Certified Registered Nurse Anesthetist Career Guide

    Certified Registered Nurse Anesthetist Career Guide

    If you’re a Registered Nurse (RN) looking for more autonomy working with patients in an operating room, intensive care unit, or surgical facility, then becoming a Certified Registered Nurse Anesthetist (CRNA) might be the perfect job for you.

    Nursing students and RNs often set a long-term goal of becoming a CRNA, and for good reason. CRNAs are highly respected for their work and earn some of the best salaries in the nursing field. They’re also an important part of our healthcare system.

    In fact, according to the American Association of Nurse Anesthetists (AANA), CRNAs are the sole providers in nearly 100 percent of the rural hospitals for some states.

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    Part One What Is a Certified Registered Nurse Anesthetist (CRNA)? 

    CRNAs are advanced practice registered nurses (APRNs) who administer anesthesia and other medications. They also monitor patients who are receiving and later recovering from anesthesia. CRNAs have acquired a Master’s degree focusing on anesthesia, completed extensive clinical training, and passed a certification exam approved by the National Boards of Certification and Recertification of Nurse Anesthetists (NBCRNA).

    CRNAs care for patients from all walks of life. Some patients are scheduled for surgery, while others come in for emergency surgeries related to trauma or other potentially life-threatening events.

    Part Two What is the Salary Range for a Certified Registered Nurse Anesthetist? 

    CRNAs are some of the highest paid RNs in the field. Depending on the work setting and state where CRNAs are employed, the U.S. Bureau of Labor Statistics (BLS) noted that in 2016, CRNAs made between $105,400 to $242,000, with the average annual salary being approximately $157,000.

    In comparison, the average annual salary for an RN in 2016 was $72,180, approximately half the earning potential of CRNAs. The top 5 states with the highest annual wages for CRNAs in 2016 include: 

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    Metropolitan areas tend to pay higher salaries to CRNAs. Some of the highest paying cities include:

    San Diego, CA San Francisco, CA  Spokane, WA  Louisville, KY Providence, RI
     $241,670  $224,310  $221,720  $217,660  $213,670

    Non-metropolitan and/or rural areas also commonly need CRNAs. In fact, some rural areas use CRNAs exclusively rather than anesthesiologists.

    Non-metropolitan areas with the highest employment of CRNAs include: 

    • Northwest Lower Peninsula of Michigan
    • Southwest Maine
    • Piedmont, North Carolina
    • Southeast Mississippi
    • Northeast Pennsylvania

    High salaries may often be accompanied by high costs of living. Below is a comprehensive listing of CRNA salaries by state along with the cost of living percentage for each one:

    Cost of Living reflects percentage above or below the national average cost of living.

