08-Jul-2024

Lena Gould, EdD, CRNA, FAANA, FAAN wins ANA Nurse-Led Team Innovation Award

Nurse anesthetist (CRNA) mentor in an operating room

6-minute read

The Immersion Model: Promoting and advancing diversity in nurse anesthesia

The ANA Innovation Awards – sponsored by Stryker – highlight, recognize and celebrate nurse-led innovation. Awards are presented to an individual nurse and a nurse-led team whose product, program, project or practice best exemplify nurse-led innovation in patient safety and/or health outcomes.

This year, the winner of the Nurse-led Team Award is Dr. Wallena (Lena) Gould, EdD, CRNA, FAANA, FAAN, founder and CEO of The Diversity in Nurse Anesthesia Mentorship Program, a 501(c)(3) non-profit organization dedicated to promoting and advancing diversity within graduate nurse anesthesia programs.

Through their innovative, evidence-based Immersion Model for Diversifying Nurse Anesthesia Programs (The Immersion Model), Dr. Gould and her team promote and advance diversification of the nursing workforce.

Certified Registered Nurse Anesthetist (CRNA) is a highly specialized advance practice nursing role requiring a master’s or doctorate degree. CRNAs often earn more than other types of nurses and have a wide variety of opportunities for growth, development and advancement – and for helping to improve health equity for minoritized people.

Demographic make up of 59,000 CRNAs in the U.S.

The U.S. nurse workforce as a whole lacks racial and ethnic diversity.² The lack of diversity in the nurse anesthesia workforce in particular, Dr. Gould explained, “contributes to racial inequities and impacts health equity in communities of color.”

These impacts are especially evident in the areas of pain management and race concordance. One study, for example, found that “Black Americans are systematically undertreated for pain relative to white Americans.”³ Further, one randomized experiment found that Black patients had a more positive view of Black care providers, and were more likely to accept a provider’s recommendation when there was race concordance.⁴

Because CRNAs are key collaborators with patients, families and care teams in creating patients’ pain management plans, improving racial diversity among anesthesia professionals is critical. “We’re responding to an urgent need for racial concordance in the nurse anesthesia workforce,” Dr. Gould explained.

The influence of a CRNA can go beyond delivering anesthesia and addressing pain disparities. Dr. Gould spoke of the Black maternal mortality rate, and how a CRNA’s ongoing attention to a patient in the first 24 hours after giving birth can help influence outcomes. She also noted that African American men and women have the highest colon cancer rates, and described how CRNAs are positioned to encourage patients and their family members to have their screening.

Addressing CRNA workforce inequities

The Immersion Model addresses CRNA workforce inequities through an evidence-based, programmatic model. It is built on two constructs:

Professional socialization process prior to matriculating into a nurse anesthesia program
Active mentoring in pipeline initiatives for nursing students and nurses of color

Pipeline programs are a well-established approach to enhancing health care workforce diversity and improving health equity. The Immersion Model has three pipeline initiatives that help prepare participants to become competitive applicants to CRNA programs. The initiatives are:

Diversity CRNA information session and airway simulation lab workshops
Diversity CRNA HBCUs and HSIs school of nursing tour
Diversity advanced practice nurse doctorate symposium

“The CRNA collaborators who are on the award are part of the pipeline initiatives,” explained Gould. “I’m proud of them; they’re very active in the program.”

The Immersion Model reaches out to nurses of color and nursing students from Historically Black colleges and universities, Hispanic-Serving Institutions and American Indian schools of nursing. More than half are first-generation college graduates in pursuit of becoming a CRNA. “We are attuned to the early professional socialization of nurses before they go into nurse anesthesia,” said Dr. Gould. “That’s where we want to capture them.”

The Immersion Model has grown exponentially since mentoring its first five nurses back in 2003. Today, Dr. Gould said, “Over 800 marginalized nurses were able to be successfully accepted and matriculated, and become nurse anesthetists. That does not even include over 160 nurse anesthesia students that are currently enrolled.”

On nurse innovation and opening doors

“To me, innovation means that sometimes you have to start with an idea and dare yourself to do it,” Dr. Gould said.

With The Immersion Model, she and her team are impacting social determinants of health as they systematically work to address racism and discrimination in healthcare and to open doors for education, income and career opportunities.

“We are an award-winning, evidence-based nursing workforce solution in the nurse anesthesia workforce, and I’m very proud of that,” Dr. Gould said. “The Immersion Model decreases workforce disparities, and it improves health equity through an anti-racist lens and that’s what it’s all about. It’s about being intentional in an innovative way.”

Visit our new nurse innovation page to learn more about Stryker’s sponsorship of the ANA Innovation Awards.

Dr Lena Gould quote - As a result of what we're doing, we are changing the culture of nurse anesthesia.

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