What is a Nurse Anesthetist (CRNA)?
IN THIS ARTICLE
Certified registered nurse anesthetists (CRNAs) are advanced practice registered nurses (APRN) specialized in anesthesia, meaning they earned a graduate-level degree—either a master’s (MS) or a doctoral (DNP)—in anesthesia.
What Does a Nurse Anesthetist Do?
Nurse anesthetists work in anesthesia and pain management before, during, and after surgery or medical procedures.
CRNA practice includes pre-anesthetic evaluation and preparation, anesthesia induction, maintenance and emergence, post-management, and cardiac life support techniques.
The responsibilities and duties of a CRNA may vary depending on the setting, but in all cases, a CRNA can provide high level local and general anesthetics, intubate, and perform epidural, spinal and nerve blocks.
The following list is based on real CRNA job descriptions to give you an idea of the tasks and functions that may be expected of a nurse anesthetist.
- Complete patient assessments, review and request laboratory/diagnostic studies as needed and examine patient medical histories for allergies or illnesses to ensure safe anesthesia administration.
- Develop and implement an anesthesia care plan, individualized to each patient.
- Educate patients about anesthetics, contraindications, side effects, and recovery.
- Select, obtain, prepare, and use equipment, invasive and non-invasive monitors, supplies, and drugs for the administration of sedation, anesthesia, and pain management services.
- Administer anesthesia through a variety of methods, including epidural, spinal, or nerve blocks
- Monitor patient vitals and anesthesia dose during surgery; perform all aspects of airway management.
- Manage emergency situations by assessing, stabilizing, and determining the disposition of patients, including providing airway management, administration of emergency drugs and fluids, and using basic and advanced cardiac life support techniques.
- Terminate anesthesia in a timely fashion, and oversee the patient’s safety during anesthesia recovery.
- Initiate and administer post-anesthesia pharmacological or fluid support of the cardiovascular system and respiratory support to ensure adequate ventilation and oxygenation.
- Provide post-anesthesia follow-up evaluation and care, including selecting, ordering, and administering medications and fluids to maintain patient stability.
After reading through that description, you may realize the striking similarities between nurse anesthetists and anesthesiologists. Because the career paths are so distinct and entrance barriers high, few nurses attempt to cross-over. The question is still valid, “anesthetist vs anesthesiologist.” Which one is right for you?
To become an anesthesiologist, you will need to go to medical school and earn a Medical Doctorate (MD) or a college of osteopathic medicine and earn a Doctor of Osteopathic Medicine (DO). The years of commitment to education are longer to become an anesthesiologist—12 years vs. 7 years—but the pay is also higher—$387,000 vs. $123,404 (average 2020 annual salary in the United States).
According to Christopher Yerington, MD, former anesthesiologist, “CRNAs can do 99% of what an Anesthesiologist can do in an operating room….An Anesthesiologist can do everything a CRNA can do, plus more invasive procedures or minor surgical privileges can be extended to an anesthesiologist because they are a physician.”
Over the years, anesthesia has become safer and the administration of anesthesia has shifted to CRNAs instead of anethesiologists. As you’ll see in a moment, this shift makes the job outlook for CRNAs excellent.
In some states, CRNAs must work under the supervision of an anesthesiologist (in which case the ratio is generally 1:4), while in other states, nurse anesthetists may work independently.
Whether or not a CRNA can prescribe medications related to pain management varies by state.
This map shows in which states nurse anesthetists are authorized to work and prescribe independently without anesthesiologist supervision.
Over the years, anesthesia has become safer and the administration of anesthesia has shifted to CRNAs. As you’ll see in a moment, this shift makes the job outlook for CRNAs far better than other nursing and healthcare roles.
Work Environment
People tend to associate nurse anesthetists with operating rooms because CRNAs are integral for any surgical procedure, but CRNAs work in a wide range of health care facilities, from surgical hospitals and ambulatory care services to dental offices and home health services.
If ORs are not your comfort zone, then some of these settings may be more your style.
- Dental offices
- Plastic surgery clinics
- Ophthalmologist offices
- Mobile surgery centers
- Outpatient care centers
- U.S. military facilities
- Research facilities
- Hospital and government administration
Where do nurse anesthetists most commonly work? Here are the results, according to data from the U.S. Department of Labor Statistics. To find out which industry sectors pay the most (or least), head to the salary section.
Members of your Anesthesia Care Team will vary between different healthcare facilities. The American Society of Anesthesiologists outlined the possible members. Here are the most common members of that team.