    CRNA Salaries by State And Cost Of Living

    State Avg Annual Avg Hourly Cost of Living
    Alabama $158,060 $75.99 -8.80%
    Alaska $167,900 $80.72 +31.60%
    Arizona $117,740 $56.60 -1.95%
    Arkansas $158,940 $76.42 -11.50%
    California $215,530 $103.62 +34.80%
    Colorado $146,410 $70.39 +2.10%
    Connecticut $180,360 $86.71 +30.70%
    Delaware no data no data +10.80%
    District of Columbia $174,420 $83.86 +49.20%
    Florida $163,370 $78.54 -1.00%
    Georgia $130,240 $62.62 -8.60%
    Hawaii $187,190 $89.99 +67.40%
    Idaho $154,650 $74.35 -10.40%
    Illinois $128,080 $61.58 -4.50%
    Indiana $148,650 $71.47 -12.10%
    Iowa $177,980 $85.57 -8.30%
    Kansas $159,130 $76.51 -9.60%
    Kentucky $181,120 $87.08 -9.60%
    Louisiana $140,980 $67.78 -5.60%
    Maine $165,020 $79.33 +12.00%
    Maryland $129,650 $61.85 +25.00%
    Massachusetts $166,490 $80.40 +34.7%
    Michigan $181,740 $87.38 -11.80%
    Minnesota $179,480 $86.29 +34.70%
    Mississippi $155,470 $74.74 -14.00%
    Missouri $156,270 $75.13 -9.20%
    Montana $242,140 $116.42 +0.80%
    Nebraska $179,410 $86.25 -8.70%
    Nevada $192,330 $92.47 +4.50%
    New Hampshire $157,320 $75.63 +0.80%
    New Jersey $184,770 $88.83 +21.00%
    New Mexico $147,300 $70.82 -4.30%
    New York $169,330 $81.41 +35.20%
    North Carolina $164,670 $79.17 -5.80%
    North Dakota $180,390 $86.73 -98.90%
    Ohio $156,820 $75.39 -7.00%
    Oklahoma $160,160 $88.83 -11.40%
    Oregon $199,860 $96.08 +15.40%
    Pennsylvania $159,700 $76.78 +2.80%
    Puerto Rico $57,350 $25.27 +22.10%
    South Carolina $163,780 $78.74 +0.50%
    South Dakota $178,870 $85.99 +2.80%
    Tennessee $142,580 $68.55 -10.20%
    Texas $152,670 $73.40 -9.30%
    Utah $155,750 $74.88 -7.20%
    Virginia $171,540 $82.47 +0.20%
    Vermont no data no data +12.00%
    Washington $187,710 $90.24 +7.10%
    West Virginia $176,110 $84.67 +4.30%
    Wisconsin $191,570 191, 570 -3.10%
    Wyoming $233,400 $112.21 -8.30%

    Part Three What is the Career Outlook for Nurse Anesthetists?  

    The job prospects for CRNAs are excellent. Healthcare legislation, increased emphasis on preventative care, an increasing number of insured patients, and an aging patient population have led to more patients seeking medical care. 

    The BLS estimates that the projected job growth for CRNAs between 2014 and 2024 will be 31%, much faster than the 16% expected job growth for RNs. As noted above, many rural areas are already using high numbers of CRNAs when they are available, and this is expected to increase significantly. Many organizations are utilizing them in place of anesthesiologists due to availability and costs.

    Part Four How Can I Become a Nurse Anesthetist?  

    What are the requirements to become a CRNA?

    CRNAs are considered Advanced Practice Registered Nurses (APRNs). As such, one must first be an RN with licensure in at least one state and possess a Bachelor’s of Science in Nursing (BSN) degree (or another appropriate baccalaureate degree). Once you have a BSN degree you will be eligible to apply for a Master of Science Degree in Nursing (MSN.) All APRNs are required to possess an MSN degree at minimum. 

    Some Nurse Anesthesia programs require a minimum of one year of acute care experience, preferably in an intensive care unit or emergency room.

    How long does it take to become a CRNA?

    CRNAs must successfully complete an accredited nurse anesthesia educational program, which can take 2-4 years, depending on the intensity of the program. There are approximately 113 accredited nurse anesthesia programs in the US, with approximately 2,200 active clinical training sites.

    A list of all COA accredited CRNA programs is available here.

    Which schools have the best CRNA programs?

    In 2016, US News & World Report ranked some of the best nursing anesthesia programs in the country. The top 5 include: 

    1. Virginia Commonwealth University 
    2. Baylor College of Medicine 
    3. Duke University
    4. Kaiser Permanente School of Anesthesia - California State University - Fullerton 
    5. Rush University

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    Is there an exam that CRNAs must pass?

    All nurse anesthetists must pass the CRNA exam prior to beginning to practice. The National Board of Certification and Recertification for Nursing Anesthetists (NBCRNA) outlines eligibility, registration processes, exam details, and renewal procedures in its Examination Candidate Handbook.

    Part Five Any Advice For Future CRNAs?

    Advice for Becoming a Nurse Anesthetist

    We asked leaders in the nurse anesthesia field for their best advice for nurses who have the goal of becoming a nurse anesthetist.

