University of the Health Sciences in Bethesda, Md.
Q. When did you decide to pursue a career in nursing and why?
A. I was a Hospital Corpsman (a Navy medic) when I made the decision to become a nurse, so I was already working in medicine and had worked with nurses. My career counselor thought I was pretty bright and felt that I had the potential to succeed at college, so he introduced me to a senior nurse and we had some frank and open conversations about the nursing career path. On the basis of those conversations, I decided that the career sounded like something I would enjoy and applied to nursing school.
Q. What led you to choose nurse anesthesia as a profession?
A. I was an intensive care unit (ICU) nurse for four years before applying to nurse anesthesia training. The part of ICU nursing that I liked best was the problem-solving it required. Basically, in the ICU setting, the patient can be viewed as a system that is not working properly, and you have to constantly and quickly choose and apply the best interventions to restore him or her to proper working order (i.e., health). Anesthesia is a logical extension of that environment, with only one patient at a time, more independence and even more time pressure.
Q. What are the primary roles and responsibilities of a nurse anesthetist?
A. The biggest role of a nurse anesthetist is to safeguard the patient during surgery. One part of that role is to create a situation where patients can undergo a physiologically stressful surgery without remembering anything, feeling pain or moving, while still ensuring that they continue to ventilate, oxygenate and perfuse. That's the physical side. The other part of that role is to ensure that patients feel like they are being looked after and that the team has their best interests at heart. That's the cognitive and emotional side, and it's just as important.
Other roles are to ensure patients are adequately prepared to undergo surgery, to treat pain in almost any patient (including women in labor) and to resuscitate critically-ill patients in crisis situations. The responsibility is full circle. Patients who undergo surgery are put into the hands of nurse anesthetists and are basically helpless during the surgery, so it's up to the nurse to provide the best care possible.
Q. What are the most rewarding and challenging aspects of being a nurse anesthetist?
A. The most challenging aspect is to remain calm in crisis situations. You have to recognize and try to head off risks, but never let yourself get paralyzed into indecision. The most rewarding part of being a nurse anesthetist is the trust patients have in you and the opportunity you have to make a difference in their lives. When people trust you completely and when you come through for them, it's a great feeling. For example, if someone says 'Every time I've had surgery I've gotten badly sick,' and you use your knowledge to prevent that and give them a comfortable recovery, then you really feel like you've made a difference.
Q. How has nursing impacted your life?
A. Being a nurse has made me a better human being. Nursing has given me an underlying purpose. I've helped a lot of babies take their first breath, and I've been there to take away the pain of many people taking their last breath. There's something sacred about being able to participate in the entire cycle of human life, and to have the opportunity to make it better for patients and their families. In 18 years as a nurse, I've never walked away from work and said, 'What's the point of doing this?' It has also made me a calmer person. When you've spent so much time close to the ends and beginnings of life, getting cut off in traffic just doesn't rate getting worked up.