Certified Registered Nurse Anesthetist (CRNA)

Certified Registered Nurse Anesthetist (CRNA) Career Overview

Amanda Gamboa, RN, BSN

Updated

Reviewed by NursingEducation Staff

What is a Certified Registered Nurse Anesthetist?

A certified registered nurse anesthetist, or CRNA, is a type of advanced practice registered nurse (APRN). A CRNA is responsible for providing anesthesia during procedures or surgery, which can include ongoing monitoring of patients during procedures and while recovering from anesthesia. The scope of practice for a CRNA varies by state and by type of employer. CRNAs have a wide range of choices in where they work and the type of patients they work with. The path to becoming a CRNA can be challenging, but successful applicants can look forward to independence, career flexibility, and the highest-paying advanced practice nursing career.

What Does a Certified Registered Nurse Anesthetist Do?

CRNAs are familiar with medications that block muscle movement, pain, and sensation. CRNAs also know how to deliver these medications safely and how to assess and monitor patients receiving these medications. Tasks associated with these skills include:

Practicing registered nurse anesthetists have a high degree of responsibility for a patient’s well-being and must be able to communicate effectively and efficiently, especially during potentially life-threatening situations. CRNAs receive thousands of hours of training to guide their decision-making. Professionalism, quick critical thinking, and problem-solving skills are key traits for successful CRNAs.

Practicing registered nurse anesthetists are also required to complete ongoing education throughout their careers. In-person classes, online lectures, skill demonstrations, and computerized testing are all possible examples of continuing education. The number of hours of continuing education required each year varies by state. Failure to fulfill the requirements would make a CRNA ineligible to practice. CRNAs may be responsible for registering for and reporting their own continuing education hours.

How Much Does a Certified Registered Nurse Anesthetist Make Per Year?

In the United States, the median annual wage for CRNAs is $203,090, or close to $100 an hour. The median pay represents the middle: half of CRNAs earned more than that amount, and half earned less. There is a large variation in annual wages for CRNAs based on location and place of employment. Carbondale-Marion, Illinois, a busy metropolitan area, reported the highest annual mean wage ($321,730) among metro areas. Across the country, pay can vary by nearly $200,000 for CRNAs.

Source: BLS

In addition to location, pay will also vary by experience and by type of employer. Outpatient care centers, such as surgical centers, reported the highest mean wages. CRNAs can also choose to take traveling contracts or short-term assignments to fill staffing needs in hospitals or clinics, including dental offices and other providers. These types of assignments often offer higher pay.

Medscape’s Annual Compensation Report demonstrated that nurse anesthetists are the highest paid of all APRN (advanced practice registered nurse) positions, which includes nurse practitioners, clinical nurse specialists, and nurse-midwifery careers. There was a noted disparity in pay between male and female CRNAs: male CRNAs earned 15% more annually than their female counterparts.

Overall employment for CRNAs is projected to increase by 38% from 2022 to 2032, which is faster than average. An aging population and increasing complexity of healthcare needs provide CRNAs with a high degree of job security. The scope of practice for CRNAs and other advanced practice nurses is evolving to allow for more independent practice and increased responsibilities to meet these healthcare needs.

Where and When Do Certified Registered Nurse Anesthetists Work?

CRNAs work in hospitals, same-day surgery centers, pain management clinics, and in the offices of plastic surgeons, podiatrists, ophthalmologists, dentists, and others. In a clinical office, a CRNA would work more traditional office hours. In hospitals or other care centers that do not close, CRNAs may be required to work nights, weekends, and holidays, and take on-call shifts to cover unplanned procedures. CRNAs working in operating rooms (ORs) may be expected to start work very early in the morning to prepare for the day’s surgical cases. The CRNA may then need to stay until the cases are completed for the day, which is not always predictable and could result in long days and evenings at work. CRNAs working in emergency rooms or in critical care patient areas may have scheduled hours, though the shifts may be long and include weekends, holidays, and on-call shifts. Full-time is often considered 36 hours, or three 12-hour shifts in a seven day period. Many CRNAs work part-time, or less than 36 hours per week.

