Where Community Meets Care: A CRNA’s Calling to Rural Health

Rural anesthesia sits at the edge of two worlds—the clinical and the familiar—and Jen Chastek, DNAP, CRNA, ARNP, navigates them with practiced grace. One evening, that balance became strikingly clear. She was called to the emergency department for a trauma case: a construction worker who had fallen nearly 20 feet and was in critical condition. When she reached the bedside, she realized the patient was her close friend’s husband. 

In rural life, the hospital is never far removed from school pick-ups, grocery aisles, or the people you gather with for backyard parties. But Chastek knew how to shift. Standing beside her friend, she stepped into her serious, clinical side—the part of her that thinks in physiology and precision. Later, her friend would tell her, “I had so much peace knowing that you were there.” 

It was a moment that captured exactly who she is: deeply compassionate, extremely skilled, and connected to the people she serves. 

While those moments aren’t rare in rural healthcare, Chastek never imagined her life would lead her here. Before becoming a Certified Registered Nurse Anesthetist (CRNA), also known as a nurse anesthesiologist or nurse anesthetist, she believed anesthesia was cold and mechanical. She laughs now at her initial naivety. “I thought anesthesia was just putting people to sleep and never talking to them. But the most meaningful part of this job is how compassionately you talk to patients.” 

This realization came from a nudge from her husband who was, at the time, a Resident Registered Nurse Anesthetist (RRNA). Chastek was working as an ER nurse, and it was he who encouraged her to become a CRNA. He saw in her the qualities that make an exceptional anesthesia provider long before she recognized them herself: instinctively nurturing, relentlessly thoughtful, drawn to complexity, and with the ability to stay calm under pressure. 

Still, it wasn’t until she experienced rural medicine that it all clicked into place. Moving to Manchester, Iowa, from Minneapolis was, at first, a practical decision. Iowa was the first state to give CRNAs full practice authority, and she and her husband were able to be part of a team that supported them. But what began as practicality soon became a deep sense of belonging. 

In rural healthcare, Chastek witnessed a very different kind of anesthesia—one built on caring and community–where a CRNA isn’t one voice in a crowd or a set of hands among dozens. Instead, the CRNA is often the sole anesthesia provider, the constant, uninterrupted thread running through the patient’s experience. 

The weight of that responsibility didn’t scare her. It felt, unexpectedly, like coming home. 

“Rural anesthesia felt complete,” she reflected. “From start to finish the patient was mine to prepare, protect, and guide. That sense of ownership—it just felt right.” 

But what struck Chastek even more deeply was the closeness. In a rural community, a patient might also be your neighbor, your child’s teacher, the waiter at your favorite restaurant, or simply the person you said good morning to in passing the day before. There’s no anonymity or room for anything less than something deeply personal. 

“You can’t treat people like numbers,” she said. “Not when you might see them again at the school play that night.” 

This closeness carries emotional weight and profound meaning. She is the steady presence for a woman whose labor takes an unexpected turn, the one who treasures a handwritten thank-you from a cataract patient, the caregiver who helps rebuilds trust for a couple traumatized by previous procedures. 

Rural anesthesia also demands flexibility far beyond the walls of the operating room. Chastek manages airways during ER trauma cases, stabilizes critically ill patients for transfers, and gets called dozens of times a week to start difficult IVs. These aren’t “extra tasks” for her—in a rural hospital, they’re simply part of the job, and Chastek embraces them fully. “You can’t show up in rural practice asking, ‘How do I work less?’”  she said. “You have to ask, ‘Where am I needed?’” 

And for her, the answer is always wherever she can help someone feel safe. 

Today, Chastek and her team rotate among several small hospitals, a model that keeps essential surgical services—like colonoscopies and tonsillectomies—available to their communities. For Chastek, this work is more than logistics; it’s about sustaining the lifeblood of small towns. 

“If people have to travel to a city for something as basic as a colonoscopy, they’ll end up doing their shopping there too,” Chastek explained. “Then their gas, groceries, and appointments… all of it leaves the community. Healthcare access is economic stability.” 

Her team’s practice model allows local hospitals that can’t afford to support a full-time anesthesia provider the ability to offer these essential services. It’s a system that has helped keep multiple operating rooms open across northeastern Iowa, preventing service closures that would otherwise force families to drive hours for care. 

It has also kept obstetric services open in some communities, allowing local families to deliver their babies close to home. That is one of the facets of her work that Chastek finds most sacred. “Being present when a new life enters the world and being someone’s steady voice in that moment… It’s a privilege I don’t take lightly.” 

Iowa RRNAs often rotate through her practice, and many arrive with misconceptions like the ones Chastek once had. She loves showing them what rural anesthesia really looks like: high autonomy, broad skill use, deep community connections, and a culture of utmost excellence. She mentors them honestly, telling them that rural practice isn’t easier or quieter—it’s simply more personal. And, for the right CRNA with a desire to be excellent, more fulfilling. 

Excellence, for Chastek, isn’t about prestige or perfection. It’s about purpose. It’s the sense of belonging she feels driving quiet roads between hospitals, in the neighbors who greet her by name, and in the families who trust her with their most vulnerable moments. It’s the knowledge that her work doesn’t end when she leaves the hospital—it lives on in every community member she’s helped and will help in the future. 

Chastek says a teenaged version of herself would never have imagined living and practicing in rural Iowa. Yet her life is now full of conversation, comfort, and, above all, connection. 

“I don’t have a job,” she said. “I have a vocation. I have a calling. I have a purpose.” 

And, in the heart of rural Iowa, surrounded by the lives and stories she helps carry, Chastek has found exactly where she was meant to be.