Opportunities abound around the world

In a remarkable journey spanning across continents, John Mundy, CRNA, DNP ‘00, recently shared his and his wife Arlee’s (CRNA ‘08) inspiring story as graduates of the University of North Dakota’s Nurse Anesthesia program.

Originally hailing from New Zealand, John Mundy immigrated to the United States in 1991, and his connection to UND has played a pivotal role in his successful CRNA career.

He met his wife, Arlee, when they worked as emergency room nurses at the King Fahad National Guard Hospital in Riyadh, Saudi Arabia. They were both drawn to the Middle East, but little did they know they would have an opportunity to return there again as Nurse Anesthetists.

With a background in paramilitary rescue, John possessed skills that naturally aligned with the responsibilities of a CRNA. The idea of independently monitoring patients under anesthesia drew him to this specialized nursing career. “I loved the skill sets that CRNAs were able to utilize,” said John.

His journey at UND began when he pursued his Master of Science in Nursing (MSN) degree with a specialization in anesthesia in 2000. “UND prepared me for my career by giving me a great foundation and education,” he remarked. John then went on to complete a Doctor of Nursing Practice (DNP) degree at Saint Scholastica in Duluth, Minnesota, in 2009. His wife Arlee also enrolled in the UND nurse anesthesia program, graduating as a CRNA in 2008.

Being able to have this opportunity had its hardships at times, but the rewards are endless… Never let an opportunity go past your way.

John has shared that the University of North Dakota played a crucial role in shaping his career. “UND had the overall package, with good clinical sites and with knowledgeable instructors,” he stated. He also highlighted the significance of UND’s emphasis on clinical practice and hands-on learning, even before the era of advanced simulation labs. Mundy noted that this foundation was crucial for students, and today’s simulation labs have built upon that legacy.

John’s career has been nothing short of diverse and impactful. He has worked in various roles, from being a staff anesthetist to directing anesthesia services at Saint Mary’s in Duluth. Notably, he even owned his own anesthesia business specializing in dental sedation.

In 2019, the Mundys moved to Jacksonville, FL, to work for Mayo Clinic. “Going from a mid-west hospital to a large teaching facility was challenging,” remarked John, but the pair quickly got to work.

In the fall of 2020, John heard of an opportunity that he could not pass up. “I happened to be working in the Gastro-Intestinal department and overheard a physician talk about the opportunity to work in Abu Dhabi,” said John. Mayo was part of a joint venture with one of the largest hospitals in the United Arab Emirates as the organization worked to make it a regional hub for world-class healthcare. “This perked my interests and before I knew it, we were offered the chance to go to Abu Dhabi to demonstrate our profession as CRNAs.”

On a hot day in July 2021, the Mundys arrived as part of the first group of CRNAs to ever be at the hospital. “They were all very keen to see what we could do,” explained John.

With the Mundys recent completion of their contract in Abu Dhabi and subsequent return to the United States, John has reflected on the opportunity and flexibility a CRNA career can offer.

For aspiring CRNAs, John emphasized the importance of building a solid foundation in nursing and gaining experience in the ICU environment before applying to CRNA programs. He described nurse anesthesia as a highly regarded and rewarding career with excellent nationwide job prospects, making it a wise choice for those passionate about advanced practice nursing.

We asked John Mundy a few questions about his experiences as a CRNA with Mayo Clinic working in one of the largest hospitals in the United Arab Emirates.

What did you experience upon arrival? What was your reception like?
Unaware of what we were walking into, the anesthesia department was also wondering what a “CRNA” was. We were greeted by a friendly group consisting of Consultants, Specialists, Anesthesia Technologists and Anesthesia Nurses. They were all very keen to see what we could do and what our experience was.
Why was your arrival important?

This would be the first time that CRNAs would practice there. For about 10 years there had been Advanced Practice Registered Nurses but no CRNAs. As a group of four, we would have to write our own scope of practice and apply for licensing through the UAE Department of Health. As a foundation for practice, we used the American Association of Nurse Anesthesiology standard of practice. Once completed we were then faced with the challenge that we could not access medications. By the time we arrived and started working independently it took almost four months.

What specialties did you cover?
Our areas of practice would include the main operating room (OR), burns unit, cath lab and the gastrointestinal (GI) department. Two CRNAs doing independent practice would be utilized in the burn unit and GI area exclusively. We provided input on practice optimization and work appropriate anesthesia policies as a framework for anesthesia practice.

What were your main challenges?
Trying to understand how the anesthesia practice worked with their different layers of skilled and educated personnel took awhile to comprehend. The anesthesia staff came from the Emirates, Egypt, England, Germany, India, Syria, Yemen, Lebanon, Philippines, Pakistan and us four USA CRNAs.

Communication both with staff and patients posed the greatest problems. The designated working language was English, but some accents could be hard to understand. Many staff would speak to each other in their native tongue, and it was common to have 3-4 different languages being spoken in one operating room at a time.

Speaking the same anesthesia lingo was also trying in the beginning. Asking for a piece of tape took me a few minutes to get my point across until I said pass me the plaster. Many of the medications came from European countries or were no longer on the USA FDA list so double checking and researching medications became the norm.

Any memorable experiences?
I think one that stands out for me was when I was able to represent SSMC Hospital at the 51st Anniversary of the Founding of the UAE gala event. The GI department at SSMC had won the Hospital Forum Excellence award and with that came the opportunity to be included in the extravaganza put on by the UAE government. The seven Sheiks of the Emirates and over 2000 guests were awed with a Hollywood like production showcasing the Past, Present and Future endeavors of the UAE.

We did have time to do some travel to other countries and the surrounding regions… There is great golfing, clay shooting, and many Souks to shop around and barter. There is endless ethnic food. The staff always wanted to share their food with you, and it was like a family sitting down for meals any time of the day at work.

The highlight for us was to bring friends and family on trips out into the desert seeing the camels roam around and even take a ride on one. Dune bashing in 4-wheel trucks was enjoyed by the local, expats and tourists. Sunsets were always amazing.