NCANA History

The North Carolina Association of Nurse Anesthetists has a long and storied history dating back to 1941. On May 10 of that year, nine nurse anesthetists met at 3 p.m. at the Sir Walter Hotel in Raleigh, NC, to establish a professional organization that would represent the interests of the state’s nurse anesthetists. The following timeline encompasses the history of the NCANA.

See also:
NCANA Past Presidents
NCANA Lifetime Achievement Award Winners

Ten years prior to the formation of the NCANA, in 1931 nurse anesthetists from across the country came together to establish the National Association of Nurse Anesthetists, shortly thereafter renamed the American Association of Nurse Anesthetists (AANA). Also during the 1930s, North Carolina's first school to train nurses in the administration of anesthesia was opened at Duke University.

Then, on Saturday, May 10, 1941, a group of nine nurse anesthetists met at the Sir Walter Hotel in Raleigh, NC and established the NCANA. Nurse anesthetist Addie Medlin organized and called the meeting, serving as the president pro tempore and insisting on proper parliamentary procedure.

The goals of the organization were:

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

In September, the certificate of affiliation arrived from the AANA headquarters. The NCANA was officially on the map. The first elected President of the NCANA was Carrie Soloman (1941-1942).

Complete list of NCANA Presidents through the years

A second anesthesia school was established in Winston-Salem, NC at North Carolina Baptist Hospital.
During the early 1940s, WWII was having an impact on the NCANA as it was on the rest of the country. There was an acute shortage of nurse anesthetists because many were employed overseas at battlefield hospitals. Association meetings were suspended for the duration of the war.

A committee was elected 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 1950s 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 up to date, so it was decided to publish a newsletter twice per year. The first issue, which arrived without a name, included a request to the membership from the Publications Committee to select a name. The final choice was ANETIC, which means "soothing and relaxing." The editor noted that its letters were also an acronym standing for Anesthetists Need Exchange Their Ideas Constantly.

he 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 required a vote by the membership to change it. Except for ink color and type face, it remains the same today.

At the AANA’s 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 the first of many future AANA Presidents from North Carolina.

Evelyn Auld became the first NC CRNA to serve as AANA President. Also in 1961, which just happened to be the NCANA's 20th anniversary, an annual fall meeting was established to be held in North Carolina. The spring meeting continued to be held with the CVA .

The Eastern Nurse Anesthetist Club was formed. Its purpose was to provide an easily reachable meeting for fellowship and education among CRNAs working in the eastern part of the state. Also in 1962, the first of two new anesthesia schools opened in North Carolina, with Charlotte Memorial Hospital admitting its first class of students.

Memorial Mission Hospital (Asheville) became the second new nurse anesthesia school to open, welcoming its first class in 1964. That same year, the Triad Nurse Anesthetist Club was organized, later to become Educational District II. Articles of incorporation and 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 in the organization, and 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 in-state insurance provider for those who practiced in North Carolina.

Vella Nelson, CRNA, was inducted as the second AANA President to hail from North Carolina.

North Carolina 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, and 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 recertification. 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.

During the 1980s North Carolina produced two more AANA Presidents: Patricia Fleming, CRNA, in 1982-1983 and Sandra Maree (Ouellette), CRNA, in 1988-1989.

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 1980s saw many NCANA firsts:

  • A lobbyist was hired to watch over CRNA interests in the state legislature,
  • Year-round legal counsel 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 was a committee to define the criteria for nurse anesthetist functioning as expert witnesses in professional liability cases.

The program at Duke closed after more than 50 years of training nurse anesthetists. School officials said that it was for financial reasons.

Memorial Mission closed its school after educating 206 nurse anesthetists.

Patricia Fleming, CRNA, received the AANA’s Agatha Hodgins Award for Outstanding Accomplishment.

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

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

On April 7, during the same meeting, the first NCANA Achievement Award was presented to Narda Dorman Croughwell, CRNA.

In the fall, the Raleigh School of Nurse Anesthesia opened with a Master of Science in Nursing tracking from the University of North Carolina at Greensboro. Nancy Bruton-Maree, CRNA, was named Program Director.

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

Management Concepts, Inc. was hired as the NCANA’s new management firm in the fall to assist with the association’s business and administrative needs. Deborah Steenson was appointed Executive Director.

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.

On January 22, Category V Interpretive Statement for the Nurse Practice Act passed. Category V was developed to define the scope of practice of nurse anesthetists consistent with the Nurse Practice Act in North Carolina.

In the spring, Charlene Barbour replaced Deborah Steenson as Executive Director of the NCANA.

The North Carolina Board of Nursing began the process of promulgating the Category V Nurse Anesthesia Practice Interpretive Statement in the NC Nurse Practice Act (Administrative Rule 21 NCAC 36.0226) on March 11.

In April, during the NCANA Annual Spring Meeting, Evelyn DeRoche, CRNA, received 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 also 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.

On July 1, the Administrative Rule, which clearly defines the legal scope of nurse anesthesia practice in North Carolina, became effective. However, just over a month later, on August 7, the NC Society of Anesthesiologists (NCSA), the NC Medical Society, and Eric Mason, MD, a local anesthesiologist, filed a Petition for Judicial Review against the Administrative Rule.

