How to Become a Nurse Anesthetist

How to Become a Nurse Anesthetist

Nurse anesthetists, also known as Certified Registered Nurse Anesthetists (CRNAs), play a vital role in healthcare. They are advanced practice nurses who administer anesthesia and manage pain relief for patients during surgery and medical procedures. CRNAs are among the highest-earning nurses and have a significant level of autonomy in their practice. Learn about the path to becoming a nurse anesthetist, their salaries, and the education needed to pursue this career.Nurse administering anesthesia to a patient

The demand for CRNAs is on the rise. The U.S. Bureau of Labor Statistics (BLS) projects a 12% growth in CRNA jobs from 2021 to 2031, which is faster than the expected 6% increase for all registered nurses. In this guide, we will walk you through the journey to become a CRNA and what you can expect in this challenging but rewarding field.

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What Is a Certified Registered Nurse Anesthetist (CRNA)?

How Long Does It Take to Become a Nurse Anesthetist?

– Approximately 7-8 years

Education Required

– Doctor of Nursing Practice (DNP) or Doctor of Nurse Anesthesia Practice (DNAP)


– Certified Registered Nurse Anesthetist

What Is a Nurse Anesthetist?

Nurse anesthetists, or CRNAs, are advanced practice registered nurses (APRNs) with specialized training in anesthesia and pain management. As APRNs, they have the authority to assess anesthesia and pain relief requirements, administer anesthesia, and prescribe pain medications, including controlled substances.

CRNAs work in various healthcare settings, including hospitals, surgical centers, clinics, and private practices. In some settings, especially in clinics and rural healthcare facilities, they may serve as the sole anesthesia specialist. In hospitals, they often collaborate with physician anesthesiologists.

Steps to Becoming a Nurse Anesthetist

Becoming a CRNA involves a multi-step process that takes several years of education and training, depending on the requirements of the state where you plan to practice.

1. Earn a BSN Degree

To start your journey, you must complete a four-year Bachelor of Science in Nursing (BSN) program. Some CRNAs begin their careers with 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 options for ADN-holders. If you hold a bachelor’s degree in a non-nursing field, you can enroll in an accelerated BSN program and earn your degree in 2-3 years, depending on transferable credits.

2. Pass the NCLEX Exam

After obtaining your BSN, you need to pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN) to become a licensed RN. This computer-adaptive exam covers various topics related to nursing practice, healthcare systems, patient care, and more. Additionally, you must meet any state-specific requirements, including background checks.

3. Gain Clinical Experience in Critical Care

All CRNA programs require RNs to accumulate 1-3 years of experience in critical care. This experience involves working in intensive care units (ICUs), medical-surgical units, or trauma and emergency centers. It equips RNs with the skills to provide medical interventions to critically ill patients with injuries, life-threatening conditions, or those undergoing surgical procedures.

4. Enroll in a Graduate Nurse Anesthesia Program

Starting in 2022, the minimum degree required for CRNAs is a Doctor of Nursing Practice (DNP) or Doctor of Nurse Anesthesia Practice (DNAP), rather than an MSN. You can choose a specialty during DNP programs, while DNAP curricula are already specialized. Most nurse anesthetist graduate programs typically require a minimum GPA, often 3.0 or higher. Candidates must also provide letters of recommendation and a personal essay or statement.

5. Graduate with Your DNP or DNAP and Pass the National Certification Exam

After completing your doctoral degree, you must pass the National Certification Exam (NCE) administered by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA). The NBCRNA currently charges $995 to take the test, which increased to $1,045 in January 2023. To take the NCE, you need a DNP or DNAP degree and an active RN license. The NCE is a computer-adaptive test that assesses your competency for entry-level practice. It includes questions on basic science, equipment, instrumentation, anesthesia principles, and anesthesia for surgical procedures and special populations.

Each state board of nursing sets the scope of practice and supervision level for CRNAs, so it’s essential to check the specific regulations in your state.

6. Start Your Career as a CRNA

CRNAs work in various settings, including hospitals, surgical centers, clinics, medical offices, and military bases. They often collaborate with surgeons, anesthesiologists, and other healthcare professionals in surgical suites. In some under-resourced areas like rural hospitals, CRNAs may function as the sole anesthesia provider, administering anesthesia independently, supervising healthcare team members, and educating patients on post-surgery pain management. Depending on the state, many CRNAs have their own practice and work independently.

Nurse Anesthetist Education

Becoming a nurse anesthetist requires a significant commitment to gaining the necessary skills and knowledge for advanced nursing practice. You should have a BSN, an advanced graduate degree from an accredited program, and certification from the NBCRNA. From 2022, all CRNAs must hold a doctoral degree, following completion of their BSN and RN license. Clinical experience in an intensive care unit (ICU) or a similar setting is also essential.

– BSN Degree:

The minimum educational requirement to obtain an RN license is a two-year Associate Degree in Nursing (ADN). However, most graduate-level nurse anesthetist programs require a BSN. Some graduate programs offer a bridge component for ADN-holders to meet BSN equivalency.

– Admission Requirements:

Most programs prefer or require a GPA of 3.0 or higher and successful completion of math and science courses, including biology and chemistry.

– Program Curriculum:

BSN programs cover subjects like anatomy, physiology, nursing best 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 in the sciences or healthcare, can often transfer credits and complete their degree in 2-3 years.

– Skills Learned:

BSN programs prepare nurses to administer tests and medications, monitor patients, work effectively in various healthcare settings, educate patients on health topics, and function as part of a healthcare team.

