How to Become a Certified Registered Nurse Anesthetist (CRNA) in the USA

By ShiftMed Team/October 9, 2022/Nursing Profession

Are you interested in surgical nursing? Do you like working with patients in high-stakes, fast-paced medical environments? If you are interested in anesthesiology and perioperative care, you may find yourself drawn to becoming a Certified Registered Nurse Anesthetist or CRNA.

CRNAs assist anesthesiologists during surgery, and in some states, they can administer anesthesia directly to patients without supervision.

Becoming a CRNA takes extensive education and experience working in the OR. Certified Registered Nurse Anesthetists are some of the most trained and specialized types of nurses in the workforce. They are in demand everywhere due to their highly specific knowledge.

If you’re exploring different career options as an Advanced Practice Registered Nurse (APRN), then becoming a CRNA is one avenue to consider.

Alt text: A CRNA working in a surgical theatre

What are the steps to becoming a qualified CRNA?

You can become a Certified Registered Nurse Anesthetist in 5 steps:

1. Earn a bachelor’s degree in nursing

All CRNAs are APRNs, meaning they hold a graduate degree in nursing. Before you can reach this point, you’ll have to complete a 4-year undergraduate degree. Although you can become an RN with an associate’s degree in nursing, you won’t be able to apply for master’s programs with it.

If you’re already a nurse, look into RN to BSN programs online. They can help you earn your degree in under three years, so you can begin to apply for CRNA master’s programs.

2. Study for and pass the NCLEX-RN exam

The NCLEX is the certifying exam for all registered nurses in the United States and Canada. The exam will test your nursing knowledge across for core areas:

Safe and effective care environment
Health promotion and maintenance
Psychosocial integrity
Physiological Integrity

Take a look at the free NCLEX test plans from the National Board of State Boards of Nursing (NCBSN) to prepare for your exam.

3. Prepare for a master’s degree in nurse anesthesia

You will need to gain some clinical experience as an RN, including work in surgical suites, before applying for your master’s degree. Choose a program specializing in nurse anesthesia, where you can study advanced physiology, pharmacology, anatomy, and chemistry.

Throughout your program, you’ll also get hands-on training in natural surgical environments, from hospitals to outpatient surgery centers.

You may decide to pursue a doctoral degree in nurse anesthesia instead. By 2025, all nurse anesthetists in the United States will be required to hold doctoral degrees.

4. Pass the national certification exam for nurse anesthetists

All CRNAs must earn their certification through the NBCRNA. After passing, your results will be sent to your state’s nursing board. Then, you can apply for licensure and complete any additional requirements to become fully licensed as a CRNA in your state.

5. Continue your education

To maintain your CRNA license, you’ll have to complete continuing education courses through NBCRNA’s Continued Professional Certification (CPC) Program. Renewal is mandatory every four years, so you will have to perform ongoing education in the:

Delivery of anesthesia care
Patient safety, development, and research
Airway management
Anesthesia equipment and technology
Physiology and pathophysiology
Advanced clinical practice

Can you become a CRNA online?

CRNAs can complete their classwork online but must complete a practicum and clinical rounds in person at an approved facility. It’s also likely that your school will require you to complete on-site in-person learning labs.

The shortest CRNA program is 24 months, but you will likely spend around 36 months preparing for your program and completing all the necessary experience to become a certified nurse anesthetist.

Is CRNA a master’s or doctorate?

There is some confusion about what type of degree you need to become a CRNA. Students can become a nurse anesthetist with a master’s degree, but that will change soon.

Starting in 2025, all aspiring nurse anesthetists will have to complete a doctorate in nurse anesthesia. However, doctorate programs do not always require a master’s as a prerequisite. Instead, the DNP (Doctor of Nursing Practice) program expands upon the MSN curriculum by offering students greater opportunities to study their specialty in-depth.

Traditionally, DNPs have been designed for nurses that want to enter leadership roles, nursing management, or research. However, that is changing as more significant specializations become available for RNs.

Most BSN to DNP in nurse anesthesia degrees is full-time, 36-month programs. You will spend more than half of this time completing your anesthesia residency.

What is the difference between a DNP and DNAP?

With the American Association of Colleges of Nursing (AACN) announcing that APRNs will require doctoral degrees by 2025, many students are looking into DNAP programs as part of their CRNA training.

DNP programs already offer specializations in nurse anesthesia; however, the DNAP, or Doctorate of Nurse Anesthesia Practice, is an even more specialized version of this curriculum.

With a DNAP, students will solely focus on learning about advanced nursing and anesthesia care. In addition, CRNAs who already have MSNs or DPNs may pursue DNAPs to become even more qualified in their fields.

DNP programs for nurse anesthetists must be accredited through the AACN, while DNAP programs are certified through the Nurse Anesthetists Council for Accreditation (NACA).

