Become a CRNA: Complete Career Guide

Anesthesia is a critical component of many surgical procedures. It prevents patients from feeling pain and affects patient outcomes and satisfaction. Despite a growing need for anesthesia providers, the United States faces a shortage of anesthesia professionals, including Certified Registered Nurse Anesthetists (CRNA). This article will provide a step-by-step guide for those interested in pursuing a career as a nurse anesthetist. 

Read more: The Pros and Cons of Becoming a CRNA

What is a Certified Registered Nurse Anesthetist?

Certified Registered Nurse Anesthetists (CRNAs) are a type of Advanced Practice Registered Nurse who provide anesthesia to patients. Their scope of practice includes:

• Preoperative/Preprocedure: These responsibilities include conducting a preanesthesia evaluation, developing a pain management plan, educating the patient, and obtaining informed consent. 
• Intraoperative/Intraprocedure: The CRNA selects, prescribes, and administers the type of anesthesia specific to each patient and procedure. Monitoring of vital signs and other data is also essential during this time.
• Postoperative/Postprocedure: After a patient’s procedure, the CRNA prescribes any postanesthetic drugs, including controlled substances, evaluates the patient postanesthesia, and educates them on recovery.
• Pain Management: Nurse anesthetists also help with pain management outside of procedures.
• Other services: CRNAs have additional responsibilities, such as prescribing medications, providing emergency care, ordering and evaluating diagnostic tests, and consulting with other providers.

Steps To Becoming a CRNA

It takes approximately eight years to complete your education as a CRNA. At a minimum, a doctorate degree from a nurse anesthesia education program is required. If you are a current nurse or a prospective nursing student, these are the steps necessary to become a CRNA:

1: Earn a BSN and Pass the NCLEX-RN

The first step to pursuing a career as a nurse anesthetist is to earn a bachelor’s degree in nursing (BSN). There are two main paths to earning a BSN: 

• Graduate from a four-year college or university with a degree in nursing
• Earn an associate degree in nursing (ADN or ASN), then pursue an RN to BSN bridge program

Before BSN graduates are allowed to work as nurses, they must pass the National Council Licensure Examination (NCLEX-RN). This computer-administered test tests nursing foundational knowledge and competencies. 

Once you have earned a degree in nursing, passed the NCLEX-RN, and earned your nursing license, you may pursue a career as a registered nurse. 

Read More: What’s a Registered Nurse?

2. Get Critical Care Work Experience 

All CRNA programs require at least one year of experience as a registered nurse in a critical care setting, such as a Critical Care Unit (CCU) or Intensive Care Unit (ICU). However, the more clinical experience the nurse has, the better. 

Experience in an ICU is crucial because the responsibilities of a CRNA include navigating life-threatening scenarios, critical thinking, and extensive knowledge of physiology. Plus, experience with skills like hemodynamic monitoring, invasive lines, ventilator support, and vasoactive infusions prepares students for a CRNA program.

3. Apply to a CRNA Graduate Program

Applying to a CRNA program is a big decision. Nurse anesthesia programs could take 24-51 months to complete and cost hundreds of thousands of dollars. CRNA schools are very competitive in their selection process, and each program may have its own application requirements, including:

• A GPA of 3.0 or higher
• A GRE score of at least 300 
• Written/video essays102 nurse accredited
• A timed writing test
• Letters of recommendation
• In-person or virtual interviews

These requirements may seem daunting but they are necessary to select candidates who are prepared for the rigorous years of coursework ahead of them.

But before you worry too much about your eligibility, you need to research the schools that best fit your lifestyle. Here are a few questions to consider when comparing CRNA schools:

• Is the program accredited? There are 130 accredited nurse anesthesia programs in the United States and Puerto Rico. As of January 1, 2022, all accredited nurse anesthesia programs must award doctoral degrees. Before January 1, 2022, aspiring CRNAs could apply to master’s degree programs (MSN) or doctoral programs (DNP). 
• How much does the CRNA program cost? Nurse anesthesia school tuition fees vary widely. For example, UPenn’s three-year nurse anesthesia program costs $243,945. On the other hand, the University of Iowa’s in-state tuition for its DNP-CRNA degree is $85,553. 
• Full-time or part-time? Some institutions offer part-time programs, while others only offer full-time programs. 
• Is the program front-loaded or integrated? Students in front-loaded CRNA programs spend the beginning of their program in the classroom before entering a clinical setting. Conversely, integrated programs offer classroom and clinical time concurrently throughout the program.
• Where is the program located? The program you choose could affect where you end up working as a CRNA.

