Certified Registered Nurse Anesthetist (CRNA): Job Description, Salary, and How to Become One

Dive into the dynamic world of certified registered nurse anesthetists (CRNAs) and learn about their responsibilities, salary expectations, and the steps to becoming one. Careers

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Whether you're a seasoned registered nurse (RN) considering advancing your career or a student mapping out your education, we've provided everything you need to know to pursue a career as a certified registered nurse anesthetist (CRNA).

Read more about the job description, responsibilities, salary expectations, and steps to becoming a CRNA. 

Job Description

CRNAs are advanced practice registered nurses (ARPNs) qualified to administer anesthesia and care for patients recovering from anesthesia.

Integral to healthcare systems, CRNAs can find themselves working in various settings with their advanced knowledge and experience. Their job prospects can range from an "easy-going setting,” like a dental clinic, to a more high-stakes, less predictable one, such as in the ICU.

Overall, CRNAs must still demonstrate the ability to provide safe patient care and effective communication skills with the patients they care for and those they work directly with. 

Practice Settings

CRNAs typically work in:

  • Hospitals (e.g., surgical units, emergency departments, intensive care units, and labor and delivery rooms)
  • Outpatient care centers
  • Physician offices or other healthcare practitioners 
  • Private practices (e.g., cosmetic surgery clinics)
  • Dental offices
  • Universities and Professional Schools

Important Skills and Qualities

  • Principles of local and general anesthesia administration, monitoring, and management
  • Attentiveness to monitoring and understanding vital signs, including ECG monitoring, ventilator settings, and lab results. 
  • Arterial line placement
  • Tracheal intubation
  • Epidurals
  • ACLS
  • Strong communication and leadership skills
  • Ability to work independently and collaborative 
  • Proficiency in surgery principles, airway management, postoperative care, teaching, critical care, and patient care. 
  • Comprehensiveness in legal aspects of nurse anesthesia practice 

CRNA Responsibilities

The type of work CRNAs perform significantly differs from that of a nurse working bedside on a general medicine unit, as they're accountable for a patient's life under the influence of full anesthesia.

The CRNA must be privy to specific conditions or diagnoses that may put a patient at high risk when under (e.g., history of smoking/alcoholism, sleep apnea, hypertension, etc.). If an acute event occurs, they must be knowledgeable and vigilant and act quickly to stabilize the patient. 

More generally, CRNA responsibilities include:

  • Patient Assessment
  • Anesthesia Plan Development
  • Administering Anesthesia
  • Patient Monitoring
  • Post-Anesthesia Care
  • Patient Education
  • Emergency Management
  • Record Keeping
  • Collaboration and Leadership

CRNA Salary

According to the U.S. Bureau of Labor Statistics (BLS), CRNAs earn:

  • Mean Hourly Wage: $98.93
  • Mean Annual Wage: $205,770

Top-Paying States:

  • North Dakota: $246,510+
  • California: $246,510
  • Connecticut: $240,580
  • New York: $238,710
  • Illinois: $238,440

Highest-Paying Industries:

  • Outpatient Centers: $246,980
  • General Hospitals: $217,570
  • Office of Physicians: $200,280
  • Colleges and Universities: $199,460
  • Offices of Other Health Practitioners: $143,790

Ultimately, the earning potential of a CRNA will vary depending on several factors, including practice setting, location, experience, and more.

How to Become a CRNA

Becoming a CRNA is a significant commitment that requires several years of education and clinical experience. Although the pathway may vary in length and degree steps, the following five steps provide a general overview of how to become certified.

1. Earn a Bachelor's Degree in Nursing (BSN)

Earning a BSN can be achieved in several ways, including a Traditional four-year program or a bridge program for practicing nurses who earned an Associate Degree in Nursing (ADN). A BSN provides the foundational knowledge and skills to practice and excel in post-graduate studies.

2. Become an RN

If a future CRNA achieves their Traditional BSN over four years of study, they must pass the National Council for Licensure Examination for Registered Nurses (NCLEX-RN) to become licensed.

