How to Become a Certified Registered Nurse Anesthetist (CRNA)


    June 5, 2024
    How to become a nurse anesthetist

    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.

    CRNAs are highly respected for their work, and according to U.S. News & World Report, Nurses Anesthetists ranked #6 in Best Health Care Job in 20241. They are also the highest-paid nurses of 2024 (the average CRNA salary is $214,200!) Read on to find out how to become a CRNA, what they do, and more.

    Expert reviewed by Wali Khan

    Part One What is a Nurse Anesthetist (CRNA)? 

    Nurse Anesthetists (CRNAs) are advanced practice registered nurses (APRNs) who administer anesthesia and other medications.

    They monitor patients receiving and recovering from anesthesia. CRNAs have acquired a minimum of a doctorate 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.

    CRNA Salary

    $214,200 per year

    Degree Requirements

    DNP or DNAP Degree

    How Long to Become

    7-10 years

     

    Related: CRNA vs Anesthesiologist: What’s the Difference?

    Part Two How to Become a Nurse Anesthetist 

    It takes about 7-10 years to become a nurse anesthetist. In order to become a CRNA, you'll need to meet CRNA school requirements, complete an accredited program, and earn your certification. You can complete these requirements using the following steps:

    1. Shadow a CRNA 
    2. Earn your Bachelor of Science in Nursing – 4 years
    3. Gain ICU experience – 1-3 years
    4. GRE & Certifications 
    5. Recommendations and Essay
    6. Interview Prep
    7. Complete Your CRNA program - 2-3 years
    8. Take and pass the National Certification Examination for Nurse Anesthetists - Eligible Upon Graduation

    Let’s take a closer look at what each step entails, including tips from Dr. Charnelle Lewis, DNP, CRNA. You can see her full explanation of how to become a nurse anesthetist in the video below.

    Youtube video

    1. Shadow

    According to Dr. Charnelle Lewis, "Becoming a CRNA is not for everyone." She recommends shadowing as your first step to make sure it’s something you enjoy.

    2. Earn your Bachelor of Science in Nursing

    You will need your bachelor’s of nursing or related bachelor’s degree as well as an RN license in order to be eligible for a CRNA program.

    Most CRNA programs have a minimum GPA requirement of 3.0, and acceptance is becoming increasingly competitive. 

    3. Gain ICU Experience

    Nurse anesthesia programs prefer candidates who have worked in the intensive critical care unit (ICU) with adult patients. You should have a minimum of 1 year of experience working in an ICU unit, but Dr. Lewis says, "the average incoming class has approximately 2.5 years of ICU experience."

    Examples of ICUs you can work in are: CVICU/CTICU, MICU, SICU, BTICU, Neuro ICU, PICU.

    Dr. Lewis adds that "some schools accept ER, CCU, and NICU, but it is best to check with the school to be sure."

    4. GRE and Certifications

    According to Dr. Lewis, there are some schools that don't require the GRE, but you'll need a high GPA in order to be a competitive applicant for those schools. 

    The CCRN or critical care certification is generally not listed as a requirement but is preferred and will help give you an edge over other applicants. 

    5. Recommendations and Essay

    Dr. Lewis says that your recommendations are a crucial step in the application process. She recommends making sure you are "networking, making connections, and staying involved in your unit because you will need people to speak about your abilities and skills."

    She also suggests keeping track of your accomplishments and shadow experiences. "Your personal essay is key to showing the admissions committee who you are and why you are right for the program!"

    6. Prepare for Your Interview

    While you're waiting to find out if you've been accepted, Dr. Lewis recommends using this time to prepare for your interview, "Grab a copy of Duke's Anesthesia Secrets and review your CCRN materials for the clinical portion."

    7. Complete Your CRNA Program

    Earning your degree will take between two and three years and will provide both high-level classroom work and clinical practice. Most CRNA schools are fully in-person, but a few universities offer hybrid online CRNA programs for increased flexibility. Students in these programs enjoy some online coursework alongside their in-person requirements.

    8. Pass the National Certification Examination for Nurse Anesthetists

    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.

