A Short History of CANA

The first advanced practice specialty in nursing began in the northeast United States (U.S.) in the 1880's. Nurses have given anesthesia since the Civil War. As a general practice, nurse anesthesia grew out of the Mid-West during the 1880s and by the 1890s was well established across the country. Together with the advent of professional nursing and the discovery of the pronciple ascepsis, nurse anesthesia ushered in the age of modern surgery.

The earliest nurse anesthetist in California, noted in historical records, was a U.S. trained British nurse who administered anesthetics at Saint Mary's Hospital in San Francisco in the 1920's. Ms Alta Bates (for whom the community hospital in Berkeley is named) was another prominent early California anesthetist. The December 1955 CANA bulletin reported that Ms Bates was the first graduate of a nurses training program in Eureka and the "first woman in the bay area to become an outstanding anesthetist." Ms Bates administered over 14,000 anesthetics in a career that lasted over 15 years.

As nurses gained a foothold in the profession during the early years of the twentieth century, organized opposition to nurse anesthesia arose from physician anesthetists. California was to become a major battleground for this conflict. This fight would give rise to the first state association of nurse anesthetists and lead to a California Superior Court decision affirming that anesthesia is a part of the practice of nursing.

Ms Adeline Curtis, a nurse anesthetist who had been working in Anaheim since 1921, received a letter from the California Board of Medicine in 1928, informing her that she was practicing anesthesia illegally. Ms Curtis spent her savings seeking legal advice. These efforts resulted in an Attorney General's opinion stating that there was no law in California forbidding nurses from administering anesthetics. Ms Curtis continued her activism by traveling around the state informing her colleagues of the threat to nurse anesthesia practice. This lead to the formation of the California Association of Nurse Anesthetists (CANA) in 1930 with Ms Sophie Gran Winton, a nurse decorated for her valorous service in France during World War I, installed as the first president.

In 1935, the California Association affiliated with the newly formed National Association of Nurse Anesthetists, the predecessor of the current American Association of Nurse Anesthetists (AANA). Since this time, CANA has remained the voice and leader for CRNA's in California. Because of CANA's continuous efforts in conducting regular educational meetings, producing a widely read news bulletin, participation in legislative activities in both Sacramento and Washington DC, and committed activism to making positive legislative, regulatory, and professional gains, CRNA's, today, enjoy an independent and respected scope of practice to provide quality health care for Californians.

Surgical anesthesia was discovered in 1846, and was soon recognized as the greatest American contribution to medicine of the nineteenth century. Anesthesia together with the emergence of professional nursing and the discovery of the principles of asepsis brought forth the age of modern surgery. But the wonder of anesthesia was soon overshadowed when its dangers became apparent. Patients died from asphyxiation, because at first, anesthesia was poorly administered by student physicians who had more interest in learning surgery than anesthesia. In order for the public to trust that surgery was safe, surgeons would need capable anesthetists who were devoted solely to the safe care of patients under anesthesia. It was felt that nurses were well suited to this job because they were intelligent, vigilantly attentive to patients, and would accept a subordinate role to the surgeon. Thus in the 1880's, the first advanced nursing specialty was born, nurse anesthesia.

Although it is unclear who the first nurse anesthetist was who practiced in California, a British nurse who obtained anesthesia training in the United States is the earliest person mentioned in the records of the California Association of Nurse Anesthetists. She administered anesthetics at the Saint Mary's Hospital in San Francisco, in the 1920s.

Alta Bates, for whom a community hospital in Berkeley was named, was another prominent early California nurse anesthetist. The CANA Bulletin of December, 1955 reported that she was the first graduate of a nurse's training program in Eureka, and the first woman in the Bay Area to become an outstanding anesthetist. Alta. Bates administered over 14,000 anesthetics during a career lasting more than fifteen years.

Adeline Curtis was a nurse anesthetist who worked at the Johnson Wickett Clinic in Anaheim. In 1928 Adeline received a letter form the Board of Medicine informing her that for a nurse to practice anesthesia was illegal. Adeline quit her anesthesia practice, and spent her savings to determine if in fact she had broken any laws. With help from an attorney, Adeline obtained an opinion from the California Attorney General informing her that there was no law in California forbidding nurses from administering anesthetics. In fact, the California Superior Court ruled that anesthesia was a part of the practice of nursing. Adeline resumed her anesthesia practice, but traveled around the State to inform her colleagues of the threat to nurse anesthetists. As a result of Curtis' efforts the California Association of Nurse Anesthetists was formed February 3, 1930. Sophie Gran Winton, a nurse anesthetist decorated for valorous service in France during WWI, became the first president.

In 1935, the California Association affiliated with the newly formed American Association of Nurse Anesthetists. CANA membership and activities expanded greatly in the 1940s and 50s. From thirteen charter members, the group grew to approximately five hundred in the 1950s and then stabilized at about one thousand throughout the 1970s.

CANA has always provided a voice for nurse anesthetists through periodic meetings, a regular bulletin, continuing education in anesthesia, and professional representation in Sacramento and Washington DC.

Today, California nurse anesthetists enjoy an independent scope of practice because of legislative and regulatory gains made by CANA. Because nurse anesthetists provide cost effective and high quality care, they are an integral part of the answer to California's health care crisis.