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How to Become a Nurse Anesthetist

Doug Wintemute, MA
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Updated March 26, 2024
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Nurse anesthetists play a critical role in our healthcare system. Learn how to become a nurse anesthetist and what to expect in this career.
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Nurse administering anesthesia to a patientCredit: andresr / E+ / Getty Images

Nurse anesthetists, also known as certified registered nurse anesthetists (CRNAs), provide patients with anesthesia and pain medication for various medical procedures. As advanced practice registered nurses (APRNs), nurse anesthetists enjoy the top salaries and highest levels of practice autonomy in the nursing field.

Explore the nurse anesthetist profession, including the steps and requirements for entering the field.

How Long to Become

7-8 years

Degree Required

DNP or DNAP

Certification

Certified Registered Nurse Anesthetist (CRNA)

What Is a Nurse Anesthetist?

Nurse anesthetists deliver anesthesia and pain management services to patients before, during, and after procedures that require them. They provide patients with pre-surgery consultations, anesthesia and monitoring during the procedure, and post-operative pain management.

CRNAs have the ability and authority to assess patient needs and administer and prescribe appropriate anesthesia and medications for pain relief. They typically work alongside anesthesia care teams, nurses, and surgeons in hospitals, surgical clinics, and physician offices. CRNAs may work independently or under the supervision of a physician, such as an anesthesiologist, depending on their state’s supervision requirements.

While CRNA supervision requirements vary by state, the size and type of practice setting can also affect how a nurse anesthetist can practice. For example, CRNAs handle more than 80% of all anesthesia needs in rural counties, according to the American Association of Nurse Anesthesiology.

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Steps to Becoming a Nurse Anesthetist

Each state dictates program and licensure requirements for nurse anesthetists. Generally speaking, you typically need the following: a bachelor of science in nursing (BSN), a passing score on the NCLEX, at least one year of independent critical care experience, and either a doctorate in nursing practice (DNP) or nurse anesthesia practice (DNAP) degree.

Here us a more detailed breakdown of each step:

  1. 1

    Earn a BSN Degree from an Accredited Program

    It usually takes four years to complete a BSN degree, though that timeframe depends on your previous education and chosen program. For example, nurses with an associate degree in nursing (ADN) and an RN license can pursue an RN-to-BSN, which often takes less than two years. With a bachelor’s degree in a non-nursing field, you can pursue an accelerated BSN and finish in less than 18 months.

  2. 2

    Pass the NCLEX Exam to Receive RN Licensure

    The requirements for RN licensure vary by state, but all RNs must first pass the National Council Licensure Examination for RNs (NCLEX-RN). The NCLEX covers four categories: safe and effective care, health promotion and maintenance, psychosocial integrity, and physiological integrity. It takes roughly five hours to complete the exam.

  3. 3

    Gain Clinical Experience in Critical Care

    After earning RN licensure, aspiring CRNAs should accumulate at least one year of full-time experience in a critical care setting, such as an intensive care unit (ICU). Candidates can complete the equivalent of these requirements through part-time work.

  4. 4

    Enroll in a DNP or DNAP program

    All prospective CRNAs need a DNP or DNAP degree accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs (COA). Both degrees lead to the same career. However, they differ in that DNP programs run through nursing departments, and DNAP programs run through health sciences and health professions departments.

    After graduation, you qualify for the National Certification Examination (NCE) from the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA). Once you pass the NCE, you can apply for state licensure.

Nurse Anesthetist Education

Nurse anesthetists need at least two degrees: a BSN and a Council on Accreditation of Nurse Anesthesia Educational Programs (COA) accredited doctorate. The time you spend completing these degrees may vary, but expect at least five years in total.

BSN Degree

A BSN degree is the minimum requirement for RN licensure and entry into a doctoral program later on. A BSN program not only provides you with a healthcare foundation for your future studies, but it also equips you with the skills necessary to build experience in acute care settings.

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    Admission Requirements

    Many BSN programs require a high school diploma with a minimum 3.0 GPA.
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    Program Curriculum

    BSN programs typically include foundational courses in anatomy and physiology, biology, and statistics, plus leadership, ethics, and evidence-based practice courses.
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    Time to Complete

    While high school graduates usually complete the program in four years, candidates with an ADN, RN, or another bachelor’s degree can complete the BSN in less than two years.
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    Skills Learned

    BSN programs help you develop skills in patient safety, patient care, and medication management, as well as communication and teamwork.

DNP or DNAP Degree

Prospective CRNAs must complete a COA-accredited DNAP or DNP degree. In addition to providing you with the skills and competencies for the nurse anesthetist profession, these programs prepare you for the certification examination and licensure.

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    Admission Requirements

    Most DNP and DNAP programs require candidates to have a BSN with a minimum 3.0 GPA, plus at least one year of full-time acute care experience.
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    Program Curriculum

    Doctoral programs include advanced courses in pharmacology, physiology, and pathophysiology, plus specialized courses in anesthesia care, patient safety, and clinical practice.
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    Time to Complete

    While BSN graduates take a minimum of three years to complete their doctorate, master’s degree-holders can finish in 1-2 years.
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    Skills Learned

    DNP and DNAP students develop skills in patient safety, anesthesia technology, and anesthetic management, along with communication, leadership, and critical thinking.

Doctor of Nursing Practice vs. Doctor of Nurse Anesthesia Practice

To qualify for the nurse anesthetist certification examination, you need a COA-accredited doctoral degree, which typically falls into one of two categories: a DNP or a DNAP. Learn the differences between these two degrees to help you decide which is best for you.

DNP

  • A terminal nursing degree only available in nursing schools
  • Practice-based program that requires specialization in one of the advanced practice fields (nurse anesthetist)
  • Programs follow the Essentials of Doctoral Education for Advanced Nursing Practice as laid out by the American Association of Colleges of Nursing (AACN)

DNAP

  • Usually offered through non-nursing schools, such as health sciences colleges
  • While still a practice-based program, they often include a capstone nursing research project
  • Typically do not require (or offer) further specialization

Licensure and Certification

CRNAs need both national certification and state licensure to practice in the United States. For certification, prospective nurse anesthetists need a valid RN license and a COA-accredited DNP or DNAP to take the national certification exam. The requirements to maintain RN licensure vary, but most states require a specific number of practice hours and continuing education.

Passing the NCE qualifies you for state CRNA licensure, for which you apply through your state nursing board. To maintain certification and licensure, CRNAs must complete the Continued Professional Certification (CPC) program from the NBCRNA. This program features 100 continuing education credits every four years and an assessment every eight years.

Working as a Nurse Anesthetist

You can find nurse anesthetists in every facility that administers anesthesia, including hospitals, surgical centers, dentist offices, and plastic surgery clinics. While their scope of practice stays the same in each setting, some states require CRNAs to work under the supervision of a physician, such as an anesthesiologist. This creates employment challenges, especially in locations where physicians are limited. For example, CRNAs are the sole anesthesia providers in the vast majority of rural locations.

While nursing and physician shortages can reduce access to proper care in some places, it also increases nurse anesthetist salaries and demand. The Bureau of Labor Statistics (BLS) projects 9% growth for nurse anesthetists between 2022 and 2032, giving CRNAs faster than average job growth. The BLS also lists a high median annual salary of $203,090 in May 2022.

Frequently Asked Questions About Becoming a CRNA

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