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anesthesia care
After graduating from the School of Nursing, Casey Wangen headed home to Crookston to be a CRNA by Brett Stursa Trauma is everywhere and Crookston, Minnesota — a town of 8,000 located 100 miles from the Canadian border — is no different. As a nurse anesthetist at the local hospital, Casey Wangen, DNP ‘16, APRN, CRNA, knows that means his days are often high-stress and fast-paced.
At the critical access hospital in town, RiverView Health, Wangen is one of four CRNAs that provide all the anesthesia services — including surgical anesthesia, pain management, vascular access and emergency services — for the 25-bed hospital with about a dozen surgeons.
“It is a lot of adrenalin and requires fast-on-yourtoes thinking. It is very dynamic and changes by the minute. Your day can go from nothing to a 17-hour shift,” said Wangen.
His work varies compared to that of peers he graduated with at the University of Minnesota, who largely practice in metro areas. “Their scope of practice is different than mine. I’m responsible for providing a variety of services throughout the entire hospital, whereas larger facilities have separate staff for different areas,” said Wangen. “Most of them are not doing regional anesthesia, like placing epidurals and spinal anesthetics, which is more the practice of their physician colleagues.”
In one day he can see the full spectrum of life, resuscitating a premature newborn and then hours later be in surgery with a 99-year-old with a broken hip. “One day I am doing lots of regional anesthesia, or blocks, then I am doing lots of spinal anesthesia for knee or hip replacements,” said Wangen. “We get to do emergency cases, traumas, and we are in obstetrics helping with labor pains. Then 10 minutes later I can be in the ER stabilizing a person who just got crushed by a bull or got an arm taken off by a piece of farm equipment. Like, boom, just like that my day changed. I love the responsibility. No day is even close to the same. I like that.” Across rural America, Certified Registered Nurse Anesthetists (CRNAs) are the primary providers of anesthesia care. In Crookston, CRNAs are the only providers of anesthesia care.
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As a nurse anesthetist in rural Minnesota, he said he spends anywhere from 30 to 70 hours at the hospital each week. He leans on regional anesthesia, or blocks, which are easier to recover from and typically mean less opioids are prescribed in the end. “It is very personalized,” said Wangen. Wangen says that practicing in a small town means that he knows many of his patients. continued on page 40
