Certified Registered Nurse Anesthetist
What is a Nurse Anesthetist?
A Certified Nurse Anesthetist (CRNA) is one of the roles of a broader group of nurses called Advanced Practice Registered Nurses (APRNs). Other APRN roles include: Nurse Practitioner, Clinical Nurse Specialist, and Nurse Midwife. Although the scope of practice for an CRNA varies by state as defined by the State Board of Nursing, a Nurse Anesthetist is typically a Master’s prepared nurse who provides anesthesia to patients for major or minor surgical procedures. In 2015, CRNAs administered over 40 million anesthetics in the United States.
The CRNA is often the sole provider of anesthesia services in medically underserved communities. However, in many cases, the CRNA collaborates with surgeons, anesthesiologists and other healthcare providers to safely provide anesthesia in many environments. In 1986, CRNAs became the first nursing specialty to be able to directly bill and be reimbursed for care under the Medicare program. Men comprise approximately 10% of all nurses; however, almost 40% of all CRNAs are men.
Quick Facts about Certified Nurses Anesthetists:
- 2015 Median Pay
- Number of Jobs in 2015
- Job Prospects from 2014-2024
- Much faster than average
- Projected Employment in 2024
- Projected Employment Change from 2014-2024
- Areas of Growth
- Rural, inner cities, medically underserved areas
Figure 1: Accessed from Bureau of Labor Statistics, July 2016
What does a CRNA do?
The CRNA role is a nursing role (nurse anesthetist) blended with a traditional physician role (anesthesiologist). Depending on state-specific scope of practice, a Nurse Anesthetist will do some or all of the following:
- Take medical and nursing histories from patients to determine any special needs or concerns that might occur during anesthesia;
- Perform basic physical exams prior to a surgical procedure;
- Order tests based on the physical exam and the scheduled procedure;
- Create plans of care for patients for patients undergoing anesthesia;
- Administer and adjust anesthesia;
- Evaluate the individual’s response to the anesthesia and monitor the patient during the procedure;
- Provide pain management and teaching about pain management;
- Consult with other members of the healthcare team;
- Conduct or participate in research studies.
Where do Nurse Anesthetists work?
Nurse Anesthetists can work in a wide variety of environments including acute care hospitals, physician offices, surgery centers, outpatient clinics, and any other environment where anesthesia is administered. Again, it is important that you understand that CRNA practice is governed by each state’s Board of Nursing so it is critical to understand the rules and regulations in your state.
Practice Environment Percent of CRNAs Physician practices 48% Acute care hospitals 42% Outpatient centers and clinics 7% Other offices 3%
Figure 2: Accessed online from Bureau of Labor Statistics July 2016
What qualities should a Nurse Anesthetist have to be successful?
In order to be successful, the CRNA should:
- Be an excellent Registered Nurse. The CRNA must have those basic skills as a foundation for advanced practice.
- In addition to great nursing skills, the successful CRNA must have critical thinking skills and must be able to function independently and quickly.
- Particularly in an environment where the Nurse Anesthetist is acting independent of a physician anesthesiologist, the ability to accurately assess and develop an appropriate and safe anesthesia plan is critical.
- Communication and interpersonal skills are vital for accurately relaying information to patients, families, surgeons and other members of the healthcare team.
- A nurse anesthetist is responsible for keeping a patient safe during surgery so must be acutely attentive to details.
- The CRNA must be able to detect even small changes in a patient’s condition.
- Finally, the CRNA must be compassionate and willing to understand that the patient and family are typically under a huge amount of stress when preparing for a surgical procedure.
How much can I expect to earn as a Nurse Anesthetist?
The great news is that, in addition to providing an essential service, the Nurse Anesthetist is the highest paid of all of the Advanced Practice RNs. As of May 2015, the median annual wage was $157,140 with a range from $54,470 to $243,550. Of course, wages vary widely by state, cost of living, and need. In May 2015, the US Bureau of Labor Statistics showed the following as average wages for a CRNA by state:
Figure 3: Accessed online from Bureau of Labor Statistics July 2016
What are the job prospects for a Nurse Anesthetist?
The need for Nurse Anesthetists is expected to grow much faster than other professions through 2024. As with the other APRNs, job prospects for Nurse Anesthetists are excellent over the next 10 years as baby boomers age, begin to leave the work force and begin to develop health issues. As health insurance becomes more universal, CRNAs will offer a more affordable alternative to traditional physician directed healthcare and will augment a physician population that is declining.
In May 2015, the US Bureau of Labor Statistics (BLS) showed the following as employment of CRNAs by state:
Figure 4: Accessed online from Bureau of Labor Statistics July 2016
How can I become a Nurse Anesthetist?
A Nurse Anesthetist must be a Registered Nurse before being eligible for this advanced degree. In order to earn a CRNA, you must earn a master’s degree (or higher) from an accredited program. Typically, this means that you must have a Bachelor’s degree in nursing first; however, if you have a bachelor’s degree in another health science, there are programs that will allow you to prepare for RN licensure at the same time you are studying for a Master’s degree in nursing. If you are a full time student in a Master’s program, you can expect to spend two to three years earning the Master’s degree that will prepare you to take the national certification exam offered by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA).
In 2015, 2,983 nurses took the National Certification Examination. Of those nurses, 81% passed the exam. The NBCRNA believes that a CRNA should be a lifelong learner; therefore, the professional organization developed the Continued Professional Certification (CPC) Program that allows the CRNA to recertify every 4 years by accumulating continuing education credits.