CareerExplorer’s step-by-step guide on how to become a nurse anesthetist.
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The first requisite for admission into a Certified Registered Nurse Anesthetist (CRNA) program is a Bachelor of Science in Nursing (BSN) degree. Coursework in BSN programs consists of physiology, anatomy, pharmacology, pathophysiology, and health assessment. The curriculum also includes clinical rotations in major health disciplines such as pediatrics, women’s health, geriatrics, and surgery.
Registered Nurse (RN) Licensure
All applicants to CRNA programs must have earned their registered nurse (RN) license. Although licensure requirements may vary somewhat from state to state, they generally involve completing an accredited RN training program and passing the National Council Licensure Examination for Registered Nurses (NCLEX-RN).
Clinical Experience as an Acute Care RN
The final prerequisite for admission to a CRNA program is a minimum of one year’s (1,000 hours) experience working as an RN in an acute care setting. Each program specifies precisely what qualifies as acute care nursing. Typically, working in clinical setting such as a coronary care unit (CCU), an intensive care (ICU), or an emergency room (ER) fulfills this requirement.
While working in acute care, some RNs choose to pursue their Critical Care Registered Nurse (CCRN) certification, offered by the American Association of Critical Care Nurses. This specialization may improve applicants’ chances of getting accepted to a nurse anesthetist program.
Graduation from an accredited CRNA program
The Council on Accreditation (COA) of Nurse Anesthesia Programs maintains a list of all programs that are acceptable for national certification organized by state.
Admission to CRNA programs is competitive, due to the occupation’s desirability and relatively high pay level. It is not uncommon for schools to require a minimum college GPA of 3.0. Some programs may accept only applicants who have earned their CCRN (see Step 3, above) or who have shadow experience with a CRNA or anesthesiologist.
The COA governs the curricula that must be followed by nurse anesthesia programs.
Required academic and prerequisite courses include:
• Anatomy, physiology, and pathophysiology
• Basic and advanced anesthesia practices
• Professional aspects of nurse anesthesia practice
• Pharmacology of anesthetic agents and adjuvant drugs within the concepts of biochemistry and chemistry
• Clinical conferences
• Radiology and ultrasound
Clinical rotations allow students to work with patients of all ages that may be in need of medical, surgical, obstetrical, and pediatric interventions. These experiences should provide students with the opportunity to:
• Apply knowledge to clinical problems
• Test theory
• Learn anesthesia techniques
National Certification Examination
To earn Certified Registered Nurse Anesthetist certification and qualify for state licensure, all CRNA program graduates must pass the National Certification Examination (NCE) administered by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA).
The exam is comprised of questions related to:
• Basic sciences (25 percent)
• Equipment, instrumentation, technology (15 percent)
• Basic principles of anesthesia (30 percent)
• Advanced principles of anesthesia (30 percent)
The NBCRNA-NCE Exam Handbook provides completes information about the exam.
State Licensure as an Advanced Practice Registered Nurse (APRN)
Most states require nurse anesthetists to be a state licensed Advanced Practice Registered Nurse (APRN). To qualify for this licensure, candidates must provide their state licensing board with a completed application, application fee, and proof that they have graduated from an accredited nurse anesthesia program and earned CRNA certification.
CRNA practice authority remains inconsistent throughout the U.S. Some states follow the APRN Consensus Model and recognize CRNAs as independent providers with full prescriptive authority. Some require CRNAs and other APRNs to practice under the supervision of a physician. Others limit CRNAs’ ability to prescribe medication.
Employment / Optional Specialization
Many nurse anesthetists work across several major departments. This is certainly the norm for entry-level CRNAs.
Some CRNAs eventually pursue a fellowship in a subspecialty of anesthesiology such as chronic pain, obstetrics, pediatrics, cardiothoracic, or critical care/trauma.
Maintenance of CRNA certification and state licensure
Nurse anesthetists maintain their CRNA designation by completing The 2-year Check-in every two years. The Continued Professional Certification (CPC) Program is administered by the National Board of Certification and Recertification for Nurse Anesthetists. In some states, maintenance of the CRNA credential also fulfills state licensure renewal requirements. In other states, additional continuing education credits are required for license renewal.
Resources & Job Boards
• American Society of Anesthesiologists
• International Federation of Nurse Anesthetists (IFNA)
• American Academy of Pain Medicine (AAPM)
• American Society of PeriAnesthesia Nurses (ASPAN)
• American Board of Perianesthesia Nursing Certifications, Inc.
• Society for Ambulatory Anesthesia (SAMBA)
• Diversity in Nurse Anesthesia Mentorship Program
• Nurse Anesthetist.org
• The CRNA.com
• The Great Z’s
• Nurse Nelle
• Nurse Jess
How to become a Nurse Anesthetist
To become a CRNA – Certified Registered Nurse Anesthetist – an individual must first become a licensed registered nurse and work for a minimum of one year in an acute care setting. Only then can he/she enter an anesthetist program and earn an MSN (Master of Science in Nursing) in Nurse Anesthesia, the degree currently required to work in the field. Classroom and clinical coursework cover anatomy, physiology, and pathophysiology; research; pharmacology of anesthetic agents and adjuvant drugs; pain management; aesthesia for various medical specialties; radiology and ultrasound; and anesthesia equipment and management.
It is important to note that the profession’s educational requirements are transitioning from the Master’s level (MSN) to the Doctoral level (DNP – Doctor of Nursing Practice). In 2025, all CRNAs will need a Doctorate in nurse anesthesia to enter the field. To meet this revised requirement, therefore, master-level nurse anesthesia programs will have to transition to a doctorate program by 2022. In other words, the Master’s will no longer be an option for students who enter programs in 2022 and beyond.
Following completion of an accredited program at the mandated education level, candidates must pass an examination administered by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA). Once they fulfill this requirement, they may apply for state licensure as an Advanced Practice Registered Nurse (APRN).
Some CRNAs choose to specialize. Sub-specialties include obstetrics, cardiovascular, pediatric, plastic surgery, dental, and neurological services.