3. Gain Experience

Gaining experience in a critical care setting is a typical requirement for admission into a CRNA program, with a usual minimum of one to two years. While gaining experience, RNs should aim to develop a strong understanding of disease processes and advanced skills such as hemodynamic monitoring, mechanical ventilation, and vasoactive drug administration.

4. Earn a Doctoral Degree from an Accredited Program

Accredited nurse anesthesia programs provide the specialized training and education needed to practice as a CRNA. These programs include coursework and clinical experiences.

CRNAs have historically become certified with an MSN; however, to comply with requirements from the Accreditation of Nurse Anesthesia Educational Programs (COA), doctoral education will be required for entry into nurse anesthesia practice by 2025. 

5. Become Certified

After graduating from a CRNA program, you must pass the National Certification Examination (NCE) administered by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA).

Once certified, CRNAs must follow state licensure requirements, complete continuing education, and undergo periodic recertification.

Columnist

Kyle Oliver has 6 years experience as a BSN, RN.

4 Articles   9 Posts
Specializes in Adult Critical Care. Has 12 years experience.

Couple of additions to the original article: 

All CRNA programs today are minimally "9 semesters (extra Summer semesters) in 36 months" doctoral programs.  2025 is the date that all formerly masters degree students must graduate by.  Hence anyone starting a CRNA program after fall 2022 is getting a doctorate.

CRNA scope also includes full scope pre-op and post-op management, peripheral nerve blocks, and medical and interventional chronic pain management.  Middle Tennesse State (MTSU) has a CRNA acute pain post-doctoral fellowship.  Texas Christian (TCU) and Univ of South Florida (USF) have CRNA chronic pain post-doctoral fellowships.

The CRNA profession dates back to at least the American civil war (1850s-1860s).   Alice Magaw, a nurse anesthetist, was performing anesthesia for the Mayo brothers at the Mayo Clinic in the 1890s.  Anesthesia in America was almost exclusively performed by nurse anesthetists until after WWII.

I recommend including minimum requirements but also typical/average requirements to give people a realistic look at what they're getting into.  For example, the NBCRNA requirement is that RNs have 1 year of critical care RN experience prior to CRNA school...the average applicant who gets in has around 4 years.   While enrolled in a CRNA school, the minimum is 2000 hours of clinical training...the average trainee completes around 2700 hours.  

Most important to mention is the that e is no state in the U.S. that requires a CRNA to be supervised by a physician anesthesiologist.  Roughly half of states permit full, independent CRNA practice.  The other half allow the operating surgeon to 'supervise' the CRNA; as you can imagine they don't know anything about anesthesia.   Some individual facilities choose to be more restrictive than state law and require CRNAs to be supervised by physician anesthesiologists.  

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CRNA School Prep Academy

6 Articles | 88 Posts

Specializes in Nurse Anesthetist, CRNA.

Great article, thank you for sharing! 

ICUSAVVY

1 Post

Specializes in ICU. Has 6 years experience.

Roseman University near Las Vegas is starting a program.  That school is awesome.  They are going to be different than all of the other schools.  You only take one class at a time.  No more juggling hard classes.

Specializes in Adult Critical Care. Has 12 years experience.

I would like to caution anyone who thinks they can find an 'easy' CRNA program.  It's likely to be the hardest thing you'll ever do. 

I went to a hybrid program.   These newer hybrid programs typically have online lectures but still have in-person tests, in person skills labs and of course in person clinical rotations. The time commitment isn't any less than a traditional program.  There is no program anywhere that's going to enable you to work full time as an RN while in school.  It's just not possible because of the number of clinical hours required. 

The minimum for any program is 2000 hrs per the NBCRNA to be licensed. The average program requires far more than that....the average graduate has around 2700.  

offlabel

1,580 Posts

Tuition also varies widely. I'm sure there's a way to find out, but I've wondered recently if there is a correlation between total tuition and overall quality of training, which, I'd think,  would correlate with competitiveness of applicant. There is wide heterogenicity in training programs and those applicants that stand out from the pack should definitely leverage that advantage in the type of program they choose to attend.

