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How to Become a Nurse Anesthetist (CRNA)

Michael McCarthy

Written By: Michael McCarthy

Published: 5/18/2022

A nurse anesthetist administers drugs that make it possible to perform complex procedures such as surgeries. Only advanced practice registered nurses (APRNs) have demonstrated the skill and experience needed to become a trusted practitioner.

To work in this field, you need a master's or doctoral nursing degree in nurse anesthesiology and deep knowledge of patient care practices. This includes thousands of hours of experience as a registered nurse (RN) with increasing levels of responsibility. Once you have the proper education and experience, you can take the national board certification exam to attain a license. Only then can you practice this critical component of patient care.

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What Is a Nurse Anesthetist?

Nurse anesthetists ensure that patients can undergo both routine and life-saving medical procedures safely and without pain. They must develop much of the same expertise as anesthesiologists, who are medical doctors. This knowledge covers all types of anesthetic drugs, including analgesics that suppress pain, paralytics that keep patients still, and hemodynamic agents that manage complex blood-flow processes.

Because their work is complex and risky, nurse anesthetists must be licensed in order to practice. These professionals are called certified registered nurse anesthetists (CRNAs) once licensed.

CRNAs work closely with other healthcare professionals on a patient's care team. Some CRNAs work with anesthesiologists daily, while others work independently. In 2001, federal lawmakers amended the law requiring CRNAs to be supervised by anesthesiologists. Since then, 32 U.S. territories have adopted laws allowing CRNAs to work independently. CRNAs in densely populated areas may work under an anesthesiologist's supervision, but they're often the only person giving anesthesia in less populous areas.

What Does a Nurse Anesthetist Do?

CRNAs usually spend only a small portion of each shift administering drugs. An important preliminary task is evaluating patients’ eligibility for anesthesia — some people have complicating risk factors, such as a history of cardiac problems. Thus, CRNAs determine whether a procedure calls for special patient-specific provisions, such as intubation guidance equipment, particular medications, or additional monitoring devices.

If the patient is eligible, the CRNA can administer anesthesia at the appointed time and then monitor its effects. Critical points in the process include:

Induction (putting the patient to sleep)

Intubation (inserting a breathing tube)

Emergence (bringing the patient back to consciousness)

CRNAs also provide postoperative care, which may involve helping patients regain motor control and assisting with pain management.

Helpful Skills for Nurse Anesthetists

All nurses need an aptitude for science so they can understand their patients' biological and physiological processes. CRNAs in particular need a facility with chemistry to understand the physical make-up of the medications they use, along with their effects on human bodies.

Beyond technical knowledge, CRNAs need excellent communication skills to help them work closely with physicians and to put anxious patients at ease. Part of this communication may call for the courage to tell a surgeon that a patient is not eligible for surgery based on an anesthesia risk analysis. CRNAs must always use their best judgment to advocate for patients above all.

Steps to Become a Nurse Anesthetist

Anesthesia nursing is a highly regulated profession with a clear pathway to entry. Therefore, CRNAs tend to face similar education, experience, and licensure hurdles before they can practice. We detail the steps required to become a CRNA here.

Nurse Anesthetist Schooling

Beginning in 2022, new CRNAs must hold an accredited doctoral degree in nurse anesthesia practice. The Council on Accreditation of Nurse Anesthesia Educational Programs (COA) grants specialized accreditation to high-quality graduate degree programs. To earn a CRNA license in any territory, you must graduate from a COA-accredited program. The council has not accredited any new master's degrees since 2015 because it's committed to raising the education requirements for nurse anesthetists.

To earn a CRNA license in any territory, you must graduate from a COA-accredited program.

Doctoral nursing degrees can take 3-5 years to complete if you study full time. These are usually professional doctorates, meaning that they emphasize clinical practice, didactic coursework, and realistic simulations rather than original research. Each program includes a supervised clinical placement letting you practice your newly learned skills in a real care setting. This experience can last up to two years and often involves rotations at several different sites.

CRNA Experience Requirements

You need an active RN designation to apply for a nurse anesthetist degree, which indicates that you’ve earned a BSN degree and have at least 1-2 years of clinical experience. According to the American Association of Nurse Anesthesiology (AANA), the average nurse anesthesia student already has 6,032 hours of experience as an RN.

This work experience requirement ensures that graduate students already understand nursing practice and medical terminology, so they don’t need to start with the basics. For the same reason, many colleges require applicants to hold certifications in basic life support, advanced cardiac life support, and pediatric advanced life support.

