Alice McGaw: “Mother of Anesthesia”

Nurses were the first professional group to practice anesthesia services in the United States. This started 125 years ago and little was known about anesthesia back then. One of the most famous nurse anesthetists was Alice McGraw. She was to be given the name “Mother of Anesthesia” for her expert application of anesthesia during surgery and her many published works regarding the procedure. Nurse anesthetists were pioneers in their field. Surgeons began seeking them out to help with anesthesia during surgery because they could provide undivided attention to the patient.

The earliest records establish the beginning of nurse anesthetists in 1887. Since then, they have been instrumental in continuing to improve anesthetic techniques and equipment. Although formal education for nurse anesthetists was not made available until 1909, it is the earlier nurse anesthetists who paved the way for safe anesthesia and opened door to this specialty for nurses. Patients reported less discomfort and the surgeons reported fewer deaths due to trauma during operations.

Currently Certified Registered Nurse Anesthetists (CRNA) are licensed professional nurses who go through extensive training after receiving their Registered Nurse (RN) degree. This is considered a specialized field and requires nurses to become board certified through a state exam before being able to practice as a CRNA. The purpose of this study was to inform and educate about the women in nursing who lead the way in the development and application of anesthesia. Alice McGaw is little known to mainstream society and yet she provided some of the most comprehensive studies in this profession.

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She also spent her life as a practicing nurse anesthetist and earned the title “Mother of Anesthesia” Alice McGaw is known as the “Mother of Anesthesia”, a title given her by Dr. Charles Mayo. She was born in 1860 and little else can be found regarding her upbringing or schooling prior to 1893. It was in this year that she became the nurse anesthetist to Drs William J. and Charles H. Mayo of the Mayo Clinic in Rochester, Minnesota. Nursing anesthesia was the first clinical nursing specialty and in the beginning consisted of predominately women.

Factors attributing to this were low wages, most nurses were female and it was considered to be a deferential position with the surgeon in charge of it all. Before the inclusion of nurse anesthetists in surgical procedures, most anesthesias had been administered by medical students or physicians with little or no anesthesia training. During the Civil War (1861-1865) anesthesia was used on the wounded but very little because it was considered too dangerous. It was not until 1878 that the first “official” nurse anesthetist came into being.

The first school of nursing anesthesia was not formed until 1909. Surgeons began seeking nurse anesthetists to try to decrease the mortality numbers and because nurses could focus their entire attention on the patient rather than on the operation. Anesthesia evolved differently in Europe and the United States. Chloroform was the preferred choice in Europe and ether the preference in the United States. One of Alice McGaw’s major accomplishments was her expertise in the open drop inhalation method of anesthesia using a combination of ether and chloroform.

It was this expertise that earned her the title “Mother of Anesthesia”. She perfected this method while working for Dr. Charles Mayo and it was he who gave her this moniker. McGaw was also very concerned with the patient’s mental state prior to surgery. She believed that the patient should be prepared with soothing words before being anesthetized. She refined a technique that prepared the patient mentally so as to increase the effectiveness of the anesthesia It was this technique that leads to a decrease in mid-operative anesthesia being required.

It was in 1899 that Alice McGaw published the first paper ever written by a nurse anesthetist based on her work in nursing anesthesia. The paper was titled “Observations in Anesthesia” and was published in the Northwestern Lancet. Alice McGaw went on to publish five papers total on the subject of nurse anesthesia. The paper in 1906 published in Surgery, Gynecology, and Obstetrics was titled “A Review of 14,000 Surgical Anesthetics”. It noted that in the 14,000 surgical procedures for which she had been the anesthetist, there had been no complications or deaths attributed to problems with the anesthetic or its application.

This was a milestone in the field of nursing anesthesia. During the time that McGaw was the nurse anesthetist for Drs. William J. and Charles H. Mayo, she and Dr. Charles Mayo set up a showcase for surgery and anesthesia. This showcase attracted students from all over the world. This was not formal training but encouraged many students to implement McGaw’s technique with anesthesia. St. Mary’s Hospital, where McGaw was the nurse anesthetist for the Mayo brothers later became the world-famous Mayo Clinic. McGaw worked for Drs. William J. and Charles H. Mayo from 1893-1908. Between 1912 and 1920, almost 20 post graduate schools for nurse anesthesia opened. The Mayo Clinic was among one of those offering the program. It was McGraw’s early work that helped to achieve the success of the nurse anesthetist and its subsequent training programs. She and other like her pioneered the field of nurse anesthesia. Previously physicians were 95 percent male and nursing was not a specialized field. This changed with the addition of the nurse anesthetist. Nurse Anesthetists today are Certified Registered Nurse Anesthetists (CRNA).

These are licensed professional nurses (RNs) who want o specialize in anesthesia. They are required to take extensive training and must be board certified by exam before being able to provide services to patients and surgeons. In 1931 the National Association of Nurse Anesthetists (NANA) was formed. It would later become the American Association of Nursing Anesthetists (AANA). It was the first national organization for practicing anesthetists and still exists today. In 1986, the Clinical Anesthesia Practitioner Award was established by the AANA.

This award was to recognize the accomplishments of Certified Registered Nurse Anesthetists who have made important contributions to the advancement of nurse anesthesia. In 1998 this award became the Alice McGaw Outstanding Clinical Practitioner Award to honor McGaws achievements as a nurse anesthetist and for her publications on her work. Without Alice McGaw, nursing anesthesia would not have moved ahead as quickly. Her dedication to perfecting her craft and the publications that she allowed others to learn from were instrumental in the field of nursing anesthesia.

Her training and showcasing taught others the importance of anesthesia and its application. Certified Registered Nurse Anesthetists of today can practice their skills with confidence because of the importance Alice McGaw placed on knowing and perfecting the specialty of anesthesia. She was one of the most important forerunners in her field and her legacy continues to evolve with advancements and achievements based on her work.

References

1. American Association of Nurse Anesthetists (2006) History of Nurse Anesthesia Practice Retrieved November 30, 2006 from http://www. aana. com/aboutaana. aspx? ucNavMenu_TSMenuTargetID=173&ucNavMenu_
2. American Association of Nurse Anesthetists (2006) A Brief Timeline of Nurse Anesthesia Retrieved November 30, 2006 from http://www. aana. com/archives/timeline. asp
3. Bankert, M. Watchful Care: A History of America’s Nurse Anesthetists. New York: Continuum 1989
4. Evans, T. CRNA, MS What is a CRNA? (1998) http://www. anesthesia-nursing. org/wina. html
5. Michigan Association of Nurse Anesthetists (2006) History of Nurse Anesthesia Practice Retrieved November 30, 2006 from http://www. miana. org/history/history. html
6. Thatcher, V. History of Anesthesia with Emphasis on the Nurse Specialist Philadelphia: Lippincott, 1953

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