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Certified Registered Nurse Anesthetist (CRNA) Career Guide

What is a certified registered nurse anesthetist?

A certified registered nurse anesthetist is an advanced practice registered nurse (APRN) specializing in anesthesia administration. In the medical field, CRNAs play an essential role in surgical, diagnostic, therapeutic, and obstetrical procedures where anesthesia is required. They are highly trained medical professionals who ensure patient comfort and safety during these procedures.

Their expertise is invaluable, bridging the gap between anesthesiology and nursing and serving as an integral part of the perioperative care team. They develop a nuanced understanding of anesthetic drugs, techniques, and equipment through their rigorous training. The care these professionals provide extends beyond the operating room, encompassing labor and delivery units, critical and emergency care, outpatient surgery centers, and pain management clinics. In many rural or underserved areas, they may be the sole providers of anesthesia care, underlining their critical role in the healthcare industry.

Duties and responsibilities

The primary role of CRNAs is related to the anesthesia care process, including preoperative evaluation, determination of anesthetic techniques, administration of anesthesia, and postoperative pain management. In collaboration with surgeons, anesthesiologists, and other healthcare professionals, they determine the best anesthesia plan for each patient. They also monitor patients during procedures to ensure appropriate anesthesia levels and manage adverse reactions.

Work environment

CRNAs work in healthcare environments requiring anesthesia services, including hospitals, outpatient care centers, physician offices, and military settings. Their work often occurs in high-stakes, high-pressure situations such as operating and delivery rooms. The role requires precision, quick decision-making, and excellent patient care skills.

Typical work hours

The working hours of a CRNA can vary depending on the healthcare setting and patient needs. Hospitals and surgical centers might have shifts that cover all 24 hours of the day, including weekends, holidays, and on-call for emergencies. Some roles might have more standard business hours in physician’s offices or clinics. Healthcare requires schedule flexibility, so those working in that space must be prepared to adapt their schedules to pressing needs.

How to become a certified registered nurse anesthetist

To become a CRNA, you will need a combination of education, training, and experience. In this career guide section, we cover the steps you’ll need to take to achieve your goal:

Step 1: Obtain a bachelor’s degree in nursing

The first step is to earn a bachelor of science in nursing (BSN) degree from an accredited college or university. This four-year program provides a strong foundation in nursing theory and practice and courses in anatomy, physiology, microbiology, and other sciences.

Step 2: Obtain RN licensure

After completing a BSN, you must pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN) to become a licensed registered nurse (RN). This exam evaluates your knowledge and skills in nursing practice and ensures preparation for entry-level nursing roles.

Step 3: Take additional courses

Continuing education is always a good idea to help stay on top of current technologies and healthcare trends. There are incredible online options available for advancing your knowledge base. Here are a few recommendations:

  • Medical Terminology from Udemy covers all the medical jargon that healthcare professionals need to know. This course also provides tools to help you remember the terms and improve your communication with coworkers. It covers common anomalies, lab tests, procedures, drugs, and abbreviations. 
  • Vital Signs: Understanding What the Body is Telling Us from Coursera covers the anatomy and physiology underlying the vital signs. Learn about normal ranges, normal variants, and the mechanisms that underlie changes in the objective measurement of vital signs. 

Step 4: Gain clinical experience

Before applying to CRNA programs, candidates typically need at least one to two years of clinical experience as an RN in a critical care setting. This experience provides valuable skills in patient assessment, decision-making, and working in high-pressure situations.

Step 5: Complete a master’s or doctoral program in nurse anesthesia

To become a certified registered nurse anesthetist, you must complete a graduate-level nurse anesthesia program accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs (COA). These programs generally take 24 to 36 months to complete, leading to either a master of science in nursing (MSN) or a doctor of nursing practice (DNP) degree focusing on anesthesia.

Step 6: Obtain national certification

After completing an accredited nurse anesthesia program, you must pass the National Certification Examination (NCE) administered by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA). This exam assesses knowledge of anesthesia principles, practices, and techniques. Upon passing the NCE, you can use the CRNA designation and practice as a certified registered nurse anesthetist.

