Subscribe to Notes on Nursing, our monthly news digest.

Certified Registered Nurse Anesthetist (CRNA) Career GuideEverything you need to know about becoming a Certified Registered Nurse Anesthetist (CRNA), which includes the crucial role of administering anesthesia and providing anesthesia-related care to manage patients' pain before, during, and after surgery. Discover the advanced training and skills nurse anesthetists acquire, as well as their significant contribution to ensuring safe and effective anesthesia care.

Getting Started: Certified Registered Nurse Anesthetist (CRNA) FAQs

What is a CRNA?

A Certified Registered Nurse Anesthetist (CRNA) is an advanced practice registered nurse (APRN) who specializes in providing anesthesia care to patients across various healthcare settings. CRNAs are crucial members of any surgical care team. They work with various medical practitioners, such as surgeons, dentists, and podiatrists, and act as a liaison between the patient and their leading care provider. Because of their constant communication with both patients and doctors, CRNAs are crucial to providing all parties with a full understanding of how a procedure needs to be approached to ensure maximum safety and comfort for each patient.

What is the demand for CRNAs?

Certified Registered Nurse Anesthetists (CRNAs) are in high demand due to the aging U.S. population and the growing number of surgical procedures performed in ambulatory surgical centers and doctors’ offices.

Overall, the U.S. Bureau of Labor Statistics (BLS) estimated that the projected job growth for CRNAs between 2018 and 2028 would be 26%, so your job as a CRNA is likely to be consistently secure.

Because of the aging U.S. population, ever-changing healthcare legislation, there is a constant demand for nurse anesthetists across various disciplines. With these factors leading to a growing emphasis on preventative care, there has been a notable increase in surgical procedures performed in ambulatory surgical centers and doctors’ offices, thus requiring an increasing number of CRNAs on staff.

In fact, more and more healthcare centers are leaning heavily on CRNAs to be primary anesthesia providers. This is largely thanks to research and reports that have found little to no major differences in ability, education or function between CRNAs and physician anesthesiologists, whose main function within an operating room is to provide CRNA oversight.

So, in absence of an anesthesiologist, CRNAs can fill the gap.

What does a CRNA do?

Certified Registered Nurse Anesthetists (CRNA) are responsible for bringing stellar communication skills, quality patient care, and a high level of scientific skill to each of your cases, which are likely to range across all disciplines. If you value human connection, independent thinking, high compensation, and on-the-fly problem solving, you just might be a CRNA.

Their roles and responsibilities can vary depending on the facility and state regulations. It's important to note that the scope of practice for CRNAs can vary by state. In some states, they may have more autonomy in their practice, while in others, they might require physician supervision or collaboration.

Here are the general duties of a CRNA:
  • Preoperative Assessment: CRNAs conduct thorough preoperative assessments of patients to evaluate their medical history, current health status, and any potential risks or contraindications for anesthesia.
  • Anesthesia Planning: Based on the patient's assessment, CRNAs create an individualized anesthesia plan, choosing the appropriate anesthetic agents and techniques to ensure patient safety and comfort during surgery or medical procedures.
  • Anesthesia Administration: CRNAs administer anesthesia, including general anesthesia, regional anesthesia, and monitored anesthesia care (MAC), depending on the specific needs of the patient and the procedure.
  • Monitoring and Adjusting Anesthesia: During surgery or medical procedures, CRNAs continuously monitor the patient's vital signs, anesthesia depth, and overall well-being. They make necessary adjustments to the anesthesia dosage to maintain the patient's stability and respond promptly to any adverse events.
  • Pain Management: CRNAs are well-versed in pain management techniques. They may provide post-operative pain relief through epidural catheters, patient-controlled analgesia (PCA) pumps, or other modalities to ensure the patient's comfort and recovery.
  • Collaborating with the Healthcare Team: CRNAs work closely with surgeons, physicians, nurses, and other healthcare providers to ensure coordinated patient care and to communicate any critical information during surgical procedures.
  • Patient Education: CRNAs inform patients about the anesthesia process, potential risks, and post-operative care to alleviate anxiety and promote patient understanding.
  • Emergency Preparedness: CRNAs are trained to handle emergency situations that may arise during surgery or medical procedures, such as anaphylaxis, airway obstruction, or cardiac arrest.
  • Post-Anesthesia Care: After surgery or the medical procedure, CRNAs continue to monitor patients during the recovery phase and manage any post-operative complications related to anesthesia.
  • Professional Development: CRNAs stay updated on the latest advances in anesthesia techniques, technology, and best practices through ongoing education and training to maintain their certification and improve patient care.
It's important to note that the scope of practice for CRNAs can vary by state. In some states, they may have more autonomy in their practice, while in others, they might require physician supervision or collaboration. Additionally, CRNAs can work in various healthcare settings, including hospitals, surgical centers, and private practices.

