How to Become a CRNA in 2023

How to Become a CRNA in 2023

Training requirements for a certified registered nurse anesthetist CRNA

Becoming a certified registered nurse anesthetist is one of the most challenging and rewarding careers you can enter in the field of nursing. As a CRNA, you’ll need to go through an extensive education process — and those in the role must have an array of skills and traits to excel. One of the main reasons this career path is so highly respected is the fact you have so much responsibility, as the person responsible for administering anesthesia care to patients. 

CRNAs are in the firing line for lawsuits, and often work with patients who are distressed and anxious about the procedure they’re about to undergo. These are just a couple of the reasons why the profession is well-rewarded and highly-respected.

Not only must precision, chemistry, and mathematics be your strong suits, but individuals in the role are also requires to have exceptional people skills. It takes a special type of person to become a CRNA, but for those who have what it takes, the job satisfaction, job prospects, and salary can be exceptional. 

What type of degree does a CRNA need?

As of 2021, a Master of Science in Nursing is necessary for anyone wishing to seek CRNA certification. However, by 2025, every new CRNA must earn a Doctor of Nursing Practice degree. The American Association of Colleges of Nursing pushed for this change as a response to the growing demands on individuals in this field, and in view of improving the American health care system.

What’s more, experts from the National Board of Certification and Re-certification for Nurse Anesthetists have stated that doctoral programs place more emphasis on the importance of basing every decision in scientific evidence. Plus, the highest level of degree in nursing teaches students how to apply the knowledge they learn in the classroom directly to a practical setting.

How to become a CRNA 

You’ll spend almost as much time in school training to become a nurse anesthesiologist as you would earning a medical degree. There are a few different approaches to becoming a CRNA, but this is the preferred route for most employers:

Earn a Bachelor of Science in Nursing

While it’s possible to become a registered nurse practitioner with an associate’s degree, the requirements might change soon to necessitate a BSN. A four-year bachelor’s degree in nursing provides extensive foundational knowledge in topics such as pharmacology, anatomy, mental health, and pathophysiology.

You’re also expected to take part in clinical rotations through various departments in clinics and hospitals. This helps to ensure you have a well-rounded education, and gives you the experience necessary to choose which patients and colleagues you’d most like to work with in future.

It might be tempting to take it easy during your undergraduate studies, knowing that you’ve got a long way to go before getting your CRNA license. However, the better your grades are at undergraduate level, the better schools you can get into for CRNA certification — and you’ll be better-placed to compete for top jobs in the field. 

Get your RN license

Graduates from BSN programs are ready to become certified RNs, which means taking and passing the National Council Licensure Examination for Registered Nurses. The examination is overseen by the National Council of State Boards of Nursing, but each state has specific requirements for RN exam registration, licensure.

Gain clinical experience on the ICU

As an undergraduate student, you’ll gain experience in a wide range of settings, with a broad array of different patients. If you’re an aspiring CRNA, it’s a good idea to ensure you work on the intensive critical care unit with adults. At least one year puts you in the best position to get accepted to the best accredited nurse anesthesia program on your wish list, but more than a year is even better. 

There are a couple of other ways to stand out above the competitors you’re up against when applying to nurse anesthetist school. Firstly, look into getting professional nursing certifications, such as the Critical Care Registered Nurse Certification. Another tip is to demonstrate your commitment to the field by shadowing a practicing nurse anesthetist. 

Attend an accredited CRNA degree program

As a CRNA, you’ll be in the most in-demand and highest paying nursing career. Data from the Bureau for Labor Statistics shows job growth is set at an astounding 45% between 2019 and 2029, which is more than 10 times faster than the national average of 4%. As such, the number of CRNA degree programs in growing, too.

Keep in mind that as of 2025, a doctoral degree is required for CRNA licensure. As the moment, an MSN is sufficient, but opting for the lower level of nurse anesthesia educational program could put you at a disadvantage in the future.  

Pass the national certification examination for CRNAs and get a state license

Once you’ve obtained your graduate CRNA degree, you can take the examination that leads to licensure. It’s an extensive three-hour certification exam, which you complete on a computer, and you’ll need to demonstrate all the skills and knowledge you’ve gained throughout your education.

When you’ve passed the exam, you can follow the process in your state that leads to CRNA licensure.

Best-practices are changing quickly as technology advanced at a faster rate than ever, so re-certification is necessary every four years and passing the new test every eight years.  

