September 22, 2023
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 rank #10 in Best Health Care Job in 2023. They are also the highest-paid nurses of 2023 (the average CRNA salary is $203,090!) 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 who are receiving and recovering from anesthesia. CRNAs have acquired a minimum of a doctorate degree focusing on anesthesia, have completed extensive clinical training, and have 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

$203,090 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. Don't let the G.P.A requirement scare you away - here are 7 Tips To Getting Into CRNA School, Even With a Low G.P.A. 

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.

>> Related: Accredited CRNA Schools by State

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.

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

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?

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 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 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 $203,090 as of their most recent survey in 2022.

Highest Paying States for CRNAs

The top 4 states with the highest mean annual average salaries for nurse anesthetists are:

California $246,510
Connecticut $240,580
New York $238,710
Illinois $238,440

Source: BLS

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 Salary
Alabama 191,200.00
Arizona 179,730.00
Arkansas -
California 246,510.00
Colorado 185,860.00
Connecticut 240,580.00
Delaware 198,070.00
Florida 174,390.00
Georgia 190,800.00
Idaho 181,110.00
Illinois 238,440.00
Indiana 220,020.00
Iowa 211,010.00
Kansas 169,410.00
Kentucky 235,260.00
Louisiana 179,140.00
Maine( 214,930.00
Maryland 182,710.00
Massachusetts 204,690.00
Michigan 199,690.00
Minnesota 222,540.00
Mississippi 184,390.00
Missouri 205,190.00
Montana 203,430.00
Nebraska 225,590.00
New Hampshire 215,970.00
New Jersey 232,630.00
New Mexico 215,240.00
New York 238,710.00
North Carolina 214,740.00
North Dakota -
Ohio 197,630.00
Oklahoma 168,470.00
Oregon 205,920.00
Pennsylvania 203,620.00
Puerto Rico 63,570.00
South Carolina 195,840.00
South Dakota 223,200.00
Tennessee 174,170.00
Texas 208,940.00
Vermont 228,710.00
Virginia 215,530.00
Washington 222,610.00
West Virginia 229,430.00
Wisconsin 230,270.00
Wyoming 205,270.00

Source BLS, Date extracted: September 22, 2023

Part Five Where Do CRNAs Work?

CRNAs typically work in healthcare settings that have operating rooms, emergency rooms, 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, there are also numerous administrative jobs 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; our panel of nurses 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!

Top 10 Nurse Anesthetist Programs

Among the most competitive and well-respected nursing programs in the nation, Duke University's School of Nursing routinely graduates some of the top nurses. Duke's DNP in nurse anesthesia (NA-DNP) sees graduates find careers across the United States, though most stay in North Carolina. Graduates also enjoy a 100% pass rate for the CRNA certification exam, and every nursing student finds employment after graduating. 
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
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. 
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. 
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. 
Considered as the home to one of the best nursing schools in the nation, Georgetown University also boasts one of the top DNAP programs*. The program begins with 12 months of coursework, followed by two years of clinical immersion at hospitals in the Washington, D.C. area. To apply, nurses must hold a bachelor's degree and be licensed RNs. All graduates eventually passed the CRNA certification exam, and graduates enjoy a 100% employment rate within three months of graduating. 
Baylor University has two DNP in nurse anesthesia programs: a BSN-DNP and an MSN-DNP, though the second option is reserved for current CRNAs. The BSN-DNP is a 36-month program, and some of the courses in the program require online study. Those planning on applying must have a BSN, an active RN license to work in Texas, and several years of professional experience. Baylor's College of Medicine does an excellent job preparing CRNAs as 97% of graduates in the past five years passed the National Certification Exam on their first attempt. 
The University of Cincinnati offers one of the oldest -- and best -- DNP in nurse anesthesia programs in the nation. After completing didactic courses and simulations (some of which can be completed online), students complete clinicals at a variety of hospitals within 45 miles of the university, some of which are within walking distance. At the end of the 36-month program, nurses complete UC's mandatory DNP Project, a project which students work on throughout their studies and defend upon graduation. Graduates also enjoy a 100% licensure exam pass rate. 
While Northeastern University offers both a master's and doctoral nurse anesthesia degree, the BSN-DNP in nurse anesthesia meets future accrediting standards and best prepares nurses for a successful career. This program places students in clinical practices in different healthcare settings, exposing nurses to different patients and practices. The class of 2018 saw a 100% job placement rate, though only 74% of students passed the licensure exam on their first try. 

Pitt's DNP in nurse anesthesia program has been considered among the best for decades. The three-year program places RNs in clinicals around the area (including University of Pittsburgh Medical Center hospitals, considered some of the top hospitals in the nation. Students begin the program with coursework, then gradually begin clinical practice. Once accepted, students are paired with faculty advisors to figure out how to quickly finish coursework so students can progress to clinical practices without worrying about courses.

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.

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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
  5. Tips To Get Into CRNA School
  6. DNP vs DNAP
  7. How to Get Into CRNA School

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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