NCANA History


On Saturday, May 10, 1941, at 3:00 PM in the afternoon, a group of nine nurse anesthetists met at the Sir Walter Hotel in Raleigh, North Carolina to establish a professional organization.

The Goals of the Organization were:

  • To advance the science and art of anesthesiology.
  • To develop educational standards and techniques.
  • To foster co-operation between nurse anesthetists and the medical profession.
  • To publish periodicals and to issue bulletins.
  • To further the educational program of the AANA.

By 1931 nurse anesthetists across the country organized and formed the American Association of Carolina's first school to train nurses in the administration of anesthesia was opened at Duke University. Addie Medlin organized and called the first meeting of the North Carolina Association of Nurse Anesthetists (NCANA). On May 10, 1941 she acted as President Protem, insisting on proper parliamentary procedure.

In September 1941 the letter arrived from headquarters enclosing the certificate of affiliation.


In 1942, a second anesthesia school was in Winston -Salem, NC at North Carolina Baptist Hospital.

During the early forties, WWII was having its effect on the NCANA. There was an acute shortage of nurse anesthetists because many were employed overseas at battlefield hospitals. Meetings were suspended for the duration of the war.


A committee was elected in 1947 to investigate and organize a tri-state nurse anesthesia association to include Virginia, North Carolina, and South Carolina. It was thought that a larger geographic area would bring a larger number of nurse anesthetists together to encourage communication between the states.

The fifties began with the opening of a third school of anesthesia for nurses located in Durham at Watts Hospital. A quick and effective method of communication was needed to keep the members informed and up-to-date. The method was to be a newsletter published twice a year. The first issue arrived without a name. In it, the publications committee requested the membership to select a name. The final choice was ANETIC meaning"soothing and relaxing." The editor noted that its letters were also an acronym standing for Anesthetists Need Exchange Their Ideas Constantly.


In 1955 the ANETIC was published in the form of a bound bulletin. North Carolina was the first state association to do so. The format was established in the bylaws, and requires a vote to change. Except for ink color and type face, it remains the same today.


Also at the Silver Jubilee an amendment was made to the national bylaws to utilize the term "Certified Registered Nurse Anesthetist" to describe its members.


The sixties were notable for the emphasis NCANA placed on education for students and CRNAs alike. This decade also produced two AANA Presidents from North Carolina. In 1961 Evelyn Auld was AANA President.


In 1961, NCANA's twentieth year, an annual fall meeting to be held in North Carolina was established. The Spring meeting continued to be held with the CVA.


In 1962, the Eastern Nurse Anesthetist Club was formed. Its purpose was to provide an easily reached meeting for fellowship and education among CRNAs working in the Eastern part of the state.


Two new anesthesia schools opened in North Carolina during the 60's. Charlotte Memorial Hospital admitted its first class in 1962 and Memorial Mission Hospital in Asheville in 1964.

In that same year, the Triad Nurse Anesthetist Club was organized, later to become Educational District II. Articles of incorporation an-exempt status were applied for and obtained. The advantages of this status included a better position for the association to act as a bargaining agent, the accumulation of larger escrow funds available for future plans, liability protection for individuals within the organization, but most importantly, identification as a specific association of professionals in North Carolina.

These were the times of the national malpractice crisis. The NCANA worked with other medical groups to support the establishment of an -state" insurance provider for those who practiced in North Carolina.


In 1970 saw Vella Nelson inducted as AANA President.


In 1971, the state had been divided into four educational districts according to AANA guidelines. The Eastern and Triad clubs became Educational Districts I and II, respectively. District III was newly organized in 1971. District IV was formed in 1973.

The AANA initiated a Certificate of Professional Excellence for CRNAs who obtained a certain number of continuing education hours. This was the forerunner of re certification. In doing so, the profession of nurse anesthesia became the first healthcare specialty to ensure continuing education among its members.


In late 1976 the NCANA formally withdrew from the affiliation with the CVA. Many members felt that the state association needed a stronger North Carolina identity, especially in view of the continued need to lobby the legislature. The funds that, in the past, paid the CVA dues would now be funneled to the educational districts to sponsor seminars.


The NCANA worked with other nursing organizations for a four year period prior to 1981. It was necessary to make sure that any change in the definition of nursing would not impact negatively on the practice of nurse anesthesia. Hard work paid off and an acceptable form of the Nurse Practice Act passed the state legislature on May 11, 1981.

The early part of the 80's decade saw a number of NCANA firsts. A lobbyist was hired to watch over our interests in the state legislature. Year-round legal council was retained for the many medico-legal and practice issues that surfaced.

The NCANA membership hosted its first legislative reception. A research committee was established, as well as a committee to define the criteria for nurse anesthetist functioning as expert witnesses in professional liability cases.


In 1982 the school at Duke closed after more than fifty years of training nurse anesthetists. Officials at Duke said that it was for financial reasons.


Memorial Mission closed its school in 1984 after educating 206 nurse anesthetists.

During the 80's North Carolina again produced two AANA Presidents: Patricia Fleming 1982 1983, and Sandra Maree 1988 - 1989.


Patricia Fleming - received the Agatha Hodgins Award for Outstanding Accomplishment.


Direct reimbursement for nurse anesthetists passed on the national level on January 1, 1989.


On April 6, 1990 at the NCANA Annual Spring Meeting, the first NCANA "Anesthesia Bowl" began. Based on the television College Bowl quiz game and the AANA's National Anesthesia Bowl, this event provides an educational opportunity for all with fun.

At the April 7, 1990 NCANA Annual Spring Meeting the first NCANA Achievement Award was presented to Narda Croughwell, CRNA.

The Fall of 1990 the Raleigh School of Nurse Anesthesia opened with a Masters of Science in Nursing tracking from the University of North Carolina at Greensboro. Nancy Bruton-Maree is the Program Director.

Three North Carolinians were honored at the AANA Annual Banquet in Atlanta in August, 1990. Clarene Carmichael, CRNA of Spruce Pine received the Helen Lamb Outstanding Educator Award; Chal Maree, husband of Sandra Maree, CRNA was honored by being awarded Honorary Membership in the AANA; and Narda Dorman Croughwell, CRNA of Durham received the 1990 AANA Clinical Practitioner Award.


In the Fall of 1991 Management Concepts, Inc. was hired as the Management firm to assist with the NCANA business and administrative needs. Deborah Steenson was appointed Executive Director for the NCANA. Paul Welty, SRNA was elected as Student Representative to the AANA Education Committee and Keith Torgerson, SRNA was elected student representative to the Council on Accreditation for students at North Carolina Baptist Hospital.


January 22, 1992 Category V Interpretive Statement for the Nurse Practice Act passed. Category V was developed to define the scope of practice of nurse anesthetist consistent with the Nurse Practice Act in NC.


In Spring of 1993 with the departure of Debora Steenson, Charlene Barbour was designated Executive Director for the NCANA.

March 11, 1993, saw the North Carolina Board of Nursing begin the process to promulgate Category V - Nurse Anesthesia Practice Interpretive Statement in the NC Nursing Practice Act to Administrative Rule 21 NCAC 36.0226.

On July 1, 1993, the Administrative Rule, which clearly defines the legal scope of practice of nurse anesthesia practice in North Carolina, became effective.

April 1993 at the NCANA Annual Spring Meeting, Evelyn DeRoche, CRNA was the recipient of the 1993 NCANA Achievement Award.

The dedication ceremony for the new AANA headquarters in Chicago occurred on April 24, 1993. The building was completely paid for by donations from CRNAs. The NCANA contributed money and was honored by having the office of the AANA President designated as the NCANA room. North Carolina had produced the most AANA Presidents to date.

August 7, 1993 brought a Petition for Judicial Review filed against the Administrative Rule on behalf of the NC Society of Anesthesiologists, the NC Medical Society, and Eric Mason, MD, a local anesthesiologist.

On August 16, 1993, during the AANA National Meeting in San Francisco, CA, a bylaw change passed requiring all states to change offices in August, September, or October. This would facilitate effective communication between AANA leadership and key individuals in State Associations. In North Carolina this would occur with 1994 election. President-elect Stephen Ciraulo, CRNA will serve an 18 month term rather than the 12 month term.


Judith Guibert, attorney with Patton, Boggs, and Blow was hired to represent the NCANA on April 10, 1994.

June 4, 1994 heralded the formation of NCANA PAC. Charter and legal documents were drafted and presented to Board. Potential committee members will be contacted.

September 22, 1994: the Administrative Rule 21 NCAC 36 .0226- Nurse Anesthesia Practice was signed and filed with the Wake County Clerk of the Superior Court, as amended consistent with GS 90- 171.20(7e) of the Nurse Practice Act. On December 1, 1994 the Rule became permanently adopted.

October 1, 1994: the inauguration of the NCANA Council for Public Interest in Anesthesia. This Council, conceived, formed, and implemented with board approval, was chaired by Ruth Long, CRNA, NCANA Past President. The primary focus of the Council branches in to three important areas 1) anesthesia safety, 2) quality of patient care, and 3) communication among anesthesia providers, primary care physicians, and the public for the purpose of promoting cost containment. The Council will place an emphasis on other issues which relate to the public's interest in anesthesia.

On September 8, 1994, Durham Regional Hospital School of Anesthesia held its last graduation

January 1995: The NCANA became an affiliate association member to the Coastal Federal Credit Union of North Carolina. Individual membership is voluntary.


On April 6, 1995, at the Spring Meeting in Chapel Hill, the NCANA Board of Directors approved the first Education and Research Grants awarded to four SRNAs from Carolinas Medical Center Nurse Anesthesia Program/UNCC. The recipients were Barbara Hadley, Dorry Gascon, Annie Manning, and Virginia McEwen.

As of June 1, 1995, CRNAs in the state of NC will be eligible to receive direct reimbursement from the NC Medicaid Program for services provided to Medicaid eligible clients.