How much does a CRNA make?

The average salary of a CRNA is about $175k, according to 2023 data from Payscale.com.

Average salaries, however, can vary depending on your area’s cost of living and level of demand. Regardless, right now CRNA is the highest-earning nursing specialty. The U.S. Bureau of Labor and Statistics projected 31% growth in compensation between 2016 and 2026.

How do you become a CRNA?

  • What Are the Steps to Becoming a Certified Registered Nurse Anesthetist?

    Here are the key stages of achieving your career as a CRNA:

  • Get a Bachelor of Science in Nursing (BSN)
    At this point, it’s not required that you know you want to specialize in Nurse Anesthesia, but, if you have an interest, it’s recommended that you take classes that expose you to a more in-depth knowledge to solidify your choice.
  • Pass the NCLEX-RN and work as a Registered Nurse
    To become a CRNA, and before you apply for your DNP or DNAP, you must have at least one year of experience as a Registered Nurse.
  • Gain at least a year’s experience in Acute Care
    This typically means working in an ICU to gain a more hands-on understanding of anesthesia management.
  • Complete a Doctoral Degree in Nurse Anesthesia (DNP or DNAP)
    After obtaining your BSN, aspiring CRNAs require a doctorate (DNP or DNAP) to practice. Click here to learn more about the differences between these two doctorate-level degrees.
  • Pass the Certified Registered Nurse Anesthetist exam through the National Board of Certification & Recertification of Nurse Anesthetists
    A three-hour exam, taken on a computer, that adjusts based on each of your answers. You must pass this test to become a CRNA.
For more detail about the steps to becoming a CRNA, click here.

Where can CRNAs work?

CRNAs provide care across practice areas, anywhere pain management is required. Typically, CRNAs are visualized in an operating room, providing anesthesia to patients undergoing surgery. CRNAs also play a vital role in providing airway establishment and management and sedation during emergencies and traumas. They provide anesthesia to women in labor and patients with pain conditions requiring nerve blocks.

CRNAs are teachers and advocates. They teach nursing and CRNA students, patients and families. They advocate for the profession and the best care of their patients.

Some settings where a CRNA might work include:
  • Hospitals: CRNAs are an integral part of surgical teams in hospitals, where they provide anesthesia care for a wide range of surgical procedures, including general surgeries, orthopedic surgeries, cardiovascular procedures, neurosurgery, obstetrics, and more.
  • Ambulatory Surgical Centers: CRNAs work in outpatient surgical centers, providing anesthesia services for same-day procedures, such as cataract surgeries, endoscopies, and plastic surgeries.
  • Obstetrics and Labor Delivery: CRNAs are involved in providing anesthesia care to pregnant women during childbirth and cesarean sections. They administer epidurals and other forms of pain relief to manage labor pain effectively.
  • Pain Management Clinics: Some CRNAs work in pain management clinics, where they administer various pain management techniques, including epidural injections, nerve blocks, and other interventions to help patients manage chronic pain.
  • Emergency Departments: CRNAs may be involved in the management of critical and trauma patients in emergency departments, providing rapid assessment and stabilization through anesthesia interventions.
  • Critical Care Units: In some settings, CRNAs work in critical care units, assisting with the management of patients who require advanced monitoring and intensive medical interventions.
  • Rural and Underserved Areas: Smaller medical offices usually have CRNAs act as the primary administrator of anesthetics. CRNAs often play a vital role in providing anesthesia services in rural and underserved areas, where access to anesthesia care may be limited.
  • Military and Veterans Affairs: CRNAs serve in the military and VA healthcare systems, providing anesthesia care to service members and veterans.
  • Research and Education: Some CRNAs choose to pursue careers in research and education, contributing to advancements in the field of anesthesia and training future CRNAs.
  • Independent Practice: In some states, CRNAs have the authority to practice independently, without physician supervision. They can establish their own anesthesia practice or work in collaboration with other healthcare providers.
  • Outpatient Care Centers: These are typically smaller clinics that provide same-day surgical and discharge services to the public. This might include administering anesthetics as part of cosmetic-surgery procedures such as a tonsillectomy, colonoscopy, or vasectomy.
  • Dental: CRNAs are present at dental centers that provide surgical services, and provide both local and general anesthetic when required to manage patient anxiety or procedural pain.
  • Pediatrics: CRNAs in pediatric clinics are trained to provide anesthesia to children of different ages, from infants to adolescents. They employ techniques that are appropriate for pediatric patients, taking into account their unique physiological and developmental considerations.

What is the job satisfaction rate for CRNAs?

