Colombia native and post-master’s DNAP candidate builds practice — and himself — through education

 

As a practicing CRNA for nearly eight years, Gabriel Restrepo loves his work, but hasn’t been satisfied with only focusing on the clinical or pharmacological aspects of anesthesia.

“I knew I always wanted to learn more about the policymaking process, novel anesthesia educational teaching techniques, how to improve patient safety, and how to get more involved with standards of care, protocols, procedures and regulations,” he says. “I want to make anesthesia better for everybody. I have a passion to get involved.”

Over the years, he’d regularly see VCU Nurse Anesthesia’s booth at CRNA conferences, and got to know Dr. Suzanne Wright, the Department’s professor and chair. “My dream was to complete my doctoral degree in nurse anesthesia at VCU,” Gabriel says.

And as these luck-would-have-it stories tend to go, a VCU Health recruiter who had his CV reached out one day with a job opening for a CRNA at the health system’s Community Memorial Hospital in South Hill. He took the job in 2017, moved from Maryland to Virginia, and shortly thereafter enrolled in VCU’s post-master’s DNAP program.

So why return for additional nurse anesthesia education?

“That’s a great question,” Gabriel says. “I’m going to be 52 this year. And everyone keeps asking me, ‘What are you doing going back to school? You get no monetary compensation or rewards, and it will take a lot of your time.’ But for me, there are multiple levels as to why: At the professional level, the theories and concepts offered in the doctoral curriculum path will enable me to become a more proficient clinician. The knowledge I gain will help me advance the nurse anesthesia profession and improve the health of our communities. And at the personal level, through the motivation and instruction of VCU’s talented faculty, I want to become the best professional and person I can be.”

“I know that path requires the next step, which is to obtain a doctoral degree in nurse anesthesia.”

That step has been more than two decades in the making. Growing up, Gabriel saw no future for himself in his home country of Colombia, South America. So in 1997, at age 27, he moved to the U.S.

He spoke no English and had no support or family nearby. Around his new home of Stamford, Conn., he held a number of jobs — “you name it, I did it” — as a construction worker, a landscaper, and a painter. Then he moved to restaurants. At first washing dishes. Then a runner. Then a waiter.

As his income grew, he decided to invest in himself, enrolling in a program at the local community college to become a paramedic. That requires starting out as an EMT. One day, the emergency department director at the Stamford hospital he routinely visited took notice of his educational track, and pushed him to become a nurse instead of a paramedic. She said he could do more with his career, and explore a greater number of opportunities.

The idea took root. Already enrolled at the community college, he shifted his mentality — and then, his course of study. He graduated in 2002 with an associate’s degree in nursing. He worked as an RN on various floors at Bridgeport Hospital — all while taking online classes for the BSN he earned in 2009.

During his time at Bridgeport, he met many CRNAs, who pushed him to pursue a career as a CRNA “because they saw I was interested in their work,” he says.

So, he kept up his education, completing all the requirements — ICU training, becoming a critical care nurse — to apply for a nurse-anesthesia program. He earned his certifications, built experience, and racked up required references. He applied to and was accepted to the University of Maryland’s Nurse Anesthesia program in 2011, graduated with honors in 2013, and has practiced as a CRNA since 2014. 

VCU Nurse Anesthesia’s post-master’s Doctor of Nurse Anesthesia Practice (DNAP) program prepares CRNAs to assume leadership positions in education, management, and clinical practice, with a curriculum focused on patient safety and human factors, ethics, quality assessment and improvement, health care systems and organizations, leadership, evidence-based practices, policy/advocacy practice, research, and adult education.

It’s also designed for full-time working CRNAs like Gabriel, and has the flexibility of one- to three-year completion options. The fact that classes are online (in non-COVID times, there are three on-campus sessions each year) wasn’t new for Gabriel, who had taken online classes since web-based learning even first began to emerge.

“When I started my education in 1999, I had to work to sustain my family, I couldn’t just say, ‘Oh, I’m going to college.’ So I’ve been forced to take so many online classes over the last 20 years,” says Gabriel, who will graduate with his DNAP in May 2021. “At VCU Nurse Anesthesia, the technology has been great. You’re able to login and see conferences, recordings, and review material at any time. It really makes a big difference in how you learn.”