4. Take the National Certification Exam (NCE) for Nurse Anesthetists

Once you’ve completed CRNA school, you need to take the National Certification Exam (NCE). The NCE is administered by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA). This examination is required by all states to designate a graduate as a nurse anesthetist.

Nurse anesthetists can then apply with their local board of nursing and maintain their licensure to practice as a CRNA.

5. Start Working as a CRNA

Nurse anesthetists work in many different settings, including hospitals, doctor’s offices, and ambulatory surgery centers. CRNAs may even choose to administer anesthesia in environments such as dental clinics, plastic surgery offices, and ketamine clinics.

Most CRNAs work full-time. Schedules depend on the setting; CRNAs in doctor’s offices may work regular business hours, while CRNAs in the hospital work any number of shifts, including nights, weekends, and holidays.

What is the Expected Salary of a CRNA?

CRNAs are the highest-paid nursing specialty. According to the U.S. Bureau of Labor Statistics, the average annual salary for CRNAs in 2022 is $203,090. Becker’s Hospital Review provides a list of the hourly and annual wages of CRNAs in all 50 states for 2023.

6. Consider Specialization (Optional)

Some CRNAs choose to obtain additional education in specialized areas. Johns Hopkins, for example, offers CRNA cohorts that provide orientation in specialties such as pediatrics, neuro/trauma, orthopedics, plastics, and more.

CRNAs may even consider other avenues for anesthesia administration or pain management, such as obstetrics or, hospice and palliative medicine.

7. Continued Professional Certification (CPC)

For CRNAs, education does not end with graduation. To maintain an active license, nurse anesthetists must complete continuing education credits through the CPC program administered by the NBCRNA. The CPC program consists of two four-year cycles. CRNAs must renew their license at the end of each four-year cycle. At the end of two cycles, they must take a CPC assessment to ensure their anesthesia knowledge is current. 

FAQs

How long does it take to become a CRNA? 

According to the American Association of Nurse Anesthesiology (AANA), it takes a minimum of 7-8.5 years to pursue a career as a CRNA. Those hoping to pursue a career as a nurse anesthetist must first earn a bachelor’s in nursing and work as a registered nurse in a critical care setting before they apply to a CRNA graduate degree program. On average, CRNA program graduates obtain 9,369 hours of clinical experience.

Where do CRNAs work?

CRNAs work in settings where patients need anesthesia. These include doctor’s offices, surgical centers, hospitals, outpatient care centers, and military environments. Nurse anesthetists play an essential role in rural areas where they are often the sole providers of anesthesia care. 

How much do CRNAs make? 

According to the U.S. Bureau of Labor Statistics, the median annual CRNA salary in 2022 is $203,090. 

Are nurse anesthetists and anesthesiologists the same? 

Nurse anesthetists and anesthesiologists both provide anesthesia, but CRNAs are nurses with a graduate degree in anesthesia. Anesthesiologists, on the other hand, are medical doctors. 

In some states, physicians must supervise CRNAs. Other states allow CRNAs to practice independently without supervision. 

Is being a CRNA worth it? 

Many CRNAs are satisfied with their jobs, according to a 2021 survey of nurse anesthetists. The survey reports that 89% of CRNAs report being satisfied in their roles, with 48% indicating that they're very satisfied and 41% responding that they're somewhat satisfied. According to U.S. News, satisfaction is based on above average opportunities for advancement and salary and a stress level comparable to their environment and job complexities.

Can I work while going to CRNA school?

Most CRNA schools discourage students from working during their program due to the intensive nature of class time, clinical hours, and study time. Employment must not conflict with clinical schedules or assignments. 

The Bottom Line

When considering a career as a CRNA, it’s important to consider the years of education required as well as the monetary investment. Despite the long journey, nurse anesthetists experience job satisfaction and excellent compensation.