A Lifelong Calling: Leading Delaware’s First Doctoral Nurse Anesthesiology Program

While most teenagers may worry about their grades, their futures, or their friends, a young Dr. Jacqueline Mainwaring faced a much deeper fear: her oldest sister Debbie’s battle with cystic fibrosis, a genetic condition affecting her lungs and other organs.

“She was in and out of hospitals her entire life. She passed away when I was 15. She was 18,” Dr. Mainwaring says. “The nurses that cared for her directly impacted my wanting to become a nurse.”

As a certified registered nurse anesthetist (CRNA), certified nurse educator, and WilmU graduate, she’s delighted to serve as director of the new Delaware Nurse Anesthesiology Program at ChristianaCare and Wilmington University. “I care so much about the school, the practice, the state,” Dr. Mainwaring says. 

The third of four children in a military family, she “grew up all over the world,” which taught her to be “open to other perspectives or views.”

“It actually makes you very adaptable and able to reach out for help because you’re always new,” Dr. Mainwaring says. “As an adult looking back, I don’t think I appreciated that as a child.”

Becoming a Compassionate CRNA 

When her father retired from the Air Force, her parents returned to their home state of Delaware. By then, she was studying nursing at Marymount University in Arlington, Virginia. One day, during clinical rounds, a chance encounter left an impression.

The operating room nurse “wanted nothing to do with a student nurse, nothing. And the CRNA said, ‘Hey, come over here with me. You can hang out with me,’ and I was hooked,” says Dr. Mainwaring. “I knew then that that’s what I wanted to do.”

She remembers how the nurse anesthetist “immediately clicked with the patient and put them at ease. It was advanced practice with so much responsibility, respect, and leadership, but it was bedside,” Dr. Mainwaring says. “For the practice of nurse anesthesia, we are at the patient’s bedside all the time.” 

She graduated with an associate degree and started caring for patients as a registered nurse at the Medical Center of Delaware, now ChristianaCare. Dr. Mainwaring took classes at night and earned a bachelor’s degree in Nursing from Wilmington College, now Wilmington University. In 1996, she completed her master’s in Nurse Anesthesia at the Medical College of Pennsylvania. She joined Anesthesia Services, P.A. (ASPA) in New Castle, where she continues to work today. 

“A CRNA is an advanced practice registered nurse who undergoes rigorous specialized training to care for patients in any setting in which anesthesia services are needed, so that’s all across the lifespan,” Dr. Mainwaring says. “CRNAs have been around for over 150 years. It was a specialty in nursing before it was a physician specialty.”

She considers practicing that specialty an honor. “It’s a privilege to me that patients entrust you at probably their most vulnerable time, a time that they can’t advocate for themselves,” Dr. Mainwaring says. “We are there for them. We have to be there for them, so our vigilance, knowledge, and skills are critical. And I think that it’s not boastful. It’s almost humbling.”

She’s cared for thousands of patients, including colleagues’ family members and several surgeons’ mothers.

“I always felt as a mother, ‘Wow, if this person is asking me to take care of their mother, it means something,’” Dr. Mainwaring says. “I’m going to care for her like she’s my loved one, and that’s how I approach every patient because they are someone’s loved one.”

Her commitment and compassion help even the most anxious patients feel comfortable, including one woman who had “some serious concerns” with anesthesia.

“I went out of my way to talk to her for a longer period to come up with a solution that I thought would make her experience different, hopefully, better than it had been in the past. And it was just something that I would normally do,” Dr. Mainwaring says. “Afterward, she wrote this long letter expressing how impactful my valuing her past experiences and considering them in the plan (was), how grateful she was.” 

Becoming an Engaging Educator

These days, Dr. Mainwaring is grateful for her new position and eager to make a difference. ChristianaCare and ASPA are partners in the Delaware Nurse Anesthesiology Program, bringing her journey full circle. 

“It was the perfect timing and connections and how it all happened,” Dr. Mainwaring says. “It just feels right to be here right now.”

This marks her third time at Wilmington University. Since she had “such a good experience” with the B.S. in Nursing program, Dr. Mainwaring chose WilmU for her Doctor of Nursing Practice (DNP) degree, graduating in 2018. While working toward her DNP, she began teaching at Thomas Jefferson University in Philadelphia, advancing to assistant director and then director of Jefferson’s DNP Nurse Anesthesia Program. 

To qualify as a CRNA, “it’s a rigorous program. It’s three years full time. The clinical component is tough. It’s in an environment that is high stakes. It is dynamic. You’re being evaluated every day. It’s not easy,” says Dr. Mainwaring, stressing the need for a collaborative environment. “I want (students) to support one another. I want faculty to support one another, and I want faculty to support students. It’s an intentional culture. You create this culture.” 

