Consider this path: CRNAs in the Military

This month, we spoke with Jan Setnor, MSN, CRNA, who serves as Chief Anesthetist at an all CRNA practice in Reston, Virginia. Jan served in the United States Air Force Reserve for 26 years and retired as a Colonel. If you’ve heard her name, it’s likely because Jan is currently serving as the vice-president of the American Association of Nurse Anesthesiology, a role that gives her the opportunity to encourage CRNAs at all levels and give them access to leadership, mentorship and advanced career opportunities.

Although I didn’t begin my medical career as a CRNA, my journey has been a unique one and one I would recommend to those who feel called to serve. Initially, I served for twelve years as an ICU nurse, a pursuit I thoroughly enjoyed. However, after shadowing and observing some incredible CRNAs over the years, I was encouraged to apply to a program and pursue continuing education. The rest is history!

When Saddam Hussain invaded Kuwait and the United States went to war, I committed to becoming an Air Force flight nurse and doing aeromedical evacuation to transport our ill and injured warriors.

As a child raised in a military family, this was a natural progression for me. My father retired as a Command Sergeant Major in the Army and he had the privilege of serving with General Colin Powell. My husband served 30 years as a fighter pilot in the Air Force, flying some amazing airplanes, including F-15s, A-7Ds and the F-117A Nighthawk Stealth Fighter.

To be competitive for promotion in the U.S. military, one must complete advanced military education and obtain an advanced degree. This is in addition to maintaining all additional requirements as a military officer.

I took advantage of several leadership programs offered by the Air Force and was able to transfer that training to my civilian job, as well as to my involvement with VANA and AANA. The time I spent training with the Air Force and furthering my education prepared me for deployments around the world. Although training never fully prepares you for the realities of war, the comprehensive deployment and trauma education has been applicable again and again in my civilian career as a CRNA.

Deployment is a challenge, certainly. Time away from family is never easy, especially when your destination is a country at war. I reconciled my choice with the knowledge that I was serving my country and saving lives every single day while I was deployed. I had the opportunity to take care of our wounded, ill and injured soldiers, sailors, Marines and airmen and I am content in the knowledge that I made a difference when I showed up to work every single day.

Most significantly, working in Afghanistan I was struck with how I was expected to practice true teamwork without restrictions. Our patients put their lives in our hands, confident in the knowledge we could handle the responsibility. We rose to that expectation on every occasion. As a group of medical professionals, we developed a sense of self-assuredness that can’t be recreated with the strict limits placed on CRNAs outside of the military, especially in Virginia.

In the military, CRNAs practice independently. As soon as we take off the uniform and come home, Virginia CRNA’s are held to antiquated and restrictive supervision requirements, as opposed to during their military service, when they are often found holding positions of senior leadership in medical treatment facilities.

I have sought out these leadership positions through my involvement in both VANA and AANA, my career professional organizations. I’m passionate in standing up for what I do and being involved in charting the course for our profession. It is a privilege and an obligation we owe to other members of our honorable profession and to those who will follow us both in Virginia and the rest of the nation.

In my eyes, what separates a profession from a mere job is that professionals have a common set of ethics and a binding sense of community. CRNAs in Virginia and nationally have pride in our profession and in the good we do for our patients. We defend our compatriots because it is the right thing to do, not merely for monetary gain, and because there is nobility in standing up for one another and for improving and increasing access to patient care.

As a civilian, it’s fairly rare to find a CRNA in any C-suite position – a fact I’m working daily to change through my work within VANA and AANA. I encourage as many CRNAs as possible to pursue leadership roles and opportunities, just as my mentors led and guided me – and continue to!

I had an amazing mentor early in my career who planted the seed to be involved in VANA and I hope to be that voice to aspiring VANA members. I’m also grateful to be surrounded by people who love and support me, including my husband, who remains my number one mentor and partner in crime. Adrienne Hartgerink and Cathy Harrison, who are both veterans, have been great friends and role models. We’ve traveled this journey together and remain one another’s support system. In the anesthesia world, my first mentor, colleague, and friend, was Louise Hershkowitz. We met when I was a senior at Old Dominion University and she encouraged me to attend my first VANA meeting! Without her taking the time to educate me on the importance of advocacy and staying the course, I don’t know what my VANA path would look like today.

I never pass up an opportunity to speak with new nurses about this great profession. Getting there is hard and takes a lot of personal sacrifice, but nothing good comes easy. A favorite saying of mine is, “Everything I have in life, I owe to luck. But I’ve always found that the harder I worked, the luckier I became.” Looking back, I find that all the things I’m proud of were hard to accomplish.

VANA is no different – it’s been an uphill battle, but VANA’s intervention has been instrumental in defining ‘supervision’ such that CRNAs can practice independently in all settings in the Commonwealth. By engaging with this group, you’re surrounding yourself with like minds; other CRNAs who care about, and want to advocate for, our profession. I can honestly say I’ve never regretted my choice to invest in myself, or in VANA.

Winter 2023 VANA Newsletter