“A Labor of Love”: How One CRNA Saved a Nurse Anesthesiology Program

In 2010, Monika Feeney, DNAP, MS, CRNA, was in the OR when she learned the nurse anesthesiology program she led would be shut down. 

Then known as the Southwest Missouri School of Anesthesia for Nurse Anesthetists, the program had been around since 1952. It had trained generations of Certified Registered Nurse Anesthetists (CRNAs), including Feeney herself. By then, she had been program director for only a few months, having taken the role in 2009. She initially turned down the position, preferring to stay in a clinical role. 

“They asked me if I wanted the job and I said no seven times,” she said. 

After hearing the news, she went upstairs to her office, where a small museum display of old anesthesia equipment was kept. Looking at it, she decided she couldn’t let the program disappear. 

“I don’t think that we should close it,” Feeney recalled thinking. “We should keep going.” 

At the time, the school was jointly owned by a local hospital and Missouri State University. Feeney said she began digging into the rules around program ownership and quickly realized there might be another path forward. She put together a business plan and went to university leaders with a proposal: let Missouri State take sole ownership of the program. 

She was not asking the university to fund it, but leaders pushed back at first. 

“I told them, ‘I don’t want your money. I just want a place. You just own us and give us a classroom. Put us anywhere—a tent in the parking lot, something.’” 

Missouri State agreed to take on the program if Feeney could secure clinical sites and help transition it to the doctoral level, which nurse anesthesiology programs were already moving toward nationwide. 

“In my heart, I had no idea how to do that,” she said, “but I told them yes. I knew I’d figure it out.” 

She got to work. Feeney made a map with Springfield, Missouri, at the center and started calling hospitals. She also emailed hundreds of alumni, asking whether they could help with clinical placements. 

“Our alumni are the ones that really stepped up,” she said. 

When local options closed off, a friend in Idaho offered her hospital as a clinical site. Despite the distance, the dean approved it. 

That support helped carry the school through a difficult time. In 2013, it became the Missouri State School of Anesthesia, no longer associated with the hospital that had previously co-owned it. The Doctor of Nurse Anesthesia Practice program was approved in 2014, and the first doctoral class graduated in 2016. After years of graduating 24 students annually, the program was recently approved for 30. Next year, it will mark its 75th anniversary. 

Those first few years weren’t easy. Students had to travel to multiple clinical sites—sometimes hours away and, in some cases, out of state—and Feeney said she spent a lot of time worrying about how to make it all work. 

“I would lay awake at night thinking, ‘Okay, where can I send this student or where can I send this one?’” she said. “Now I have a clinical site coordinator, so I can relax and know that the students are getting what they need.”

The new clinical relationships helped keep the program alive and expand training opportunities. Feeney said all residents now rotate through rural settings. Many graduates go on to practice in rural communities. 

“When I went to school, we didn’t get to have a rural rotation,” she said. “And now all of our students have to see what that looks like. The CRNAs in those rural hospitals are who saved us.” 

For Feeney, that is one of the clearest examples of why the fight to keep the program going mattered. The CRNAs and alumni who opened their doors to residents did more than help preserve a school—they maintained a pipeline into communities that need anesthesia providers. CRNAs, also known as nurse anesthesiologists or nurse anesthetists, represent more than 80% of the anesthesia workforce in rural settings nationwide. 

Today, Missouri State is still going strong. Some local clinical opportunities that had once been unavailable have started to reopen, and Feeney said the residents and graduates are an example of the program’s strength. 

“We’re training and teaching amazing CRNAs, and they speak for themselves,” she said. 

More than a decade after that moment in her office, Feeney said she still thinks about what it took to keep the program alive. 

“I wouldn’t want to do it again, but keeping this program open was a labor of love.”