His advice to those considering the DNAP? “I see a lack of involvement from many nurse anesthesia professionals. I tell students at my hospital: ‘Listen, you’re overwhelmed with clinicals and other studies and more, but never forget that in the future, you may want to take your career farther. And if you don’t get involved now, you’re going to have to fight those battles,’” Gabriel explains. “One of the ways to get involved is to move to the next level of your education with the doctoral program. Let’s all get on the same level so that we can continue pushing policy in favor of the anesthesia profession.”

And if you still think the DNAP path is too difficult or challenging, keep in mind: In 2012, deep into his education to earn the requirements to become a CRNA, Gabriel became an American citizen.

Gabriel’s doctoral project: Drug screening anesthesia patients

Every post-master’s DNAP student must complete a doctoral project, which is intended to demonstrate integration and synthesis of concepts learned throughout the program and practice experience. Gabriel has witnessed firsthand many anesthesia patients who, at the time of procedure, have illicit substances in their system. But there’s no standard of care around testing and treatment, which is a problem he wants to solve. Learn more about Gabriel’s doctoral project.

The DNAP opens new doors for CRNA and entrepreneur

A blog post years ago drove Jean Snyder into action.

The story was about a mother whose son died during a routine surgery. “I’m going to get choked up telling you about it,” Snyder recalled in a recent interview. The boy arrested on the table, the cause: the anesthesia provider used the wrong medication, and further failed to dilute it. The boy was given one-hundred times the necessary dose, had it been the proper medication in the first place.

“I can still remember my husband walking into the room while I was crying at the computer,” Snyder says. “This poor mother lost a child because an anesthesia provider made an error.”

She took her anger and sadness and turned it into the Error Recovery and Mitigation Aide, or ERMA. A clear box attached to the middle of a traditional needle reservoir, ERMA allows a practitioner in any high-risk area to see all the syringes and vials used during a procedure in real time through the plexiglass. They can recognize errors early, pre-disposal, and address issues faster. Once the procedure is complete, a trap door allows the waste to fall into the reservoir.

But there was a problem: Snyder had the prototype, but didn’t know the next step.

Living in Williamsburg at the time, she phoned Suzanne Wright, PhD, CRNA, then a professor and now chair of the VCU Department of Nurse Anesthesia. Wright encouraged Snyder to write a whitepaper on the device and get her post-master’s DNAP in the process.

Snyder is a 1983 graduate of Niagara University, and earned her master’s degree in nurse anesthesiology from the University at Buffalo in 1995. She graduated from VCU’s post-master’s DNAP program in 2016.

The DNAP, which she earned over one year of hybrid learning at VCU (meaning most learning was done online, with three visits to the Richmond campus), has also given her more power to run her business.

After earning her licensure as a CRNA in the mid-1990s, she worked for several health systems, and in 2006 began work as an independent contractor. Realizing a business opportunity and opportunity to save clinics additional cost, the entrepreneurial bug bit, and led her to start her own practice. As co-founder of Goodwin & Snyder Anesthesia Associates PLLC, she and her business partner provide anesthesia services to three Tidewater-area ambulatory surgical centers. Their contracts supply CRNAs to the ASCs with the oversight of an on-site surgeon. (She and Howie Goodwin also own a ketamine and infusion clinic in Newport News, Ecstasis, where they treat post-traumatic stress disorder, treatment-resistant depression, and complex regional pain syndrome).

For her DNAP capstone project, Snyder further refined the ERMA and built evidence to back it up through a whitepaper that outlined the many stories of anesthesia errors that could have been prevented with such a product. The whitepaper, she said, “showed why we need ERMA.”

Today, she holds a patent on the device along with her former employer. And yet, she gained much more from her DNAP experience than the evidence to back up ERMA.

“I went in thinking I would just develop ERMA and save the world,” she says. “What I didn’t realize is that the DNAP would give me parity. I now have a door into C-suites to talk about providing anesthesia services, or to explain the ERMA device. It’s the sad truth that, in many cases, you need more than a nursing degree to get your foot in the door. The DNAP makes a difference, and gives you the credentials you need to make change happen.”

