develop educational standards, and by 1952, formal accreditation standards were in place. Legal cases Under US law, Frank v. South, Chalmers-Francis v. Nelson and other court decisions established that anesthesia was the practice of nursing as well as medicine. As such, the practice of anesthesia in the US may be delivered by either a nurse anesthetist or an anesthesiologist. The decisions have not been challenged since the Dagmar Nelson case. In addition to legal decisions, individual hospital and surgical facility policies also regulate the granting of anesthesia clinical privileges and are often based on contractual agreements with provider groups. Education History The first school of nurse anesthesia was formed in 1909 at St. Vincent Hospital, Portland, Oregon. Established by Agnes McGee, the course was seven months long, and included courses on anatomy and physiology, pharmacology, and administration of the few common anesthetic agents available at the time. Within the next decade, approximately 19 schools opened. All consisted of post-graduate anesthesia training for nurses and were about six months in length. These included programs at Mayo Clinic, Johns Hopkins Hospital, Barnes Hospital, New York Post-Graduate Hospital, Charity Hospital in New Orleans, Grace Hospital in Detroit, among others. During those early days of administering anesthetics, knowledge and available anesthetic options were extremely limited and programs provided what little education they could for all levels of health providers. For example, in 1915, chief nurse anesthetist Agatha Hodgins established the Lakeside Hospital School of Anesthesia in Cleveland, Ohio. This program was open to nurses, physicians, and dentists. The training was only six months and the tuition was $50. In its first year, it graduated six physicians, eleven nurses, and two dentists. Among the oldest schools in the U.S., Ravenswood Hospital in Chicago, opened in 1925 by Mae Cameron, which in 2001 became the NorthShore University HealthSystem School of Nurse Anesthesia, was the first school to be accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs in 1952. In 1981, the Nursing Council on Accreditation developed guidelines for master's degrees. In 1982, it was the official position of the AANA board of directors that registered nurses applying for a school of anesthesia shall be, at minimum, baccalaureate prepared and then complete a master's level anesthesia program. As early as 1978, the Kaiser Permanente California State University program had evolved to a master's level program. All programs were required to transition to a master's