    Joseph A. Rodriguez, MSN, CRNA, President of Arizona Association of Nurse Anesthetists

    For those looking to join the ranks of CRNAs, a few pieces of advice. First, get used to thinking independently. Protocols, order sets, guidelines – all are useful and important – but you have to have the critical thinking ability, the knowledge, and judgment to make the right choice for the patient – in the crucial moments.

    Second, get used to constant advocacy. CRNAs only exist because we’ve battled, for over 100 years, just for the right to do our job and take care of our patients.

    Third, you must properly – and frequently - articulate your practice to others who likely know nothing about your practice. Few people (even surgeons, physicians, and nurses) understand the knowledge, background, and capabilities of CRNAs, and fewer will know that you have a deep understanding of perioperative anesthetic management.

    Last, surgery and anesthesia are all about teamwork, not egos - the only measurement that ever matters - is the safety of our patients.

    Anesthesia is the only field in all of health care to be “jointly owned” by 3 professions – CRNAs, physicians, and dentists. If you want to join us, you’ll have to make great personal sacrifices, and continue to advocate for your profession your entire career. But it’s well worth it – you’ll almost never find a CRNA that doesn’t love their profession and their practice.

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    Kris Rohde CRNA, MSN, BSN, President-Elect of the Nebraska Association of Nurse Anesthetists

    For nurses who would like to become Certified Registered Nurse Anesthetists, I recommend that one does a bit of research into the profession. I believe that it would benefit the nurse to shadow a couple different CRNAs in a couple different types of practice. See what it is like in a busy, metropolitan trauma center compared to a solo provider in a rural area serving many small communities. Understanding the different types of practice is key to understanding our profession completely.

    I also think that a nurse working in critical care will develop skills that are crucial to our profession. Understanding laboratory results, ventilator settings, & EKG interpretation are just the tip of the iceberg for us. A successful CRNA understands all of those things, plus the pathophysiology behind it. Working in an ICU or other critical care areas will also help an RN develop critical thinking skills that are absolutely essential to a CRNA. This is something that is learned over time, not just in a year. I truly believe that applying for school when one is ready, not just after the minimum requirement, is important.

    Shawn Seifert, MS, CRNA, President-Elect of the Maryland Association of Nurse Anesthetists

    The best advice I can give critical care nurses interested in a career in Nurse Anesthesia is to focus on leadership.

    That is, seek opportunities outside of the purely clinical and be involved politically, socially, or even artistically.

    These experiences will allow you to evolve into the advanced role of nursing leadership that Nurse Anesthesia demands as well as makes your application for school more impactful and likely to lead to an interview.

    Marcia Kluck, MNA, APRN, CRNA, President-Elect of the Minnesota Association of Nurse Anesthetists

    After you’ve made the decision and have gotten a minimum of two years of solid ICU, minimize your lifestyle and expenses for the short term while in school. This is to minimize debt. You will have time to decompress during school. But international vacations at this time are an unnecessary luxury (in my humble opinion and experience). You will have time and money after boards!


    Cheryl L. Nimmo, DNP, MSHSA, CRNA, President of the American Association of Nurse Anesthetists

    For me, becoming a Certified Registered Nurse Anesthetist (CRNA) took my career to another level entirely. I’m still amazed that the vast array of surgical, obstetric, emergency and pain management procedures performed tens of thousands of times every day across the country is only possible thanks to the discovery and advancement of anesthetic drugs and procedures. There is nothing more personally rewarding than ensuring patients’ safety and comfort when they are at their most vulnerable. My advice for nurses who wish to become a CRNA is this: As you pursue your bachelor’s degree, attain the highest grades possible. It is difficult to get accepted into a nurse anesthesia program, so increase your odds with excellent academic work. After becoming an RN, you will need to obtain at least one year of experience working in an intensive care setting. My recommendation: Work for 2-3 years at a minimum before applying for nurse anesthesia school. Absorb advice and information like a sponge, and become the best intensive care nurse you can be. Find a CRNA and ask if you can shadow him/her in the OR for a day. This will give you a total picture of what the career entails. Also, get your CCRN certification. Obtaining the certification shows that you are able to learn and retain new concepts and shows that you have the motivation to learn while working. Also, if you had a science course and your grades were not outstanding, take another science course before applying to show you are capable of the science courses in anesthesia school. This will position you well for the next stage of your career…as a CRNA! Good luck in your future career.

