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    RN to CRNA Guide

    If you are a registered nurse who is independent, dedicated to quality patient care and interested in advancing your career and earning significantly more income, then becoming a Certified Registered Nurse Anesthetist (CRNA) may be the right choice for you. The Bureau of Labor Statistics projects a 31% expansion in job opportunities and demand for CRNAs between now and the year 2024.

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    CRNAs are among the most highly respected advanced practice nurses, capable of administering anesthesia in the same way that physician anesthesiologists do and very much in demand by medical facilities throughout the country. 

    This guide will show you everything you need to know to become a Certified Registered Nurse Anesthetist.

    The Benefits of Getting a Certified Registered Nurse Anesthetist Degree

    The Certified Registered Nurse Anesthetist degree has unique benefits and advantages, including:

    • Autonomy and responsibility. CRNAs are able to work with a high degree of independence. Many rural communities receive all of their anesthesia care from Certified Registered Nurse Anesthetists, and even in major metropolitan acute care settings, they assume responsibility for much of patient anesthesia care. 
    • Generous compensation. The median national annual salary for CRNAs is $160,250, which is more than double the national median salary for Registered Nurses.
    • Wide range of practice environments. Certified Registered Nurse Anesthetists can work in any practice setting where anesthesia is delivered. 
    • High level of job satisfaction. CRNAs have a high level of job satisfaction, which is attributed to their many opportunities for advancement, the relatively low stress of the job, and their ability to provide one-on-one patient care.

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    What is a Certified Registered Nurse Anesthetist Degree?

    According to the American Association of Nurse Anesthetists, Registered Nurses who have their CRNA degree “provide anesthesia in collaboration with surgeons, dentists, podiatrists, physician anesthesiologists, and other healthcare professionals” and provide the majority of anesthesia care in rural America. 

    The CRNA degree provides the education and experience needed to prepare and administer anesthesia to patients, as well as to monitor and inform physicians of patient conditions while under anesthesia. Degrees provide both pre-and post-anesthesia care and documentation.

    The degree requires:

    • Either a Bachelors or Master’s degree in nursing or other appropriate major
    • An unencumbered license as either a Registered Nurse or Advanced Practice Nurse
    • A minimum of one year of full-time work as an RN in a critical care setting
    • Graduation with a master’s degree from an accredited nurse anesthesia educational program. 

    Though every CRNA program has its own requirements, most take between two and four years to complete and include both didactic classroom education and an average of 9,369 clinical hours spent providing anesthesia services for patients in a wide range of settings.

    Career Outlook

    According to the Occupational Information Network, a free database developed under the sponsorship of the U.S. Department of Labor, the job outlook for Certified Registered Nurse Anesthetists is extremely strong.

    CRNAs are projected to have much faster job growth than average with a projected 2,800 job openings through 2026. The RAND Corporation conducted a study in 2010 that confirmed a national shortage of CRNAs. The growing demand has led to CRNAs being among the most highly compensated nurses in the country.

    Salary and Pay

    According to Salary.com, as of July of 2019, the average salary paid to Certified Registered Nurse Anesthetists in the United States was $182,357, with the range typically falling between $167,591 and $198,930. 

    Specific salaries depend upon several factors including,  

    • The individual employee’s education, 
    • Experience and certifications 
    • The job’s geography and setting 
    • The training and expertise that a CRNA provides command one of the most coveted salaries in the nursing profession. A high salary is just one of the reasons that U.S. News and World Report ranks Certified Registered Nurse Anesthetist as the #3 Best Job in Healthcare, as #5 in Best Jobs, and #11 in Best Paying Jobs.