Step 7: Maintain licensure and certification

CRNAs maintain their RN licenses and CRNA certifications throughout their careers. The process involves completing continuing education requirements and, in some cases, periodic recertification examinations. Be sure to stay informed about the specific requirements in your state.

How much do certified registered nurse anesthetists make?

Several factors can influence salary and compensation. One major determinant is education, as all CRNAs must have a master’s degree or higher in nurse anesthesia and a certification from the National Board of Certification and Recertification for Nurse Anesthetists. Experience also plays a significant role, and professionals with more years in the field generally earn more.

The industry or sector of employment is also a factor. For example, those working in outpatient care centers or specialty hospitals often make more than those in general medical and surgical hospitals. Geographic location, such as regions with a higher cost of living or increased demand for healthcare services, results in higher pay. Finally, the employer’s size can impact compensation.

Highest paying industries

  • Outpatient Care Centers – $217,480
  • Specialty Hospitals – $213,250
  • General Medical and Surgical Hospitals – $202,290
  • Offices of Other Health Practitioners – $197,540
  • Offices of Physicians – $194,820

Highest paying states

  • Montana – $243,550
  • California – $227,290
  • Iowa – $224,120
  • Oregon – $221,980
  • Wisconsin – $220,380

Browse CRNA salary data by market

Types of certified registered nurse anesthetists

A CRNA’s primary role is relatively standardized but has nuances depending on the healthcare setting or the population served. This career guide section will explore various specializations, highlighting their unique responsibilities.  

Pediatric CRNA

Pediatric CRNAs specialize in providing anesthesia care to infants, children, and adolescents. This role requires a deep understanding of the unique physiological differences and challenges inherent to the age group and the ability to interact effectively with young patients.

Obstetric CRNA

Obstetric CRNAs focus on providing pain management and anesthesia services for women during labor and childbirth. They may administer epidurals, monitor the mother’s condition, and provide anesthesia for cesarean sections.

Cardiothoracic CRNA

Cardiothoracic procedures, including heart and lung surgeries, often require that CRNAs provide complex anesthesia management and patient care due to their critical nature. 

Neurosurgical CRNA

CRNAs specializing in neurosurgery provide anesthesia for brain and nervous system procedures. The severe nature of these surgeries requires a high level of expertise and precision.

Pain management CRNA

Pain management CRNAs often work in pain clinics or integrated healthcare settings. They focus on providing long-term pain management services to patients suffering from chronic conditions.

Rural CRNA

Rural settings include critical access hospitals, rural health clinics, or private practices in rural areas. These CRNAs may provide a broad range of anesthesia services across various surgical procedures due to the general nature of healthcare practices in rural areas.

Military CRNA

Military CRNAs serve in various branches and provide anesthesia services to military personnel and their families in the United States and abroad. The role might involve deployment and care in combat or for emergencies.

Top skills for certified registered nurse anesthetists

Thriving as a CRNA requires a combination of advanced clinical abilities, meticulous attention to detail, strong interpersonal skills, and mental agility. The following descriptions provide insights into the abilities anyone aspiring to this role should focus on developing.

At the core of a nurse anesthetist’s role is administering anesthesia safely and effectively, which requires a profound understanding of different anesthesia techniques, including general, regional, and local anesthesia. There must be proficiency in selecting the most appropriate method based on the type of surgery, the patient’s medical history, and other relevant factors.

They must be proficient in assessing patients preoperatively, including evaluating the patient’s physical condition and medical history to understand potential risks. Making precise assessments is crucial in devising an appropriate anesthesia plan that minimizes risk and ensures patient safety.

Throughout the surgical procedure, these professionals are responsible for monitoring the patient’s vital signs, adjusting anesthesia levels as required, and promptly addressing any complications. This skill involves a high level of vigilance and a thorough understanding of the physiological effects of anesthesia. Ensuring patient safety is paramount and requires swift, confident decision-making abilities.

Working in surgical settings often involves high-stress situations requiring quick, critical decisions. They must possess high-stress tolerance and mental resilience. Staying calm, focused, and making clear decisions under pressure can significantly impact patient outcomes.

