What Is a Nurse Anesthetist?
A certified registered nurse anesthetist (CRNA) is an advanced-practice nurse who is certified in anesthesia. According to the American Association of Nurse Anesthetists (AANA), nurses first gave anesthesia to wounded soldiers during the Civil War. Today, nurse anesthetists work in a variety of settings such as:
- Operating rooms
- Obstetric care
- Outpatient surgery centers
- Plastic surgery centers
- Dental offices
- Pain management centers
- Public Health centers
The difference between certified registered nurse anesthetists and anesthesiologists is that CRNAs are graduate degree-level nurses, and anesthesiologists are medical doctors. In many states, CRNAs can practice without physician supervision. According to the AANA, when anesthesia is administered by a certified nurse anesthetist, it is considered nursing practice. If administered by an anesthesiologist, it is considered practicing medicine. However, anesthesia is administered the same way by both professionals.
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Why Are Certified Registered Nurse Anesthetists So Important?
Certified registered nurse anesthetists are valuable members of the health care team. Not only do they work in busy hospitals in metropolitan areas, but they can also serve as primary anesthesia providers in rural and underserved communities. Their presence in these communities allows for improved access to treatments while providing competent, quality care.
Nurse anesthetists also help reduce health care costs. Since they do not always require physician supervision, depending on the state in which they practice, they are sometimes the only anesthesia provider available. Organizations compensate CRNAs less than anesthesiologists, which reduces the cost to the organization as well as insurers, thereby reducing the cost to the patients.
Certified registered nurse anesthetists start off as registered nurses. A significant role of the RN is to provide education. CRNAs thoroughly educate patients and families about specific anesthesia and treatments, including side effects and recovery. Comprehensive education can enhance recovery and lead to higher patient satisfaction.
How to Become a Nurse Anesthetist
Nurses interested in becoming nurse anesthetists should value autonomy and independence. They should be able to:
- Pay close attention to detail
- Work well under pressure
- Work collaboratively with different personality types
- Be flexible, and adapt to changing situations
- Prioritize responsibilities
What Are the Education Requirements for Nurse Anesthetists?
CRNAs are advanced practice registered nurses who have completed a Master's of Science in Nursing (MSN) or doctoral degree program (DNP). Currently, the AANA plans to require all CRNA programs to change from MSN to DNP programs by 2025.
To advance to a master's degree, a student must first complete an accredited nursing program and obtain a bachelor's degree in nursing (BSN). Successful completion of the NCLEX-RN is needed for licensure. The length of time to become a Certified Registered Nurse Anesthetist (CRNA) may vary depending on the program. However, these are the minimum requirements:
- A Bachelor of Science degree in nursing (BSN) or another related field from an accredited program
- An unrestricted license as a registered nurse
- A minimum of one year (full-time or part-time equivalent) experience as an RN in a critical care setting
- Completion of, at minimum, a master's degree from an accredited nurse anesthesia educational program
Nurse anesthesia programs are accredited by the Council on Accreditation of Nurse Anesthesia Education Programs (COA). There are currently 121 accredited nurse anesthesia programs in the US and Puerto Rico.
A nurse anesthesia program ranges anywhere from 24-51 months, depending on the university, and includes clinical experience as well as didactic classroom hours. On average, it takes a minimum of 7 to 8.5 years of experience and education to become a CRNA.
Recertification and continuing education for CRNA's is different than other APRNs. The recertification program for nurse anesthetists is called the Continued Professional Certification (CPC) Program and is administered by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA). The requirement for continuing education (CE) credit is robust; CRNA's must meet 60 general CE credits and an additional 40 CE credits covering four content areas including airway, pharmacology, physiology and pathophysiology, and anesthesia equipment along with a comprehensive certification exam every eight years.
Depending on the school, the curriculum for CRNAs can vary slightly, but core concepts include:
- Advanced pathophysiology in anesthesia
- Advanced health assessment for nurse anesthesia
- Principles of anesthesia
- Clinical anesthesia
Are Any Certifications or Credentials Needed?