    CRNAs can work in any environment where anesthesia is delivered, and that encompasses a wide variety of settings, including:

    • Hospital surgical suites
    • Hospital obstetrical delivery rooms
    • Critical access hospitals
    • Ambulatory surgery centers
    • Dentistry offices
    • Podiatry offices
    • Ophthalmologist offices
    • Plastic surgery offices
    • Pain management specialty practices
    • U.S military
    • Public health services
    • Department of Veterans Affairs facilities

    CRNAs can also specialize in particular fields, including:

    • Pediatric and geriatric patients,
    • Neurosurgery and trauma patients
    • Outpatient orthopedic patients
    • Plastic reconstructive surgery patients
    • Cardiology
    • Endoscopy

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    Types of CRNA Programs 

    Becoming a Certified Registered Nurse Anesthetist requires attaining certification as a Registered Nurse and both a BSN degree and an MSN degree from a school accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs (COA). There are currently 121 accredited CRNA programs, 91 of which are approved to award doctoral degrees for entry into practice, a program that is anticipated to become the standard for advanced practice nurses in the future.

    Though each program has its own requirements, all applicants must have a BSN and a minimum of one year of working as a Registered Nurse in a critical care setting. There are a few different paths to earning the CRNA degree, including:

    • Accelerated RN-BSN-MSN program. These programs are available for nurses whose initial bachelor’s degree was in an area outside of nursing. The program provides the required courses to earn a BSN and then to move directly into an MSN program. These programs are available in-person and online and provide both classroom learning and the required clinical hours to earn the CRNA degree.
      • Basic requirements: Applicant must have a Bachelor’s degree in a field other than nursing and be an RN.
    • MSN-CRNA. These programs take 24-51 months to complete depending on each individual school’s requirements. All programs include clinical experiences as well as classroom learning, with the average number of practicum hours reported to be 9,369.
      • Basic requirements: Applicant must have an MSN.
    • DNP. The Doctorate of Nursing Practice is a terminal degree that the American Association of Colleges of Nursing has voted to endorse as the future standard for advanced practice nurses. To that end, many of the accredited CRNA programs offer curricula that build on the existing master’s programs, with a greater focus on evidence-based practice, quality improvement, and systems leadership.
      • Basic requirements: Applicant must have a BSN or an MSN.
    • Post-Masters Certificate in CRNA. Students who have already earned their MSN from an accredited program and wish to pursue a CRNA degree are able to pursue full-time and part-time programs that complete all of the requirements outlined by the Council on Certification of Nurse Anesthetists. These programs generally consist of 52-credit hours of academic and practical education. 
      • Basic requirements: Applicant must have an MSN.

    Online CRNA Programs 

    Moving from a Registered Nurse career to becoming a Certified Registered Nurse Anesthetist represents an enormous shift in responsibility, job outlook, satisfaction, and income, but it also represents a significant time and financial commitment. Fortunately, nurses interested in pursuing a CRNA degree may do so through an online program. 

    What type of students thrive in online CRNA programs?

    Online options have many advantages for those nurses who need flexibility, such as,

    • Working nurses
    • Nurses with family obligations
    • Nurses who need to study part-time
    • Nurses who can’t commute to school

    How long does it take to complete a CRNA program online?

    Online CRNA programs generally take two years to complete, though the time it takes to complete an accredited degree depends on your personal situation and current level of education. For example, earning a DNP will likely take longer than completing a CRNA Post-Master’s Certificate.

    Some of the essential factors that require evaluation include:

    • What your responsibility will be for arranging for clinical experience
    • How much in-person attendance will be required

    Importance of choosing an accredited online program

    Before enrolling in an online program, it is critical that you make sure the CRNA program is accredited. Choosing a program that lacks the right accreditation could make it difficult to find work as a Nurse Anesthetist. 

    When looking at accreditation, make sure the nursing school is accredited by:

    Also, be sure that the CRNA program is accredited by COA.

    Accredited online programs are held to the same academic standards as their on-campus counterparts, so receiving an accredited online education is equal to that of traditional, on-campus education. 

