Transforming CRNA practice: One nurse’s story


This is the third of the APNs Transforming Care series brought to you by the Johnson & Johnson Campaign for Nursing’s Future.


By Janice Petrella Lynch, MSN, RN A


li Baghai, MS, CRNA, knew he wanted to help people, but he wasn’t sure how. He decided to major in psychology in college hoping to care for people like his mother who


suffered from mental illness. His experiences at the Hole in the Wall Gang Camp, a summer


camp in Connecticut for children with cancer and other chronic and terminal illnesses, was life changing. While helping run a weekend retreat for campers with sickle cell anemia, Baghai cared for an ad- olescent in crisis, whose pain he couldn’t relieve no matter what he did. Reflecting on that, he knew he’d found his calling and transferred to Boston College school of nursing. Baghai worked in pediatric emergency medicine and surgical ICU at major medical centers for five years after nursing school. Becoming a CRNA was a seed planted in nursing school that later germinated in the ICU because the knowledge, clinical skills and critical thinking of an ICU nurse are applicable to the CRNA role, he said. In 2006, Baghai was one of 15 applicants out of more than 400


to be accepted into the CRNA program at Midwestern University in Glendale, Ariz. “I took to anesthesia like a duck to water and realized that being a CRNA was exactly what I was meant to do,” he said. Ten years later, Baghai loves his role. “We have about 10 minutes


to assess the patient, develop and discuss an anesthetic plan with the patient, and establish trust,” he said. “Then we become practical pharmacologists, administering correct medications at proper doses to place patients in an anesthetic state.” The caring side of anesthesia is a real draw for Baghai. Surgery is a major stressor, and patients are vulnerable and need someone to calm their fears and ease them through the process, he said. Baghai’s work involves many technical aspects, including intubat-


ing, inserting central lines, and administering epidurals, spinals and peripheral nerve blocks, and he said he loves working with his hands to provide quality care. Once surgery is complete, the anesthetist


must wake the patient at the right time, Baghai said, making an analogy between anesthesia and flying a plane. “It’s all about takeoffs and landings, doing it smoothly and properly to keep our patients safe.” As a CRNA, he has worked as an independent contractor at hos-


Ali Baghai MS, CRNA


pitals, surgery and endoscopy centers, and pain clinics, and for the past three years he has been working full-time at Tempe St. Luke’s Hospital in Arizona, where he serves as chief CRNA. Baghai has assumed a number of roles in the Arizona Association of Nurse Anesthetists, where he is now president. He co-founded the CRNAs of Arizona PAC, and helps lead the Arizona APRN Coalition, whose goal is to gain full practice authority for the state’s APRNs. This past legislative session Baghai was asked to lead the co- alition, which presented “monumental legislation that met all IOM recommendations for practicing APRNs,” he said. “Despite our efforts, the evidence, support from third-party groups, letters from nearly 200 independent physicians, thousands of letters and emails from constituents, and concessions our group made, we didn’t have enough votes to see our legislation through to law.” Although a disheartening experience, Baghai knew they had


increased public and legislators’ knowledge about the CRNA role, which was previously one of healthcare’s best kept secrets, he said. Three months since the coalition pulled its legislation, Baghai is bringing the group together to make another run with a different strategy for the next legislative session, with some fresh ideas from new leaders, he said. “My juices are flowing as we prepare for the next battle!” Hanging in his young son’s bedroom is a poster summing up Baghai’s advice to others considering an APRN role: Shoot for the moon, even if you miss you will land among the stars.


Janice Petrella Lynch, MSN, RN, is nurse editor/nurse executive. 15


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