CRNAs need to communicate effectively with surgeons, nurses, and other healthcare professionals involved in patient care. Additionally, they must be able to explain complex medical procedures to patients and their families, answer questions, and address concerns to build trust and ensure informed consent.

Medical ethics and laws include patient rights, informed consent, and confidentiality. The nurse anesthetist must uphold these ethical principles and legal requirements in all aspects of their practice to maintain professional integrity and ensure patient care. This understanding also helps to navigate difficult situations and make decisions that respect a patient’s autonomy and dignity.

Certified registered nurse anesthetist career path

The career path for a CRNA begins with becoming an RN. Following some years of practical experience in critical care settings, these professionals typically pursue advanced degrees in anesthesia, leading to a specialized role.

CRNAs provide anesthesia and related care before, during, and after surgical, therapeutic, and diagnostic procedures under the supervision of medical doctors. In time and with experience, they may be able to manage complex cases independently.

With significant experience and proven proficiency, they might specialize further in specific types of anesthesia care, such as pediatrics, obstetrics, cardiovascular, or neurosurgical anesthesia. This path involves focusing on a particular patient demographic or type of surgical procedure, which can offer new challenges and opportunities for professional growth.

Experienced nurse anesthetists may also progress into leadership or administrative roles, such as an anesthesia department director or manager, overseeing a team, setting protocols, and ensuring the quality of care.

Additionally, some may opt to move into academia, teaching aspiring nurses or conducting research, contributing to advancements in the field of anesthesia.

As the population ages and the demand for healthcare services increases, CRNAs play a vital role in providing anesthesia care, particularly in rural and medically underserved areas. There is a growing trend toward autonomy in this profession, with some states allowing these professionals to practice without physician supervision. This move is partly driven by the need to increase healthcare access and efficiency. Technological advancements are also influencing the profession, with developments in monitoring equipment and anesthesia delivery systems enhancing the safety and effectiveness of anesthesia care.

Employment projections for certified registered nurse anesthetists

The U.S. Bureau of Labor Statistics groups certified registered nurse anesthetists under the larger category of “Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners.” Employment in this category is projected to grow by 40% through 2031, much faster than the average for all occupations. The primary driver for this growth is an increased emphasis on preventive care and the demand for healthcare services from the aging population. CRNAs, in particular, will be needed to provide anesthesia services, often the sole providers in rural areas. With healthcare legislation allowing these professionals to perform more procedures and the growing emphasis on team-based care, job prospects are expected to be excellent.

Certified registered nurse anesthetist career tips

Maintain high ethical standards

You are critical to patient safety and care. Uphold a high standard of ethical conduct in all aspects of work, respect patient confidentiality, and advocate for patients’ best interests.

Keep up with advancements in anesthesia

The field of anesthesia is continually evolving, with advancements in techniques, medications, and technologies. Stay up-to-date with these changes by engaging in continuing education and actively participating in professional development opportunities.

Manage stress effectively

This role is often high-stress, with the well-being of patients in your hands. Develop effective stress management strategies, such as mindfulness techniques, regular physical activity, and a strong support network, to ensure high performance even in challenging situations.

Build a professional network

Building a professional network can offer many opportunities for learning, collaboration, and career advancement. Consider participating in these associations and networks:

  • American Association of Nurse Anesthetists (AANA)
  • International Federation of Nurse Anesthetists (IFNA)
  • State-level associations
  • LinkedIn groups

Continuous learning

Continued professional development is crucial in maintaining competence and staying updated on the latest best practices. Here are a few recommendations:

  • Engage in continuing education: Both online and offline resources are available to stay updated with the latest in anesthesia.
  • Attend conferences and seminars: These gatherings provide valuable insights, offer shared experiences, and expand your network.
  • Read relevant publications: Journals and publications can provide updated research and developments in anesthesia practice.

Cultivate excellent communication skills

You must communicate clearly with patients, their families, and the medical team, including explaining procedures, addressing concerns, and providing updates on a patient’s condition. Excellent communication can enhance patient trust, team collaboration, and the overall quality of care.

Develop leadership skills

Even if you’re not in a formal leadership position, developing leadership skills can significantly enhance your effectiveness in the role. This includes skills like decision-making, problem-solving, delegating, and influencing others. Leadership skills can help to navigate challenging situations, advocate for patients, and contribute positively to the healthcare team.