She is as devoted to teaching as she is to health care. “I’m passionate about curriculum. I’m passionate about education. I’m passionate about advocacy and well-being,” says Dr. Mainwaring, who also holds a Ph.D. in Nursing from Indiana University of Pennsylvania. Plus, “I am genuinely, authentically passionate about my practice and my patients.”

Like other WilmU instructors who are active leaders in their fields, she will continue her clinical practice part time — recognizing the importance of “role modeling and empowering and inspiring the future CRNAs.” 

Staying involved in patient care “gives you credibility with the students that you know what you’re talking about: ‘Yes, I was in the operating room last week, and this happened to me. How can we learn from this experience? Tell me about your experience,’” Dr. Mainwaring says. “There is a story for each of these cases. And each case then informs your clinical decision-making for the next case.”

Those who know her praise Dr. Mainwaring’s knowledge and kindness. “The students love her. She would always go out of her way to help all of her students,” says Dr. Li Maceda, an anesthesiologist, ASPA board chair, and longtime co-worker. “If you talk to Jacqui, the first thing that comes to mind is just how kind and thoughtful she is. You see that in patient interactions. You see that in her interaction with colleagues, students, surgeons — across the board.” 

“Dr. Mainwaring is deeply committed to the comprehensive development of nurse anesthetist students in her program,” says Dr. Tabassum Salam, chief learning officer at ChristianaCare. “She emphasizes the importance of creating a positive environment and actively works to foster a culture that supports student well-being alongside their academic and technical achievements.”

Becoming an Ardent Advocate

Dr. Mainwaring effects change in and out of the classroom. When she was president of the Delaware Association of Nurse Anesthetists (DANA), she and others successfully lobbied for advanced practice registered nurses (APRNs), including CRNAs, to have full practice authority in the state. 

“It was very exciting. I got to testify in front of the House and Senate,” says Dr. Mainwaring, calling 2021 “a landmark year” because Delaware Gov. John Carney signed the bill into law.

Dr. Mainwaring advocates for nurses as vice president of the Delaware Board of Nursing and chair of DANA’s Government Relations Committee. 

“Even though she’s gentle and kind, she’ll also stand up for what she believes to be right,” Dr. Maceda says. “She has a lot of emotional intelligence, which I think is an extremely important quality to be a good program director.” 

“Dr. Mainwaring is an experienced clinician and academic leader with deep roots in the Delaware anesthesiology community,” says Dr. Aaron Sebach, dean of WilmU’s College of Health Professions and Natural Sciences. “Her unwavering dedication to academic excellence and advocacy advancing the nurse anesthesiology profession make Dr. Mainwaring the ideal leader for the Delaware Nurse Anesthesiology Program at ChristianaCare and Wilmington University.”

Establishing a DNP Degree in Anesthesiology  

The 36-month, full-time, cohort-based DNP degree program will transform critical care registered nurses into CRNAs. Courses will focus on real-world learning, with more than 2,000 hours of clinical experience across surgical specialties and patient populations.

“Delaware provides a unique opportunity to do that in a small geographical area,” Dr. Mainwaring says. “We have only three counties, but our students can engage with the urban patient population, the suburban patient population, and rural populations.”

From a staffing perspective, the timing couldn’t be better. “The demand for surgical services has just gone up to an incredible amount compared to five years ago, and the number of our anesthesia providers has gone down 20% since COVID, both physicians and CRNAs, due to retirement and due to just the average age of the current providers being above 55 years old,” says Dr. Maceda, who describes “phenomenal” interest in the new program. “The enthusiasm from other health systems throughout Delaware: It has just been incredible.”

Everyone involved is eagerly awaiting Delaware’s first doctoral nurse anesthesiology program, which is under review and pending approval from the Council on Accreditation of Nurse Anesthesia Educational Programs (COA). Once the COA awards its initial accreditation, WilmU can start enrolling students. 

Looking Ahead to a Meaningful Year

“I just think it’s going to make an impact in this state, and that means a lot to me,” says Dr. Mainwaring as she prepares for a “huge” year ahead, personally and professionally.

In addition to launching the much-anticipated Delaware Nurse Anesthesiology Program at ChristianaCare and Wilmington University, she’s looking forward to two family weddings.

Dr. Mainwaring’s daughter will walk down the aisle in May, and her son will marry in September. She and her husband, a retired anesthesiologist, have been married for 15 years and enjoy being grandparents to his daughter’s two children. “This is a big year, but it’s an exciting time for all of us,” Dr. Mainwaring says, speaking as a mother, educator, and nurse.

“It was my personal experiences with the nursing profession that influenced my decision to become a nurse, and I love being a nurse,” she says. Reflecting on her future at Wilmington University, Dr. Mainwaring shares a piece of wisdom someone once gave her: “If each of your graduates takes care of 1,000 patients a year, how many patients are you actually impacting? So many more than if you were a full-time practitioner.”

— Emily Ryan