Surgery assistant operating equipment

How to Become a Certified Registered Nurse Anesthetist (CRNA)

Duties, Requirements, Certifications, Job Outlook, and Salary

Surgery assistant operating equipment

Registered Nurses (RN) can choose what they’d like to do with their careers after they’ve earned their certification. There are several nursing specialties to choose from, all with their job responsibilities, work environments, perks, and unique professional development opportunities. Each of these specialties requires different levels of education, training, and certification. For nurses who prioritize compensation or are drawn to the critical aspect of anesthesia care, a career as a Certified Registered Nurse Anesthetist (CRNA) may be the ideal path.

Nurse Anesthetist: A High-Stakes and High-Reward Profession

Nurse Anesthetist ranks among the highest-paid nursing jobs for good reasons. They bear the significant responsibility of administering anesthesia to patients before medical operations and handling recovery afterward. The high stakes of working with anesthesia mean that CRNAs must complete rigorous education, gain practical experience, and maintain continuous learning and professional growth to ensure safe and effective care.

The role of a CRNA is not only financially rewarding but also crucial in the healthcare system. CRNAs often work in medically underserved areas, providing essential anesthesia services in areas where physicians may be scarce. Their expertise makes surgeries and other essential medical procedures accessible to more people, underscoring the societal importance of this profession.

(Click here to see our complete list of highest-paid nursing jobs)

In this comprehensive guide, we will explore all the facets of becoming a CRNA and what makes this career both challenging and rewarding.

What is a Nurse Anesthetist?

A Certified Registered Nurse Anesthetist is a Registered Nurse who administers anesthesia to patients that are undergoing surgical or other medical procedures. CRNAs work with Surgeons, Anesthesiologists, and other medical professionals to safely administer anesthesia. Nurse Anesthetists can work in hospitals, clinics, and outpatient settings.

Nurse anesthetists use a variety of anesthesia techniques, including general, regional, and local anesthesia, tailored to the specific procedure and patient needs. They are skilled in using cutting-edge technology and equipment to monitor patients during procedures, ensuring safety and comfort.

What Does a Nurse Anesthetist Do?

Nurse anesthetists are advanced practice Registered Nurses (APRNs). Their primary responsibility is to work with patients throughout their medical procedures to ensure they are pain-free. To do this, CRNAs must determine the exact amount of anesthesia needed to medicate the patient safely. Going under anesthesia can be a nerve-racking experience for some patients, so as a Nurse Anesthetist, you’ll need to be highly responsible and accommodating to the patient’s needs.

Some Nurse Anesthetist duties include:

  • Determining the proper dose of anesthetic to meet the patient’s need
  • Educating patients about the procedure and their recovery
  • Monitoring patient vital signs and dosage throughout the procedure
  • Conducting patient assessments

CRNAs can also take on administrative roles later in their career, such as training new staff or ordering anesthesia.

The Challenges and Rewards of Being a CRNA

The role of a CRNA can be emotionally demanding, as it requires making critical decisions under pressure, often in life-or-death situations. Ethical considerations, such as informed consent and patient autonomy, are integral to their practice. Despite these challenges, many CRNAs find deep satisfaction in providing essential care and making a positive impact on patients’ lives, knowing that their skills and compassion make a real difference.

What’s the Difference Between an Anesthesiologist and a Nurse Anesthetist?

Nurse Anesthetists and Anesthesiologists often work together to administer anesthesia to patients. However, the main differences between a Nurse Anesthetist and an Anesthesiologist are their educational background, working environment, and salary.

Anesthesiologists are medical doctors, which means they spend upwards of 11 to 12 years in school before they can begin working. They must first earn their bachelor’s degree, then their medical degree, and finally, they must obtain a state and national license. CRNAs are only required to earn their bachelor’s degree, spend a year working in critical care, then complete a CRNA program which takes about 2-3 years.

