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Certified Registered Nurse Anesthetist (CRNA)

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Specializes in Nephrology, Cardiology, ER, ICU. Has 27 years experience.

What is a CRNA?

The CRNA is a popular advanced practice nursing specialty. It is one of the more, if not the highest paid APRN. Competition is fierce to get into school and once in school, studying for many hours per day is the norm.

Certified Registered Nurse Anesthetist (CRNA)

The Certified Registered Nurse Anesthetist (CRNA) is an Advanced Practice Registered Nurse (APRN) who provides anesthesia to a wide variety of patients; from neonates to the geriatric population.

Work Environment

Most of the workday, CRNAs are in the operating room (OR) providing anesthesia to patients. There is a wide variety of OR settings. A CRNA can be in a level one trauma center with multiple ORs going many hours of the day. Or, a CRNA can be in a more rural environment where they might be the only anesthesia provider. Or, they could be active duty military deployed to some remote post providing emergent anesthesia in a war zone.

Some other CRNAs work in research, pain management, office settings, and politics. With the advent of managed care on the horizon, opportunities are wide open for CRNAs to lobby on Capitol Hill. Other CRNAs teach and mentor. There are many opportunities for CRNAs.

Some of the Steps Involved in Anesthesia

  • Preoperative assessment which includes airway, need for consults/clearance from specialists, thoughts as to need for invasive monitoring
  • Sedation, induction, advanced airway placement
  • Maintenance of anesthesia to ensure patient safety
  • Rapid Sequence Intubation (RSI)
  • Extubation
  • Postoperative visits to patients and families

Qualifications

CRNA school admission is very competitive. For most schools, a registered nurse will need at least one year (2 years preferred) of Intensive Care Unit (ICU) experience, along with solid letters of recommendation and an interview. Other qualifications might include specialty certifications such as Critical Care Registered Nurse (CCRN). Each school has its own nuances that go into the selection of CRNA candidates.

Qualities

All nurses need to be compassionate and caring. CRNAs need additional qualities (not all-inclusive):

  • Affinity for "hard sciences" such as bio-Chemistry, physics, advanced pathophysiology and advanced cellular biology. (Each school has its own particular curriculum - this is just a general list).
  • Confidence in their own ability to provide safe and cost-effective anesthesia.
  • Ability to work with many different types of people, including attending physicians, nurses, techs and patients and families
  • Must be able to explain complex medical concepts to patients and families in a way that they understand

Professional Organizations

The American Association of Nurse Anesthetists is the organization that represents CRNAs. This organization lobbies for CRNA specific legislation and develops policy, practice standards and guidelines.

Education (not all-inclusive)

  • Graduate from accredited Registered Nurse (RN) nursing program
  • Successfully pass the NCLEX-RN
  • Unencumbered, current RN license in U.S. state of practice
  • Master's degree and more frequently, the Doctor of Nurse Anesthesia Practice (DNAP) or the Doctor of Nursing Practice (DNP).

Certification

As with other APRNs, the CRNA must successfully pass a certification test in order to use the title CRNA.

The Council on Accreditation of Nurse Anesthesia Educational Programs (COA) is nationally recognized by the U.S. Department of Education (USDE) and the Council for Higher Education Accreditation (CHEA) as an accrediting agency for the “accreditation of institutions and programs of nurse anesthesia at the post-master’s certificate, master’s, or doctoral degree levels in the United States, and its territories, including programs offering distance education.”

Graduates of a COA-accredited and approved school of anesthesia are eligible to sit for their National Certification Examination (NCE)  through The National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA).

Here is a list (2020) of the COA-accredited/recognized Nurse Anesthesia programs.

Salaries (2020)

A CRNA can expect a starting salary in the 6 figures.

Payscale

The average salary for a CRNA is $152,222.

salary.com

The average CRNA salary in the U.S. is $130,527 and ranges upwards of $234,778.

ZipRecruiter

Average CRNA Salary by State.

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Kathleen Piotrowski, DNP, CRNA, a nurse anesthesia specialty director and coordinator at the University of Arizona College of Nursing, describes what it's like to be a Certified Registered Nurse Anesthetist (CRNA).

14-yr RN experience, ER, ICU, pre-hospital RN, 12+ years experience Nephrology APRN.

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