Frank Titch Transitioned from Military CRNA to Civilian CRNA to Nurse Anesthetist Educator

Frank Titch has learned to adjust and adapt throughout his career as a certified registered nurse anesthetist (CRNA). The transition from a U.S. Air Force nurse anesthetist to a civilian CRNA proved to be the most difficult because of the change from full practice authority in the military to a supervisory model as a civilian CRNA. After a long career of administering anesthesia, he now teaches the next generation of CRNAs as a college professor.

Frank first learned of the nurse anesthetist profession from a family friend while in high school. He got to job shadow her one day and knew it was what he wanted to do.  “Our family lived in a town with a small hospital where nurse anesthetists administered anesthesia. I wanted a job where I could work independently and earn the respect of my colleagues,” Frank said.

In 1979, he joined the Air Force and entered the nurse anesthesia program in 1982. He graduated from anesthesia school in 1984. In the military, Frank had full practice authority and cared for patients’ anesthesia needs without physician oversight. He worked at an air transportable hospital during a six-month deployment in Desert Storm. He and another CRNA were the sole anesthesia providers for an air base with 5,000 personnel.

“As a military CRNA, I was forced to work with what I had. I didn’t always have access to equipment that was available in United States’ hospitals. Often times I gave anesthesia to patients in a noisy environment and had to manually feel for their blood pressure,” said Frank. “But I knew the patient was depending on me and if I couldn’t provide anesthesia, there would be no surgery.”
Upon retiring from the military in 2001, it took Frank time to adjust to working as a civilian CRNA.

“It was quite a transition for me to leave the military where I had a significant rank, responsibilities, respect and a fairly high leadership position,” he said. “For 20 years, I worked independently with full practice authority. It took time to adjust to a civilian model where supervision was now part of my job.”

Today, as a professor of Duke University’s nurse anesthesia program, he teaches students basic and advanced courses on the principles of anesthesia. He also hopes to educate the public about the capabilities of nurse anesthetists. The standard of care is the same when provided by an anesthesiologist or CRNA.

“CRNAs are assets to anesthesia,” said Frank. “Oftentimes the levels of oversight are not necessary. Allowing nurse anesthetists to practice to the full extent of their education and training can only improve patient care.”

Recently, the U.S. Department of Veteran Affairs (VA) published a proposed rule extending full practice authority to CRNAs, which would allow nurse anesthetists working in the VA to provide anesthesia services without the oversight of physician. Frank says he fully supports the rule as a Veteran and a CRNA.

“The efficiency within the VA system would be much greater if the scope of practice for CRNAs was expanded,” he said.

CRNAs and others are encouraged to visit before July 25, 2016, to ensure veterans have access to the high-quality health care they deserve.