How to Become a Certified Registered Nurse Anesthetist (CRNA)

March 2, 2022 , Updated on June 23, 2022 · 6 Min Read

Reviewed by Shrilekha Deshaies

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How to Become a Certified Registered Nurse Anesthetist (CRNA)
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What is a certified registered nurse anesthetist (CRNA)? How long does it take to become a nurse anesthetist? This guide answers common questions about nurse anesthetist careers, including how to become a CRNA.

What Is a Nurse Anesthetist?

CRNAs are advanced practice registered nurses (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

1. Earn a bachelor of science in nursing (BSN) degree.

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.

Learn More About Nurse Anesthetist Schooling

2. Pass the NCLEX-RN exam.

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.

Pursue specializations while working as an RN in an acute care setting.

Most graduate nurse anesthetist programs require at least 1-3 years of experience in an intensive care unit or a critical care program. During this time, candidates must maintain an unencumbered nursing license.

4. 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.

Read About Choosing a Specialization

5. Get certification from the National Board of Certification and Recertification for Nurse Anesthetist (NBCRNA).

Offered through the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA), this computerized examination varies in length and covers all topics related to planning and administering anesthesia and managing anesthesia programs. These topics include but are not limited to physiology and anatomy, pharmacology and different types of anesthesia, administering and monitoring different types of anesthesia, and potential complications and how to address them.

Learn About Nurse Anesthetist Credentials

6. Get Nurse Practitioner State Licensure.

Professionals who want to practice advanced practice nursing in the nurse anesthetist specialty must earn licensure specific to their state. Licensing requirements vary by state.

7. Find employment.

Nurse anesthetists work in hospitals and surgical centers, typically in collaboration with physicians 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.

Read About Working as a Nurse Anesthetist

Featured Online MSN Programs

Nurse Anesthetist Schooling

Starting in 2022, nurse anesthetist schooling will take most students 7-8 years to complete as a DNP or DNAP will become the minimum required degree.

BSN Degree

While 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.

  • Admission Requirements: Most programs require or prefer a GPA of 3.0 or higher and successful completion of math and science programs, including biology and chemistry.
  • Program Curriculum: 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.
  • Skills Learned: BSN programs prepare nurses to administer tests and medications, monitor patients, understand and work in most healthcare settings and as part of a medical team, and educate patients on health topics.

Doctor of Nursing Practice

As of 2022, nurse anesthetists must hold a DNP or DNAP. The DNP is the highest practice degree a nurse can earn.

  • Admission Requirements: Most DNP/DNAP programs require or strongly prefer at least a 3.0 GPA from the undergraduate or MSN degree, an unrestricted RN license, 1-3 years experience in critical care, and professional references.
  • Program Curriculum: 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.
  • Skills Learned: 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.

CRNA Certification

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 Licensure

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

Nurse anesthetists are in demand and nurse anesthetists' salaries reflect this. As of 2021, the median annual nurse anesthetist salary approached $195,610. Nurse anesthetists work in a variety of settings, with their responsibilities and scope of practice, including professional autonomy, varying by state.

Hospital Surgical Suites

Nurse anesthetists collaborate with anesthesiologists and the healthcare team, administer anesthesia either under supervision or independently, and manage RNs, surgical technologists, and nursing assistants.

Critical Access Hospitals

Nurse anesthetists provide anesthesia independently depending on the state, work with a healthcare team, and educate patients on postanesthesia pain management.

Ambulatory Surgical Centers

Nurse anesthetists deliver anesthesia independently or in collaboration with anesthesiologists, release patients to go home after procedures, and prepare patients for postanesthesia pain management.

Doctor Office/Pain Management Clinics

Nurse anesthetists educate patients on pain management and provide anesthesia either independently or with supervision.

Nurse Anesthetist Resources

As a professional association of nurse anesthetists, the American Association of Nurse Anesthetists serves more than 53,000 members, including student, certified, and recertified members. AANA's clinical practice resources provide professionals with information and tools relevant to clinical practice, including the nursing code of ethics for CRNAs and information about pain management. The NBCRNA administers the national certification exam that measures the skills, knowledge, and abilities needed to pursue entry-level nurse anesthesia practitioner careers. As the official career center of the AANA, CRNA Careers allows professionals to search for job opportunities. Additionally, professionals can access career resources and learn more about AANA membership.

Frequently Asked Questions About Becoming a Nurse Anesthetist

How many years does it take to become a CRNA?

It takes at least six years of education and at least one year of experience as an RN to become a CRNA. In 2022, prospective CRNAs must complete at least seven years of education to earn the required DNP or DNAP.

What is the quickest way to become a CRNA?

This depends on current credentials, enrollment status, and the program's requirements for RN experience. A nurse with an MSN can finish a full-time program in one or two years, while a nurse with an ADN may take six or more years to graduate.

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.

Learn More About Nurse Anesthetists

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