CRNA time frame

A lot of work goes into gaining CRNA licensure, and you’ll need to plan ahead as you’ll be in education for a significant amount of time. There are fast-track options available at some schools, and most nursing colleges offer part-time study. Here’s a general idea of the timeline you can expect to follow:

  • Earning a BSN: Four years
  • RN licensure: Eligible as soon as you’ve gained a BSN
  • Gain relevant experience: One to three years
  • Attend a nursing anesthesia program: Two to three years
  • Pass the NCE for anesthesia professionals: Eligible as soon as you’ve completed graduate studies
  • Get a CRNA license: Eligible as soon as you pass the NCE-CRNA
  • Total time: Between seven and 10 years

Roles and responsibilities of CRNAs

People who work in this role have almost as much responsibility as a medical doctor, and the amount of time spent training is similar. The main difference being that a nurse isn’t expected to attend medical school — although many of the duties remain the same nonetheless. Let’s take a look at the main roles and responsibilities of nurse anesthetists:

CRNA job duties 

There are three major responsibilities a CRNA holds: Pre-operative patient care that helps patients understand the procedure they’re about to undergo; post-operative patient care that helps a patient recover from anesthesia; and intra-operative patient care, which involves administering and monitoring pain management during a procedure. A certified nurse anesthetist can also conduct research in the field and pursue a career as a CRNA educator. Read on for a broad overview of what each duty entails. 

Pre-operative anesthesia

Each patient that requires pain management needs a detailed anesthesia plan that’s tailored to their specific needs and the procedure they’re undergoing. When a CRNA compiles this plan, they take the client through an interview process to determine if there are any underlying health conditions that might have an impact on proceedings. The CRNA then liaises with other medical experts to put the plan into action.

When the patient history is established, the nurse anesthetist orders any relevant tests or lab work, such as X-rays or an ECG. Another aspect of the pre-operative procedure for a CRNA is evaluating the client’s airways. They check how wide their mouth can open, the condition of their teeth, how flexible their neck is, and how visible the structures in their mouth are. This is very important because it helps the CRNA understand how easy or challenging airway management is going to be.

It’s also essential that the nurse anesthetist answers any questions to put the patient’s mind at ease, as well as getting them to sign a consent form.   

Post-operative anesthesia 

The role of a CRNA once an operation is complete is to bring the patient back around and monitor their vital signs. This involves extubating the client, developing a plan for pain management, and following up with them to ensure their needs are met and they’re as comfortable as can be. 

You’re then expected to report your findings to the medical team and take part in any post-surgery care. Finally, you take care of the patient until they’re ready for discharge or transfer to another unit.   

Intra-operative anesthesia

CRNAs are responsible for the administration and management of anesthesia during surgical procedures. This involves starting IV lines, intubation, starting central and arterial lines if required, monitoring vital signs, and initiating treatment in case a patient’s conditions changes from baseline. They’re also expected to insert lines for monitoring patients, altering anesthetic levels, and administering pain relief medication.

To do this job, a CRNA must demonstrate exceptional attention to detail and have the ability to pre-empt what might happen next. Anesthesia carries lots of risk, and it’s your duty to monitor patients’ conditions and maintain fluid levels in the body. You’ll provide enough pain medication to make sure the patient isn’t in excruciating pain when they wake up, but never so much it shuts down the respiratory drive.  

Academic education

If you see yourself working in a nursing school in the future, mentoring the next generation of licensed CRNA professionals, certification prepares you fully for a role as a nurse educator. Those with a doctoral-level nursing degree might be able to work as CRNA faculty, provided they obtain the necessary licensure.  

Staff leadership and training

If you’re a CRNA and you enjoy coaching others and taking part in managerial duties, you get seek roles such as chief nurse anesthetist and assisted chief CRNA in large health care settings. They can also take on roles such as education coordinator, where you help to make changes as new best practices come in and solve problems with procedures and processes. 

What skills do you need as a CRNA?

A CRNA is one of the most challenging and well-respected professionals in the nursing industry. This is because the skillset required from these individuals is extensive and demanding, and the job role necessitates that people are able to work well under pressure, offer genuine support to patients, and understand a wide variety of medications and how they interact with the body.

