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Under the supervision of an Attending Anesthesiologist, this employee administers, monitors and manages patient's care before and after anesthesia. Relies on experience and judgment to plan and accomplish goals. Performs a variety of tasks. Reports to Attending Anesthesiologists. A certain degree of creativity and latitude is required. Nurse Anesthetists will rotate responsibility for daily scheduling of case coverage.
Responsibilities

1. In conjunction with attending anesthesiologist, Nurse Anesthetist will perform a thorough and complete pre-anesthesia assessment. Nurse Anesthetist is responsible for obtaining reviewing relevant tests and discussing findings with the Attending.
2. The Nurse Anesthetist shall obtain or verify that an informed consent has been obtained for the planned anesthetic intervention from the patient or legal guardian. Discuss anesthetic options and risks with the patient and/or legal guardian after discussion with Attending Anesthesiologist. Nurse Anesthetists must document in the patient's medical record that informed consent was obtained.
3. The Nurse Anesthetist, in conjunction with the Anesthesiologist, must formulate a patient-specific plan for anesthesia care. The plan is based upon comprehensive patient assessment, problem analysis, anticipated surgical or therapeutic procedure, patient and surgeon preferences and current anesthesia principles.
4. The Nurse Anesthetist shall induce anesthesia under the supervision of an Attending Anesthesiologist and maintain anesthesia at required levels. The Nurse Anesthetist shall continuously assess the patient's response to the anesthetic and/or surgical intervention and must immediately notify the Attending Anesthesiologist of significant changes in the patient's condition and intervene as required, under the supervision of an Attending Anesthesiologist to maintain the patient in a satisfactory physiologic condition.
5. The Nurse Anesthetist must monitor the patient's physiologic condition as appropriate for the type of anesthesia and specific patient needs:
   A. Monitor ventilation continuously. Verify intubation of the trachea by auscultation, chest excursion, and confirmation of carbon dioxide in the expired gas.
   Continuously monitor end-tidal carbon dioxide during controlled or assisted ventilation. Use spirometry and ventilatory pressure monitors.

B. Monitor Oxygenation continuously by clinical observation, pulse oximetry, and if indicated, arterial blood gas analysis.
C. Monitor cardiovascular status continuously via electrocardiogram and heart sounds. Record blood pressure and heart rate.
D. Monitor body temperature continuously on all pediatric patients receiving general anesthesia and when indicated, on all other patients.
E. Monitor neuromuscular function and status when neuromuscular blocking agents are administered.
F. Monitor and assess the patient positioning and protective measures. The omission of any monitoring standards shall be documented and the reason stated on the patient's anesthesia record. The Nurse Anesthetist shall be in constant attendance of the patient until another qualified health care provider has accepted the responsibility for care.
6. The Nurse Anesthetist is responsible for maintaining complete, accurate, and timely documentation of pertinent information on the patient's medical record. Must document all anesthetic interventions, and patient responses.
7. The Nurse Anesthetist is responsible for transferring the responsibility for care of the patient to other qualified providers in a manner that assures continuity of care and patient safety.
8. The Nurse Anesthetist must adhere to appropriate safety precautions, as established within the institution, to minimize the risks of fire, explosion, electrical shock and equipment malfunction. Document on the patient's medical record that the anesthesia machine and equipment were checked.
Prior to use, the Nurse Anesthetist shall inspect the anesthesia machine and monitors according to established guidelines. The Nurse Anesthetist shall check readiness, availability, cleanliness, and working condition of all equipment to be utilized in the administration of the anesthesia care. When the patient is ventilated by an automatic mechanical ventilator, monitor the integrity of the breathing system with a device capable of detecting a disconnection by emitting an audible alarm. Monitor oxygen concentration continuously with an oxygen supply failure alarm system.
9. Precautions shall be taken to minimize the risk of infection to the patient, the Nurse Anesthetist, and other healthcare providers.
10. The Nurse Anesthetist shall participate in the ongoing review and evaluation of the quality and appropriateness of the anesthesia care as a member of the Department of Anesthesiology. Evaluation shall be performed based upon appropriate outcome criteria and reviewed on an ongoing basis. The Nurse Anesthetist shall participate in a continual process of self-evaluation and strive to incorporate new techniques and knowledge into the practice.
11. The Nurse Anesthetist will participate in departmental Grand Rounds, presenting their cases as appropriate.
12. The Nurse Anesthetist shall respect and maintain the basic rights of patients.
13. The Nurse Anesthetist assists in research projects as directed by an anesthesiologist.
14. The Nurse Anesthetist may supervise and teach Student Registered Nurse Anesthetists (SRNAs)
Qualifications
Nurse Anesthetists must be a graduate of an accredited school of nurse anesthesia and be a Certified Registered Nurse Anesthetist (CRNA) with proof of current certification and with experience in anesthesiology acceptable to the Chairman/Director of Anesthesiology and/or minimum of 1-2 years work experience.
Nurse Anesthetist must have completed appropriate accredited training program and clinical rotations and must have graduated from degree program.
One year experience in an acute care nursing setting.
Must have current valid NYS nursing licenses.
Must be certified by the Council of Certification of Nurse Anesthetists. (New graduates are allowed 12 months to comply with the standards of certification); recertification bi-annually according to the standards of the Council of Recertification CNA.
Basic MS Word, internet, and research engine skills required.
Excellent written and oral communication skills.
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Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 48,000 employees working across eight hospitals, more than 400 outpatient practices, more than 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time - discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it. Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients' medical and emotional needs at the center of all treatment. The Health System includes more than 9,000 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics, top 5 in Cardiology/Heart Surgery, and top 20 in Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report's "Best Children's Hospitals" ranks Mount Sinai Kravis Children's Hospital among the country's best in several pediatric specialties. The Icahn School of Medicine at Mount Sinai is ranked No. 11 nationwide in National Institutes of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek's "The World's Best Smart Hospitals" ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally.
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The Mount Sinai Health System is an equal opportunity employer, complying with all applicable federal civil rights laws. We do not discriminate, exclude, or treat individuals differently based on race, color, national origin, age, religion, disability, sex, sexual orientation, gender, veteran status, or any other characteristic protected by law. We are deeply committed to fostering an environment where all faculty, staff, students, trainees, patients, visitors, and the communities we serve feel respected and supported. Our goal is to create a healthcare and learning institution that actively works to remove barriers, address challenges, and promote fairness in all aspects of our organization.