Earning a License as a Nurse Anesthetist

Once you graduate, you can register for the National Certification Exam, which the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA) administers. This comprehensive test is divided into sections on anatomical science, equipment and technology, general principles of anesthesia, and anesthesia for surgery and special populations.

Passing the exam qualifies you to register for a license from your state's board of nursing. You'll need to pay a nonrefundable application fee for initial licensing, plus a fee when it's time to renew your license.

To remain certified, you will need to renew your CRNA credential every four years in a process known as Continued Professional Certification. This requires you to complete hundreds of hours of continuing education to make sure you're up to date on the latest anesthesia practices.

To learn more about nursing requirements and to see a list of accredited online nursing programs by state, explore our guide to becoming a nurse.

What Is the Career Outlook for Nurse Anesthetists?

The job outlook is bright: the U.S. Bureau of Labor Statistics (BLS) expects a job growth rate of 13% in the 2020-2030 period, which is faster than the U.S. average of 8%.

According to labor market data from the analytics company Burning Glass Technologies, 75% of job posts for CRNAs require 0-2 years of experience. This indicates that most employers will be satisfied with hiring a relatively new CRNA. Burning Glass also notes that in 2021-2022, a travel-nursing company was the top employer of nurse anesthetists by a large margin. These companies send qualified nurses around the country on short-term assignments wherever they're requested, often in rural areas where staffing is a problem.

How Much Do Nurse Anesthetists Make?

Nurse anesthetists earn median annual salaries of $195,610, which is more than four times the $45,760 median wage for all jobs combined. They earn the highest wages in Connecticut, New Jersey, and Illinois, though the greatest number are in Texas and Florida.

Career Advancement

Once you earn a CRNA license, you've already climbed a steep hill in your nursing career. At this level, the most common way to advance is to earn a supervisory or management role. This may involve a mixture of anesthetist duties and management tasks or it may mean you spend all your time as an administrator, though the latter is more common at large facilities such as hospitals.

Should I Become a Nurse Anesthetist?

The answer is ultimately up to you, but there are a number of reasons to seriously consider a nurse anesthetist career. We present a few pros and cons here for you to weigh.

On the plus side, CRNAs are very well paid. Nurse anesthetist skills are highly prized by medical administrators, who pay their CRNAs accordingly. The field is also growing relatively fast. What's more, CRNAs perform an important service that allows people to have life-changing procedures — if you're passionate about helping your nursing patients, then this is another way to do what you love.
The main downside is the sheer amount of time, money, and work involved in securing a CRNA job. CRNAs spend 7-9 years in postsecondary education programs and years in lower level nursing jobs before they even have the opportunity to test for their certification. This involves lots of time spent on coursework rather than family or other personal interests. The monetary cost is also significant, even if you receive some financial aid.

Even if you decide not to pursue a nurse anesthetist career, you might be interested in other nursing specializations. Check out our Guide to Online Nurse Practitioner Degrees to learn about alternate nursing career paths.

FAQs About Becoming a Nurse Anesthetist

How Hard Is It to Get into CRNA School?

You need to take many steps in your education and career before you even qualify for consideration by program administrators:

  • Earning a Bachelor of Science in Nursing
  • Passing an RN exam
  • Working as a critical care nurse for at least a year or two.

In addition, the nurse anesthetist programs themselves tend to be selective, with minimum GPA requirements of 3.0-3.2, professional letters of recommendation, and at least one interview required. Meeting these requirements can make it difficult for some to get into CRNA school.

How Long Does It Take to Become a Nurse Anesthetist?

It takes many years to meet the eligibility standards to become a nurse anesthetist. The education requirements take a minimum of seven years at a full-time pace. Assuming a low-end estimate of two years of RN experience between degrees, you need at least nine years after graduating high school to become a CRNA. Again, it usually doesn't happen that fast — the AANA says that the average graduate school candidate has four and a half years of RN practice.

How Much Does It Cost to Become a Nurse Anesthetist?

This will vary widely depending on which schools you attend and how much financial aid you secure. The National Center for Education Statistics (NCES) calculates a yearly cost of $9,400 for bachelor's degrees from public colleges, along with $36,700 for private nonprofit schools. For-profit schools are in between at $19,100. These numbers include tuition and fees.

NCES gives an average annual cost of $12,410 for graduate degree programs at public schools, $28,430 for nonprofit private colleges, and $14,289 for for-profit institutions.

How Much Money Do Nurse Anesthetists Make?

CRNAs make median wages of $195,610 per year. They're the highest paid nurses and among the highest paid occupations in the country.

Resources for Nurse Anesthetists

Read on for a collection of organizations that might interest you as a student of nurse anesthesia, as well as related nursing and healthcare degree programs you might pursue instead.

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