The most important skills a CRNA must possess are:

  • Maths and chemistry: As a CRNA, subjects such as math, chemistry, and pharmacology are the most important when it comes to proficiency. Administering medication requires exceptional math skills as well as understanding of the science behind the substances.  
  • Teamwork: Nurse anesthetists almost always work as part of a team while supervising medical procedures. Individuals who work well as part of a team can read their colleague’s body language and retain a detailed knowledge of each role so they can pre-empt their actions and needs. As a CRNA, you’ll work closely with surgeons, physicians, anesthesiologists, nurses, and various other medical professionals.
  • Attention to detail: There is no room for error when it comes to administering anesthesia and monitoring patients during surgical procedures. From intubation to starting IV lines and giving the precise amount of pain management medication necessary — you must have superb attention to detail. Being observant is just as important as the speed of thought necessary to be proficient in this role.
  • Resourceful: If something goes wrong while a patient is under anesthesia, there’s no room for panicking or freezing up. Nurse anesthetists must be able to think quickly and act to avoid disaster in the blink of an eye. This is especially important in hospitals in high-traffic metros or rural communities, where systems are often strained.
  • Compassionate: Being a compassionate person makes the job role easier to engage with, and usually provides the motivation necessary to push through difficult shifts and challenging procedures. You’ll also care for patients, and having the ability to calm and soothe people makes your job easier.
  • Work under pressure: In this job, a CRNA is performing tasks that can mean the difference between life and death. The level of responsibility the role carries means nurse anesthetists must be calm under pressure and remain clear-minded, even in a crisis.  
  • Communication skills: You’ll need exceptional written and verbal communications skills, and be proficient at speaking to people from all different backgrounds. Speaking to family members and offering guidance and support to patients is a crucial part of the role, and being reassuring and confident are imperative. 

The difference between a CRNA and an anesthesiologist

While a CRNA is a nurse who administers and manages anesthesia, an anesthesiologist is a physician who specializes in the administration of anesthesia. The main difference being that the former is a registered nurse, while the latter is a medical doctor. Let’s take a look at what’s expected from an anesthesiologist.

Anesthesiologist duties

In this role, medical doctors administer medications to reduce pain, eliminate it entirely, or put them to sleep before, during, and after a surgical or medical procedure. Some of the things an anesthesiologist does include:

  • Ensuring compliance with hospital, local, state, and federal regulations
  • Reviewing lab results and medical files
  • Approving anesthetics
  • Administering spinal blocks, anesthesia, epidurals, and other pain management medications
  • Monitoring vital signs 
  • Supervising CRNAs and anesthesia assistants
  • Informing patients of the side-effects of anesthesia

Requirements to become an anesthesiologist

Getting into the field of anesthesiology, you’ll need to go through an extensive education. Altogether, it can take between 13 and 15 years to fulfil the requirements necessary to get into this role. Hopefuls start by obtaining a bachelor’s degree in any scientific field, and then attend medical school upon completing undergraduate study. 

You can study to become a Doctor of Osteopathy or a Medical Doctor, and afterwards you’ll attend a year-long internship specializing in anesthesia. After the internship, take up a three-year residency in anesthesiology, before potentially spending at least a year learning a specialty. Specializations include critical care, pain management, obstetric, neurologic, pediatric, and cardiac. Afterwards, you’ll pass the American Board of Anesthesiology Exam.

Career path options for CRNAs

As a CRNA, you have plenty of choice about the type of setting you work in, and can practically work anywhere in the country and earn an excellent wage while enjoying more job security than practically any other profession. Read on to find out more about a nurse anesthetist’s salary and the different settings they can work within.

Where do certified nurse anesthetists work?

A wide range of medical settings necessitate the use of anesthesia and pain management. While hospitals are the places where CRNAs are in highest-demand, there are plenty of other places to work.

In some cases, working in smaller settings might be less demanding and taxing than working in a hospital. However, many CRNAs are passionate about working in hospitals and report getting the most job satisfaction from this type of role. Below is a detailed explanation of the various settings.


There are countless conditions that require that a person goes to hospital for surgery. Acute care and surgical departments, orthopedics, emergency rooms, palliative care, and OB/GYN are just a few examples of department a CRNA might work in. It’s normal for nurse anesthetists to rotate between units depending on where they’re needed, rather than specializing in a specific unit. 

All patients who undergo surgery have complex needs, and it’s a CRNA’s responsibility to understand co-morbidities and the implications of mixing all medications. Working in a large medical center usually means working in several departments in one day, helping in several operating rooms. 

Palliative care clinics, dentist’s offices, and freestanding surgery centers

There are many outpatient environments where patients may require low-levels of anesthesia. No matter how much the dosage, it’s essential that a licensed professional manages these procedures. In dentist’s offices and freestanding surgery centers, you’ll mainly work with patients who don’t need to remain under medical supervision overnight. In palliative care settings, you administer pain management to help patients manage chronic pain.   