She also didn’t want the program to end. “I learned so much by how the VCU faculty handled themselves and how they worked with students and communicated with us,” she says. “I try to mirror those behaviors when I work with [my peers] and employees. I have learned so much about the whole process of dealing with other people by how they dealt with other students.”

In summer 2020, Snyder stepped into her role as president of the Virginia Association of Nurse Anesthetists, where she is pushing to build membership and member engagement and advance its legislative agenda in the General Assembly.

 

“I am committed to empowering all nurses, but especially CRNAs, to be heard as subject matter experts, to be business owners, and to empower them to step into leadership positions,” she says. “Nurse anesthesia has given me so much in my life, and a career I’ve not had one moment of regret about. I believe firmly in nurse anesthesia as model for the future.”

“It’s time to build our organization up and profession up —because there are plenty of people out there trying to tear it down.”

MCV Foundation Honors Community Members, Faculty Who are Changing Lives in Richmond and Beyond

Each year, the MCV Foundation Board of Trustees honors people who have made significant contributions to the world-class patient care, research and education that VCU Health delivers right here in our community.

The generosity, leadership, vision and impact this year’s award recipients have embodied are worthy of great praise, attention and admiration.

“The comprehensive academic health center we have here in Richmond, serving Central Virginia and influencing healthcare around the world, is powerful and essential,” said Margaret Ann Bollmeier, president of the MCV Foundation. “These engaged, committed, generous and visionary awards recipients have played critical roles in helping VCU Health advance lifesaving care, preeminent research and transformational education. We can’t thank them enough for what they have given directly, and for the influence they have had on inspiring others to give.”

pic of Fallacaro
Michael Fallacaro, D.N.S., served as professor and chairman of the Department of Nurse Anesthesia in the VCU College of Health Professions for 20 years. Photo: VCU University Marketing

Robert Irby Award

Michael Fallacaro, CRNA, D.N.S., FAAN, who served as professor and chairman of the Department of Nurse Anesthesia in the VCU College of Health Professions for 20 years, received the Robert Irby Award.

For much of Dr. Fallacaro’s time leading the department, it was the top-ranked program of its kind in the nation.

“Dr. Fallacaro’s service to the profession of nurse anesthesia is second to none,” said Chuck Biddle, Ph.D., professor and director of research in the Department of Nurse Anesthesia. “His reputation as a professional of high integrity and as a clinician, scholar and leader is perhaps matched by some, but exceeded by no one. My view comes from one who ‘knows’ all of the principal players in a field that I have been a part of for twenty years.”

In 2011, Dr. Fallacaro established the Fallacaro Patient Safety Endowment for the Department of Nurse Anesthesia, which was the first endowment established for the department. Shortly thereafter, every faculty member in the department also established an endowment. Since Dr. Fallacaro set his example of philanthropic support, there have been an additional 24 endowments created for the department.

Established in memory of Robert Irby, M.D., an MCV rheumatologist who was devoted to securing financial support for the MCV Campus, this award is presented to a faculty member who has assisted with major fundraising efforts. 

Michael B. Dowdy Award

Adrienne Maxwell (front-center, in yellow), has dedicated her time and leadership to the Massey Cancer Center for almost 30 years. Here she stands with members of the Women & Wellness Legacy Committee in 2019.
Adrienne Maxwell (front-center, in yellow), has dedicated her time and leadership to the Massey Cancer Center for almost 30 years. Here she stands with members of the Women & Wellness Legacy Committee in 2019. Photo courtesy of VCU Massey Cancer Center

Adrienne Maxwell, one of VCU Massey Cancer Center’s most tireless volunteers, received the Mickey B. Dowdy Award.

For almost 30 years, Adrienne has dedicated her time, expertise, leadership and generosity to the cancer center. A natural leader and passionate advocate, she helped found Massey Club, Massey’s leadership annual giving society, which now brings in nearly $2 million dollars in unrestricted funds to support the center’s greatest needs.

Concerned about the lack of awareness in the Richmond community regarding research being conducted at Massey and a desire to raise money for women’s cancers, Adrienne encouraged her friends to join her and create a fundraising event. With her guidance, this committee of devoted volunteers received support from local businesses and organizations to produce the first Women & Wellness Signature Luncheon 25 years ago. Adrienne continues to be instrumental in the success of this event, this year gathering former event chairs to form the Legacy Committee, which helped raise record-breaking funds. Her continued support toward the research of women's health has been the reason this annual event has raised more than $5.5 million.

