In 2024, Eva Hardin, MSN, MBA, CRNA, became Tennessee’s second nurse anesthetist certified in nonsurgical pain management (NSPM). Her achievement marked an important milestone in an effort to grow the nurse anesthesia profession’s presence in the pain management (PM) field.
Eva’s motivation for taking her career in that direction was, however, far more personal.
“The most fulfilling aspect of my job is giving back to the community I was raised in,” said Eva, who practices at West Tennessee Healthcare Dyersburg in her hometown of Dyersburg, TN. “To be able to provide pain management services that didn’t used to be offered in town is rewarding. The community gave me a lot of opportunities to be involved when I was growing up, so I am honored to give back and offer these services locally and keep people from having to travel 60 minutes to get the healthcare they need.”
Eva’s journey to becoming an NSPM-CRNA (a subspecialty certification established by the National Board of Certification and Recertification for Nurse Anesthetists) actually began in 2018, a few years after Medicare mandated that all epidural steroid injection (ESI) pain procedures except OB be done under fluoroscopy. The rural hospital where Eva was working decided to send two CRNAs for training so it could continue providing PM services for the local community.
“I was one of the CRNAs that was sent to Chicago to learn at the Jack Neary course,” she said, fondly recalling the legendary CRNA and groundbreaking PM educator. At the time, Eva didn’t realize that she would become one of just a small number of NSPM-CRNAs across the country.
“It is surprising to me that so few CRNAs are board certified in this specialty,” Eva said. “But I’m happy that more CRNAs are entering the field all the time.”
As an NSPM-CRNA, Eva’s practice incorporates her NSPM skillset into her overall role as a surgical and OB anesthesia provider at the CRNA-only facility where she works on a PRN basis. Practicing autonomously, the services she provides to acute and chronic pain patients typically include the assessment, planning, implementation, and evaluation of multimodal approaches in patient care.
One could say Eva was destined for a career in healthcare. Both her parents were in the medical field—her dad an x-ray tech and her mom a nuclear medicine tech. “I spent a lot of my younger years wandering the halls of the hospital when my parents were at work and on call,” she said. “I would look at images with my dad or cardiac diagrams with my mom and ask lots of questions. And in my other spare time, I would try to find some money from hospital employees to buy snacks out of the vending machines!”
In high school, a career day for seniors led to her spending one day shadowing a kindergarten teacher and another day shadowing a nurse practitioner at her mom’s work. “I decided after those two days I wanted to go into nursing,” she said.
As with so many nursing students who decide to pursue a career in nurse anesthesia, Eva was inspired during her surgery rotation by a generous CRNA mentor. “I was observing a carotid endarterectomy,” she remembered. “The CRNA in the room was so nice and let me stand behind the drape to watch the procedure. I can’t remember his name, but he explained all of the things that were going on during the procedure, drugs given, and the ventilator. It was from that point forward I knew I wanted to go into anesthesia.”
Eva went on to be part of the third class at the Union University Nurse Anesthesia Program in Jackson, TN. Besides the anonymous CRNA who showed her the ropes that influential day in nursing school, there were numerous other mentors she credits with informing her way.
“My parents were a huge factor to my college degrees,” Eva said. “They did not have the money to pay for my schooling, but I did not have any other choice but to go to college. My mom went to college when we were younger and she did not want any of her children to wait until later in life to go to college like she did.”
In her nurse anesthesia program, Eva was particularly grateful for the impact Dean Tim Smith and Professor Molly Wright had on her career as well as her life. She refers to both as “role models.”
“My dad became very ill about three months into anesthesia school,” she said, reflecting on that difficult time in her life. “I will never forget Dean Smith calling me while I sat in the ICU waiting room. He said for me to stay at the hospital with my family—that school would be there when things settled down with my dad. And he was right!” Eva explained that “Union University is a very Christian-based school that puts family first with God by your side every step of the way. They will tell you that everything else will fall into place.” Eva said she would choose Union again for nurse anesthesia school if she had to do it all over again.
Professor Wright, who ended up taking over as chair of the anesthesia department following Eva’s graduation, remains a role model and asset to her career to this day. “She will always be a shoulder to cry on or offer a valuable piece of advice in an anesthetic,” Eva said.
Ten years after graduating from Union, Eva joined Rural Health Pain Management and opened the clinic at West Tennessee Healthcare Dyersburg. She explained that the biggest challenge she encountered was trying to obtain pain privileges at her small hospital in Dyersburg. “None of the surgeons or department directors wanted to sign off on my privileges,” she said. “Their answer was they didn’t know anything about pain management and didn’t want to be responsible for anything that went wrong. After about six months, one of the doctors finally agreed to sign off on my privileges.”
Ask Eva if she would do it all over again, and she’ll answer with an emphatic “yes” to both being a CRNA and specializing in PM. “I truly enjoy working with older patients,” she said. “Most elderly patients have some type of pain. Our elders are our past. They built the foundation for us, and you cannot replace them.”
Eva’s recommendation to RNs interested in becoming CRNAs, and to CRNAs interested in PM, is an equally enthusiastic, “Yes, do it!”
“If you are flexible, resilient, and able to thrive in changing environments, you’ll do well,” she said. “I feel these qualities are valuable in the anesthesia world. Working in rural healthcare the majority of my career, you have to be able to go from one extreme to the other—from putting in an epidural for a laboring patient, to inserting a central line in the ICU, to switching from general anesthesia to a peripheral nerve block as the primary anesthetic because the patient is too sick for GA…. You have to be adaptable.”
If a CRNA has questions about specializing in pain management, Eva invites them to “feel free to reach out” to her. She emphasizes that the route she took to achieving her PM goal was one way to go about it, but there are others as well. And with a wink and a smile, she is quick to remind CRNAs—well, just about anyone—that there aren’t any anesthesiologist assistants (AAs) who do pain management.
“I work for a wonderful company called Rural Health Pain Management,” she said. “We offer a mentorship program within our company. Currently we have contracts in six states and are looking to expand within those states and add additional states.”
Eva met her husband, Joseph, while in high school; the couple celebrated their 19th wedding anniversary in July. Her twin sister is a co-owner of C&C Pharmacy in Dyersburg. “It is super nice to have someone so knowledgeable on the medication side since my PM practice does not involve medication management.” Eva also has a brother who lives in Maryville, MO.