YOU'VE SEEN THE OLD WESTERN movies when someone who has been shot is given a bullet to clench between his teeth so he won't bite his tongue off during surgery. Prior to the advent of anesthesia in the mid-1800s, even the most modest of surgeries were usually excruciatingly painful for patients. Since then, the field of anesthesiology has advanced significantly, offering patients a painless, comfortable, and safe surgical experience. Each year in the United States, approximately 30 million people receive anesthetics, with certified registered nurse anesthetists (CRNAs) administrating approximately 65 percent of them. The oldest recognized nursing specialists, nurse anesthetists have touched millions of lives over the years. Although anesthesia may be thought of as merely putting patients to sleep so they will not experience surgical pain, nurse anesthetists also play an important role acting as the patient's eyes and ears during surgery, essentially serving as a patient advocate because the patient is unconscious and cannot speak. Often the CRNA is the last person a patient sees before being put under, and it is the CRNA who offers comfort and confident reassurance, and then proceeds to watch over the patient like a guardian angel. CRNAs are an integral part of the entire operative process. After inducing sleep, they monitor vital signs, adjust anesthesia levels, and wake the patient after surgery. Throughout, they are vigilant monitors of every heartbeat and every breath, as they must be ready to respond if something is not right, such as a patient having a negative response to a certain anesthetic. Fortunately, according to a recent Institute of Medicine report, due to advances in the field, anesthesia is approximately 50 times safer than it was as recently as the 1980s. Nurse anesthetists have been blazing trails in the field since the Civil War, when they were responsible for giving soldiers ether during surgery. Since then they have been the principal providers of anesthesia care to US military personnel on the front lines. The CRNA credential was first established in 1956, and today approximately 42,000 nurse anesthetists throughout the United States administer anesthesia for all types of surgical procedures, from simple to complex. They also work in a variety of settings, from hospitals to private healthcare practices of dentists, podiatrists, ophthalmologists, plastic surgeons, and pain management specialists. On an international basis, according to the International Federation of Nurse Anesthetists, CRNAs are solely responsible for providing 60 percent of anesthesia worldwide and are the predominant providers of anesthesia in rural areas and developing countries. Being a nurse anesthetist is exciting, challenging, and rewarding. They are among the highest paid of all nurses, with salaries typically in the six-figure range. In addition, nurse anesthetists are in great demand and have been so since the late 1980s. If you are thinking of a career as a nurse or are currently a registered nurse (RN) who is thinking about going on to become a CRNA, this report will provide you with valuable information on everything from the history of the field and career duties, to educational requirements and a first-hand look at the field through the eyes of its practitioners.