From Ashley Kliewer, PA-C, Director, Advanced Practice
Tell me about your career background that led you to becoming a Certified Registered Nurse Anesthetist.
I worked as an operating room nurse for 17 years and obtained my MSN. During my time in the OR, I was intrigued with what CRNAs did–their autonomy and how they cared for their patients. In 2004, I completed my CRNA training at the Frank J. Tornetta School of Anesthesia at Einstein Medical Center Montgomery, in partnership with La Salle University School of Nursing and Health Sciences. I worked at Reading Hospital for 12 years as a CRNA. During that time, I was also a casual CRNA at LGH. In 2016, I took the Anesthesia Manager position here and also obtained my Doctorate of Nursing Practice.
What have been your career successes as a CRNA?
I was the Clinical Coordinator for Student Registered Nurse Anesthetists (SRNAs) at Reading Hospital. In 2016, I received the Clinical Preceptor Appreciation Award from Frank J. Tornetta School of Anesthesia. I find mentoring and teaching SRNAs very rewarding. I serve as an editor for the International Student Journal of Nursing Anesthesia and have participated in quality improvement projects and research. For my DNP project, I educated perioperative nurses on extrapyramidal symptoms of ondansetron administration tracked with pre-test and post-test evaluations of the education provided. After approval through IRB, I am participating in research for a project evaluating oxygen saturation while sedated in patients undergoing MAC anesthesia with obesity, obstructive sleep apnea and Mallampati scores of three or four. As anesthesia manager, I have completed the advanced Lean Management System training.
Describe the team approach of the CRNAs and anesthesiologists at LGH.
I am very happy to work side by side with a great team of CRNAs and anesthesiologists. In the Anesthesia department, there truly is a teamwork culture between the CRNAs and anesthesiologists. As we continue to recruit for growth and need for increased operating room time, our staff is working hard and working together to fill the gaps. Each of us is dedicated to patient safety and good outcomes. As part of this team approach, our CRNAs have a lot of autonomy. We are able to perform spinal anesthesia, place A-lines, attend codes and traumas, and manage difficult airways.
What have been some of your recruiting strategies for CRNAs?
Our team of CRNAs sees the value in working with SRNAs who then go on to become a co-worker. In 2016, LGH had only one SRNA clinical site affiliation. As of today, we have four affiliations, including Cedar Crest, Jefferson, Frank J. Tornetta and Villanova. These affiliations have been our feeder system to future staffing of CRNAs. We are working on attractive recruitment strategies specific to SRNAs. Additionally, we go to our anesthesia schools and actively recruit.
What are some changes that have improved your practice as a CRNA?
Going from paper charting to an electronic medical record has been instrumental to our CRNA practice. I cannot imagine practicing without the EMR. Additionally, the Perioperative Surgical Home has really helped us know more about our patients prior to arrival so we can take better care of patients.
We are looking forward to utilizing Mobile Heartbeat to improve perioperative communication between the anesthesia techs, anesthesiologists and CRNAs.
Tell me about life outside of work.
I am married to my husband, Todd, 30 years this year. We have a cat, Scruffy, and a new Chow-Chow puppy named Tobie. I love to be outside, garden, travel to the beach or anywhere there is warm weather. I really enjoy art and musical festivals. I also love to cook and am trying new recipes with a new air fryer. I grew up in California, as my father was in the Air Force. My grandparents were from Lancaster, so we moved back here. I feel that all of my career choices have been the right ones, and I am very happy to be at Lancaster General Health. It is a great place to work.