Edited by offlabel

amigRN

14 Posts

Hi CRNAs!

I am really excited to become a CRNA--I am a critical care nurse accepted into a CRNA program. Are there any CRNAs out there that can speak to their roles and impact as CRNAs yet still maintain flexible schedules (Per diem, part time, non traditional practice settings like pain management, contract/locum work) in the Northern California/Reno/Tahoe/Sacramento area? I love to travel, ski, climb and have a very active outdoor lifestyle and I have appreciated the schedule flexibility of being an RN, and want to maintain that moving into the new role. Would love to connect with CRNAs who share a passion for the mountains, recreation and balancing a fulfilling career as a CRNA. Thanks in advance!

Edited by amigRN
grammer

Specializes in Adult Critical Care. Has 12 years experience.

I'm currently a Northern California CRNA and can certainly speak to this.  Northern California is an excellent area for CRNAs.  California is a full-practice state for CRNAs.  That means you can do independent practice to your heart's content complete with full prescriptive authority on day 1 after graduation.  CRNA non-surgical pain management practices are new in that last decade in NorCal, however CRNAs who complete one of the additional 1 year pain fellowships will find plenty of opportunity.  Some individual hospitals in NorCal (mostly U.C. Davis and some of the Kaiser hospitals) choose to be more restrictive that California state law and mandate supervision by a physician anesthesiologist.

With the exception of Kaiser and U.C. Davis, CRNAs in NorCal are exclusively 1099/independent contractors.  Generally, that means you work whenever you want.  You choose whether you want to do call or nights/weekends.

I would dissuade you from practicing in Nevada.  Lots of legislative issues. There is no CRNA license in Nevada, and CRNAs working there currently have to practice under their RN license.  This significantly impedes their ability to practice independently, because the surgeon typically has to cosign all orders in rural areas that don't have physician anesthesiologists.

Edited by jfratian

offlabel

1,580 Posts

jfratian said:

I'm currently a Northern Californi

I would dissuade you from practicing in Nevada.  Lots of legislative issues. There is no CRNA license in Nevada, and CRNAs working there currently have to practice under their RN license.  This significantly impedes their ability to practice independently, because the surgeon typically has to cosign all orders in rural areas that don't have physician anesthesiologists.

This is a manifestly and demonstrably false statement.

https://nevadanursingboard.org/wp-content/uploads/2023/09/NV-State-Board-of-Nursing-Message-to-CRNAs.pdf

Specializes in Adult Critical Care. Has 12 years experience.

I stand corrected on that.  I'm quite glad they fixed their prescriptive issues earlier this year.  

I would still argue practice is better on this side of the boarder.   Cost of living in Northern Nevada is almost just as high and pay is substantially less.  Nevada is one of the few non opt out states in west for CRNAs.  NorCal also has many great CRNA predominant and/or CRNA only practices.

 

Edited by jfratian

offlabel

1,580 Posts

You wouldn't be able to tell the difference on a practical, day to day level. Clinically speaking, nothing has changed. If someone is ideologically driven to the point of denying themselves a potentially advantageous/rewarding practice, there's not much I can say about that. 

Specializes in Adult Critical Care. Has 12 years experience.

All CRNA programs require 36 month/9 semester practice doctorates.   Those either end in a Doctor of Nursing Practice (DNP) or a Doctor of Nurse Anesthesia Practice (DNAP). 

PhDs are research doctorates.  Many CRNAs also have them, however they are not require to treat patients.

There are no masters programs left.  The transition to all doctorates began with the class that started Spring 2023.

As for whether truly independent CRNA practice matters, it does.  If you've never experienced it, you just don't know.  It's personally extremely fulfilling to manage a patient from preop to discharge. It's beyond the hospital politics of proving you can (does matter to surgeons and hospital boards when anesthesia groups bid for contracts by the way).