Private practice

Small private practices are the preferred choice for nurse anesthetists who don’t want to work in a hospital. In some states, you might be authorized to work independently of a medical doctor, which means you can specialize in a specific area.

In these areas, a CRNA can be the sole provider, which means working independently of an anesthesiologist. You’ll need to have extensive experience working as a CRNA, as you’ll be in charge of their wellbeing and all the equipment used in the anesthetic process.

Military settings

Some CRNA’s are passionate about working with the U.S. military, where they carry out similar duties as they would in a civilian setting. 

Best places to work for nurse anesthetists

According to the BLS, the top paying states for nurse anesthetists are: Oregon ($236,540), Wisconsin ($231,520), Wyoming ($231,250), Nevada ($233,680), Connecticut ($217,360), New York ($217,050), Montana ($216,420) and Minnesota ($216,050). The highest demand for CRNA professionals is in West Virginia, South Dakota, Alabama, North Carolina, and South Carolina.  

How much can you make as a certified CRNA?

While the above figures represent the highest wages you can command as a CRNA, average annual earnings are $189,190. The lowest 10% of people in the profession earn an average of $133,970 per year and the upper 10% earn over $208,000 per year. As such, even if you’re working in the areas where nurse anesthetists earn the least, you’re still earning more than double the national average annual wage.  

Best CRNA programs available

Now you’re aware of everything you need to know about becoming a CRNA, you need to choose the best school to study for certification. Getting into the best colleges in the U.S. for CRNAs isn’t easy, and you’ll need to demonstrate excellent academic achievement to get accepted to the university of your choice and complete the course.

What are the requirements for a CRNA degree?

To be eligible for CRNA certification, you need to meet the following requirements:

  • BSN degree
  • RN license
  • ICU experience
  • GPA of 3.0 or higher
  • National certification exam for nurse anesthetists 
  • Life support certifications
  • Resume
  • GRE of over 300
  • Experience shadowing a CRNA and an essay describing the experience
  • RNC and CCRN certification 

Top schools for CRNA degrees

We’ve used data from the U.S. News & World Report’s list of the top schools for nurse anesthetists to compile this guide. Read on to find out about the best places to study for CRNA certification in the United States. 

Virginia Commonwealth University

Virginia Commonwealth University is a public research university in Richmond, VA, and it takes the number one slot in U.S. News & World Report’s Top Health Schools list. It has an excellent acceptance rate of 87% and a decent graduation rate of 61%, and costs around $32,000 a year before financial aid.

Students can study a BSN to Doctor of Nurse Anesthesia Practice degree, which lets registered nurses pursue a DNAP qualification, which leads to CRNA certification. The university has a great reputation for producing leaders in the field of nursing and offers continuing education programs.

Baylor College of Medicine

The Baylor College of Medicine in Houston, Texas is part of the Texas Medical Center, which is the biggest medical school in the world. It costs $37,665 per year for tuition to non-Texas residents and $24,565 to local students. You need an impressive academic record to get into this nursing school, where the acceptance rate is 5% and the graduation rate is 93%. 

There’s a BSN to DNP program for aspiring CRNAs and 100% of graduates are employed when they finish their degree.  

Rush University

Rush University in Chicago is a private school that is ranked as having the best MSN program in the country. It has an acceptance rate of 37% and a graduation rate of 85%, so it’s one of the institutions that’s easiest to get into considering its great reputation. Tuition costs $1,035 per semester credit, making it one of the more expensive options on this list. 

The MSN to DNP and BSN to DNP CRNA programs take 36 months to complete, and the program has a 100% employment rate within six months of graduation. It also has a simulation lab, which nurse students can use during their tenure.  

University of Pittsburgh

The University of Pittsburgh has an impressive acceptance to graduation rate ratio, with the former being 57% and the latter being higher, at 81%. This state school is relatively affordable, with a year’s tuition costing around $34,000. 

You can attend a 36 semester credit course for CRNA students, including BSN to MSN and BSN to DNP programs. This school treats nursing as a strictly academic subject, and aims to improve the health of society by producing exceptional nursing professionals.  

University at Buffalo SUNY

The University at Buffalo SUNY is voted as number one for action against climate change by The Times’ Higher Education Rankings. It’s one of the most affordable college’s for a CRNA to obtain certification, costing $28,666 per year for tuition. The acceptance rate is 61% and the graduation rate is 73%.

There’s a BS to DNP course for aspiring nurse anesthetists, and an MS to DNP for CRNAs who wish to upgrade their master’s degree to a doctorate. 

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