- Anesthesiologist (Director of the Anesthesia Care Team)
- Anesthesiology fellow or physician resident (physician in training)
- Nurse Anesthetist (CRNA)
- Anesthesiologist Assistant (CAA)
- Student Nurse Anesthetist (SRNA)
- Anesthesiologist Assistant Student
As I mentioned earlier, in some healthcare facilities the CRNA may head the team or work independently. In most cases, nurse anesthetists work closely with all medical staff, patients, and families.
CRNA Job Outlook
The prognosis is excellent. Whether dental offices or large hospitals, medical facilities are increasingly hiring CRNAs to fulfill all anesthetic and pain management needs, particularly in states where nurse anesthetics are qualified to work independently.
CRNAs are in high demand. The projected employment growth of nurse anesthetists in the United States is expected to be 17% from 2018 to 2028, far higher than expected growth for all other occupations at 5%. Nurse practitioner employment is expected to grow at a phenomenal rate of 28%, though average salaries are far below those of a nurse anesthetist, which brings us to our next topic.
CRNA Salaries
Salaries vary by location and facility, so we’ll give you the numbers for different locations, facilities, and even nursing professions.
First off, the top-paying industries for CRNAs are—drumroll, please—outpatient care centers at an average rate of $93.84 per hour, followed by home health care services at $91.84 per hour.
| How Much Do CRNAs Earn? | |
|---|---|
| 5 Highest Paying Industries | Hourly Wage |
| Outpatient Care Centers | $93.54 |
| Home Health Care Services | $91.84 |
| Hospitals (Local government) | $91.73 |
| Specialty hospitals (State government) | $89.95 |
| General Medical and Surgical Hospitals (Private) | $89.76 |
| Lowest 3 Industries | Hourly Wage |
| Offices of Physicians | $80.84 |
| Colleges, universities, and professional schools (State government) | $69.15 |
| Professional, Scientific, and Technical Services | $48.41 |
The average nurse anesthetist salary in each state is in large part dependent on the living expenses in the area. To get an idea of what the average salary is in your state, you can find the average CRNA salary in your state by hovering over your state in the interactive heatmap below.
You may also want to try out Payscale’s nifty salary report tool, which tells you the expected salary based on location and experience.
Compared to other nursing professions, CRNAs are the highest paying nursing profession. Nurse.org gathered average salaries from various sources to compile their list of the 15 Highest Paying Nursing Careers. Here are a handful of those career options.
Do you have what it takes?
Nurse anesthetists need to have a high level of autonomy, work well under pressure, communicate clearly with medical staff and patients, multitask effectively, be attentive to detail, and prioritize responsibilities.
Performance requirements in a job posting may include some of these additional characteristics and skills.
- Effectively communicate both verbally and in writing to collaborate with various clinical staff
- Ability to demonstrate knowledge and skills necessary to provide care appropriate to the patients served
- Knowledge of infection prevention and control techniques
- Ability to demonstrate knowledge of the principles of growth and development over life-span and the ability to assess data reflective of the patient’s requirements relative to his or her population-specific and age-specific needs
- Proficient technical (computer) skills
- Self-motivated with initiative
- Strong sense of ethics
- Ability to manage conflict and resolve problems
Education and Experience Requirements
The minimum requirements to become a Certified Registered Nurse Anesthetist are education and certification.
- Master of Science in Nursing (MSN) from an accredited nurse anesthesia school
- Certification via the National Certification Examination
CRNAs gain clinical experience during the training program, accumulating 9,369 hours on average.
Ongoing certification is maintained through an eight-year Continued Professional Certification (CPC) Program.
We’ll go through all the details now.
Path to Becoming a CRNA
Are you still with us? If all this data has solidified your determination to become a nurse anesthetist, then let’s get into the details of what you need to do.
Nurse Anesthetists are advanced practice registered nurses (APRN). As such, they’ve earned their Bachelor of Science in Nursing (BSN) and worked as a registered nurse—yes, it’s required for at least one year—then returned to earn their Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP).
Note that “beginning January 1, 2022, all students matriculating into an accredited program must be enrolled in a doctoral program,” according to the AANA. Starting in 2025, CRNAs must complete a doctorate degree to be considered for a new certification.
If you are an RN with an ADN but have not earned your BSN, then look into RN-BSN bridge programs that can be completed in two years.
Once you earn your BSN, get your RN license, and work as an RN for at least one year, you will go through these milestones to become a CRNA.
