How to Become a Nurse Anesthetist

Last Updated on January 15, 2023

Those of you seeking the nurse anesthetist salary or what does a nurse anesthetist do are in for a treat. This article will give you all the information you require and more to help you shine your educational pathway to becoming a nurse anesthetist. The below review has been written for the benefit of nursing students, but it is also useful for nurses, regardless of experience or career stage, who are interested in exploring their potential job opportunities in this specific field.

Nursing students and RNs often set a long-term goal of becoming a CRNA, and for good reason. CRNAs are highly respected for their work and earn some of the best salaries in the nursing field. They’re also an important part of our healthcare system.

If you’re a Registered Nurse (RN) looking for more autonomy working with patients in an operating room, intensive care unit, or surgical facility, then becoming a Certified Registered Nurse Anesthetist (CRNA) might be the perfect job for you.

what does a nurse anesthetist do

Responsible for providing anesthesia and related care before, during, and after therapeutic, surgical, obstetrical, and diagnostic procedures, nurse anesthetists also provide emergency services and pain management. Before the start of procedures, nurse anesthetists work with patients to discuss their medications and medical history, and explain the type of anesthesia, its risks, and benefits, to obtain consent.

Nurse anesthetists provide patients with general anesthesia, relieving pain or discomfort during surgery and other medical procedures. They also administer local and regional anesthesia to numb areas of the body, staying with patients during procedures, monitoring their vital signs, and making adjustments to the anesthesia as needed. CRNAs may also act as support for the post anesthesia care team by making a postoperative visit to the patient to assess for any complications, and provide medication to alleviate pain, nausea, or other complications.

How To Become A Nurse Anesthetist

You must be legally licensed in your state to work as a nurse anesthetist, which requires having at least a master’s degree. You must also earn national certification. But to enter into a master’s program, you must first be a registered nurse (RN) with a Bachelor of Science in Nursing (BSN). You’ll also need to complete at least 1 year of experience in an acute care setting such as an ICU or ER, though you might need more depending on the acceptance requirements of your school.

School requirements

After earning your BSN and completing your acute care experience, you can then apply to master’s programs for nurse anesthetists. Prior to doing so, some nurses choose to pursue specialty certification as a critical care registered nurse (CCRN), which could possibly increase the chance of getting accepted.

When applying to CRNA programs, make sure the schools you choose have been approved by the Council on Accreditation of Nurse Anesthesia Educational Programs (COACRNA). Graduation from an accredited program is a requirement for taking the certification test.

As for coursework, all accredited nurse anesthesia programs require studies in the following areas:

• Anesthesia pharmacology
• Chemistry, biochemistry, and physics
• Anatomy, physiology, and pathophysiology
• Anesthesia equipment and technology
• Pain management
• Statistics and research
• Professional and legal aspects of nurse anesthesia practice

Step 1: Earn a Bachelor’s Degree

To become a CRNA, aspiring nurse anesthetists must first earn a Bachelor of Science in Nursing (BSN). They may have to finish two years of prerequisites before applying to a bachelor’s-level nursing program. Some students become nurses through diploma or associate’s degree programs and gain some experience before completing an RN-to-BSN program. Coursework topics include basic nursing skills, health assessment fundamentals, human anatomy, biology, psychology, pharmacology, and pathophysiology. Students complete clinical rotations in major health departments, like women’s health, pediatrics, mental health, and surgery.

Step 2: Get Experience

Nurse anesthesia master’s degree programs require applicants to have a minimum of one year of professional, hands-on experience in critical care nursing. RNs can acquire experience by working in an intensive care unit, cardiac care unit, or surgical intensive care unit.

Step 3: Earn a Master’s Degree

A master’s degree program in nurse anesthesia requires a minimum of 27 months of full-time attendance. Students learn to operate anesthesia equipment and manage surgical and emergency situations that require anesthesia. Course topics commonly include anesthesia pharmacology, anesthesia pathophysiology, anesthesia biochemistry, geriatric anesthesia, obstetric anesthesia, and pain management. Students complete numerous supervised clinical experiences involving diverse anesthesia situations, from eye surgery to plastic surgery and open-heart surgery.

Step 4: Obtain State Licensure

All states require nurses to pass the National Council Licensing Exam for Registered Nurses (NCLEX-RN) and obtain licensure before being allowed to practice. Individual states might have additional requirements. One’s RN license must be in good standing to apply to a nurse anesthesia program.