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    Gus Powell, CRNA, President-Elect of the Idaho Association of Nurse Anesthetists

    My best advice for nurses who want to become a nurse anesthetist (CRNA) is to have a plan and be willing to challenge yourself. That plan begins with focusing on academic success and picking the anesthesia program that is right for you, such as a program with an independent practice or regional anesthesia emphasis. In addition, it is very important to gain as much clinical exposure as possible while working as an RN and applying to anesthesia programs. I also feel it is helpful to find a CRNA mentor and shadow that person for enough time to really establish if this profession is for you. Becoming a CRNA is very rewarding and challenging. I have never regretted my decision to become a CRNA. Good luck to you!

    Maricel Isidro-Reighard, CRNA, MSNA, DNAP, President of the California Association of Nurse Anesthetists

    My best advice would be that in order to be successful in the CRNA job market is that you have to check your pride at the door. There are many humbling moments that you will encounter, that you will need to rely on your current fellow nurses. You will learn how important it is to respect them in order for them to respect you. Our peers will have high expectations of us, and we have to know how to deliver. Don’t think that just because you have “CRNA” behind your name, that immediate ‘carte blanche’ is granted to you. It is, in fact just the opposite! We have to prove ourselves every single day! There is no doubt that in your CRNA career, you will need their helping hands and their moral support, and they will give it you almost 100% if they see that you did not shoot way too far into the stratosphere when you became a CRNA.

    Christopher Bartels, CRNA, President of the Connecticut Association of Nurse Anesthetists

    Take a job in a high acuity ICU and gain as much experience as possible by seeking out the challenging assignments. Get your CCRN and never stop learning. Take a leadership position in or out of the workplace (e.g. a professional association). Come in early and be willing to stay late. Prepare your family and support system for the commitment required in nurse anesthesia school. Utilize AANA.com as a resource. Shadow a CRNA, save your money, avoid advertising your professional goals and stay humble.

    Part Six What Do Nurse Anesthetist Jobs Look Like?  

    Many CRNAs work with anesthesiologists, surgeons, dentists, and other physicians in serving patients who are to receive anesthesia. CRNAs usually work in hospital operating rooms (ORs), emergency rooms (ERs), intensive care units (ICUs), cardiac care units (CCUs), or outpatient surgical clinics.

    CRNAs work with surgical teams, with most surgical procedures occurring from early morning (6 am) to late afternoons/evenings (6-7 pm), Monday through Friday. However, emergency surgery and unplanned cases can occur at any moment, thus it is not unusual to see CRNAs working evenings, nights, weekends, and holidays. 

    CRNAs have specific duties, which include but are not limited to:

    • Assessing patient response to anesthesia
    • Identifying possible risk to the anesthetized patient, including allergies and overdose
    • Administering precise dosages 
    • Educating patients before and after receiving anesthesia 

    Nurse Anesthetists are a vital part of today’s medical facilities, and the need for CRNAs is expected to grow.

    Part Seven Where Can I Find More Information On CRNA Careers? 

    The American Association of Nurse Anesthetists (AANA) is an excellent resource for those interested in more information about this career path. AANA offers information about continuing education, advocacy, and upcoming annual meetings.

    Becoming a Nurse Anesthetist is a lot of work, but with that title comes a rewarding and lucrative career. If your goal is to take your RN career to the next level, look into becoming a CRNA.

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