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Nurse Anesthetist
Laurelton, NY
Headshot of Thomas Pallaria

Every day that I go home, I know I have impacted someone’s life in a positive way. I love knowing that I have been there for my patients, from those who are toddlers to those who are geriatrics. I help to alleviate their fears and be with them during a frightening experience in their lives.

My inspiration

I was a second-degree BSN student, having worked in the business world for 5 years. I always wanted to have meaningful interactions with people, and working in a career that focused on financial gains was not rewarding at all. Nursing was a career that I identified with secondary to the constant interaction with the public and the ability to make a difference in the lives of those I cared for.

Video still of Dr. Thomas Pallaria

My life as a Nurse Anesthetist

Johnson & Johnson discovers the highlights of being a Nurse Anesthetist from Thomas, DNP, APN/CRNA.

The responsibilities of a Certified Nurse Anesthetist

I’ll interview the patient. Help with room preparation. Wheels are rolling in the operating room at 7:30, not 7:31. The surgeon is on our team—they’re usually very demanding, as we all are. And I’ll do maybe one long case, or, depending on the room, I might be doing three or four cases. If I’m in the endoscopy suite, we’re talking up to 10 or 12 patients in that day.

What a typical work shift is like for me

Because I have three distinct roles, each day presents new and different challenges.

During academic days, there is no “shift”...the day continues until the students no longer need me. As an administrator, “shift work” is replaced by never-ending availability via email, text and phone. I would not have it any other way. My staff is very important to me and when they need me, I need to be there for them.

The only “shift work” I maintain is during my clinical days. Prior to my administrative role, I would typically work 12–16 hour days, delivering anesthesia care to my patients. Now with my expanded roles outside of the operating room, I cap my clinical day to 8–10 hours.

The clinical pace is dependent on the environment, but overall, the preoperative world is a very dynamic and fast-paced environment, which CRNAs thrive in!

Volunteering, missions and disaster relief
I am the liaison for the nurse anesthesia residents in our program. I coordinate 1–2 trips per year for eligible residents, who provide volunteer care in several remote locations and countries such as Columbia and Guatemala.

My innovation story

It was a patient who had multiple sclerosis. It makes them very weak. So this surgeon was doing something in which I was going to have to give general anesthesia, not just sedation. I spoke with the daughter and her husband beforehand and they were very concerned because she had had a couple of other procedures in which the general anesthesia typically includes endotracheal intubation, which is putting a breathing tube into their trachea.

It is a challenge for an anesthesia provider to make sure that we can safely take that tube out. And the risk is that we won't be able to, and they’re going to have that tube in for an extended period of time. And no one wants that.

So, I altered my anesthetic plan to focus on that. We got through the procedure with the surgeon’s help and with a very clear, defined timeline, without having to breathe for her. I was able to maintain her own spontaneous respirations. We dropped her off in the recovery room still breathing on her own. So that was a huge postoperative complication that was successfully sidestepped.

How I balance work and life
First and foremost, love what you do. Work doesn’t always have to be “work”. Secondly, have a support system in place that understands your passion, but also reminds you that there are other things out in the world for you to enjoy. Work hard-play hard isn’t just a line on a T-Shirt!”
For someone starting out, you need to absolutely have a very clear focus as to what your goals are. There are so many different opportunities in nursing and in advanced practice nursing that someone could get a little bogged down once they start looking into all the options.
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