Step 5: Gain Experience

A CRNA is an advanced RN position, but further advancement is an option for enterprising CRNAs. With leadership acumen and formal business education, CRNAs may move into managerial or high-level administrative positions within hospitals or medical facilities. Alternatively, more academic-focused CRNAs may wish to obtain a doctorate and conduct research or be part of a research team.

Step 6: Become a CRNA

Attaining the CRNA credential is necessary to practice. Individuals with master’s degrees in nurse anesthesia from accredited schools and unrestricted RN licenses are eligible to take the National Certification Exam, which is administered by the National Board of Certification & Recertification for Nurse Anesthetists. Some states also require CRNAs to obtain specialty licensure status.

how many years to become a nurse anesthetist?

Nurse anesthetists complete a BSN (4 years), an MSN (2 years), and with the new mandate a DNAP (4 years). Including an average of 2.6 years of critical care experience, this amounts to an estimated 11 years to achieve certification. Anesthesiologists are licensed medical doctors who specialize in anesthesia.

What Are the Education Requirements for Nurse Anesthetists?

CRNAs are advanced-practice registered nurses who have completed a Master’s of Science in Nursing (MSN) or doctoral degree program (DNP). Currently, the AANA plans to require all CRNA programs to change from MSN to DNP programs by 2025.

To advance to a master’s degree, a student must first complete an accredited nursing program and obtain a bachelor’s degree in nursing (BSN). Successful completion of the NCLEX-RN is needed for licensure. The length of time to become a Certified Registered Nurse Anesthetist (CRNA) may vary depending on the program. However, these are the minimum requirements:

• A Bachelor of Science degree in nursing (BSN) or another related field from an accredited program
• An unrestricted license as a registered nurse
• A minimum of one year (full-time or part-time equivalent) experience as an RN in a critical care setting
• Completion of, at minimum, a master’s degree from an accredited nurse anesthesia educational program

Nurse anesthesia programs are accredited by the Council on Accreditation of Nurse Anesthesia Education Programs (COA). There are currently 121 accredited nurse anesthesia programs in the US and Puerto Rico.

A nurse anesthesia program ranges anywhere from 24-51 months, depending on the university, and includes clinical experience as well as didactic classroom hours. On average, it takes a minimum of 7 to 8.5 years of experience and education to become a CRNA.

Recertification and continuing education for CRNA’s is different than other APRNs. Recertification program for nurse anesthetists is called the Continued Professional Certification (CPC) Program and is administered by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA). The requirement for continuing education (CE) credit is robust; CRNA’s must meet 60 general CE credits and an additional 40 CE credits covering four content areas including airway, pharmacology, physiology and pathophysiology and anesthesia equipment along with a comprehensive certification exam every eight years.

Depending on the school, the curriculum for CRNAs can vary slightly, but core concepts include:

• Advanced pathophysiology in anesthesia
• Advanced health assessment for nurse anesthesia
• Principles of anesthesia
• Clinical anesthesia
• Research

nurse anesthetist salary

Certified registered nurse anesthetists most often provide anesthesia services to rural communities, though they may work in urban medical facilities alongside anesthesiologists or other nurse anesthetists. They are some of highest paid medical professionals, both because of the training they undergo and because of the responsibilities they have for patient safety and comfort. It takes hard work and dedication to reach this level of specialization, and there are many opportunities in various medical settings for nurse anesthetists throughout the nation.

INDUSTRIES WITH THE MOST CRNAS

CRNA Salary 

Certified Registered Nurse Anesthetist salaries are among the highest in the nursing profession. While the Bureau of Labor Statistics reports that the national median salary for CRNAs was $174,790, Becker’s Hospital Review took a more granular view to see how incomes for the profession varied by state and found that the highest average CRNA salaries are paid in Montana (246,370) and the lowest average CRNA salary was found in Idaho ($143,270). 

In addition to earning substantial salaries, CRNAs can expect to be offered attractive employment benefits that go beyond the typical offerings of health insurance, vacation and sick time to include perks such as on-site childcare, financial incentives for healthy living, tuition reimbursement and career coaching.

CRNA Career Outlook

There is a growing and well-documented nursing shortage that is expected to continue through the year 2030, and that means the demand for nurses of all types and working in all specialty areas will be in constant demand for the foreseeable future.

