How to Become a Certified Registered Nurse Anesthetist (CRNA)
Job Duties, Certifications, and Required Education for CRNAs
Modern anesthesia is one of the most important medical advances in history—it wasn’t all that long ago that doctors could only offer patients a bottle of whiskey before a major operation! Nowadays, anesthesia care is an essential part of keeping patients safe and comfortable, everywhere from routine surgeries to critical-care situations.
For registered nurses who want to take their careers to the next level, becoming a certified registered nurse anesthetist (CRNA) is one of many pathways potentially available after earning a BSN. If you’re drawn to a nursing career where the stakes are high—and so is the compensation—a career as a CRNA could be a great choice to build upon your nursing skills.
Nurse Anesthetist: A High-Stakes and High-Reward Profession
Nurse Anesthetist ranks among the highest-paid nursing jobs for good reason. They bear the significant responsibility of administering anesthesia to patients before medical operations and handling recovery afterward. In these environments, a dosage miscalculation or negative reaction could lead to life-altering consequences for a patient.
The high stakes of working with anesthesia mean that CRNAs must complete rigorous education, gain practical experience, and maintain continuous learning and professional growth to ensure safe and effective care.
CRNAs play a critical role in the healthcare system, particularly in areas with a shortage of physician anesthesiologists. By providing essential anesthesia services in areas where physicians may be scarce, they make surgeries and other procedures accessible to more people who need them.
To help you learn more about this rewarding career, we put together this comprehensive guide about what CRNAs do, what it takes to become a CRNA—and how long it takes to gain the education and experience to perform the job safely.
Still considering your options for which nursing specialty to choose? Check out our complete list of the highest paid nursing jobs.
What is a Nurse Anesthetist?
A Certified Registered Nurse Anesthetist (CRNA) is an advanced-practice registered nurse (APRN) who administers anesthesia to patients undergoing surgery or other medical procedures. CRNAs have years of nursing experience, multiple college degrees, and advanced training that enables them to administer anesthesia safely and effectively. They often work closely with surgeons, anesthesiologists, and other medical professionals.
Nurse anesthetists use a variety of anesthesia techniques, including general, regional, and local anesthesia, tailored to the specific procedure and patient needs. They have an advanced understanding of pharmacology to help them calculate dosages safely and are skilled in using a variety of medical technology and equipment to monitor patients during procedures.
What Does a Nurse Anesthetist Do?
A nurse anesthetist’s ultimate responsibility is to prevent patients from experiencing unnecessary pain or distress and to help surgeons and other specialists complete procedures safely and without excessive risk to the patient.
To do this, CRNAs must determine the exact amount of anesthesia needed to medicate the patient safely and make adjustments as necessary during a patient’s time under anesthesia. They also meet with patients before their procedure to answer questions, address concerns, and help patients understand what to expect before, during, and after their procedure.
In addition to their skills in administering anesthesia, nurse anesthetists can have a major impact on the patient’s experience by helping them relax and overcome the nerves that are common before undergoing surgery.
Common duties for CRNAs include:
- Conducting patient assessments before procedures
- Determining the proper dose of anesthetic to meet the patient’s needs
- Educating patients about the procedure, possible side effects, and their recovery
- Monitoring patient vital signs and dosage throughout the procedure
Experienced CRNAs can also take on supervisory or administrative roles later in their career.
Is it Hard to Become a CRNA?
It’s a serious commitment to become a CRNA—it takes years of schooling and experience beyond your BSN nursing program. Because there can be such a slim margin for error in anesthesia, it’s critical for anesthesia care providers to have training that reflects the weight of their responsibility to the patient.
The role of a CRNA can also be emotionally demanding, as it requires making critical decisions under pressure—often in life-or-death situations. In addition to quick thinking in high-stakes situations, CRNA careers require a strong focus on ethical considerations such as informed consent and patient autonomy.
Despite these challenges, many CRNAs find deep satisfaction in providing essential care and making a positive impact on patients’ lives. If you’re willing to put in the work to advance your career, becoming a CRNA is an achievable goal for many nurses who want to expand their skills and their scope of practice.
What’s the Difference Between an Anesthesiologist and a Nurse Anesthetist?
Anesthesiologists are medical doctors, which means they usually spend 11 to 12 years in school before they can begin working. Anesthesiologists must earn a bachelor’s degree, followed by a medical degree, and then complete a residency program which typically takes another four years. After their residency, many anesthesiologists also spend another year in a fellowship program.