    Once you pass the exam and have become a CRNA, you must maintain certification, which involves recertifying every four years and taking a new test every eight years. 

    Recertification requires the completion of 100 units of continuing education in a variety of areas, including pathophysiology and anesthesia technologies.

    Part Three What Do CRNAs Do?  

    In many states, CRNAs work with complete autonomy. In other team models, they work with anesthesiologists, surgeons, dentists, and other physicians in serving patients who are to receive anesthesia. But what does a nurse anesthetist do on a day-to-day basis?

    In this specialty nursing career, you'll 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, and most surgical procedures occur 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, so 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 risks to the anesthetized patient, including allergies and overdose
    • Administering precise dosages 
    • Educating patients before and after receiving anesthesia 

    >> Show Me CRNA Programs

    Part Four Nurse Anesthetist Salary

    Nurse anesthetist's salaries are some of the highest in the field. Depending on the work setting and state where they are employed, the U.S. Bureau of Labor Statistics (BLS) reports that the median average nurse anesthetist salary is $214,200 as of their most recent survey in 2023.

    Highest Paying States for CRNAs

    The top 5 states with the highest mean annual average salaries for nurse anesthetists are:

    Illinois $281,240
    Massachusetts $272,510
    Montana $256,460
    New York $256,160
    Vermont $254,790

    Source BLS, Date extracted: June, 2024

    Nurse Anesthetist Salaries by State

    Here's a map of all the United States and the average CRNA salary for each per the BLS. 

    CRNA Salary by State

    State Annual Mean Wage
    Alabama $173,370
    Alaska -
    Arkansas -
    California $250,920
    Colorado $215,870
    Connecticut $247,740
    Delaware $207,030
    Florida $176,950
    Georgia $204,070
    Idaho $178,600
    Illinois $281,240
    Indiana $207,180
    Iowa $227,710
    Kansas $184,650
    Kentucky $185,630
    Louisiana $218,770
    Maine $227,270
    Maryland $187,420
    Massachusetts $272,510
    Michigan $219,050
    Minnesota $221,650
    Mississippi $201,280
    Missouri $230,470
    Montana $256,460
    Nebraska $212,860
    New Hampshire $239,630
    New Jersey $252,130
    New Mexico $212,950
    New York $256,160
    North Carolina $222,560
    North Dakota $234,950
    Ohio $210,760
    Oklahoma $208,410
    Oregon $215,260
    Pennsylvania $209,890
    Puerto Rico $60,540
    South Carolina $233,920
    South Dakota $211,090
    Tennessee $194,790
    Texas $216,280
    Utah $125,890
    Vermont $254,790
    Virginia $232,250
    Washington $246,350
    West Virginia $232,410
    Wisconsin $247,160
    Wyoming $228,780

    Source BLS, Date extracted: June, 2024

    Part Five Where Do CRNAs Work?

    CRNAs typically work in healthcare settings with operating, emergency, and intensive care units.

    CRNA Work Environments

    1. Medical and surgical hospitals
    2. Critical access hospitals
    3. Mobile surgery centers
    4. Outpatient care centers
    5. Nursing research facilities
    6. Offices of plastic surgeons, dentists, ophthalmologists, pain management specialists, and other medical professionals
    7. U.S. military medical facilities

    While most CRNAs choose to practice at the bedside, numerous administrative jobs are also available for nurse anesthetists. Individuals can work in a managerial role that includes personnel and resource management, financial management, quality assurance, risk management, department meetings, continuing education, and staff development.

    Furthermore, CRNAs may hold positions within state and federal government agencies, including the state boards of nursing, U.S. Food and Drug Administration, and for professional testing organizations such as the American Society for Testing and Materials.

    Part Six Which Schools Have the Best CRNA Programs?

    There are numerous CRNA programs in the US; we've ranked them based on reputation, certification pass rate, cost, accreditation, and acceptance rates and determined these are some of the best options out there. See the full list of the best nurse anesthetist programs here, and a sneak peak below!

