Certified Registered Nurse Anesthetist (CRNA)

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I. What They Do

Certified registered nurse anesthetists (CRNAs) are responsible for managing and monitoring a patient’s pain levels and vital functions during medical and surgical procedures. This career is categorized as an advance practice registered nurse (APRN) role because it requires graduate-level educational and clinical training. CRNAs spend 2-3 more years in school than many nursing professionals, such as RNs and LPNs, who do not need to earn a graduate degree. Due to the high level of precision and knowledge demanded of them, CRNAs operate with high levels of autonomy.

Daily Responsibilities

  • Assesses patient health and responsivity to anesthesia
  • Identifies potential risks of anesthetizing a patient, including allergies and overdose
  • Calculates precise dosage and titration of anesthetic medicines
  • Manage vital functions throughout sedation
  • Carefully and clearly communicates with patients before, during and after administering anesthesia
  • Support trauma stabilization procedures during and after procedures

Ideal Candidates

  • Remain calm and controlled in high pressure situations
  • Easily and quickly perform precise biometric calculations
  • Enjoy multi-tasking and following complex protocols
  • Excel in explaining medical procedures and sedation to patients and their families

Work Environments

  • Emergency rooms
  • Intensive care units
  • Cardiac care units
  • Dental and oral surgery offices
  • Outpatient medical facilities
  • Private, specialized physician offices

II. Career Outlook

As with all advanced practice nursing professions, the demand for nurse anesthetists is rising rapidly. More and more community hospitals are choosing to employ a team of highly qualified CRNAs than a single, high-cost anesthesiologist. In fact, anesthetists are already the sole providers of anesthesia in nearly 100% of rural U.S. hospitals.

Job Growth

Generally, there are far fewer professionals working in APRN fields when compared to other nursing professionals, such as RNs – in 2013 there were 35,430 employed nursing anesthetists to 2,661,890 registered nurses. This is due to the stringent requirements for APRNS, who need to earn their RN license, graduate degree and national credentials before gaining employment. Sill, the demand for CRNAs is rising.

Projected job growth for NAs between 2012-22: 25% (faster than the 19% growth projected for RNs and the 11% average for all positions)

Projected Job Growth for Nursing Anesthetists, 2012-2022

Job Growth Percent Change for Nurse Anesthetists vs Other U.S. Occupations

Metro Areas with Highest Number of CRNAs Employed
Metro Area Number of CRNAs Employed
Source: Bureau of Labor Statistics, Occupational Employment Statistics. Accessed May 2014.
Houston-Sugar Land-Baytown, TX 1,500
Tampa-St. Petersburg-Clearwater, FL 950
Nashville-Davidson-Murfreesboro-Franklin, TN 870
Minneapolis-St. Paul-Bloomington, MN-WI 820
Nassau-Suffolk, NY 810

CRNA Salary

According to the U.S. Bureau of Labor Statistics (BLS), the average annual salary for CRNAs is over $58,000 higher than the yearly earnings for a nurse practitioner.

2015 Average Salaries for CRNAs, NPs and RNs

Industries Paying the Highest Average CRNA Salary in 2015
Industry Average CRNA Salary
Source: Bureau of Labor Statistics, Occupational Employment Statistics. Accessed April 2016.
Specialty Hospitals (except Psychiatric and Substance Abuse) $178,810
Outpatient Care Centers $174,850
General and Surgical Hospitals $170,060
Federal Executive Branch $159,390
Physician Offices $156,940

States with the Highest Average Salaries for CRNAs in 2013

III. How to Become One

According to the American Association of Nurse Anesthetists (AANA), CRNAs must graduate with a minimum of a master’s degree from an accredited nurse anesthesia program and pass the national certification exam following graduation.These programs will take anywhere from two to two and a half years to complete. A bachelor’s degree is required for admittance and all programs include clinical training classes at university or community hospitals before graduation.

Education Requirements

Aspiring CRNAs must ensure that they enroll in a graduate program accredited by the Council of Accreditation of Nurse Anesthesia (COA). This particular accreditation agency is extremely important – candidates can only register for the national CRNA exam if the COA has endorsed their graduate program.

There are currently 113 accredited nurse anesthesia programs in the U.S.; together these schools use more than 2,200 active clinical sites for training. 16 of these programs offer a doctorate degree option.

CRNA program entrance requirements:

  • A Bachelor of Science in Nursing or an appropriate baccalaureate degree
  • A current license as a registered nurse
  • National Council Licensure Exam for Registered Nurses (NCLEX)
  • Graduate Record Examination (GRE)

Many graduate programs in this field will only accept applicants with acute care experience, so students might need to take a year or two off from school to gain clinical experience at a hospital or with a physician’s office.

Certification and Licensing Requirements

All nurse anesthetists must pass the CRNA exam: The National Board of Certification and Recertification for Nursing Anesthetists outlines eligibility, registration processes, exam details and renewal procedures in its Examination Candidate Handbook.

Requirements to take the NBCRNA exam:

  • Hold an active RN license in one’s state of employment
  • Hold a graduate degree from a nursing anesthetist program accredited by the COA
  • Submit a completed application form along with all supplemental materials
  • Acknowledgement that one does not suffer from ailments that would prohibit work as a CRNA (drug or alcohol abuse)
  • A clean RN license record without instances of suspension, restrictions, or disciplinary action

CRNA recertification requirements:

  • Obtain a minimum of 40 hours of approved continuing education every two years
  • Document substantial anesthesia practice
  • Maintain current state licensure
  • Certify that one has not developed any conditions that could adversely affect their ability to practice

Prospective CRNAs should also note that the National Council of State Boards of Nursing (NCSBN) is taking steps to standardize APRN licensure across the U.S. However, not all states have adopted these guidelines yet, so it is important for nursing anesthetist candidates to check their state’s current status and examine the proposed model for regulation.