1. Picking nurse anesthesia programs.
The accreditation body—the Council on Accreditation of Nurse Anesthesia Educational Programs (COA)—provides a search tool where you can search for schools based on several criteria including
- degree type,
- location,
- minimum GPA,
- minimum GRE,
- program duration,
- distance education (online learning),
- full/part-time, and
- application deadline.
You’ll need to determine if you can afford to stop working to pursue your degree. These programs can be very pricey with private schools costing more than sixty thousand dollars and public schools costing around forty thousand.
Regardless of your decision, spend time looking into scholarships. Don’t let a good opportunity pass you by.
So, if you find you need to continue working or simply want to continue working…
Can you study part-time while working? Yes. You have two options: part-time programs and online programs.
There are currently 13 accredited part-time programs listed on the COA site.
Nursing.org maintains a searchable database of accredited online programs. To date, 74 programs are listed.
Scroll down for a list of the top-rated programs nationwide.
2. Applying to accredited nurse anesthesia schools.
Preparing for the application process is actually a series of hurdles that you will need to leap through, like taking your GREs or shadowing.
Keep in mind that the program requirements vary, so you must pay close attention to admission requirements for each of your target programs.
- One to two years of experience as an RN (including one year in critical care nursing)
- Proof of valid RN license
- Bachelor’s degree in qualifying concentrations
- Completion of math and science prerequisites
- 3.0 overall GPA in college coursework
- GRE scores
- College transcripts
- ACLS/BLS/PALS certifications
- References
Additional requirements vary, including shadowing a CRNA, earning a CCRN (a specialty certification for acute/critical care nursing), or submitting your resume.
Applications to accredited nurse anesthesia schools are generally due between January and April, and studies begin in May at most schools. Some programs start in January with summer application deadlines. Because there is a wide variety, you will need to look up the schools you’re interested in and mark your calendars.
3. Earning an MSN or DNP in Nurse Anesthesia.
Every nurse anesthetist must finish an accredited program. These programs can take anywhere from two to four years.
Courses include pain management, anesthesia pharmacology, and anesthesia pathophysiology.
A critical part of any nursing program is clinical practice, which trains nurses to handle a variety of procedures for children, adults, and seniors.
4. Passing the National Certification Examination.
Graduates of nurse anesthesia educational programs must also pass the National Certification Examination administered by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA) to become a CRNA. Most institutes incorporate preparation and testing in their programs.
The exam consists of 100 to 170 questions, generally completed in three hours. This computer-administered test is designed to be responsive, which means the posed questions change based on the answers provided.
If you pass, then you’ve made it. You are officially and finally a nurse anesthetist or CRNA. To be able to continue to practice you will need to maintain certification over the years.
5. Maintaining CRNA Certification.
To maintain lifelong learning, the NBCRNA created a Continued Professional Certification (CPC) Program based on an eight-year period made up of two 4-year cycles.
This program requires online check-ins every two years, assessments, various credits and modules. It is quite involved and beyond the scope of this article. I recommend you check out the link.
Top Ranked CRNA Programs
Every year U.S. News ranks the top universities in every field, including nurse anesthesia. Here are the top seven schools holding the top four positions (four of them tied for fourth place).
| Rank | Program | Application Deadline | Tuition |
|---|---|---|---|
| 1 | Virginia Commonwealth University Richmond, VA |
March 1 | $6,300 |
| 2 | Baylor College of Medicine Houston, TX |
July 1 | $18, 536 |
| 3 | Duke University Durham, NC |
Oct. 1 | $26,535 |
| 4 tie | Kaiser Permanente School of Anesthesia – California State University – Fullerton Fullerton, CA |
Oct. 31 | $73,800 |
| 4 tie | Rush University Chicago, IL |
August 1 | $1,110/credit hour |
| 4 tie | Uniformed Services University of the Health Sciences Bethesda, MD |
August 15 | Free |
| 4 tie | University of Pittsburgh Pittsburgh, PA |
Feb. 15 and May 1 | $27,590 |
CRNA Podcasts
One of the best ways to get a sense of the discourse in the field of anesthesia is to listen to podcasts.
 From the Head of the Bed…a podcast for the anesthesia community |
 Beyond The Mask: Innovation & Opportunities For CRNAs |
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If you prefer to read or watch videos, then you might like to follow these CRNA bloggers: Nurse Jess and Nurse Nelle.
If you hear of a new podcast, blog, or other helpful resources, send us a message. Be sure to share this post and connect with us on social media.