Nurse Anesthetists work in various medical offices, such as hospitals, outpatient care centers, and doctor’s offices. Anesthesiologists work in operating rooms, intensive care units, and delivery units. Anesthesiologists also can focus on certain sub-specialties of care, such as pediatrics, obstetrics, and critical care.

CRNAs and Anesthesiologists often work together in a team-based approach to anesthesia care. While they may have distinct responsibilities, their collaboration ensures that patients receive well-rounded care. Their roles may vary depending on hospital policies, state regulations, and individual preferences.

The wage difference is the most substantial difference between a CRNA and an Anesthesiologist. According to the BLS, the average salary* of a CRNA is $206,000, while the average salary* for Anesthesiologists is about $303,000 (BLS). With an annual salary* close to $100K higher than a CRNA, the extended educational requirements of becoming an Anesthesiologist ultimately pay off.

How Long Does it Take to Become a Nurse Anesthetist?

To be a Nurse Anesthetist, you’ll have to spend a longer amount of time in school. You’ll also have to gain work experience and pass a certification exam before holding the position. Here’s a step-by-step guide to show you how to become a Nurse Anesthetist:

BSN sign on a stack of books with a stethoscope

1) Earn your Bachelor of Science in Nursing (BSN) or similar degree:

The first step in becoming a CRNA is earning your BSN nursing degree. Your BSN will take about four years unless you’ve already earned your associate degree in nursing (ADN). Students who’ve already earned their ADN can enroll in an RN-BSN program which can be completed in as little as 20 months. Students enrolled in a BSN program take courses such as anatomy, pharmacology, and physiology. The average cost of a BSN program can range between $40k – $100k, depending on which educational institution you decide to attend. Once you’ve earned your BSN, you must pass the National Council Licensure Examination for Registered Nurses (NCLEX) to earn your nursing license.

(Click here to learn more about the NCLEX-RN examination)

2) Gain at least one year of experience working as an RN in a clinical setting:

The second step to becoming a Nurse Anesthetist is gaining quality experience working as an RN. It’s standard that RNs looking to apply for a nurse anesthesia program spend at least one year working in a clinical setting such as an emergency room (ER), intensive care unit (ICU), or cardiac care unit (CCU). Many RNs earn their Critical Care Registered Nurse Certification (CCRN) to further their chances of getting accepted. To earn your CCRN, you’ll need 1,750 hours of direct critical care as well as pass a licensure exam.

3) Get accepted and complete a nurse anesthesia program:

Admission to a nurse anesthesia program can be highly competitive, and you’ll need to meet a set of minimum requirements to be considered for acceptance. These requirements vary depending on the institution offering the program. The AANA reports that as of September 2020, there were 124 CRNA programs in the United States. They also reported that the average experience held by RNs applying to nurse anesthesia programs is about 4.5 years. The average in-state tuition for a nurse anesthesia program is around $93,000. Before you apply, assessing your qualifications and determining which program best fits you is essential.

4) Graduate from the nurse anesthesia program with your Master’s degree:

The average completion time of a nurse anesthesia program is about 24 to 36 months. Nurse anesthesia programs include courses such as pharmacology, pain management, biology, and pathophysiology. You’ll learn to operate anesthesia equipment and manage surgical and emergencies throughout the program. On top of coursework, students are required to complete supervised clinical experiences that present an array of different anesthesia situations.

CRNA educational programs must be accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs (COA). This ensures that they meet the rigorous standards necessary to prepare students for the profession. The certification exam itself is comprehensive, covering topics like pharmacology, physiology, anesthesia equipment, and professional issues, reflecting the depth and breadth of knowledge required in this specialized field.

Some Nurse Anesthetists may choose to continue their education to pursue a Doctor of Nursing Practice (DNP). The shift toward requiring a Doctor of Nursing Practice for CRNAs is part of a broader movement to elevate the education level in advanced nursing practice. This change aims to provide CRNAs with the additional knowledge and skills needed in today’s complex healthcare environment. Furthermore, CRNAs must commit to continuous education and professional development, reflecting the ever-evolving nature of anesthesia practice and healthcare.