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    CRNA Program Requirements 

    No national certification has been created for CRNA licensure, but almost every state has its own requirements. Long before a CRNA candidate has to concern themselves with certification, they need to meet the requirements of the individual CRNA degree program that they are interested in attending. Most schools have similar entry requirements, which generally include:

    • Unencumbered, active RN license
    • BSN degree (unless pursuing an RN-to-BSN-to-MSN program)
    • Minimum of one year of critical care experience
    • Official transcripts sent to the school
    • Minimum 3.0-grade point average 
    • Minimum GRE score of 300 or better
    • Prerequisite courses 
    • Personal letters of recommendation
    • TOEFL test if applicable

    Classes and Clinical Hours 

    Every CRNA-degree program is different and is a reflection of the philosophy and goals of the school and of the CRNA licensing requirements of the state where it is located. That being said, the Council on Accreditation of Nurse Anesthesia Educational Programs sets certain standards that all CRNA educational programs must meet. These standards include:

    Basic Nurse Anesthesia Academic Curriculum and Prerequisite Course, including:

    • 105 hours dedicated to the pharmacology of anesthetic agents and adjuvant drugs, including concepts in chemistry and biochemistry
    • 135 hours of anatomy, physiology, and pathophysiology
    • 45 hours of professional aspects of nurse anesthesia practice
    • 105 hours of basic and advanced principles of anesthesia practice including physics, equipment, technology and pain management
    • 30 hours of research
    • 45 hours of clinical correlation conferences

    The didactic curriculum requirements include separate comprehensive graduate-level courses in:

    • Advanced physiology/pathophysiology
    • Advanced health assessment
    • Advanced pharmacology

    Accredited programs are designed to prepare CRNA-degree candidates for the full scope of current anesthesiology practice, and must include a minimum exposure to procedures, techniques and specialty practice involving 550 clinical cases.

    DNP to CRNA curriculum

    The DNP-CRNA curriculum also includes competencies in the following areas of academic focus:

    • Biological Systems, Homeostasis and Pathogenesis
    • Professional Role
    • Healthcare Improvement
    • Practice Inquiry
    • Technology and Informatics
    • Public and Social Policy
    • Health Systems Management
    • Ethics

    CRNA certification exam and recertification

    Once a Certified Registered Nurse Anesthetist candidate has completed their program, they must pass a credentialing exam administered by the National Board of Certification and Recertification for Nurse Anesthetists

    In addition to the initial certification, CRNAs are required to recertify their credentials using an 8-year cycle comprised of two four-year cycles. A newly updated two-year check-in program has made the process easier while confirming that all practicing CRNAs have current state licensure and are pursuing the required continuing education in the field.

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    CRNA Program Cost

    In February 2014, the AANA Journal published a study that analyzed the cost of tuition for CRNA programs and compared it to the earning potential. After collecting data from accredited schools’ websites along with salary data from the Medical Group Management Association’s Physician Compensation and Production Survey: 2012 Report, the researchers reported that:

    • The median cost of public CRNA programs is $40,195
    • The median cost of private programs is $60,941
    • The overall median cost of a CRNA degree is $51,720. 

    By comparing the overall median program cost to the mean compensation for CRNAs in 2011, which was $156,642, the study’s authors concluded that for those who already possess a nursing license, nurse anesthesia school is a good choice. 

    How to Pay for the CRNA Program 

    Even knowing that Certified Registered Nurse Anesthetists earn generous salaries does not allay the challenge of paying for a CRNA program. There are very few Registered Nurses who are able to pay for their education out of their savings. 

    The good news is that there are numerous options available to help you either minimize your expense or make paying a bit easier. The many benefits of becoming a CRNA make finding a suitable solution well worth the effort, and the information provided below should help you identify options that are worth investigating:

    • Tuition reimbursement through your employer – If you are already working as a Registered Nurse and plan on pursuing a CRNA degree, check if your employer offers tuition reimbursement. A study conducted by Cigna’s Lumina Foundation determined that their education reimbursement program resulted in a 129% return on investment, avoiding losing talent to other organizations and filling higher-level positions within the organization. 

    Healthcare organizations facing a staffing shortage know that tuition reimbursement programs not only help them to retain skilled staff members but also serve as an attractive recruitment tool. Some employers also provide tuition discounts to schools located in their state.

    • Grants — A grant is a form of financial aid provided to enable the pursuit of education. Grants do not need to be paid back. Grants are offered:
    • By the federal government
    • By the state that you live in
    • By the school to which you are applying
    • By a variety of organizations and corporations

    Some grants are offered on the basis of need while others reward academic achievement. Others selected for membership in a specific demographic, such as grants designed to promote a racial minority or those pursuing a particular area of study. 