On August 16, during the AANA Annual Meeting in San Francisco, a bylaw change was passed requiring all states to change officers in August, September, or October to help facilitate effective communication between AANA leadership and state association leaders. North Carolina decided to make this change with the 1994 election; therefore, President-elect Stephen Ciraulo, CRNA, would serve an 18-month term rather than the 12-month term.

Judith Guibert, attorney with Patton, Boggs, and Blow, was hired on April 10 to represent the NCANA in the Judicial Review of the Administrative Rule that had been requested by the NCSA, et al, in 1993.

The NCANA PAC was formed on June 4. Charter and legal documents were drafted and presented to Board, and potential committee members were to be contacted.

The Durham Regional Hospital School of Anesthesia held its last graduation on September 8.

On September 22, Administrative Rule 21 NCAC 36 .0226 of the 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. The rule was permanently adopted on December 1.

The NCANA Council for Public Interest in Anesthesia was inaugurated on October 1. The Council, which was conceived, formed, and implemented with Board approval, was chaired by Ruth Long, CRNA, NCANA Past President. The primary focus of the Council branched into 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 would also emphasize other issues related to the public's interest in anesthesia.

The NCANA became an affiliate association member of the Coastal Federal Credit Union of North Carolina in January, with individual membership being designated as voluntary.

At the Spring Meeting in Chapel Hill in April, 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, North Carolina CRNAs were eligible to receive direct reimbursement from the NC Medicaid Program for services provided to Medicaid eligible clients.

In the fall, Sandra Maree Ouellette, CRNA, was appointed by the board of the AANA to serve as the American representative to the board of the International Federation of Nurse Anesthesia (IFNA). Also that fall, Nancy Bruton Maree, CRNA, received the NCANA Achievement Award for her accomplishments and contributions to the profession of nurse anesthesia in and for the state of North Carolina.

Julie V. Garrison, CRNA, was honored on September 16 with 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 and giving freely and unselfishly of her time and expertise, she had kept many NCANA Presidents and Board members informed about various pieces of legislation that could impact nurse anesthesia practice.

The Inaugural Chief CRNA/Hospital Administrator Seminar was held on January 27.

In August, the NCANA became a member of the AANA/ERF Friends for Life and Nancy Bruton -Maree, CRNA, MS, was installed as the incoming President of the AANA.

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

NCANA moved into cyber world with the establishment of its own website at

At the AANA Annual Meeting, Helen Vos, CRNA, received the Helen Lamb Outstanding Educator Award.

Sandra Maree Ouellette, CRNA, was honored with the Program Director of the Year Award.

Richard G. Ouellette, CRNA, and Sandra Maree Ouellette, CRNA, received the Agatha Hodgins Award for Outstanding Accomplishment during the AANA Annual Meeting. Also at that meeting, NCANA received its first AANA PR Award for the video "The Best Kept Secret of Health Care." The AANA went on to modify the video and use it as part of its PR campaign.

NCANA was named co-winner of the AANA PR Award.

Mark Haffey was elected as the first student representative on the NCANA Board of Directors.

Joanne Payne, CRNA, won the NCANA Achievement Award.

George P. Haag, CRNA, received the AANA’s Helen Lamb Outstanding Educator Award and Patricia Fleming, CRNA, won the NCANA Achievement Award.

Duke University reopened its School of Nurse Anesthesia offering a Master’s Degree in Nursing; Mary Karlet, CRNA, was named Program Director.

Joanne Stevens was 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 NCANA Public Relations Committee gave its first-ever award to the anesthesia department doing the best job of promoting grassroots efforts of educating the public about the nurse anesthesia 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: The NCANA implemented a new website, electronic voting was introduced, online meeting registration started, the ANETIC was placed online, district meetings were combined into two rather than four, and Frank Gray was hired as the state association’s second lobbyist.

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).

Two members from North Carolina served on the AANA Board of Directors: Julie Lowery, CRNA, and Sherry Owens, CRNA. Lowery also served on the AANA Practice Committee while Owens was a member of the AANA Education Committee.

The task force on Doctoral Education of Nurse Anesthesia Practice issued its final report, with the AANA formally supporting doctoral education for entry into nurse anesthesia practice by 2025.

The AANA Peer Assistance program for nurse anesthetists reached its 25th year.

For the first time an article written by a CRNA written appeared in Anesthesia and Analgesia.

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

Nationally, the AANA launched its in-house continuing education program called CRNALearn, started its Twitter account, published a Resource for Nurse Anesthesia Educators, and renamed the AANA Archives and Library in honor of former AANA President and Executive Director John Garde, CRNA.

NCANA received a report from Suzi Brewer, CRNA, chair of the Bylaws Committee. It had been more than 20 years since NCANA had revised its bylaws. The revisions were discussed article by article and then voted on by serpentine ballot; it passed by a 2/3 majority.

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

NCANA celebrated 75 years of being a professional organization.

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