Continuing education for CRNAs includes not only mandatory recertification courses but also opportunities for further specialization in areas such as pediatrics or cardiac care. Engaging with professional organizations like the American Association of Nurse Anesthetists (AANA) can provide support, networking, and additional educational resources. This commitment to lifelong learning is essential for keeping up with advances in anesthesia technology, techniques, and best practices.

Pass the National Certification Examination:

Once you’ve completed your CRNA program and earned your master’s degree, you must pass the National Certification Examination from the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA). This exam contains between 100 and 170 questions and takes about 3 hours to complete. You’ll be given a preliminary pass or fail report upon completing the exam. Once you pass the exam, your certification verification will be sent to your state board of nursing. From there, you can meet any state-specific requirements before employment.

To remain employed as a CRNA, you must maintain your national certification. The NBCRNA evaluates nurse anesthetists every eight years as part of their continued professional certification program (CPC), broken into two 4-year periods. During each 4-year period, you are required to complete:

  • 60 “Class A” Credits in activities related to the delivery or improvement of anesthesia care
  • 40 “Class B” Credits in anesthesia practice as well as a wide range of professional development topics
  • 4 Core Modules that address applied clinical pharmacology, human physiology and pathophysiology, airway management, and anesthesia equipment

At the end of each 8-year period, you’ll be required to take the CPC assessment exam. This exam has 150 questions that test how well you know the 4 Core Modules. A lot of work is needed to maintain your CRNA certification, but the hard work pays off when it comes to job outlook and salary.

Nurse Anesthetist Salaries

How much does a Nurse Anesthetist make?

Nurse Anesthetists top the list of the highest-paid nursing jobs. According to the BLS, the average nurse anesthetist’s salary* is about $206,000.

Salaries and job opportunities for CRNAs can vary widely depending on factors such as geographic location, years of experience, area of specialization, and the type of healthcare setting. For example, CRNAs working in critical care settings or major metropolitan areas may earn higher salaries. The demand for CRNAs is expected to grow, especially in rural areas where healthcare services are often limited.

Highest Paying Industries for Nurse Anesthetists

Industry Average Hourly Pay Average Salary
Outpatient Care Centers $118.74 $246,980
Specialty Hospitals $110.68 $230,220
Ambulatory Health Care Services $105.67 $219,790
General Hospitals $104.60 $217,570
Offices of Physicians $96.29 $200,280

Highest Paying States for Nurse Anesthetists

State Average Hourly Pay Average Salary
California $118.52 $246,510
Connecticut $115.66 $240,580
New York $114.77 $238,710
Illinois $114.64 $238,440

Highest Paying Cities for Nurse Anesthetists

City Average Hourly Pay Average Salary
Carbondale, IL $143.70 $298,890
Hartford, CT $136.32 $283,550
Los Angeles, CA $133.08 $276,810
Riverside, CA $131.28 $273,060

Stethoscope draped over a laptop 

What is the Job Outlook for a Nurse Anesthetist?

The BLS reports that the overall employment of Nurse Anesthetists is projected to grow 40% by 2031. Nurse Anesthetists will be increasingly needed to care for the large, aging baby boom population. CRNAs will be required to keep patients healthy and to treat the growing number of patients with chronic and acute conditions.

Are You Ready to Start Your Career as a Certified Registered Nurse Anesthetist?

Nurse Anesthetists are the highest-paid nurses in the field, but it comes with a cost. You’ll be spending a significant amount of time in school just earning the qualifications and certifications needed to get a job as a CRNA. Earning your master’s degree also costs a lot of money, and that financial commitment can turn many people away. However, if you’re willing to commit your time and money to becoming a Nurse Anesthetist, your efforts will pay off. Working as a CRNA is also very fulfilling for those who thrive under pressure and take pride in handling the lives of their patients. If you want to become a Nurse Anesthetist, you can start by earning your BSN at Provo College.

Click here to learn more about our BSN program.