CRNAs are advanced-practice nurses who have completed a BSN program and gained experience as nurses, before completing a master’s degree CRNA program. Both anesthesiologists and nurse anesthetists can work in various medical settings like emergency rooms, surgical wards, outpatient clinics, and private physician’s offices.
However, because of their more advanced education and medical training, anesthesiologists typically have more opportunities to specialize further in fields like obstetrics, pediatrics, cardiac care, or neurocritical care.
Can Nurse Anesthetists Practice Independently?
The short answer is “it depends.” The allowed scope of practice for CRNAs varies between states. In some states, CRNAs can practice independently with no supervision, while in other states, nurse anesthetists may require supervision by a physician. States may also specify which procedures can be performed by a CRNA vs. those that require a physician anesthesiologist.
The National Council of State Boards of Nursing has created a useful CRNA practice regulations map, where you can learn more about which states allow independent practice for CRNAs.
How Long Does it Take to Become a Nurse Anesthetist?
While everyone’s timeline looks a little different depending on how long it takes to complete the various steps in the process, the total time it takes to become a CRNA is usually at least 7-8 years. This includes the time it takes to complete your bachelor’s and master’s degree programs, and time to gain experience working in the field as a registered nurse between your BSN program and CRNA program.
For more details about each major milestone, let’s take a step-by-step look at how to become a certified registered nurse anesthetist:
1) Earn your Bachelor of Science in Nursing (BSN)
The first step in becoming a CRNA is earning your BSN nursing degree. Your BSN will take about four years, unless you’ve already earned your associate degree in nursing (ADN). Students who’ve already earned their ADN can enroll in an RN-BSN program which can be completed in as little as 20 months.
Students enrolled in a BSN program take courses such as anatomy, pharmacology, and physiology. A bachelor-level nursing education is important to establish the fundamentals you’ll need for more advanced CRNA training. If you’re still gearing up for this stage of your nursing journey, you may want to check out our helpful guide on how to prepare for nursing school.
Once you’ve earned your BSN, you must also pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN) to earn your nursing license on a state-by-state basis. You can learn more about the certification exam for nurses in our NCLEX-RN review guide, full of useful info and test prep tips.
2) Gain Experience as a Registered Nurse
After you’ve become a licensed registered nurse, gaining quality experience working as an RN is a vital step toward becoming a nurse anesthetist. You’ll need to spend time solidifying and applying your skills, and gain exposure to the massive variety of clinical situations that arise while working in healthcare.
Most RNs looking to apply for a nurse anesthesia program spend at least one year working in a high-stakes clinical setting such as an emergency room (ER), intensive care unit (ICU), or cardiac care unit (CCU). To further their chances of being accepted to a CRNA program, many RNs earn their Critical Care Registered Nurse Certification (CCRN) from the American Association of Critical Care Nurses. Earning your CCN requires at least 1,750 hours of direct critical care experience while practicing as a registered nurse.
3) Get Accepted to a Nurse Anesthesia Program
Admission to a nurse anesthesia program can be highly competitive, and you’ll need to meet a set of minimum requirements to be considered for acceptance. Admissions requirements vary depending on the institution offering the program.
The Council on Accreditation of Nurse Anesthesia Educational Programs recognizes nearly 150 accredited CRNA programs in the United States, so there are many options available for your CRNA training. Tuition costs can vary significantly depending on location and state residency status, so be sure you fully understand your obligations before you commit.
4) Graduate from a CRNA Program with a Master’s Degree
On average, nurse anesthesia programs typically take two to three years to complete.
CRNA programs expand on your knowledge of pharmacology, pain management, biology, and pathophysiology. You’ll gain an advanced knowledge of how medications interact, learn to operate high-tech anesthesia equipment, and expand your ability to think and act quickly in emergency situations.
On top of coursework, students are required to complete supervised clinical experiences that present an array of different anesthesia situations. Just like your clinical rotations during nursing school, these are an essential ingredient in applying your knowledge to the real world. In anesthesia, small mistakes can have life-altering consequences, so it’s crucial for nurse anesthetists to receive plenty of guidance from experienced mentors.
5) Pass the National Certification Examination for CRNAs
Once you’ve completed your CRNA program and earned your master’s degree, you must pass the National Certification Examination from the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA).
