How to Become a Nurse Anesthetist
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Certified registered nurse anesthetists (CRNAs) administer anesthesia and pain relief to patients during surgery and other medical procedures. These highly respected advanced practice registered nurses (APRNs) earn some of the highest salaries in the nursing profession and enjoy considerable practice autonomy.
The demand for CRNAs has never been higher. The U.S. Bureau of Labor Statistics (BLS) projects CRNA jobs to grow by 12% between 2021 and 2031, which is much faster than the 6% expected increase for all registered nurses.
Explore this guide to learn how to become a CRNA and what to expect working in this challenging field.
How Long to Become
DNP or DNAP
Certified Registered Nurse Anesthetist
What Is a Nurse Anesthetist?
CRNAs are APRNs trained in anesthesia and pain relief. As APRNs, they can determine anesthesia and pain relief needs, administer anesthesia, and prescribe pain medications, including controlled substances.
Nurse anesthetists work in hospitals, surgical centers, clinics, and private practices. In some settings, especially clinics and rural healthcare facilities, they may act as the only anesthesia specialist, while in settings like hospitals they typically work with physician anesthesiologists.
This guide describes nurse anesthetist education, credentialing, and work in detail, while our nurse anesthetist career overview offers a broader picture of the profession.
Steps to Becoming a Nurse Anesthetist
It takes 7-10 years of education and training to become a nurse anesthetist, depending on the licensing and certification requirements mandated by the board of nursing in the state where you intend to practice.
In addition to earning a four-year bachelor of science in nursing (BSN) and passing the National Council Licensure Examination for RNs (NCLEX-RN), you will need to complete a doctor of nursing practice (DNP) or doctor of nursing anesthesia practice (DNAP) degree, which takes around three years.
After completing the doctoral degree, you must pass the National Certification Exam (NCE) administered through the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA).
Earn a BSN degree from an accredited program.
It takes four years to earn a BSN. Some nurse anesthetists begin their careers by earning an associate degree in nursing (ADN), which takes two years. Many schools offer RN-to-BSN programs, and some master of science in nursing (MSN) programs include a bridge option for ADN-holders. Students with a bachelor's degree in a non-nursing field can enroll in an accelerated BSN program and earn a BSN in 2-3 years, depending on how many transferable credits they hold.
Pass the NCLEX exam to receive RN licensure.
Prospective RNs must pass the National Council Licensure Examination for RNs (NCLEX-RN). This test, which is computer adaptive, takes up to six hours and covers topics such as conditions and treatments, nursing practice, the healthcare system, working as part of a healthcare team, and patient communications and education. RNs must also meet state requirements, such as passing a background check.
Gain clinical nursing experience in critical care.
All CRNA programs require RNs to complete between 1-3 years of experience in critical care, working in intensive care units (ICUs), medical-surgical units, or trauma and emergency centers. Critical care training teaches RNs how to deliver medical interventions to critically ill patients with injuries and life-threatening conditions or during surgical procedures.
Enroll in a graduate nurse anesthesia program.
Starting in 2022, the minimum degree requirement for CRNAs will be a doctor of nursing practice (DNP) or doctor of nurse anesthesia practice (DNAP) rather than an MSN. Students select a specialty area during DNP programs, while DNAP curricula are already specialized.
Most nurse anesthetist graduate programs require at least a 3.0 GPA, although some require or strongly prefer 3.5 and higher. Candidates also submit letters of recommendation and a personal essay or statement.
Graduate with your DNP or DNAP and pass the National Certification Exam.
The NCE determines your competency for entry-level practice. Candidates for this certification test must hold a DNP or DNAP degree and an unencumbered RN license. The NBCRNA currently charges $995 to take the test, which will increase to $1,045 in January 2023. This three-hour computer-adaptive test consists of 100-170 questions covering topics in basic science; equipment, instrumentation, and technology; principles of anesthesia; and anesthesia for surgical procedures and special populations.
All states require NBCRNA certification to use the title "nurse anesthetist." In most states, CRNAs must also have APRN licenses. Each state board of nursing determines CRNA scope of practice and level of supervision.
Begin your career as a CRNA.
Nurse anesthetists work in hospitals and surgical centers, typically in collaboration with surgeons, anesthesiologists, and other healthcare professionals as part of an anesthesia team. They also work in clinics, medical offices, and military bases, where they may lead an anesthesia team.
In under-resourced environments like rural hospitals, they may be the only anesthesia practitioner. Individual states maintain different regulations on nurse anesthetists' scope of practice, including whether they hold full professional autonomy or must work under a physician's supervision. Depending on the state, many CRNAs have their own practice and work independently.
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Nurse Anesthetist Education
Nurse anesthetist schooling requires a strong commitment to gaining the skills and knowledge needed for advanced practice nursing. You must have a BSN and an advanced graduate degree from an accredited school in addition to NBCRNA certification. Beginning in 2022, all CRNAs must complete a doctoral degree once they have completed their BSN and acquired an RN license. They should also have ICU or related experience.
The minimum degree needed to earn an RN license is a two-year ADN degree. Most graduate-level nursing programs require a BSN. Some graduate programs include a bridge component that allows ADN-holders to complete the equivalent of a BSN.
Most programs require or prefer a GPA of 3.0 or higher and successful completion of math and science programs, including biology and chemistry.
BSN programs include courses on anatomy and physiology, effective nursing practices, statistics, community health, and ethical issues.
Time to Complete
A high school graduate can usually earn a BSN in four years. Students with an ADN or a bachelor's degree in another field, especially the sciences or healthcare, can usually transfer in credits and finish in 2-3 years.
BSN programs prepare nurses to administer tests and medications, monitor patients, understand and work in most healthcare settings and as part of a healthcare team, and educate patients on health topics.
