November 20, 2023

How to Become a Certified Registered Nurse Anesthetist (CRNA)

In this guide, we explore the education and training requirements for nurse anestheists.

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How to Become a Certified Registered Nurse Anesthetist (CRNA)

Anesthesia is a critical medical treatment for many procedures, such as surgery. It prevents patients from feeling pain and affects patient outcomes. However, the United States faces a shortage of anesthesia providers, including Certified Registered Nurse Anesthetists (CRNA). This article will provide a step-by-step guide for those interested in pursuing a career as a nurse anesthetist. 

Read more: The Pros and Cons of Becoming a CRNA

1: Earn a BSN and Apply for a Nursing License

The first step to pursuing a career as a nurse anesthetist is to earn a bachelor degree in nursing (BSN). There are two main paths to earning a BSN: 

  • Graduate from a four-year college or university with a degree in nursing
  • Earn an associate degree in nursing (ADN or ASN), then pursue an RN to BSN bridge program

Before BSN graduates may be allowed to work, they must pass a licensing exam and apply for a license or register where they wish to be licensed. The exam, the National Council Licensure Examination (NCLEX-RN), is a computer-administered test that tests nursing knowledge. According to the National Council of State Boards of Nursing (NCSBN), 85.59% of U.S.-educated nurses graduating from BSN programs pass the NCLEX. Nursing programs are required to publish their graduates’ NCLEX pass rates, which could help you compare and choose programs. 

Applying for a nursing license depends on the state where you wish to work. Many states recognize the Nurse Licensure Compact (NLC), which allows nurses to work in their home state as well as other compact states. Other states, California for example, require a separate license. Once you have earned a BSN, passed the NCLEX-RN and earned your nursing license, you may pursue a career as a registered nurse. 

Read More: What’s a Registered Nurse?

2. Get Critical Care Work Experience 

All CRNA programs require at least one year of experience as a registered nurse in a critical care setting, such as a Critical Care Unit (CCU) or Intensive Care Unit (ICU). However, many nurses who pursue careers as nurse anesthetists end up with close to three years of experience. 

Experience in an ICU may help nurses better handle a CRNA program’s demanding coursework. Specifically, the following skills may help students prepare for a CRNA program: hemodynamic monitoring, invasive lines, ventilator support and vasoactive infusions as well as continuous electrocardiogram monitoring. 

3. Apply to a CRNA Graduate Program

After gaining experience in critical care nursing—provided your license is in good standing—you could apply to a certified registered nurse anesthetist program. To apply, programs may require an application fee, nursing school transcripts, essays and letters of recommendation. The exact application requirements varies from school to school. 

With your prerequisites completed, you could apply to the nurse anesthesia education programs. Here are a few questions to consider when creating a list of target schools:  

  • Is the program accredited? In the United States, there are 102 nurse accredited anesthesia programs. As of January 1, 2022, all accredited nurse anesthesia programs must award doctoral degrees. Before January 1, 2022, aspiring CRNAs could apply to either master’s programs (MSN) or doctoral programs (DNP). 
  • How much does the CRNA program cost? Nurse anesthesia programs differ from school to school. For example, UPenn’s DNP Nurse Anesthesia program costs $233,932. On the other hand, the University of Iowa’s in-state tuition for its DNP-CRNA degree is $75,861
  • Full-time or part-time? Some institutions offer part-time programs, while others only offer full-time programs. 
  • Is the program front-loaded or integrated? Students in front-loaded CRNA programs spend the beginning of their program in the classroom before entering a clinical setting. Integrated programs 
  • Where is the program located? The program you choose could affect where you end up working as a CRNA.

Applying to a CRNA program is a big decision. Nurse anesthesia programs could take 24-51 months to complete and cost hundreds of thousands of dollars. 

4. Take the National Certification Exam (NCE) for Nurse Anesthetists

Once you’ve made it through CRNA school, you need to take the National Certification Exam (NCE). The NCE is administered by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA). After CRNA program graduates pass the exam, they could register with a relevant regulatory body. 

In California, for example, CRNAs must register with the Board of Registered Nursing to obtain a nurse anesthetist license. The license costs $75 and the only requirement is a certificate from the NBCRNA and an active California RN license. 

To receive a qualification, CRNAs must complete an examination offered through the NBCRNA, which covers different topics relating, but not limited to, subjects such as anatomy, pharmacology, and various methods for administering anesthesia.

