John Garde and Nurse Anesthetists

Profiles in Nursing

John Garde and Nurse Anesthetists

Awakening the practice of anesthesia

By Elizabeth Hanink, RN, BSN, PHN
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While nurse anesthetists have an exciting history that includes quirky characters who were trailblazers, no one in recent memory has contributed as much to the profession as John Garde. When he died suddenly in 2009 of pancreatic cancer, his passing left a real gap in the field — and in the many nursing organizations he had helped.

His leadership of the American Association of Nurse Anesthetists, which includes 90 percent of all CRNAs (a truly enviable record for any nursing organization), was especially significant. Certified registered nurse anesthetists provide more than 30 million anesthetics a year and give two-thirds of all anesthesia delivered in rural hospitals.

Garde’s career in nursing spanned over 50 years. He began with his military service in the U.S. Public Health Service, serving in Detroit, Michigan. When his stint was up, he enrolled in the Alexian Brothers’ Hospital School of Nursing in Chicago, from which he received his diploma in 1956. His diploma in anesthesia came in 1957, from the St. Francis School of Anesthesia in La Crosse, Wisconsin. He also held degrees in physiology and psychology from Wayne State University in Detroit.

An Influential Career

During his long career he served as division head for the Department of Anesthesia at Detroit General Hospital and as program director of the Wayne State University Program for Nurse Anesthetists. He was also an associate professor and chair of the Department of Anesthesia in the College of Pharmacy and Allied Health Professions at Wayne State. The fact that nurse anesthetists are now prepared at the graduate level is largely due to Garde’s efforts during this time.

Under his leadership, the American Association of Nurse Anesthetists (AANA) established a public policy and governmental affairs office in Washington, D.C. along with one of the nation’s largest PACs. Garde led the effort to secure Medicare reimbursement for nurse anesthetists, the first non-physician group to gain this recognition.

Reimbursement to other advanced practice nurses now rests on this precedent. This victory required the removal of physician supervision as a federal mandate and was achieved only after intense and lengthy lobbying. Garde also facilitated the development of the International Federation of Nurse Anesthetists, which led to the establishment of international quality assurance and education standards for that specialty.

In a sort of “have gun, will travel” aspect in his later career, Garde served as a nursing consultant to several organizations undergoing difficult leadership transitions. His tenure as director of the AANA ran from 1983 to 2001, although his original term in office began in 1972. At that time he was the first male and the youngest person to serve as president.

Garde was the recipient of multiple nursing honors, including election as a fellow in the American Academy of Nursing. In his honor there is the John F. Garde AANA Researcher of the Year Award.


Did You Know? Early Anesthesia

Thousands of years B.C. the Chinese used acupuncture and the smoke of Indian hemp to dull pain.

Ancient Romans bled patients into unconsciousness before performing surgery, a practice revived in Scotland in 1800.

Opium was praised as a stupor-inducing substance by the Persians in the 11th century, and continues to be an effective painkiller today.

In the 13th century, Italians invented a “sleep sponge” soaked in a solution of opium, mandragora, hemlock juice and other substances, and placed it over the patient’s nose.

Later came nitrous oxide, ether and chloroform.      —Discoveries in Medicine

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