– Doctor of Nursing Practice (DNP):

Aspiring CRNAs can pursue a Doctor of Nursing Practice (DNP) degree through a nursing school accredited by the American Nurses Credentialing Center. This doctoral program takes 2-3 years and may involve additional time to specialize in areas like chronic pain management, adult cardiac anesthesiology, or pediatric anesthesiology.

– Admission Requirements:

Most DNP programs prefer a GPA of 3.0 or higher from your undergraduate or MSN degree, an unrestricted RN license, 1-3 years of critical care experience, and professional references.

– Program Curriculum:

The DNP curriculum covers topics such as 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 typically finish a DNP in 1-2 years. Those with a BSN can complete the program in 3-4 years.

– Skills Learned:

Nurse anesthetist students learn to apply research to new practices, exercise sound clinical judgment, use technology, and develop expertise in anesthesia administration and pain relief.

Doctor of Nursing Practice vs. Doctor of Nurse Anesthesia Practice

CRNAs have options for meeting the new doctoral degree requirement. The Doctor of Nursing Practice (DNP) and the Doctor of Nurse Anesthesia Practice (DNAP) are two popular choices.

Doctor of Nursing Practice (DNP):

– The DNP is the highest nursing practice degree, often required for university teaching positions.
– It is available exclusively from nursing schools.
– DNP standards and curricula are defined by the American Association of Colleges of Nursing.
– The DNP is more common compared to the DNAP.
– This doctoral degree focuses on practice rather than research, which is typical for a Doctor of Philosophy (Ph.D.).

Doctor of Nurse Anesthesia Practice (DNAP):

– DNAP programs can be offered outside of nursing schools.
– Programs are approved by the Council on Accreditation of Nurse Anesthesia.
– This doctoral degree is practice-focused but often requires a capstone nursing research project related to nurse anesthesia practice, education, or administration/management.

Nurse Anesthetist Credentials

Nurse anesthetists must possess both certification and licensure to practice anesthesia. State boards administer licensure, while the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA) manages CRNA certifications.

– CRNA Certification:

To become a CRNA, candidates must pass the National Certification Exam (NCE) administered by the NBCRNA. Additionally, they must graduate from an accredited CRNA program, hold an active and unencumbered RN license, and provide a statement confirming their ability to administer anesthesia without limitations. Maintaining certification requires continuing education credits, completing core modules, and passing an assessment.

– CRNA Licensure:

Licensing requirements for CRNAs vary among states, but every state mandates CRNA certification. Nurse anesthetists apply for licensure with their local state board of nursing. Some states may require additional applications for prescriptive authority or physician supervision forms. To maintain licensure, CRNAs must complete continuing education credits.

Working as a Nurse Anesthetist

CRNAs have a diverse range of work environments to choose from, including hospitals, medical-surgical units, and critical care facilities in rural communities. They can also find employment in outpatient and ambulatory surgical centers, doctors’ offices, pain management clinics, military and government facilities, dental offices, ketamine clinics, and plastic surgery clinics.

– Hospital Surgical Suites:

Hospitals are among the most common employers for CRNAs. In this setting, they work alongside anesthesiologists, RNs, and other healthcare professionals to administer anesthesia and manage pain. Their responsibilities include monitoring patients and ensuring pain management.

– Critical Access Hospitals:

CRNAs with licenses from states that grant full-practice authority are in demand in critical access hospitals located in rural areas. In these settings, they often administer anesthesia independently, supervise healthcare team members, and educate patients about post-surgery pain management.

– Ambulatory Surgical Centers:

CRNAs find employment opportunities in ambulatory surgical centers, responding to the increasing number of patients seeking outpatient procedures. Their duties in these settings may include administering anesthesia independently or in collaboration with anesthesiologists, monitoring patients after procedures, and providing education on pain management.

– Doctors’ Offices and Pain Management Clinics:

The roles of CRNAs in doctors’ offices or pain management clinics can 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 follow-up care for patients post-surgery.

Nurse anesthetists can anticipate an increase in employment opportunities and earning potential in the coming decade. According to the BLS, there will be an addition of 5,300 nurse anesthetist positions by 2031. CRNAs rank among the highest-paid advanced practice nurses, earning an average annual salary of $202,470, compared 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?

The timeline to become a CRNA can vary depending 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, and admission to CRNA programs can be highly competitive. Graduate-level nurse anesthetist programs typically require a GPA of 3.0 or higher and include courses in pharmacology, anatomy and physiology, and nursing practice. Some programs admit only a small percentage of applicants, while others have slightly higher acceptance rates.

– Are nurse anesthetists paid well?

Nurse anesthetists enjoy some of the highest salaries among advanced practice nurses. The median annual salary for nurse anesthetists is $195,610, which is significantly higher than the median annual salary for all occupations, which is $45,760. However, it’s important to note that the job of a nurse anesthetist can be very demanding and comes with a significant level of responsibility due to the inherent risks associated with anesthesia.

– What is the difference between a CRNA and an anesthesiologist?

CRNAs are advanced practice nurses who have earned a graduate nursing degree, while anesthesiologists are medical doctors who have completed a four-year medical degree and a four-year residency. The scope of practice and level of supervision for CRNAs are determined by state boards of nursing, with some states allowing CRNAs to work independently. Anesthesiologists, on the other hand, are physicians who provide anesthesia services, and they often work in collaboration with CRNAs.

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