In the fall of 1995, Sandra Maree Ouellette, CRNA, MEd, FAAN, was appointed by the board of the AANA to serve as American representative to the board of the International Federation of Nurse Anesthesia (IFNA).

September 16, 1995: Nancy Bruton Maree, CRNA, MS was the recipient of the NCANA Achievement Award for her accomplishments and contributions to the profession of nurse anesthesia in and for the state of North Carolina.

September 16, 1995 saw Julie V. Garrison, CRNA become the recipient of the NCANA Outstanding Service Recognition Award for commitment and dedication in serving as the Government Relations Chair for over a decade, working in the best interest of the NCANA, giving freely and unselfishly her time and expertise. She had kept many NCANA Presidents and Board of Directors informed and alerted to the various pieces of legislation that may have had an impact on our practice and profession.


January 27, 1996: the Inaugural Chief CRNA/Hospital Administrator Seminar was held.

August 1996: the NCANA became a member of the AANA/ERF Friends for Life.

On August 11, 1996, Nancy Bruton -Maree, CRNA, MS from Raleigh, NC was installed as the incoming President of the AANA.

September 1996: the recipient of the NCANA Education and Research Grant was Julie Fritz, SRNA of the Raleigh School of Nurse Anesthesia.

NCANA moved into cyber world with the creation of its own web site on the internet,

Helen Vos- received the Helen Lamb Outstanding Educator Award.


Sandra Maree Ouellette- received the Program Director of the Year Award.


Richard G. Ouellette and Sandra Maree Ouellette- received the Agatha Hodgins Award for Outstanding Accomplishment.

NCANA receives the AANA PR Award for "The Best Kept Secret of Health Care." The AANA went on to modify the video and use it as part of their PR campaign.


NCANA was co -winner of the AANA PR Award.

NCANA initiated a student representative to the BOD. Mr. Mark Haffey was the first student elected to that position.

Joanne Payne won the NCANA Achievement Award.


Patricia Fleming won the NCANA Achievement Award

George P. Haag received the Helen Lamb Outstanding Educator Award.

Duke University reopened its School of Nurse Anesthesia offering a Masters Degree in Nursing. Mary Karlet is the Program Director.

Joanne Stevens hired as new NCANA lobbyist.


ACLS was offered for the first time, and the 2nd annual golf tournament to benefit the Strategic Reserve Fund was held.

The Public Relations committee for the first time gave an award to the anesthesia department doing the best job of promoting grass roots efforts of educating the public about our profession.

In school news, East Carolina University School of Nursing broke ground on a new School of Nursing Building.

Many positive things happened in 2004. NCANA implemented a new web site, electronic voting was introduced, online meeting registration started, and the state newsletter the “Anectic” was placed online. District meetings were combined into two rather than four. NCANA hired a second lobbyist, Mr.Frank Gray.


The Office Based Anesthesia brochure was published.


The AANA celebrated its 75th anniversary. The yearlong celebration culminated at the annual meeting, which featured U.S. President Bill Clinton, whose mother was a nurse anesthetist, as the keynote speaker. The AANA Foundation celebrated its 25th anniversary.


For the first time, a CRNA served on the board of the National Advisory Council on Nurse Educating and Practice. 

The Council on Recertification of Nurse Anesthetists and the Council on Certification of Nurse Anesthetists formed the separately incorporated National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA).


Nationally the AANA Wellness Initiative continued with focus on stress management and the Peer Assistance program took hold. We had two members of our state serving on the National Board. Julie Lowery as Director of Region 2 was also a member of the Practice Committee, and Sherry Owen was a member of the Education Committee. The task force on Doctoral Education of Nurse Anesthesia Practice issued a final report, and the AANA formally supported the doctoral education for entry level into nurse anesthesia by 2025.


AANA Peer Assistance reaches its 25th year.

For the first time a CRNA written article appears in “Anesthesia and Analgesia.”

Nationally, following five years of advocacy by the AANA, the Centers for Medicare and Medicaid Services issued new Medicare hospital conditions of participation interpretive guidelines for anesthesia services.


Nationally AANA Learn, the AANA’s in-house Continuing Education program, was launched. The AANA started a twitter account. The AANA published a Resource for Nurse Anesthesia Educators. The BOD voted to rename the AANA Archives Library in honor of Mr. John Garde. Peer Assistance reached its 25th year.


NCANA received a report from Suzi Brewer, Chair of By-laws Committee. It had been more than 20 years since NCANA had a bylaws revision. The revisions were discussed article by article and then voted on. The full revision was voted on by serpentine ballot and passed by a 2/3 majority.

Linda Stone was recognized and given the inaugural NCANA Humanitarian Award in recognition of her promotion of CRNA wellness in N.C.


NCANA celebrates 75 years of being a professional organization.


NCANA wins the Government Advocacy Campaign award at the AANA Mid Year Assembly for their “Veteran CRNA Stories: From the Front Lines to the Home front” Campaign.