What is the difference between a CRNA and an anesthesiologist?

A CRNA is a nurse, albeit one with a graduate degree and extensive experience in anesthesiology. However, they still must maintain a valid RN license and are not allowed to call themselves anything other than a nurse.

Anesthesiologists are medical doctors who have graduated from medical school and completed residencies in general medicine and anesthesiology. They are also board-certified anesthesiologists with thousands of hours of experience.

Although some states allow CRNAs to act independently, they are still not considered anesthesiologists and can’t call themselves such.

What does a CRNA do daily?

CRNAs have a much greater responsibility than bedside nurses. Their focus lies on pre-surgical preparation, perioperative care, and post-surgical recovery.

All nurse anesthetists collaborate closely with the anesthesiology team and surgeon to deliver their patients the most excellent possible care. They develop specialized anesthesia plans for each person’s needs, considering factors such as age, medical history, and the type of procedure they’re undergoing.

A nurse anesthetist:

Meets with patients before surgery to discuss their anesthesia options
Offers anesthesia education to patients and their families
Prepares patients for local and general anesthesia procedures
Administers anesthesia to patients in hospital and outpatient settings
Monitors patients’ vitals throughout procedures
Manages patients’ post-anesthesia recovery

In emergencies, nurse anesthetists must be able to rapidly intervene, administer drugs to reverse the effects of anesthesia, and provide life support as needed.

The nurse anesthetist also consults with physicians and surgeons to update them on patients’ conditions. Together, they help streamline healthcare, giving every individual the best possible surgical care.

Where does a CRNA work?

A CRNA can work in a surgical hospital, or they may work in an outpatient surgical center. Working in outpatient surgery includes less intensive procedures, and you may administer sedation, regional anesthesia, and local anesthesia more often than general anesthesia in these environments.

Many patients also want to be part of their anesthesia plan, so the CNRA works with them to explore their options. The goal is to make them as comfortable as possible while ensuring they are adequately sedated or anesthetized for the procedure's safety.

Some CRNAs specialize in specific fields, like dentistry or plastic surgery. With so many different types of surgery available, it is easy to follow your passion as a nurse anesthetist and work with your favorite patient populations.

Is being a CRNA boring?

One of the most commonly asked questions about nurse anesthetists is whether their job is tedious. It can seem so from the outside since most of your patients are either sedated or unconscious for their procedures. However, being a CRNA is anything but boring!

As an advanced nursing specialty, anesthesia is an incredibly complex and intricate field. You are constantly learning more about the best practices and ways to administer medication to people, as well as how to support the best surgical outcomes.

CRNAs have to be engaged in their work constantly. You continuously monitor your patients’ vitals and ensure that their recovery goes smoothly. If there are ever complications, your fast thinking and rapid response save their lives.

While they may be advanced nurses, CRNAs still learn regularly from their patients and procedures. And with continuing education courses, you can improve your practice even more throughout your career.

What positions can you progress to from being a CRNA?

CRNA is the highest possible nursing position in anesthesiology. As an APRN, you can either continue to work in anesthesiology or get another master’s degree to transfer to a different field.

For example, you could become a nurse practitioner if you grew tired of the surgical suite and wanted to treat patients in a family health practice.

CRNAs can also become anesthesiologists if they attend medical school and complete their residencies. You could also earn a doctoral degree in nurse anesthesia and teach it to other aspiring CRNAs.

Do CRNA qualifications expire?

Yes, you have to maintain your CRNA certification like your RN license. In addition, every four years, you will have to demonstrate you have completed continuing education requirements and apply to re-certify through the NBCRNA.

How much do CRNAs make per year?

Because they are nearly as qualified as medical doctors in anesthesia, CRNAs are also some of the top earners in the nursing field. According to thelatest data from Indeed, the average CRNA makes $118,629 per year.

CRNA salaries typically start at six figures and can top well over $200,000 later in their career. As a result, it’s not uncommon for an experienced CRNA to earn as much as a doctor.

The top-paying companies for CRNAs in the United States offer salaries ranging from $242,000 to over $400,000 per year.

How long does it take to become a CRNA?

It will take a minimum of 8 years to become a CRNA, but expect to spend around ten years meeting all the requirements. Nurse anesthetists must gain extensive clinical experience in the OR and other surgical settings before being eligible for the best CRNA jobs.

You will also need to complete both a bachelor’s and master’s or doctoral degree program before you are eligible to take the national certification exam (NCE).

Download the official NCE handbook to learn more.

Employers also look for nurse anesthetists with several years of nursing under their belts, including hours of work as an RN in surgical settings outside of clinical rounds.

Try not to pressure yourself if you feel like becoming a CRNA is your calling. You have plenty of time to work toward your dream, and it’s best to gain experience as an RN before you embark on your studies. Many master’s programs, for example, require students to work for at least two years as a registered nurse before they apply.