Job satisfaction among Certified Registered Nurse Anesthetists (CRNAs) tends to be relatively high for several reasons:
  • Challenging and Rewarding Work: CRNAs have a crucial role in the healthcare team, providing anesthesia care for patients undergoing various surgical procedures. The complexity and responsibility of their work can be intellectually stimulating and rewarding.
  • Autonomy and Responsibility: Many CRNAs work with a high degree of autonomy, especially in states where they have full practice authority. This independence allows them to make critical decisions and manage anesthesia care for patients, which can be professionally fulfilling.
  • Opportunities for Advancement: Within the field of nurse anesthesia, there are opportunities for career advancement and specialization, such as pursuing leadership roles or focusing on specific subspecialties like pediatric anesthesia or cardiac anesthesia.
  • Work-Life Balance: While the job can be demanding, CRNAs often have the flexibility to choose their work schedules, which can contribute to a better work-life balance.
  • Positive Impact on Patient Care: CRNAs play a vital role in ensuring patients' safety and comfort during surgery and medical procedures. Knowing they contribute to positive patient outcomes can be deeply satisfying.
  • Constant Learning Opportunities: Medicine and anesthesia practices continuously evolve, and CRNAs have ample opportunities for professional development, attending conferences, and staying up-to-date with the latest advancements in their field.
  • Team Collaboration: Working closely with other healthcare professionals in the surgical team fosters a sense of camaraderie and teamwork.

What does anesthesia management mean?

Anesthesia management refers to the administration of anesthesia before, during and after a procedure. Pre-op anesthesia management requires a full patient work-up to understand the body’s response to the anesthetic and how much each patient will require. Once in surgery, it’s the job of the CRNA or anesthesiologist to monitor the patient’s response and administer more anesthetic if necessary. Post-op anesthesia management focuses on pain management. Here it’s important that enough anesthetic is administered for the body to fully rest and also fully heal, without completely numbing the patient to their body’s natural response.

This is where the CRNA patient relationship is so important. The better you know your patient’s personality, pain cues and mannerisms, the better you’ll be able to care for them.
Certified Registered Nurse Anesthetists play a vital role in every surgical team. In your role as a CRNA, you will bring exceptional communication abilities, top-notch patient care, and advanced scientific expertise to every case, which may span various disciplines. If you value face-to-face human interaction, independent decision-making, career opportunity and advancement, and the need for quick problem-solving skills, then beocming a CRNA might be the nursing speciality for you.
  • What Special Skills Does a Certified Registered Nurse Anesthetist Need?

    The day-to-day of a CRNA is constantly shifting based on their case-load, the level of oversight required for their patients, and the general demand for their services. Because of this, a day as a CRNA can require one, if not all of the following.

  • Administration
    You’ll give anesthetics and epidurals, and monitor breathing, temperature, heart rate, and other vital signs. While these actions may seem mundane, they’re extremely important in understanding and maintaining the baseline health of a patient, and can be the first indicators of a potential problem or negative reaction to an anesthetic or procedure.
  • Collaboration
    You’ll be the liaison between the doctor and various healthcare departments involved in the procedure. You’ll often be asked to provide patient background information, baseline vitals, and any other pertinent information so that you and the rest of the care team can make a treatment plan that best suits every individual patient. So, while you may be the only CRNA in the room, it’s very crucial that you’re an active and communicative team member.

    NOTE: As you work with various departments and doctors, it’s important that you know what you need from them as a teammate and are clear with them about your needs in order to do your job safely and effectively.
  • Documentation
    You’ll take patient histories and get consent before any procedures. Document basic pre-op vitals, what medications have been administered and how much, and record patient responses during and after surgery.
  • Education
    You’ll teach patients and their families about the effects and adverse reactions of anesthesia. Remember, any time in a hospital or under medical care can be scary for both patients and their families. It’s your opportunity to validate and reassure them that their questions are understandable and normal. Don’t assume that they understand everything that you’re throwing at them as nerves can often get in the way of active listening. When in doubt, check in and make sure they feel comfortable coming to you with any further questions and/or concerns.
  • Treatment
    You’ll take care of patients pre- and post-surgery, helping them with recovery and pain management. This is where the importance of your patient relationship and bedside manner really come into play. It’s extremely important that patients are comfortable communicating with you about any change they might feel and that you have a robust understanding of their medical background, especially when they aren’t in a state where they can communicate for themselves.
How Much Does a CRNA Make?
The average salary of a CRNA is about $175k, according to 2023 data from Payscale.com.
Female nurse holding up chest X-ray cartoon graphic
The Challenges & Rewards of Being a Certified Registered Nurse Anesthetist