For Certified Registered Nurse Anesthetists, the employment outlook is particularly strong, as the current anesthesia model of care, which centers on a physician anesthesiologist, is being increasingly criticized as it drives costs up without improving quality, outcomes, morbidity or mortality. CRNAs are likely to be providing more and more anesthesia care on their own, without the need for supervision, and that will lead to more and more facilities looking to hire these highly skilled professionals.

Certified Registered Nurse Anesthetists work in a wide range of healthcare settings, including:

• Hospital surgical suites
• Critical care hospitals
• Ambulatory surgery centers
• Hospital obstetrical delivery rooms
• Private practice dentistry offices, podiatry offices, plastic surgery offices, and ophthalmologists’ offices
• Pain management centers
• U.S. military and Veterans’ Affairs hospitals
• Community care clinics

Types of CRNA Programs 

Though there are several available routes to becoming a Certified Registered Nurse Anesthetist, all begin with programs that have been accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs, and all involve earning a BSN, being certified as a Registered nurse through NCLEX-RN and then pursuing your MSN or DNP degree.

A quick search of the online database reveals that there are a total of 121 programs available, which means that whether you’re looking for in-person education or an online degree, a post-master’s certificate or have not yet earned your BSN, you’ll be able to find a program that suits your need. Take the time to fully explore every program that matches your criteria, as you’ll find that every school has its own philosophy, requirements, and approach. 

• Accelerated RN-BSN-MSN program. Many nurses come to the profession with a degree focused outside of nursing science, but if you want to move into a position as a CRNA, you’ll need to complete the courses required for a BSN. An Accelerated RN-BSN-MSN program allows you to complete all of those steps in a comprehensive format that expedites the process and provides you with all you need in terms of both classroom learning and the required clinical hours.
• MSN-CRNA program.  These programs last anywhere from two years to just over four years, depending upon the focus of study and the individual school curriculum. There is a wide range of expectations and requirements in terms of both classroom hours and clinical hours, with the national average of hands-on experience required for a CRNA totaling 9,369. 
• DNP. For nurses who want to become CRNAs, the Doctorate of Nursing Practice provides an education that goes beyond what is presented in MSN programs, preparing graduates for careers both in their profession and in community health, research, policy and leadership. It is expected that the Doctor of Nursing program will eventually become the standard for all advanced practice nurses, as the American Association of Colleges of Nursing has endorsed that goal. 
• Post-Masters Certificate in CRNA – Advanced Practice Registered Nurses who have already earned their MSN and who then choose to take the Certified Registered Nurse-Anesthetist certification exam can take a specialized program that provides the education and training needed. These programs can be taken on either a full-time or part-time basis and generally involve 52 hours of combined academic and clinical hours.

Online CRNA Programs 

Nursing is a hands-on profession that requires a significant amount of hands-on training. Still, technology has presented those who wish to become Certified Registered Nurse Anesthetists with the ability to fulfill many of their educational requirements online so that they continue to work and to fulfill their family responsibilities. Though online Certified Registered Nurse Anesthetist programs do have requirements for completing a certain amount of academic hours in person, the curriculum usually limits that attendance to concentrated periods of time two or three times per semester, and allow nurses who are working to make arrangements for practicum hours to be fulfilled near to their homes.

Not only do accredited online CRNA programs provide all of the education and experience that is needed to graduate with the same knowledge and skills as traditional, in-person programs, but they are often more affordable, while providing the ability to continue earning income to help pay for tuition.

Online programs are available all over the country, and you can find excellent choices close to home as well as at schools that are hundreds of miles away. When investigating, make sure that you understand all of the attendance and clinical hour requirements of these programs so that you’re sure that they’ll fit your specific needs and abilities to attend.

CRNA Program Length

CRNA programs, regardless of whether an individual will earn their MSN, DNP, or DNAP, are all extremely time-consuming. Students are highly discouraged to work as they are expected to spend approximately 60 hours a week studying and preparing for class, on top of the time spent in the physical class. During practicum, students have call time and work full-time hours while still taking classes. Some programs will offer a stipend to students. 

CRNA programs are between 24-51 months of full-time classes depending on university requirements. Some programs will split it into 9 distinct semesters with holiday and summer breaks, while others will have their students continue right through the program. 