5. Find Job as a CRNA

Upon passing the NCE and obtaining a nurse anesthetist license, CRNAs are allowed to work. Nurse anesthetists work in many different settings, including hospitals, doctor’s offices and universities. Nurse anesthetists play an important role in administering anesthesia to patients in the United States—many rural hospitals rely solely on CRNAs to provide anesthesia care. 

The BLS predicts a 13% increase in nurse anesthetist jobs between 2020 and 2030. 

6. Do a Fellowship (Optional)

Some CRNAs choose to further specialize by undertaking a year-long fellowship after graduating. For example, the American Association of Nurse Anesthetists (AANA) and Middle Tennessee School of Anesthesia offer an Acute Surgical Pain Management fellowship for certified nurse anesthetists hoping to gain experience treating acute surgical pain. 

The Council on Accreditation of Nurse Anesthesia Educational Programs (COA), publishes a list of accredited fellowship opportunities each year. 

7. Continued Professional Certification (CPC)

For CRNAs, education does not end with graduation. In order to maintain an active license, nurse anesthetists must complete continuing education credits through the CPC program administered by the NBCRNA. The CPC program consists of two four-year cycles. At the end of each four year cycle, CRNAs must renew their license. At the end of two cycles, they must take a CPC assessment to ensure that their anesthesia knowledge is up to date. 


What is a CRNA?

Certified Registered Nurse Practitioners are a type of Advanced Practice Registered Nurse—specialized nurses with graduate degrees—who provide anesthesia to patients. There are five main areas of responsibility, also known as scope of practice: 

  • Preoperative/Preprocedure: These are responsibilities CRNAs have before a patient’s procedure, such as conducting a preanesthesia assessment or providing education. 
  • Intraoperative/Intraprocedure: These are responsibilities a nurse anesthetists have during medical procedures, such as administering anesthesia or monitoring vital signs. 
  • Postoperative/Postprocedure: After a patient’s procedure, CRNAs are responsible for their recovery from anesthesia. 
  • Pain Management: Nurse anesthetists also help with pain management outside of procedures.
  • Other services: CRNAs have other assorted responsibilities, such as prescribing medications and providing emergency care. 

How Long Does It Take To Become a CRNA? 

According to the American Association of Nurse Anesthesiology (AANA), it takes a minimum of 7-8.5 years to pursue a career as a CRNA. Those hoping to pursue a career as nurse anesthetists must first earn a bachelor’s in nursing and work as a registered nurse in a critical care setting before they apply to a CRNA graduate degree program. On average, CRNA program graduates have 9,369 hours of clinical experience including their time as registered nurses. 

Where Do CRNAs Work?

CRNAs work in settings where patients need anesthesia. These include doctor’s offices, surgical centers, hospitals, outpatient care centers and universities. Nurse anesthetists play an important role in rural areas where they are often the only providers of anesthesia care

How Much Do CRNAs Make? 

According to the U.S. Bureau of Labor Statistics, the median annual salary for CRNAs is $195,610* per year. 

Are Nurse Anesthetists and Anesthesiologists the Same? 

Nurse anesthetists and anesthesiologists both provide anesthesia, but the main differences between the two career paths are educational requirements and how they’re regulated. CRNAs are nurses who have a bachelor’s degree in nursing and a graduate degree in anesthesia. Anesthesiologists, on the other hand, are medical doctors. 

In some states, physicians must supervise CRNAs. Others allow CRNAs to practice independently without supervision. Many studies have shown that there is no difference in patient care between physician anesthesiologists and nurse anesthetists. 

Is Being a CRNA Worth It? 

Many CRNAs are satisfied with their jobs, according to a 2021 survey of nurse anesthetists. The survey reports that 89% of CRNAs report being satisfied, 48% indicating that they’re satisfied and 41%responding that they’re somewhat satisfied. Certified nurse anesthetists play a critical role in providing patient care.

The Bottom Line

When considering a career as a CRNA, it’s important to consider the years of education as well as the monetary investment. Despite the long journey, there are many reasons to pursue a career as a nurse anesthetist. They also play a critical role in patient care, especially in rural areas. Finally, a career in nurse anesthesia could be be intellectually stimulating

Program outcomes may vary depending on each institution's specific curriculum and employment opportunities are not guranteed.