    To identify and apply for grants, you can fill out the FAFSA application, which will provide you with information on how much grant support you are entitled to and which federal loans for which you can apply. You can also search for nurse anesthetist associations and professional organizations who want to support the field. Your school’s financial aid office will also be able to provide you with additional grant opportunities for which you can apply.

    • Scholarships — Numerous scholarships are available to support nurses and CRNA candidates. Some scholarships offer partial tuition support while others provide full tuition. A robust search effort will lead you to countless scholarships to which you can apply. Here are just a few scholarships to look at:
      • AANA Foundation Scholarships – The AANA coordinates the application and selection of multiple scholarships each year to CRNA-degree candidates. In order to qualify, students must have completed a minimum of six months of their CRNA program.
      • After College/AACN Scholarship Fund – This $10,000 scholarship is for students who are pursuing a bachelor’s, masters or doctoral degree in nursing. Special consideration is given to those who intend to become a nurse educator; students completing an RN-to-BSN or RN-to-MSN program, and those enrolled in an accelerated program. The scholarship is broken down into four $2,500 awards that are given out quarterly.
      • Duke University Nurse Anesthesia Merit And Financial Aid Scholarships – Duke University offers a Nurse Anesthesia Doctor of Nursing Practice program for which they offer scholarships for both financial need and for merit.
      • Tylenol Future Care Scholarship —  This nonrenewable scholarship is awarded to a minimum of 40 students each year in support of undergraduate or graduate studies of those pursuing healthcare careers. Scholarships are awarded to applicants whose applications reflect academic credentials and recommendations as well as community service and are awarded in amounts from $500 to $10,000.
      • Health Occupation Students of America Scholarship – Awarded to students pursuing healthcare careers for both secondary and post-secondary programs, these scholarships are sponsored by major corporations and foundations. A single application provides students the opportunity for consideration for numerous scholarships.
    • Loans — Though loans require repayment of both principal and interest accrued, they provide a straightforward source of funding that will allow you to pursue your education and pay it back at a later date. One of the advantages of taking out a federal student loan (which generally charges lower interest rates and extended payment terms) or private loans is that some employers offer loan forgiveness.

    It is important to note that many student loan programs allow you to defer already-existing undergraduate degree loans while you are enrolled in a CRNA program. There are also government programs such as the Public Service Loan Forgiveness Program which forgives the remaining balance on your direct Federal Loan after you’ve made 120 payments and agree to work full time for a qualifying organization.

    Students who plan on paying for their CRNA education from their savings should contact their school’s office of financial aid as many offer plans to help make the process easier.

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    Is the CRNA Degree Right for Me? 

    A CRNA degree promises you the ability to advance your career, provide one-on-one patient care, and experience one of the highest degrees of job satisfaction of any nursing career. With a CRNA degree, you’ll enjoy 

    • A high degree of autonomy
    • New challenges
    • Increased responsibility
    • The professional respect of your colleagues
    • A much higher salary. 

    CRNA-degreed nurses have nearly unlimited career opportunities, as they are in demand everywhere that anesthesia is administered. Nurse anesthetists are the primary providers of anesthesia in America’s rural areas, as well as in the military.

    Registered Nurses who earn their CRNA degree and become Certified Registered Nurse Anesthetists are known for their leadership, dependability, competence, collaboration, and their adherence to the principles of scientific research in order to advance patient outcomes. Being situationally aware and engaged is a hallmark of their profession. 

    If these characteristics describe you and you are interested in significantly increasing your earnings capacity, then a CRNA degree may be right for you.

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    References

    Bureau of Labor Statistics

    AANA Journal

    Becker’s Hospital Review

    Anesthesia Journal

    American Association of Nurse Anesthetists

    U.S. News and World Report

    Occupational Information Network

    Johns Hopkins Medicine

    American Association of Colleges of Nursing

    Council on Accreditation of Nurse Anesthesia Educational Programs

    Lumina Foundation

    FAFSA

    Federal Student Aid

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