Certified Registered Nurse Anesthetist Overview

Learn what it takes to become a CRNA.

Providing critical care at some of the most significant times in their patients’ lives, a certified registered nurse anesthetist (CRNA) is responsible for safely administering anesthesia prior to medical procedures. CRNAs are responsible for much of the comfort and safety of their patients, and the role requires extensive education and experience.

Why Enter this Field?

While it takes time and dedication to become a nurse anesthetist, the work can most certainly pay off. Not only do many CRNAs work independently, but they also make the most money among advanced practice registered nurses (ARPNs). If you’re interested in joining this rewarding and high-paying field, learn about the education you’ll need, job duties, certification requirements, and advancement opportunities.

Working in settings such as hospitals, surgery centers, medical offices, and dental clinics, CRNAs administer anesthesia to patients for surgical, obstetrical, and trauma care procedures.  

Not only do many CRNAs work independently, but they also make the most money among advanced practice registered nurses (ARPNs).

CRNAs collaborate with doctors and other nurses to develop pain management plans for each patient. The methods for administering anesthesia vary and can include injections, inhalants, and oral anesthetics.

Education Requirements for CRNAs

Currently, you need a master’s degree and national certification to become a certified registered nurse anesthetist, but that will change in 2025, when a doctoral degree will be required to enter the field. Per the Council on Accreditation (COA) of Nurse Anesthesia Educational Programs, all CRNA degree programs must include a doctoral degree by January 1, 2022. All students enrolled in CRNA master’s degree programs at that time will be required to transition to a doctoral program.

Since it generally takes two years for a student with an MSN to earn a doctorate, students hoping the beat the DNP deadline would have to be well into the first year of their doctorate in 2020.

Nursing Groups Welcome the Shift to a Doctoral Degree for CRNAs

Raising the education level to a doctorate for CRNAs has been a long time coming and has strong support from nursing organizations.

“The movement to doctoral education for CRNAs was not a snap decision; rather it was a long-evaluated and thoroughly explored decision,” says John C. Preston, DNSc, CRNA, FNAP, APRN, chief credentialing officer with the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA).

The American Association of Colleges of Nursing (AACN), a trade group that represents private and public schools of nursing nationwide, also welcomes the change.

“Since 2004, the American Association of Colleges of Nursing has called for doctoral preparation for all advanced practice registered nurses, including certified registered nurse anesthetists (CRNAs),” says Robert Rosseter, AACN spokesman. “We applaud the American Association of Nurse Anesthetists, the Council on the Accreditation of Nurse Anesthesia Educational Programs, and the larger CRNA community for making this transition, which will ensure that patients have access to the highest quality nurse anesthetists possible.”

While the new certification requirements do not specify the type of doctoral degree CRNAs must pursue, the most common choice likely will be the Doctor of Nursing Practice (DNP).

Other options will be:

  • Doctor of Philosophy (PhD)
  • Doctor of Education (EdD)
  • Doctor of Nursing Science (DNS)

CRNA Prerequisites

Before beginning a CRNA degree program, you must be a registered nurse (RN) with a Bachelor of Science in Nursing (BSN) degree. You’ll also need at least one year of experience in an acute care setting such as an intensive care unit (ICU) or emergency room (ER), though you might need more depending on the acceptance requirements of your school.

Before you can apply to a master’s program, you’ll need at least one year of experience in an acute care setting.

After meeting these requirements, you can apply to a graduate degree program for nurse anesthetists. To increase their chances of getting accepted, some nurses pursue specialty certification as a critical care registered nurse (CCRN).

Is Accreditation Important?

When applying to master’s programs, make sure the one you choose has been approved by the Council on Accreditation of Nurse Anesthesia Educational Programs (COACRNA). You must graduate from an accredited program to take the certification test.

What Will I Study in a CRNA Program?

All accredited nurse anesthetist programs require studies in the following areas:

  • Anesthesia pharmacology
  • Chemistry, biochemistry, and physics
  • Anatomy, physiology, and pathophysiology
  • Anesthesia equipment and technology
  • Pain management
  • Statistics and research
  • Professional and legal aspects of nurse anesthesia practice

In addition, you’ll have supervised clinical practice to apply the theories and techniques you’ve learned in a hands-on way. You’ll work at a university-based or large community hospital and gain experience in a wide variety of procedures, from labor and delivery to open-heart surgery. Learn more about the requirements for getting into a graduate degree program and what you’ll study.

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How Long Does It Take to Get Certified?

The steps to become a CRNA take a minimum of seven years to complete.

Step

Time


Bachelor’s degree in nursing

Average of four years


RN licensure

Eligible upon completion of bachelor’s degree


Acute care experience

Minimum of one year


Graduate degree (MSN or DNP) in nurse anesthesia

Two to four years


CRNA certification

Eligible upon completion of graduate degree


State licensing

Eligible upon passing CRNA certification exam

Earning a Doctorate: How Long Does It Take?

The time required to earn a doctoral degree in a CRNA program will vary depending on your level of education.