After graduating from an advanced-degree program, nurses can become credentialed as CRNAs. The National Board of Certification & Recertification of Nurse Anesthetists (NBCRNA) offers certification by examination. The exam is of variable length and designed to ensure the competency of entry-level CRNAs. The NBCRNA provides a handbook outlining detailed eligibility requirements to take the exam. General requirements include:
- Hold an active, unrestricted RN license
- Hold a graduate degree from an accredited nurse anesthetist program
- Submit a record of academic and clinical experience which must:
- Be submitted by the nurse anesthesia educational program administrator
- Be signed by both the administrator and candidate
- Accurately show the minimum requirements have been met
Licensure and certification are different—certification means the CRNA is competent to deliver anesthesia in a health care setting; licensure means they are legally permitted to practice in their state of residence. State nursing boards list the requirements for testing and can vary from state to state. The CRNA can, after meeting the specified requirements, apply to the state board for licensure.
Certified registered nurse anesthetist is a specialty in and of itself. There is no further delineation in practice per se, other than focus areas. For example, there is no specific "Pediatric Certified Registered Nurse Anesthetist" or "Obstetric Certified Registered Nurse Anesthetist" and so on. However, CRNAs can complete clinical rotations in various care areas to gain skills. For example, they may work in:
- Children's hospitals
- Obstetric/ labor and delivery units
- Cardiothoracic care areas
Post-graduate CRNAs can also participate in accredited fellowship programs (Updated Jan 5, 2021) that focus on certain populations, for example:
- Trauma/critical care
- Acute surgical pain management
- Advanced pain management
The NBCRNA offers a voluntary sub-specialty certification in nonsurgical pain management. CRNAs who obtain certification are competent in neural or neuraxial blocks, alternative techniques for the management of acute and chronic pain (pharmacologic and non-pharmacologic). Criteria for examination include:
- Unrestricted RN/APRN license
- Current CRNA certification
- At least two years of nurse anesthetist clinical experience
- Attestation of being actively engaged in nurse anesthesia practice
- Evidence of completion of the education in specific pain management areas
- Provide three letters of support from colleagues who have observed the practitioner's techniques
- Successful completion of a simulation course
- Successful completion of the certification exam
Nurse Anesthetists FAQs
Nurse Practitioners (NPs) and nurse anesthetists are similar in that they are both advanced-practice nurses. However, they do differ in terms of education, job duties/roles, and salary.
Both NPs and certified registered nurse anesthetists (CRNAs) start off in a master’s or doctorate program to earn their advanced-practice degree. After foundation courses are completed, students complete courses pertaining to their specialty “track”. For example, NP students focus on adult or pediatric primary or acute care, women’s health, psychiatry, etc., while the nurse anesthetist students begin a course of study on anesthesia concepts and research.
The roles and duties of an NP versus a nurse anesthetist are quite different. While both must take a complete history and complete a full assessment, a nurse practitioner, depending on his or her role, is responsible for the care of the patient in either the acute or primary care setting. They may focus on preventive care, or care for the patient during an acute illness. Nurse anesthetists have a different, highly specialized role. They are responsible for administering anesthesia and sedation, monitoring the patient during a procedure, and inserting central lines and epidurals. They must be knowledgeable about the different types of anesthesia medications and be alert to any adverse reactions.
Because CRNAs are in high demand, it is not uncommon for hospitals to begin recruiting students. Depending on the state, some CRNA students can sign contracts while still in school, and employment is contingent on becoming licensed. In other states, licensing is required first.
Many hospitals offer employment contracts with CRNA students, advertising student loan reimbursement, benefits packages, etc. It’s a good idea to read these contracts closely. Sometimes students are dazzled by the loan reimbursement, but realize the pay or benefits aren’t that great. Also, sometimes a length of time of employment is outlined in the contract, and the new graduate decides a specific work area or organization is not a good fit for them - and they are stuck. There may be the possibility to “buy out” of a contract, but it would take time and money out of pocket to do so.