Doctor of Nursing Practice
Aspiring CRNAs pursue either a DNP degree through a school of nursing accredited by the American Nurses Credentialing Center or a DNAP approved through the Nurse Anesthetists Council of Accreditation. In addition to the 2-3 years required for doctoral training, many CRNAs take additional time to specialize in areas like chronic pain management, adult cardiac anesthesiology, and pediatric anesthesiology.
Most DNP/DNAP programs require or strongly prefer at least a 3.0 GPA from the undergraduate or MSN degree program, an unrestricted RN license, 1-3 years experience in critical care, and professional references.
The curriculum includes epidemiology, pharmacology, safety and risk management, advanced evidence-based medical practice, organizational leadership, and healthcare legality. Programs also include clinical residencies.
Time to Complete
Students with an MSN can finish a DNP in 1-2 years. Students with a BSN can finish in 3-4 years.
Nurse anesthetist students learn to apply research to new practices, use sound clinical judgment, employ technology, and other topics related to planning and administering anesthesia and providing pain relief.
Doctor of Nursing Practice vs. Doctor of Nurse Anesthesia Practice
There are a few educational options available to help CRNAs satisfy the new doctoral level degree requirement. The DNP and the DNAP are two popular degree options.
Doctor of Nursing Practice
As the terminal (highest) degree in nursing practice, the DNP is required for some university teaching positions.
The DNP is available only from nursing schools.
The American Association of Colleges of Nursing defines DNP standards and curricula.
The DNP is more common than the DNAP.
This doctoral degree focuses on practice rather than research, which is typical for a doctor of philosophy.
Doctor of Nurse Anesthesia Practice
The DNAP degree is available outside of nursing schools.
The Council on Accreditation of Nurse Anesthesia approves programs.
This doctoral degree is practice-focused but usually requires a capstone nursing research project on nurse anesthesia practice, education, or administration/management.
Nurse Anesthetist Credentials
Nurse anesthetists must be both certified and licensed to practice anesthesia. States administer licensure, while the NBCRNA manages nurse anesthetist certifications.
- The NBCRNA certification exam tests students' knowledge of nurse anesthesia practice.
- MSN and DNP students take specialized courses in nursing anesthesia, while DNAP programs are already designed around the specialty.
Candidates seeking the NBCRNA certification to become a CRNA must pass the National Certification Exam, earn a degree from an accredited CRNA program, hold a current and unencumbered RN license, and provide a statement asserting that they do not have any condition limiting their ability to administer anesthesia.
Recertification requires continuing education credits, completing core modules, and passing an assessment.
CRNA licensing requirements vary among states, but every state requires CRNA certification. Nurse anesthetists apply for licensure with their local state board of nursing. Some states require additional applications for prescriptive authority and/or physician supervision forms. CRNAs must complete continuing education credits to maintain licensure.
Working as a Nurse Anesthetist
CRNAs can choose from many different work environments, including hospitals, medical-surgical units, and critical care facilities in rural communities. Outpatient and ambulatory surgical centers, doctors' offices, and pain management clinics are also options. They may find positions in military and government facilities, dental offices, ketamine clinics, and plastic surgery clinics among other settings.
Hospital surgical suites are among the most popular employers. CRNAs in this setting work with anesthesiologists, RNs, and other healthcare professionals, administering anesthesia and monitoring pain management.
CRNAs licensed in states that grant full-practice authority are in demand in critical access hospitals in rural areas. In these settings, they may administer anesthesia independently, supervise members of the healthcare team, and educate patients on pain management following surgical procedures.
CRNAs also find employment opportunities in ambulatory surgical centers in response to the increasing number of patients seeking outpatient procedures. Their duties in these settings include administering anesthesia independently or in collaboration with anesthesiologists, monitoring and releasing patients after procedures, and providing pain management education.
The duties performed by CRNAs in doctors' offices or pain management clinics vary widely depending on the types of medical procedures and services offered. In addition to administering anesthesia independently or under supervision, they typically provide pain management education and patient postsurgery follow-up.
Nurse anesthetists can anticipate expanding employment opportunities and earning potential through the decade. The BLS projects the addition of 5,300 nurse anesthetist positions through 2031. CRNAs rank among the highest-paid advanced practice nurses, earning anaverage annual salary of $202,470compared to$82,750 for registered nurses.
Frequently Asked Questions About Becoming a Nurse Anesthetist
How many years does it take to become a CRNA?
Becoming a CRNA may take between 7-10 years, including clinical experience working as an RN in an ICU or a critical care department. Beginning in 2022, aspiring CRNAs should plan on spending 2-3 years to complete the required DNP or DNAP degree after earning their BSN and RN license.
What is the quickest way to become a CRNA?
This depends on several factors, including the number of previously earned college credits accepted in transfer. Prospective CRNAs entering nursing with a bachelor's in a non-nursing field will take longer to complete all educational requirements than RNs who already have an ADN degree.
Is it difficult to become a nurse anesthetist?
Nurse anesthetist schooling is demanding. Graduate-level nurse anesthetist programs require at least a 3.0 GPA and include courses in pharmacology, anatomy and physiology, and nursing practice. Some selective programs admit only 10% of applicants, while others accept closer to 20%.
Are nurse anesthetists paid well?
Nurse anesthetist salaries are the highest of all APRN earnings, with a median annual salary of $195,610, compared to $45,760 for all occupations. However, nurse anesthetist jobs can be very stressful, as anesthesia is risky for many patients.
What is the difference between a CRNA and an anesthesiologist?
CRNAs are advanced practice nurses who have earned a graduate nursing degree; anesthesiologists are physicians who have completed a four-year medical degree and an additional four years in residencies. State boards of nursing regulate CRNAs, determining whether they may work independently or under the supervision of a physician.
Page last reviewed September 25, 2022
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