How to Become a Nurse Anesthetist
Certified registered nurse anesthetists (CRNAs) use their advanced training in pain management to relieve suffering and discomfort due to surgery, trauma, childbirth and illness. After administering anesthetic, they remain at the patient’s side, providing support and adjusting the dosage as needed. CRNAs also care for people before and after surgery and play an important role in ensuring patient safety.
Nurses have been providing anesthesia care since the Civil War. Today, CRNAs administer 33 million anesthetics annually in the United States. In addition to working in operating rooms, these professionals serve as pain management specialists, first responders and coordinators of emergency care. Depending on state law, CRNAs either practice independently or in conjunction with an anesthesiologist, surgeon, dentist or podiatrist. Nurse anesthetists are sometimes incorrectly called nurse anesthesiologists; the correct term for a nurse practicing in the field is nurse anesthetist.
Nurse anesthetists care for a wide variety of patients, from children to expectant mothers to senior citizens. They begin each case by conducting a preoperative interview with the patient to determine the most appropriate type of anesthesia. Before a procedure, they help patients understand what to expect, answer questions and offer personal support. The care they provide helps to relieve the anxiety associated with surgery and can make an enormous difference in the patient’s experience.
The work of CRNAs has significant social benefits. Nurses are responsible for the vast majority of anesthesiology care in rural areas and other places experiencing a critical shortage of health care professionals. Their assistance allows smaller hospitals to offer comprehensive services close to home, including surgery, obstetrics and trauma care.
Anesthesiology is among the most challenging and rewarding of the nursing specialties. These professionals find great satisfaction in relieving patients’ discomfort and anxiety. They are also proud of the crucial role they play on surgical, emergency response and palliative care teams.
CRNAs practice in almost every health care setting where anesthesia is needed, including hospitals, outpatient surgery centers and government and public health facilities. They can also be found in the offices of surgeons, dentists, ophthalmologists, palliative care specialists and podiatrists.
Depending on state law, nurse anesthetists either work independently or within a collaborative team of health care professionals. According to The American Association of Nurse Anesthetists (AANA), they are the only anesthesia professionals working in over 60% of rural hospitals and the primary anesthesia providers for members of the U.S. armed forces and pregnant women.
Because most surgeries are performed in the daytime, CRNAs generally work regular business hours. However, they often spend nights, weekends and holidays on call and can be summoned at any time in the event of an emergency.
CRNAs must complete at least six years of full-time classroom and clinical study beyond the high school level. This begins with earning a four-year bachelor’s degree (in nursing or another field) and obtaining licensure as a registered nurse (RN).
Candidates then continue on to graduate school to pursue a master’s or doctoral degree in nursing. The core curricula of these programs are identical with additional research and clinical requirements for doctoral students. Both pathways take 2-3 years to complete.
There are over 100 accredited CRNA programs in the United States, and that number is growing each year. The Council on Accreditation of Nurse Anesthesia Educational Programs (COA) maintains an updated list of approved institutions on its website.
Some institutions offer nurse anesthetist certificate programs for qualifying students who hold a master’s or professional degree in a non-nursing discipline. CRNAs must complete additional post-graduate study to practice in specialties such as pediatrics or obstetrics.
Admission to most nurse anesthetist programs requires at least a year of professional nursing experience in an acute care setting—preferably surgery or critical care. During graduate school, CRNAs complete about 2,500 hours of clinical training and administer approximately 850 anesthetics, according to AANA.
Licensing and/or Certification
Nurses must be licensed in all states. Upon graduation from an accredited training program, nurse anesthetist candidates may sit for the CRNA certification exam through the National Board of Certification and Recertification of Nurse Anesthetists. To maintain their credentials, practicing CRNAs must participate in continuing education throughout their careers.
Necessary Skills and Qualities
Regardless of practice level, all RNs must possess organizational, critical thinking and teaching skills. Patience, compassion and the ability to communicate clearly with patients and team members are also key assets. Because they work in high-stakes settings, CRNAs need to be independent, and able to think and act decisively under pressure. Physical fitness will help them to stand and walk for long periods without fatiguing.
Opportunities for Advancement
Experienced CRNAs often head care teams or take administrative positions within health care facilities. Others start private practices, pain management clinics or other businesses. Nurse anesthetists with a doctorate have the opportunity to teach at the university level or conduct research.
Anesthesia care is among the most lucrative nursing specialties. According to the latest salary survey by recruiting firm Locum Tenens, annual salaries for CRNAs range from $100,000 to over $190,000 and average $168,000. Salaries vary by geographic region and practice setting and are generally best in major metropolitan areas.
According to the Bureau of Labor Statistics Occupational Outlook Handbook, employment of RNs (including CRNAs) is projected to grow by 26% between 2010 and 2020, faster than the average for all occupations.
There is currently a shortage of qualified CRNAs in the United States. Because these professionals provide cost-effective services in an era when health care facilities are scrambling to contain rising costs, demand for CRNA services is likely to rise. In addition, nurse anesthetists play an important role in promoting patient safety and increasing health care accessibility for underserved populations.
In the job market, candidates who hold a doctorate have a slight edge over those with a master’s degree.