Those with a BSN degree can expect to spend three to four years in a full-time doctoral degree program, while candidates who already hold a master’s degree may be able to earn a doctorate in just one to two years.

Some students choose accelerated programs to save time and money. For instance, a BSN-to-DNP program can take three to four years of full-time coursework, compared to five to six years to complete an MSN and then a doctorate.

Earning Certification

After completing a master’s program, you’ll be eligible to take the certifying exam administered by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA). You’ll answer a minimum of 100 computerized questions, though you may be given up to 170 as the test determines with certainty whether you’ve passed.

If you pass, verification of your certification will be sent to your state board of nursing, at which time you can complete any additional steps required by your state to become a CRNA.

Certification Renewal and Continuing Education

To maintain your national certification, you’ll need to pursue continuing education in line with the NBCRNA’s Continued Professional Certification (CPC) Program. The NBCRNA evaluates nurse anesthetists on an eight-year cycle consisting f two four-year periods. This means that every four years, you must complete:

60 Class A credits on activities directly related to the delivery or improvement of anesthesia care

40 Class B credits on anesthesia practice or professional development topics such as:

  • Patient safety
  • Public education
  • Research

Four core modules that address:

  • Airway management
  • Applied clinical pharmacology
  • Physiology
  • Pathophysiology
  • Anesthesia equipment and technology (doesn’t apply to those in their first four-year cycle)

In addition, every two years, you’ll complete an online check-in to confirm your state license and that you’ve been continuing to practice.

At the end of each eight-year cycle, you’ll be required to take the CPC Assessment test. This 150-question exam is used to test your knowledge of the four Core Modules of nurse anesthesia.

The test isn’t pass/fail, but if you’re deemed to not meet the performance standards, you’ll need to complete additional continuing education to maintain your certification.

Job Duties of a CRNA

Once you’re on the job, you’ll spend a great deal of time with patients. The day-to-day work of a nurse anesthetist includes:

  • Requesting diagnostic studies and examining patients’ medical history
  • Developing an appropriate anesthetic plan
  • Discussing side effects and risks with patients and families
  • Preparing and administering anesthesia in a variety of forms
  • Performing spinal, epidural, or nerve blocks
  • Monitoring vital signs during and after surgery to prevent and manage complications
  • Responding to emergency situations with medication, airway management, or life support techniques

Many CRNAs also take on administrative duties such as ordering medications, managing finances, and training new staff. They might act as instructors for development courses, hold positions with state boards of nursing, or be involved in organizations that set standards for the medical field.

Nurse Anesthetist vs Anesthesiologist:
What’s the Difference?

Nurse anesthetists and anesthesiologists are both medical professionals who are trained to administer anesthesia to patients. The primary differences between the roles are title and education.

As medical doctors (MDs), anesthesiologists complete at least four years of post-graduate education and four years of residency and earn higher salaries.

While both medical professionals work in a variety of settings, smaller offices tend to employ CRNAs over anesthesiologists. In some states, CRNAs are required by law to work under the supervision of a board-certified physician. In other states, CRNAs can practice independently.

CRNA Salary & Job Outlook

According to the U.S. Bureau of Labor Statistics (BLS), the average annual salary for nurse anesthetists is $181,040, with the top 10% earning more than $200,000 per year. Compare that to the average wages for other APRNs and it’s clear that nurse anesthetists have by far the highest earning potential in the field.

Salaries for nurse anesthetists and other advanced practice registered nurses:

APRN Position
Average Annual Salary

Nurse anesthetist

$181,040


Nurse practitioner

$111,840


Nurse midwife

$108,810

As a group, the BLS says APRNs can expect to see job growth of 45% through 2029—much higher than the 4% projection for all jobs. For CRNAs alone, job growth is projected at 14%.

45%

APRN Job Growth Through 2029

How to Get Ahead in Your Career

There are several ways to move up or increase your earning potential as a CRNA. The first is to consider tailoring your education toward a particular patient population, condition, or surgical subfield.

Specializing can open the door for greater opportunities, with popular concentrations including obstetrics, pediatrics, neurosurgery, cardiovascular, and dental surgery, among others. Professional organizations for these specialties can also be beneficial when it comes to networking and applying for jobs.

Where you work can affect what you make. Salaries in the five states with the top pay are all above $200,000.

Another option for advancement is to find work in the settings that report the highest salaries for CRNAs. Of the top employers, both general medical/surgical hospitals and outpatient care centers list salaries that are greater than the national average. 

Your geographic location can affect what you make as well. Salaries in the five states with the top pay are all above $200,000, according to the BLS.

State

Annual Salary

Wyoming

$243,310

Montana

$239,380

Oregon

$234,750

Wisconsin

$233,600

California

$227,290


malia jacobson

Written and reported by:

Malia Jacobson

Contributing Writer

With professional insight from:

john preston

John C. Preston, DNSc, SRNA, FNAP, APRN

Chief credentialing officer for the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA)


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