Classes and Clinicals

The Council on Accreditation of Nurse Anesthesia Educational Programs has established standards for both clinical education and program accreditation, including entrance requirements for applicants to these programs. For a program to be accredited, it needs to demonstrate that it will be able to provide the “potential for professional and educational growth of students and faculty,” as well as a curriculum that will allow its graduates to pass the CRNA certification exam.

The standards require that full-time anesthesia programs be at least 24 months in length and that part-time programs provide the equivalent amount of time. Coursework should include:

• Pharmacology of anesthetic agents and adjuvant drugs (105 hours)
• Anatomy, physiology and pathophysiology (135 hours)
• Professional aspects of nurse anesthesia practice (45 hours)
• Basic and advanced principles of anesthesia practice including physics, equipment, technology and pain management (105 hours)
• Research (30 hours)
• Clinical correlation conferences (45 hours)
• Radiology and ultrasound

Every accredited CRNA program uses these standards as the foundation on which it builds its own individual curriculum and requirements. 

Certified Registered Nurse Anesthetist Program Requirements

Though every CRNA degree program is different, all have to meet the entrance requirements that the Council on Accreditation of Nurse Anesthesia Educational Programs imposes in order to gain and maintain accreditation. These generally include:

• Unencumbered, active RN license
• BSN degree (unless pursuing an RN-to-BSN-to-MSN program)
• Minimum of one year of experience as an RN in a critical care setting
• Official transcripts demonstrating academic success in Bachelors-level degree programs
• Minimum 3.0-grade point average 
• Minimum GRE score of 300 or better
• Prerequisite courses 
• Personal letters of recommendation
• TOEFL test if applicable
• Applicants for DNP-level CRNA programs must have both ACLS and PALS certification before beginning clinical activities and should have demonstrated independent decision=making skills using and interpreting advanced monitoring techniques based on knowledge of physiological and pharmacological principles

Graduates of CRNA programs must also pass the National Board of Certification and Recertification for Nurse Anesthetists’ credentialing exam and to continuously recertify on an 8-year cycle that is administered using a two-year check-in program to ensure that CRNAs maintain their licensure.

CRNA Program Cost

CRNA programs are costly, but studies have confirmed that when compared to the high earnings potential it provides, it is well worth it. Though most CRNA students graduate with over $100,000 in student debt, the ability to begin earning up to three times what you previously were makes that investment and temporary financial stress well worth it. 

Costs can also be managed through careful selection of a program that is within your means: public CRNA programs average approximately $40,195 while private programs add $20,000 with a median cost of $60,941. The national average is $51,720. With the national average compensation well above $150,000, CRNA graduates will quickly be able to pay off loans and significantly improve their economic position. 

How to Pay for the CRNA Program 

There are very few Registered Nurses who can enter a CRNA program without financial concerns: most have to seek loans, scholarships, grants, or some other form of financial assistance in order to afford the costs of tuition. Fortunately, there are several resources available to help you manage the costs. Here are just a few:

• Scholarships – Whether you find a scholarship whose goal is the support of a particular demographic of which you are a member, to encourage people to pursue advanced nursing education, or to specifically support those who want to become CRNAs, there are numerous opportunities available. 
  • AAUW Career Development Grants –  The American Association of University Women provides funding for women who earned a bachelor’s degree at least five years earlier and who are preparing to advance or change careers. Grants range from $2,000 to $12,000.
  • AfterCollege/AACN $10,000 Scholarship Fund – For students pursuing a bachelor’s master’s or doctoral degree in nursing. One scholarship in the amount of $2,500 is awarded each quarter.
  • AANA Foundation Scholarships – The American Association of Nurse Anesthetists administers multiple scholarships specifically created to support CRNA-degree candidates who have completed at least six months of their program.
• Tuition reimbursement through your employer – Employers in healthcare are acutely aware of the looming nursing shortage, as well as of the tremendous value that CRNAs provide to their facility. Many offer tuition reimbursement and student loan forgiveness as part of their recruitment and retention programs.
• Your program’s financial aid office – Financial aid offices are among the most underutilized tools available to CRNA students. The professionals who work in these are offices are there specifically to help ease the financial burdens of those who have been accepted into their programs. Be sure to check in with them to see what resources they can provide or direct you to. 
• Loan repayment programs – The Health Resources and Services Administration (HRSA) and the National Health Services Corporation (NHSC) are just two of the programs that provide loan repayment programs in exchange for service to specific, underserved communities. Many CRNAs find it extremely meaningful to begin their careers by working in communities where there is desperate need.