    Top Nurse Anesthetist Programs

    1. Duke University

    Total Program Cost: $69,736 (based on per-credit tuition rate)
    Online: No
    Program Length: 36 months

    Duke University's nursing program is among the most competitive and well-respected nationwide and routinely graduates top nurses. Duke also has one of the best CRNA programs in North Carolina, offering a DNP in nurse anesthesia (NA-DNP). Graduates achieve a 100% pass rate for the CRNA certification exam, and every nursing student finds employment after graduating. 

    2. Mayo Clinic College of Health and Sciences

    Total Program Cost: $62,610
    Online: No
    Program Length: 42 months

    The Mayo Clinic in Rochester, Minnesota, offers a 42-month doctor of nurse anesthesia practice (DNAP) program to current RNs. Students complete clinical experiences on Mayo Clinic's campus, though rotations might be completed off-campus. Those who completed the Mayo Clinic master of nurse anesthesia or those currently employed as nurse anesthetists by Mayo Clinic may enroll in a post-graduate doctoral program

    3. Villanova University

    Total Program Cost: $94,000
    Online: No
    Program Length: 36 months

    Villanova University offers its DNP in nurse anesthesia through the M. Louise Fitzpatrick College of Nursing in conjunction with Prospect Medical Holdings - Crozer-Chester Medical Center. Applicants don't need a master's degree but must have a BSN with a 3.4 GPA or higher and be currently practicing RNs with five years of experience. Villanova selects 24 new students each year out of nearly 100 applications, making this a highly competitive program. 

    4. Virginia Commonwealth University

    Total In-State Program Cost: $52,272
    Total Out-of-State Program Cost: $94,446 
    Online: Hybrid
    Program Length: 36 months

    Intended for current RNs with a BSN, the DNAP entry-to-practice program utilizes a hybrid on- and off-campus format for the first two semesters of study. The final seven semesters are completed on-site, including five semesters gaining clinical experience. Students gain clinical experience across Richmond, interacting with various types of patients in different settings. VCU also offers a postmaster's DNAP for current CRNAs. 

    5. Rush University 

    Total Program Cost: $103,774 (based on per-credit tuition rate)
    Online: Hybrid
    Program Length: 36 months

    Rush University's 89-credit DNP in nurse anesthesia may seem expensive, but the university does not charge any fees on top of its per-credit tuition rate. Over the course of the 36-month program, students begin in a simulation lab and gradually move into clinical rotations. Most of the coursework is available entirely online, except for 756 hours of specialty curriculum and 2,300 hours of clinical immersion. DNP students complete their rotations at major Illinois hospitals, or at the University of Washington Medical Center in Seattle, Washington. 

    Part Seven Nurse Anesthetists Top Tips on Becoming CRNAs

    We asked leaders in the nurse anesthesia field for their best advice for nurses who want to become nurse anesthetists.

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

    Joseph A. Rodriguez, President of Arizona Association of Nurse AnesthetistsFor 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.

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

    Kris Rhode, President of Nebraska Association of Nurse AnesthetistsFor 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 CRNAs in a couple of 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

    Shawn Seifert, President of Maryland Association of Nurse AnesthetistsThe 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

    Marcia Kluck Presdient of Minnesota Association of Nurse AnesthetistsAfter 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

    Cheryl L. Nimmo, President of American Association of Nurse AnesthetistsMy 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.

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

    Gus Powell, President of Idaho Association of Nurse AnesthetistsMy 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

    Maricel Isidro-Reighard, California Association of Nurse AnesthetistsMy 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, and 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

    Christopher Bartels, Connecticut Association of Nurse AnesthetistsTake a job in a high-acuity ICU and gain as much experience as possible by seeking out 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.

    >> Show Me CRNA Programs

    Part Eight What is the Career Outlook for CRNAs?  

    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 2022 and 2032 will be 38%, much faster than the 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 Nine 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.

    Additionally, Nurse.org is an invaluable resource for everything you need to know about a career as a CRNA and about CRNA programs. You’ll find the answers to all of your questions in these articles:

    1. Top 10 CRNA Programs
    2. CRNA Schools by State 
    3. Top RN to CRNA Programs
    4. CRNA Salary Guide

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

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