My life as a Nurse Anesthetist


For Thomas P., DNP, APN/CRNA, the journey into nursing was a second career. Since earning his Master’s degree in Nurse Anesthesia, he spends his days focusing on quality one-on-one patient care, in and out of the operating room. Between the variety of cases that come across his desk, and the opportunity to put his patients at ease, both physically and mentally, Thomas’s career as a CRNA is always fulfilling and never boring.
Video still of Dr. Thomas Pallaria
My life as a Nurse Anesthetist

My day as a CRNA

As both a professor and working CRNA, Thomas has two kinds of days: The academic and the clinical. On a clinical day, Thomas arrives at the hospital by 6:30 to set up his operating room and review his plan for the day. Most operating rooms open at 7:30, so this gives him ample time to set up, check in with his patient, and make any necessary adjustments.

“Wheels are rolling in the operating room at 7:30, not 7:31.” Thomas and the surgeons he works with are sticklers for starting on time, and for good reason. “I'll do maybe one long case or depending on the room I might be doing three or four cases. If I'm in the endoscopy suite we're talking up to 10 or 12 patients in that day.”

If he has any down time, which is rare on surgical days, Thomas prioritizes the more administrative side of things, like scheduling and checking in with the other CRNAs under his supervision.

Even with all of this under his belt, Thomas still does his best to make it home by 6:00 for dinner.

The key differences between a Certified Registered Nurse Anesthetist (CRNA) and anesthesiologist is that a CRNA is licensed to practice as an advanced-practice nurse and graduates from an accredited nursing school. An anesthesiologist is licensed to practice as a physician and graduates from a medical school.

How Do You Become a CRNA?

Becoming a Certified Registered Nurse Anesthetist (CRNA) involves several steps, including education, experience, and certification. Here is a general guide on how to pursue a career as a CRNA:

Obtain a Bachelor of Science in Nursing (BSN) degree

The first step is to complete a BSN program from an accredited nursing school. This typically takes around four years. During your undergraduate studies, focus on courses related to anatomy, physiology, pharmacology, and critical care, as they will be essential for your future career as a CRNA.

Gain Nursing Experience

Most CRNA programs require applicants to have a minimum of one to two years of acute care nursing experience as a registered nurse (RN). Work in critical care units such as intensive care (ICU), cardiac care, or emergency room settings to gain valuable experience in managing critically ill patients.

Complete a Doctoral Degree in Nurse Anesthesia

After obtaining your BSN and fulfilling the required nursing experience, you'll need to enroll in a nurse anesthesia program. These programs are at the graduate level and will lead to Doctor of Nursing Practice (DNP) or Doctorate of Nursing Anesthesia Practice (DNAP) degree in nurse anesthesia. Make sure to choose a program accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs (COA).

CRNA Program

Nurse anesthesia programs typically take about 3-4 years to complete. The curriculum will cover advanced anesthesia courses, pharmacology, pathophysiology, and clinical experiences in various anesthesia settings.

Obtain Certification

After successfully completing the nurse anesthesia program, you will need to pass the National Certification Examination (NCE) administered by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA). Passing this exam grants you the title of Certified Registered Nurse Anesthetist (CRNA). Click here to learn more about the exam.

State Licensure

In addition to national certification, you will need to obtain a state license to practice as a CRNA. Licensure requirements vary by state, so you must meet the specific criteria set by the state board of nursing.

Continuing Education

To maintain your CRNA certification and license, you'll need to participate in continuing education and meet the recertification requirements outlined by the NBCRNA.

It's important to note that the process of becoming a CRNA can be competitive and demanding. Admittance to nurse anesthesia programs can be competitive, and you may need to demonstrate a strong academic background, relevant nursing experience, and a genuine commitment to the field of nurse anesthesia.

In this episode, we meet nurse anesthetist, founder and CEO of Diversity in Nurse Anesthesia Mentorship Program, Wallena Gould, EdD, CRNA, FAAN, whose personal experiences led to a recognition of the scope and root problems that prevent innovation from being impactful or scaled, which led to a body of work that has been applied across healthcare to forge a more equitable future.
2021-02-12T22:26:32.676Z
Paying for Nursing School
Learn more about how to fund your CRNA education with nursing scholarships.
Nurse in scrubs typing on a keyboard
Join an Organization
Stay up to date with, or become a member of, CRNA organizations to find career opportunities, learn from your colleagues, and support the profession.

Sources

    Follow us

    Group of smiling nurses in scrubs holding folders
    Group of smiling nurses in scrubs holding folders
    Subscribe to Notes on Nursing, our monthly news digest.
    Explore issues of our monthly newsletter, which features the many ways nurses' innovation and leadership drive transformative change in healthcare.