“Adrienne Maxwell is one of those indispensable volunteers that Massey truly cherishes,” said Martha Quinn, executive director of development at Massey. “I know I speak for the entire Massey development office and Massey leadership when I say that we are indeed fortunate to continue to merit her generosity and expertise year after year.”

Established in honor of Mickey Dowdy, who served as president of the MCV Foundation from 1993 to 2006, this award recognizes a volunteer who has played a lead role fundraising for the MCV Campus.

Eugene P. Trani Award

Roger Boevé has been a leader, donor and friend of the MCV Campus for many years, focusing much of his giving in support of research.
Roger Boevé has been a leader, donor and friend of the MCV Campus for many years, focusing much of his giving in support of research.

Roger Boevé, a leader, donor and friend of the MCV Campus for many years, received the Eugene P. Trani Award.

Roger served 12 years on the MCV Foundation Board of Trustees and is now a member of the foundation’s Leadership Council. In his time on the board, he chaired the Development Committee, served on the host committee for the inaugural Discovery Series RVA, and opened his home along with his wife Anne so their friends and neighbors could meet and ask questions of MCV Campus faculty and leadership.

Roger also serves on the Massey Advisory Board and as an external advisory board member for VCU’s Weil Institute of Emergency and Critical Care Research. Most recently, Roger helped establish and now serves as chair of the Pauley Heart Center Advisory Board. An advisory board had been discussed for many years, and Roger readily agreed to help faculty launch the board and personally contacted most of its 11 members to ask them for their service. He enthusiastically took the initiative and the leadership role required to make the longtime dream a reality.

In addition to serving as ambassadors and leaders on the MCV Campus, Roger and Anne have generously supported the Massey Cancer Center and Pauley Heart Center as leadership donors. They’ve shown strong interest in research, supporting studies on leukemia and the Pauley Pilot Grants funds at the MCV Foundation.

Established in honor of Eugene P. Trani, Ph.D., who served as president of VCU from 1990 to 2009, this award recognizes exceptional dedication and support of the MCV Campus.

Jerome F. Strauss III Award

David Sarrett, D.M.D., has served the MCV Campus for more than 25 years as a faculty member and dean of the VCU School of Dentistry.
David Sarrett, D.M.D., has served the MCV Campus for more than 25 years as a faculty member and dean of the VCU School of Dentistry. Photo: VCU University Marketing

David Sarrett, D.M.D., longtime faculty member and dean of the VCU School of Dentistry, received the Jerome F. Strauss III Award.

He has been an academic leader, dental community leader and faculty advocate throughout his more than 25 years on campus. In addition to acting as a collaborative partner in fundraising efforts on behalf of the School of Dentistry, Dr. Sarrett has given and pledged his own resources to ensure programs, research and scholarship will continue to thrive at the school.

In 2013, Dr. Sarrett and his wife Beth established an endowed scholarship at the school to encourage dental students to enter academic dentistry and/or research in the dental field. Their goal was to alleviate student debt burden to encourage young dentists to enter the field for which they might have a passion, rather than choosing paths based on financial necessity. In addition, Dr. Sarrett further established himself as a philanthropic leader at the school and across campus when he made a $100,000 commitment to the new Adult Outpatient Pavilion in which the dental clinic enterprise will be housed.  “As in so many other areas of his life and career, Dr. Sarrett stepped up first,” said Gloria Callihan, associate dean for development at the school.

In 2018, Dr. Sarrett and Beth cemented their legacy and vision for the school’s future when they shared their intention to endow a chair in general practice through a $1 million estate gift.

Established in honor of Jerry Strauss, M.D., Ph.D., former dean of the School of Medicine, this award is presented to a VCU administrator, faculty or staff member who has demonstrated extraordinary service and stewardship to MCV Campus alumni, donors or other members of the community to support and advance the mission of the MCV Foundation.

If you too are interested in supporting and being a part of the lifesaving care, research and education that happen on the MCV Campus every day, visit our giving page to learn about the various ways to make contributions across campus.