Industries With the Highest Levels of CRNA Employment
Industry Employment Annual Mean Wage
Offices of Physicians 24,240 $200,280
General Medical and Surgical Hospitals 15,290 $217,570
Offices of Other Health Practitioners 2,380 $143,790
Outpatient Care Centers 2,560 $246,980
Colleges, Universities, and Professional Schools 1,060 $199,460

Source: BLS

Nurse anesthetists can practice in a CRNA-only or an anesthesia care team model. In a team model, the CRNA collaborates or reports to an anesthesiologist or other medical doctor. Other CRNAs decide to own their own practice and negotiate contracts with offices. Depending on a CRNA’s experience and preferences, there are also opportunities to work as a traveling CRNA or in locum tenens positions. Locum tenens (Latin for “to hold the place of”) assignments allow CRNAs to take temporary jobs in various settings and locations, so long as they are certified and allowed to practice in that state. These positions allow CRNAs to travel, earn extra income, and have new learning experiences.

How Do I Become a Certified Registered Nurse Anesthetist?

The first step to becoming a CRNA is to become a registered nurse (RN) with a Bachelor of Science in Nursing (BSN) and pass the NCLEX-RN examination. CRNA education is at the master’s or doctoral level and lasts two to three years. Nearly all schools recommend not working during the program and only offer programs for full-time students. Very few CRNA programs accept applicants with a bachelor’s degree in an unrelated field. Beginning in 2025, all new CRNAs will need a doctorate degree to practice. Current CRNAs with a master’s will not be required to complete a doctoral program at this time. Regulations may change in the future, and current CRNAs may consider adding to their education in order to stay competitive in the field.

To be a competitive applicant to nurse anesthetist programs, a nurse should have a minimum of one year of critical care nursing experience, though at least two years is recommended. Critical care experience can be gained by working as an RN in intensive care units (ICUs) or critical care units (CCUs). While nurses in emergency rooms and post-anesthesia care units (PACUs) care for patients at critical moments, this experience usually will not qualify as critical care experience for CRNA applications. Certification by exam as a critical care registered nurse (CCRN) is also recommended. CCRN is an additional certification for experienced RNs that is not required by employers. CCRN certification demonstrates that an RN has achieved a high level of skill and makes applicants more competitive.

Prerequisite courses for CRNA programs include undergraduate-level anatomy, physiology, chemistry, and physics, and must have been completed within a reasonable number of years prior to application. CRNA programs are competitive. In addition to the above requirements, future CRNA students go through an interview process and may be expected to complete emotional intelligence or personality testing prior to admission.

After accumulating thousands of clinical hours during school and graduating, hopeful nurse anesthetists must pass the national certification exam offered by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA). CRNAs must also check the requirements of the state board of nursing where they wish to practice. When all requirements have been met, CRNAs need to apply to the nursing licensure board in that state. Applications generally require a fee, background check, and proof of active RN license in good standing, along with proof of all required education and training achievements.

What Are the Benefits of Being a Certified Registered Nurse Anesthetist?

Certified registered nurse anesthetists often have the longest path from RN to APRN, but often have the biggest rewards, too. In addition to earning the highest pay of all APRNs, CRNAs also have excellent flexibility in choosing the environment in which they work. Being able to select one’s work environment helps ensure a better fit and reduces stress.

A career as a CRNA offers the chance to practice as independently as possible and reap the rewards of lucrative pay in a large variety of settings. CRNAs are trusted by their patients to provide compassion and professionalism during stressful experiences. Working as part of a team that provides treatments and pain control, CRNAs can find fulfillment in making the lives of their patients better.

What Are Other Advanced Practice Registered Nurse (APRN) Careers?

In addition to CRNAs, three additional APRN providers practice in the U.S. Advanced practice nurses in these roles have earned at least a master’s degree and have specialized in caring for specific patient populations. They are certified to assess, diagnose, prescribe, and treat patients at various levels based on state regulations.

Other APRN roles in the United States include: