Subscribe to Notes on Nursing, our monthly news digest.

Nurse Anesthetist (CRNA) at a Glance

Certified Registered Nurse Anesthetists are crucial members of any surgical care team. As a CRNA, you’re responsible for bringing stellar communication skills, quality patient care, and a high level of scientific skill to each of your cases, 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.


Nurse Anesthetists are in demand due to the aging US population and the growing number of surgical procedures performed in ambulatory surgical centers and doctors’ offices.

What is a CRNA?
A CRNA (Certified Registered Nurse Anesthetist) administers and provides anesthesia - related care to patients before, during, and after surgery. CRNAs 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 Nurse Anesthetists?
  • Because of the aging US 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, by taking physician anesthesiologists out of the equation, healthcare facilities are able to lower overall procedural costs without sacrificing their patient’s quality of care. Overall, the BLS estimates that the projected job growth for CRNAs between 2018 and 2028 will be 26%, so your job as a CRNA is likely to be consistently secure.
Once you’re a registered CRNA, there’s no one way to go about your career. You can apply your knowledge across a variety of medical practices, and can serve as the primary anesthesia provider in some states or rural communities.

How Much Does a CRNA Get Paid?
The average salary of a CRNA is about $97k–$199k, but this can vary depending on your area’s cost of living and level of demand. Regardless, right now CRNA is the highest-earning nursing specialty and the BLS has projected that we’ll continue to see 31% growth in compensation between 2016 and 2026.

Source: PayScale, Aug 2018

Because of the broad range of medical situations that might require any level of anesthetic, CRNAs must be able to react and make decisions quickly in a variety of demanding conditions. Also, because CRNAs often act as the liaison between patients and their leading care provider, CRNAs need to quickly answer questions, relay information, and communicate potential risks to all parties involved.
Higher Salary
Because CRNAs require extra schooling, a more advanced skill set, and are highly involved in the care process, they are often just as highly compensated. States with the most highly paid CRNAs can be found here
CRNAs must be comfortable with independent thinking, especially when emergencies arise. Within both hospitals and smaller medical offices, CRNAs often work alone and are heavily relied upon to create individual care structures that work best for them, the doctors they’re working with, and their individual patients. As mentioned, some states allow CRNAs to practice independently, without the supervision of a registered physician.
NOTE: CRNAs are crucial members within a medical team. However, if you don’t think of yourself as a self-starter or you aren’t comfortable with having to troubleshoot or work alone for long periods of time, this might not be the specialty for you.
CRNAs are constantly hands-on and working directly with patients. They are also responsible for acquiring proper patient medical history, assessing vitals and responses, administering proper dosages, and answering any questions throughout the duration of a patient’s medical care. All of this information is crucial, especially when dealing with anesthesia, because the slightest variance could impact the way a patient responds to their treatment.
Following a set routine is critical for CRNAs in order to best anticipate and prepare for every situation thrown at them in a given day.
Because they’re often asked to work across a variety of surgical cases and specialties, no two days are the same for a CRNA. Cases, patient personalities and day-to-day colleagues change regularly, so it’s extremely important for CRNAs to be adaptable, highly communicative, and quick thinkers.
I love to be able to be that person who is going to put them at ease as much as anyone could.
- Thomas Pallaria
What does a Nurse Anesthetist do?

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.


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.


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.


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.


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.


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.

Hear what Nurse Anesthetists have to say
  • Video still of Dr. Thomas Pallaria
  • 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.

I love to be able to be that person who is going to put them at ease as much as anyone could.
- Thomas Pallaria

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.

How do you become a CRNA?


Becoming a CRNA is a rigorous process involving advanced schooling and hands-on clinical practice. So, while a BSN (Bachelor of Science in Nursing) isn’t required, it’s beneficial when it comes time to apply to the competitive accredited Nurse Anesthetist programs That being said, before you can apply to these graduate programs, you’ll need to apply for and receive your nursing license and have at least one year of experience in acute/critical care nursing.

Earning Your MSN

MSN (Masters in Science of Nursing) programs for Nurse Anesthesia are highly competitive and usually require a minimum of a 3.0 undergraduate GPA. This is where having a BSN gives you an edge, especially if you’ve taken undergraduate courses that have given you a baseline knowledge on anesthesia. Additionally, MSN programs like to see that you’ve had hands-on experience in some kind of surgical or cardiac unit during your time in undergrad or as an RN.

Completing your MSN can take anywhere from two to three years, depending on the intensity of your program. With this in mind, make sure you do your research to ensure you’re applying to programs that best align with your personal and professional goals. We’d suggest starting your search by looking through our school finder app and by visiting the counsel of accreditation to find accredited Nurse Anesthesia programs and learn about them in more detail.

Shifting CRNA Requirements

It’s important to note that starting in 2022, CRNA requirements are transitioning from master's level to doctoral level.
Therefore, all students applying to or entering accredited anesthesia programs will need to complete Doctor of Nursing Practice or DNP coursework in addition to the comprehensive clinical and didactic preparation that’s covered at a master’s level.

Getting Certified

The final step toward becoming a CRNA is passing the National Certification Examination (NCE), which is a three hour exam, taken on a computer, consisting of 100-170 questions. As you go through the exam, each successive question will be based on your previous answer. To find out more about the exam, click here

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.
Where Can a CRNA Work?
  • Ambulatory surgical centers
    Because ASCs are healthcare facilities that typically administer same-day surgical care, CRNAs tend to work on the fly on a case-to-case basis, often getting a more varied caseload.
  • Dental centers
    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.
  • Doctors’ offices
    Smaller medical offices usually have CRNAs act as the primary administrator of anesthetics. Because of this, about 2/3 of all anesthetics in rural areas are administered by CRNAs.
  • Hospitals
    Hospitals typically employ both anesthesiologists and CRNAs. Here, CRNAs typically hold similar responsibilities as those in smaller offices, but aren’t always the go-to point person for anesthesia related questions or complications.
  • Outpatient care centers
    These are typically smaller clinics that provide same day surgical and discharge services to the public.
The CRNA Path

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 MSN, you must have at least one year of experience as a Registered Nurse.

Get a Master of Science in Nursing (MSN).

Depending on the intensity of your program, you can earn your MSN in two to three years. This will change to a Doctorate requirement starting in 2022.

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.

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.

You’re ready to work as a Nurse Anesthetist.

Congratulations! You get to have a career that allows you to play a crucial role in the health of your community. CRNAs are critical healthcare providers and are constantly proving their value and pushing the medical field forward with their naturally independent and innovative skillset.

Join an Organization
Joining and becoming an active member of a Nurse Anesthetist organization is an incredible way to find career opportunities, learn from your colleagues, and support the progression of the CRNA profession. You’ll be able to speak with veteran and future CRNAs, discuss different ways you can advance your personal career track, and provide your own insights on what methods work best and what areas of anesthesia might need more attention.
Innovation 101
Down to their core, nurses carry a fundamental respect for human dignity and an intuition for patient needs. That's why they're natural innovators. If you'd like to learn more about nurse-led innovation, here's where you can get started.
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.