Graduating Doctor of Nursing Practice (D.N.P.) student Kirsten Toft-Nielsen, B.S.N. ’13, likens certified registered nurse anesthetists (CRNAs) to her profession’s “apex predators,” and she knew she wanted to be one. “I appreciated just how wide a scope of practice they had,” she explained. “They can do it all—regional anesthesia, obstetrics, pediatrics. They’re working autonomously and trusted with somebody’s life while they’re under anesthesia during complex procedures.”
To get into a CRNA program, she needed experience in an intensive care unit, a competitive placement. “I kind of had to claw my way into the ICU to get the qualified time,” she recalled. She ended up loving her job. “I wanted to go back to school, but recognizing when I was ready to make that leap was challenging,” she said. “Some of my mentors and colleagues really had to kick me out of the nest.”
Toft-Nielsen’s “nest” was the Veterans Health Administration in Miami, where she worked from 2014 through 2021, starting as a telemetry nurse the year after earning her Bachelor of Science in Nursing from the University of Miami School of Nursing and Health Studies. “Veterans are some of my favorite people to serve,” she said. “The sacrifices they made, everything they went through—these are some resilient people!”
Her affection for the veteran population grew out of stories her grandfather, uncle, and godfather told her about their own military service. “I just felt this strong sense of wanting to give back to them,” she said. That sense of duty fortified her through the pandemic. “I can’t stop doing my job just because it’s scary,” she said. “That bond you forge with your patient is worth overcoming the fear.”
In January 2022, Toft-Nielsen started the school’s full-time B.S.N.-to-D.N.P. Nurse Anesthesia program. “UM was always my dream school. I loved the B.S.N. program. It was challenging but never felt impossible,” she said. “They do a really good job of supporting you through it.” Her return to the U was equally rewarding. “I definitely appreciate the many connections and lasting bonds I’ve been able to make at UM through this program, both with my classmates and the academic and clinical faculty,” she said.
Over the course of three years, Toft-Nielsen completed clinical rotations at some 10 different sites, covering everything from obstetrics and trauma to cardiothoracic and pediatrics. She gained regional anesthesia experience, presented at national conferences, mentored incoming students, served as vice president of the school’s Nurse Anesthesia Student Association (NASA) chapter, and this past November spent a week in Guatemala, volunteering with a nonprofit organization that provides surgical care to children in need. “Guatemala was so rewarding and impactful,” she said. “We were able to accomplish a lot while still being mindful of resources, being safe, and being efficient.”
For over a year, Toft-Nielsen also worked with Doreen Ashley, D.N.P. ’11, executive director for Acute and Critical Care Services at UHealth – University of Miami Health System, on a practice improvement project to reduce noise exposure that can adversely affect anesthetists and patients. “Dr. Ashley was a great site lead and resource on the ground at University of Miami Hospital in making the connections I needed to accomplish the project,” she said. In advance of Commencement, December 12, Toft-Nielsen formally presented and handed off the project, “Recommendation for ‘Silent’ Paging of Rapid Response Alerts to Reduce Excess Hospital Noise from Overhead Paging,” to UHealth. “The goal is to reduce more than half of overhead paging with the initial transition of rapid response pages to this ‘silent’ clinical communication system,” she stated. “Implementation of this technology will only enhance patient, family, and anesthesia provider experience.”
As for her own future, Toft-Nielsen reports that she and one of her program peers were offered positions as CRNAs at the Miami VA. “It feels like I’m having a full-circle moment,” she said. “The fact that they feel so strongly about hiring two UM grads speaks volumes.” The D.N.P. program was “100 percent worth it,” she added. “There were so many ‘aha’ moments where I just made deeper connections of understanding. I’d do it again in a heartbeat.”