CRNA students should read any contract carefully, and possibly have an attorney advise. Identifying the positive and negative aspects of a contract is a must to determine what component is of most value to the individual. Additionally, CRNA students are strongly encouraged to check their state's board of nursing to see if licensing is needed before signing a contract.
Certified Registered Nurse Anesthetists (CRNAs) are advanced-practice nurses who are certified in administering anesthesia. Due to a widespread physician shortage, advanced-practice nurses are taking a more prominent role in healthcare delivery - including the field of anesthesiology.
While healthcare continuously progresses and evolves, there are still remnants of “old-school” hierarchies that exist between physicians and nurses and yes, male and female providers. Some physicians have difficulty coming to grips with a nurse practicing at an advanced level and performing the same work as medical doctors. Additionally, tensions run high during a surgical procedure. Everything must be precise and organized to allow for the best patient care outcome. The strain of this considerable responsibility often brings the worst out in people- and a hierarchical environment doesn't help matters.
In healthcare, new practitioners sometimes must “prove themselves” to experienced staff to earn respect. There are many anecdotes of nurses and APRNs verbally biting back when they are snapped at by a physician, and the hostility stops. However, it's not acceptable for any verbal abuse or harassment to occur in any setting, including the operating room. It doesn't matter if the culture is "old-school" or not. If discussing the issue directly with the surgeon doesn't end the behavior, it should be reported immediately to a supervisor.
What Does a Nurse Anesthetist Do?
Nurse anesthetists have a vital role in the delivery of anesthesia. Medications used for anesthesia can be risky. CRNAs must use their nursing skills and knowledge of the medications to maintain patient safety as well as achieve the desired effect of the drug. Specific duties may include:
- Performing a physical assessment
- Taking a patient history
- Educating patients and families on the anesthetics used: the desired effect, common side effects, and potential adverse reactions
- Obtaining informed consent before procedures
- Administering the anesthetic, which may be:
- Monitoring patients during administration to include:
- Cardiovascular status (including fluid balance)
- Neuromuscular status
- Utilizing adjunctive medications, fluids, and other treatments to maintain cardiorespiratory status and fluid balance if needed
- Maintaining/managing patients' airways using intubation, mechanical ventilation, and pharmacological support
- Inserting peripheral or central lines
- Inserting epidurals for obstetric patients
- Recovering patients from anesthesia
What Are the Roles and Duties of a Nurse Anesthetist?
The overall responsibilities of CRNAs include:
- Developing, implementing, and evaluating an anesthetic plan of care
- Recognizing emergent situations and responding rapidly and appropriately
- Implementing and evaluating response to chronic/acute pain management techniques
- Discharging patients and educating them on follow up anesthesia care
- Acting as a liaison between various departments, such as:
- Post-anesthesia care units
- Intensive care units
- Collaborating with a physician regarding treatment plans and anesthesia efficacy
- Maintaining patient safety during treatment
- Following strict infection control policies and procedures
Nurse Anesthetist Working Conditions
The working conditions of CRNAs have positive and negative aspects. There can be a significant amount of stress involved. For example, patients who suffer from chronic pain and who fail to respond to treatments can be emotionally draining to providers. Patients who experience an unexpected adverse reaction to anesthesia can also cause stress. Certified nurse anesthetists must "expect the unexpected" and be able to act quickly. The constant requirement to be on guard can be draining.
However, CRNAs have a rewarding job. They can relieve a patient's pain. Pain relief may seem like it's easily achieved, but for many suffering from chronic pain, that is not always the case. Nurse anesthetists can help patients go from poor quality of life to living life to the fullest. They help new mothers experience childbirth without being distracted by the pain. They help patients through sometimes life-saving surgeries.
CRNAs may work in high-risk areas that may expose them to workplace violence, blood-borne pathogens, and chemicals. Safety precautions and policies and procedures must be followed to maintain the health and safety of the CRNA as well as patients. Additionally, CRNAs sometimes spend a lot of time on their feet, assisting during long surgeries or procedures.