This exam contains between 100 and 170 questions and takes about 3 hours to complete. You’ll be given a preliminary pass or fail report upon completing the exam. Once you pass the exam, your certification verification will be sent to your state board of nursing. From there, you can meet any additional state-specific licensing requirements before starting to practice as a CRNA.
6) Maintain Licensure with Continuing Education for CRNAs
To ensure they’re keeping up with the latest knowledge in the profession, nurse anesthetists must complete ongoing education and professional assessments to remain in good standing with the NBCRNA.
Beginning in August 2024, the NBCRNA moved to a simplified model for maintaining certification, with a new four-year renewal cycle. The Maintaining Anesthesia Certification (MAC) Program includes three key components that must be completed every four years:
- 60 MAC Ed credits (aka Class A credits), earned through continuing education activities like online courses or workshops
- 40 MAC Dev credits (aka Class B credits) earned through professional development activities like teaching, publishing, or research
- MAC Check self-paced quarterly assessments
MAC Check is a self-paced platform that uses longitudinal assessments rather than a traditional recertification exam. Instead of taking a lengthy exam once every several years, you’ll receive short quarterly assessments that range from 25-30 questions. You can complete these assessments at your convenience from a computer or mobile device, anytime within each three-month window.
These shorter, more frequent assessments can help you identify any areas you may still need to master and plan out the professional development activities that will be most useful to advance your career as a CRNA.
Nurse Anesthetist Salaries
How much does a nurse anesthetist make?
Nurse anesthetists are consistently at the top of the list when it comes to the highest-paid nursing jobs. According to the BLS, as of May 2023, the average nurse anesthetist’s salary* is over $212,000 per year.
Salaries and job opportunities for CRNAs can vary widely depending on factors such as geographic location, years of experience, area of specialization, and the type of healthcare setting. For example, CRNAs working in critical care settings or major metropolitan areas may earn higher salaries.
Highest Paying Industries for Nurse Anesthetists
According to the BLS, as of May 2023, these are the highest-paying industries for nurse anesthetists.
| Industry | Average Hourly Pay | Average Salary |
| Outpatient Care Centers | $126.91 | $263,960 |
| General Medical & Surgical Hospitals | $110.65 | $230,150 |
| Specialty (except Psychiatric and Substance Abuse) Hospitals | $110.57 | $229,980 |
| Home Health Care Services | $103.87 | $216,040 |
| Offices of Physicians | $99.82 | $207,630 |
Highest Paying States for Nurse Anesthetists
According to the BLS as of May 2023, these are the highest-paying states for nurse anesthetists.
| State | Average Hourly Pay | Average Salary |
| Illinois | $135.21 | $281,240 |
| Massachusetts | $131.01 | $272,510 |
| Montana | $123.30 | $256,460 |
| New York | $123.15 | $256,160 |
| Vermont | $122.50 | $254,790 |
Highest Paying Cities for Nurse Anesthetists
These are the metropolitan areas with the highest listed annual salaries from the BLS, as of May 2023.
| City | Average Hourly Pay | Average Salary |
| San Diego, CA | $141.44 | $294,180 |
| Carbondale, IL | $137.94 | $286,920 |
| Boston, MA | $136.80 | $284,550 |
| Greenville, SC | $132.80 | $276,230 |
| Chicago, IL | $130.59 | $271,620 |
What is the Job Outlook for a Nurse Anesthetist?
The job outlook for CRNAs is quite positive—the BLS projects a 40% increase in demand for nurse anesthetists between 2023 and 2033. That’s over ten times the 4% average growth rate among all jobs over the same time period.
As the overall need for healthcare continues to grow amidst the significant baby boom population’s transition to old age, nurse anesthetists should remain in high demand for years to come.
Begin Your Journey Toward Becoming a CRNA
The road to becoming a nurse anesthetist can be long and challenging at times, but it comes with countless opportunities to touch many people’s lives—and some significant financial rewards as well. If you want to achieve a future career as a CRNA, choosing the right BSN program can put you off to a great start on your journey.
At Provo College, we build our nursing programs with a focus on opening up career opportunities for graduates—whether as a CRNA or any other specialty within nursing. You’ll learn from experienced instructors in a supportive environment, and train using modern tools that simulate real clinical scenarios. Throughout your BSN training, you’ll start developing the skills, resilience, and clinical judgment you’ll need to thrive as a nurse anesthetist.
Still deciding what your future in healthcare looks like? Learn more about the healthcare training programs available at Provo College.