Maintain meticulous record-keeping

Accurate and detailed record-keeping is vital in anesthesia practice because it ensures continuity of care and provides legal protection. Data also contributes to anesthesia research and quality improvement efforts.

Practice self-care

The role can be physically and emotionally demanding. Taking care of your health and well-being is essential to provide the best care for patients. Be sure to get enough rest, eat a healthy diet, exercise regularly, and take time to relax and recharge.

Foster a patient-centered approach

You should strive to enhance patient comfort and care. Take a patient-centered approach to care, respect individual needs and preferences, and involve patients in decisions to achieve the best outcomes.

Where the certified registered nurse anesthetist jobs are

Top companies

  • HCA Healthcare
  • Mayo Clinic
  • U.S. Department of Veterans Affairs
  • Kaiser Permanente
  • Envision Health

Top states

  • Texas
  • California
  • Pennsylvania
  • Florida
  • New York

Top job sites

  • Zengig
  • Glassdoor
  • LinkedIn
  • Indeed
  • Monster


What educational background is typically expected for a CRNA?

They generally begin their education with a bachelor’s degree in nursing. After gaining some clinical experience as an RN, a master’s degree or doctoral degree in nurse anesthesia is typically pursued. After graduation, they must pass the National Certification Examination to become a CRNA.

What are the key responsibilities of a certified registered nurse anesthetist?

Their primary responsibility is administering anesthesia to patients undergoing surgery or other medical procedures. They assess patients before procedures, administer anesthesia, monitor progress, and provide post-anesthesia care. Some CRNAs also provide pain management care.

What skills are essential for a certified registered nurse anesthetist?

This role requires advanced clinical skills to assess patients, administer anesthesia, and respond to potential complications. They also need strong decision-making and problem-solving abilities to make quick decisions in high-pressure situations. Excellent communication skills are essential for coordinating with other healthcare professionals and communicating effectively with patients.

In what types of settings do certified registered nurse anesthetists typically work?

They work in various healthcare settings where anesthesia is administered, including hospitals, outpatient surgical centers, dental offices, and pain clinics. In rural and medically underserved areas, CRNAs often serve as the primary providers of anesthesia care.

What is the role of a certified registered nurse anesthetist in a surgical team?

In a surgical team, a CRNA is responsible for all aspects of anesthesia care, including preoperative assessment, administration of anesthesia, intraoperative life support, pain control, and post-anesthesia care. They work closely with surgeons, anesthesiologists, and other healthcare professionals to ensure safe and effective anesthesia care.

Is continuing education required for a certified registered nurse anesthetist?

Yes, continuing education is required to maintain their certification. The National Board of Certification and Recertification for Nurse Anesthetists requires them to recertify every four years, which includes completing a certain number of continuing education hours.

What are the most challenging aspects of being a certified registered nurse anesthetist?

This role can be highly stressful due to the critical nature of their work. Administering anesthesia and monitoring patients during surgery requires skill, focus, and decision-making ability. They must also keep up with the latest advances in anesthesia care and manage the physical demands of long hours and on-call schedules.

What role does a certified registered nurse anesthetist play in patient safety?

Patient safety is a top priority. They play a crucial role in ensuring the safety of patients undergoing surgery or other procedures requiring anesthesia. Their work involves carefully assessing patients before procedures, monitoring vital signs and anesthesia levels, and providing post-anesthesia care to ensure a safe recovery.

Do certified registered nurse anesthetists work independently or under the supervision of an anesthesiologist?

The work environment can depend on state laws and hospital policies. Some work independently, while others work in a team under the supervision of an anesthesiologist. Regardless of the practice model, they are highly trained professionals critical to patient care.

What is the typical day-to-day experience of a certified registered nurse anesthetist?

The day-to-day experience can vary depending on the practice setting. A typical day may involve performing preoperative assessments, administering anesthesia for surgeries or other procedures, monitoring patients, and providing post-anesthesia care. Time may also be spent collaborating with other healthcare professionals, participating in team meetings, and maintaining patient records.