As far as work hours, CRNAs can work in various settings, many times in acute care. Hours vary but may require night, weekend, holiday, and on-call shifts.
Nurse Anesthetist Employment Outlook & Salary
Nurse anesthetists have had a long, robust history that has evolved into a highly respected and in-demand career. They are commonly the only anesthesia providers in less populated communities, which leads to higher access to care and therefore, improved patient outcomes.
Certified registered nurse anesthetists are one of the highest-paid advanced-practice nurses. According to Payscale, the salary can range from $110k to $203k. The median salary is $158k per year. The top-paying states for CRNAs are:
Salary is dependent on city and state of residence, years of experience, and the organization of employment
According to the Bureau of Labor Statistics, the projected employment of CRNAs is expected to grow 45% by 2029, which is a much faster-than-average growth. Currently, the states with the highest level of employment for CRNAs are:
- North Carolina
For a more detailed understanding, check out our breakdown of a nurse anesthetist salary.
Helpful Organizations, Societies, and Agencies
- American Association of Nurse Anesthetists
- American Society of Regional Anesthesia and Pain Medicine
- International Student Journal of Nurse Anesthesia
- American Society of PeriAnesthesia Nurses
- National Board of Certification and Recertification for Nurse Anesthetists
- Diversity of Nurse Anesthesia
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How can I increase my chances of getting into CRNA school? ›
- 1) Graduate from an accredited BSN program. ...
- 2) Maintain good grades. ...
- 3) Obtain critical care experience as an RN. ...
- 4) Be a leader in your community—get involved. ...
- 5) Job Shadow. ...
- 6) Take the GRE/CCRN. ...
- 7) Take Graduate level courses. ...
- 8) The interview is KEY.
Current registered nurses seeking a career change can become a nurse anesthetist with 1-3 years of critical care experience and a graduate degree from a nurse anesthesia program. This route typically takes 2-3 years for those with a BSN or 3-4 years for RNs without their BSN.Am I good enough to be a CRNA? ›
If you have a mind for science, have always excelled in critical thinking skills, and are somewhat of an introvert, you should be a CRNA. Everyone wants a career that's at least a little bit challenging, but you don't want to struggle through every day at work!Is a 3.5 GPA good for CRNA school? ›
It's especially important that you earn a GPA of at least 3.0 in your health- and science-related courses for admission to most programs. If you're anything like me, then you had no idea where you were going to work after graduating from nursing school, let alone even think about applying to CRNA school.What is a competitive CRNA GPA? ›
While GPA is very important, and we will not consider students who do not meet our minimum GPA, students do not need a 4.0 to get into our program. Our 2022 cohort had an average overall GPA of 3.43 and an average nursing GPA of 3.59.Is it too late to become a CRNA? ›
Am I too OLD to go back for CRNA? It's a very common question asked inside our communities, and the decision can feel really overwhelming. The good news is, whether you're looking at a career change, or just getting a later start, CRNA is a total possibility for you!Why is CRNA so hard? ›
Why is CRNA School Hard? CRNA school is so hard because of the massive amount of information that students have to retain. They may be expected to read several hundred pages of information each week that contains information they need to know for their lectures and clinical experiences.What is the average age of a CRNA? ›
Certified Registered Nurse Anesthetist Gender By Year.
According to the website Salaryexpert.com, an entry-level nurse anesthetist will command an annual salary of $120,581, while a senior CRNA will earn $220,557.Can an average student become a CRNA? ›
To be considered competitive for CRNA school you should aim to have a 3.5 or higher. Keep in mind that a lower GPA will still be considered because they look at the candidate as a whole, however, there are necessary steps you need to take to be competitive with a lower GPA.
What personality type is CRNA? ›
You should be patient, compassionate, accurate, and responsible. The CRNA profession requires a “Type A” personality that is willing to work diligently and willing to continue their education after graduation to keep pace with changes in the field of anesthesia.Can a CRNA make 300k? ›
Yes. Nurse anesthetists can make $300,000 a year, or close to that figure. In upstate New York, one of the top-paying nonmetropolitan areas for nurse anesthetists, CRNAs earn $261,730 annually.Can you go to CRNA school without ICU experience? ›
Why is ICU experience important for applicants? All CRNA programs require some ICU experience. Those applying for admission who possess comprehensive intensive care unit (ICU) experience are better equipped to handle the demanding program of study and are thus considered more competitive candidates for admission.Does CRNA require lots of math? ›
We had a semester long class of Chemistry and Physics of Anesthesia. It was mainly focused on Gas/Fluid Laws and their application to anesthesia; but there was some math. Generally the math is nothing more complicated than the med calcs you did in nursing school.What is the best state to be a CRNA? ›
|Rank||State||Average CRNA Salary|
The average CRNA salary is so high because the position requires very advanced knowledge and skills. While many nursing positions only require that you have a Bachelor's degree, or even an Associate's degree, Certified Registered Nurse Anesthetists need at least their Master's of Science in Nursing (MSN) degree.Can CRNAs practice in all 50 states? ›
Although 30 states, such as California, and the District of Columbia, allow CRNAs independent practice, many other states, including Florida and South Carolina, require physician supervision of CRNAs.What is a good GPA for CRNA? ›
The average GPA of accepted students is 3.7. You are right where you need to be with this domain. Evidence of academic ability is extremely important. Graduate education in general and anesthesia education in particular are very demanding, academically.What GPA do CRNA schools look at? ›
Admission Requirements: To qualify for admission into this highly competitive CRNA program in California, you must either have a BSN or a BS and an active RN license. Furthermore, National requires you to have an undergraduate GPA of 3.25 and a science GPA of 3.0 or higher.Can a CRNA call themselves an anesthesiologist? ›
“While there is no question about the level of service and professionalism CRNAs bring to anesthesia care, they are not anesthesiologists, in the same way nurses are not physicians,” the brief informs the court in the case, In re Appeal of New Hampshire Association of Nurse Anesthetists.
How old are most CRNA students? ›
Most of us are probably in the 26-30 range, though there are more than a few 30+ and 40+, and a handful of 50+.Can CRNA work 12 hour shifts? ›
A certified registered nurse anesthetist (CRNA) typically works two 24-hour long shifts per week. There are some settings which a certified registered nurse anesthetist (CRNA) may work 8 or 12-hour shifts, but 24-hour shifts are also common.Do nurse anesthetists work 12 hour shifts? ›
You may be assigned to a combination of 8, 10, or 12 hours shifts, including evening, nights, weekends, and holidays totaling 40 hours per week as well as on call shifts.
While the CRNA degree is challenging, most health care professionals would agree that medical school for doctors is far more rigorous.How many people fail CRNA? ›
Attrition rates between 20-30% mean 1 out of every 3 or 1 out of every 5 students who begin the program do not graduate.Can you get rich as a CRNA? ›
The average annual salary for a CRNA is $140,357.71 a year. However, this is only a small fraction of the position's earning potential. With a bit of experience and working in the right location, a CRNA can earn over $200k a year.How can I raise my GPA for CRNA school? ›
If the minimum cumulative GPA is below 3.0, the applicant will not be considered for admission. An applicant can raise the GPA by retaking courses to improve a grade or taking additional courses and receiving higher grades. A new GPA will then be re-calculated from both new and previous transcripts.What is the acceptance rate for CRNA school? ›
CRNA School Acceptance Rate
Acceptance rates to CRNA School vary quite a bit: from 6% to 63% of applicants accepted. The average acceptance rate is 24%.
The average GPA of accepted students is 3.7. You are right where you need to be with this domain. Evidence of academic ability is extremely important. Graduate education in general and anesthesia education in particular are very demanding, academically.Why is CRNA school so difficult? ›
Intense clinical requirements:
Most CRNA programs require 2,000 hours or more of direct anesthesia-related patient care. This time does not include the time you will spend preparing for clinicals and prepping for difficult cases. Completing intense clinical requirements on top of your coursework makes CRNA school hard.