How to Become a Nurse Anesthetist

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Becoming a certified registered nurse anesthetist (CRNA) can be a rewarding career choice due to the personal satisfaction, benefits to society, and relatively generous compensation. CRNAs perform similar work to anesthesiologists including giving local and general anesthetics; performing epidural, spinal and nerve blocks; providing twilight sedation; and facilitating pain management for patients. In 2012, nurse anesthetists were ranked #41 out of CNN’s 100 Best Jobs in America. Currently, hundreds of self-reporting nurse anesthetists have given their profession a perfect score in job satisfaction in a Payscale report. It is easy to see why working as a nurse anesthetist can be a competitive and highly desirable line of work.

So how does someone become a nurse anesthetist? According to the American Association of Nurse Anesthetists (AANA), it generally takes a minimum of seven years postsecondary education and experience to become a certified registered nurse anesthetist (CRNA). An average student will complete approximately 2,500 clinical hours and administer 850 anesthetics before obtaining his or her certification. The general requirements and more detailed steps to becoming a nurse anesthetist are presented below.

Certifications and Requirements to Become a Nurse Anesthetist

Since nurse anesthetists work in patient healthcare, there is extensive training and clinical work involved to enter the profession. Before becoming a nurse anesthetist, candidates typically work in acute care settings (e.g., emergency rooms or intensive care units) as registered nurses (RNs) for at least a year. The AANA reports that in order for an RN to become certified in administering aesthetics, they must first complete an accredited program. The Council on Accreditation of Nurse Anesthesia Programs (COA) has a complete list of all programs that are acceptable for national certification organized by state. These programs can be highly competitive due to the desirability and relatively high pay of the work, so it is important to carefully examine the admission requirements prior to completing an application to ensure qualification.
After completing an accredited program, candidates must pass the National Certification Examination (NCE) which is offered by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA). Finally, every two years, nurse anesthetists are required to recertify, a process which involves 40 hours of continuing education.

Steps to Becoming a Nurse Anesthetist

Nurse anesthetists require several years of experience and schooling prior to becoming certified. The AANA provides one possible path to become to becoming a CRNA:

  1. Pursue a Bachelor of Science in Nursing (BSN) or a similar degree
    The road to becoming a certified nurse anesthetist typically begins as an undergraduate. Students take courses such as physiology, anatomy, pharmacology, pathophysiology, and health assessment. Although a BSN is not required for becoming a RN, students who complete these undergraduate programs may have an edge in the highly competitive application process to accredited nursing anesthetics programs. Students are also required to complete clinical rotations in major health departments such as women’s health, surgery, and pediatrics. While pursuing a BSN or other qualifying degrees, it is advisable to get good grades. The accredited nurse anesthetist programs often require applicants to have maintained a GPA of 3.0 or higher, particularly in science courses. This criteria and the application prerequisites are covered in more detail below.
  2. Obtain a license as a registered nurse (RN)

    After completing an undergraduate program, registered nurses must become licensed. These requirements may vary by state, but they generally involve passing an approved training program and the National Council Licensure Examination for Registered Nurses (NCLEX-RN). These exams are given by the National Council of State Boards of Nursing (NCSBN), and cover topics such as health assessment, physiological integrity, and infection control. Since requirements and licensure may vary by state, it is important to check with local NCBSN Member Boards prior to registering for the exam.

  3. Get at least one year of experience as an RN in an acute care setting

    Prior to applying to an accredited nurse anesthesia program, candidates typically complete at least one year of work in a clinical setting such as an intensive care unit (ICU), cardiac care unit (CCU), or emergency room (ER). At this phase, some RNs choose to pursue a Critical Care Registered Nurse Certification (CCRN), a specialization that may improve one’s chances of getting acceptance to a nurse anesthetist program. Eligibility for a CCRN includes having a valid RN license, passing an exam, and completing at least 1,750 hours of direct critical care within the previous two years. Other prospective CRNAs choose to shadow anpracticing nurse anesthetist, an experience that some programs advise prior to applying for admission.

  4. Gain admittance to an accredited nurse anesthesia program

    The AANA estimates that as of August 1, 2018 there were 121 accredited nurse anesthesia programs and more than 1,799 active clinical sites. Admission to these programs can be highly competitive. For example, the nurse anesthetist program at Kansas University has the following requirements for applicants:

    • Two years of experience as an RN
    • One year of full-time ICU experience
    • Proof of valid RN license
    • Bachelor’s degree in an appropriate discipline
    • Completion of prerequisites: chemistry (2 courses), human anatomy, physiology, microbiology, and statistics
    • 3.0 overall GPA in college coursework
    • 3.0 GPA in 5 science prerequisites
    • Graduate-level writing abilities
    • Shadow experience with a CRNA or an anesthesiologist
    • Three references
    • College transcripts
    • ACLS/BLS/PALS certifications
    • Resume
    • Goal statement (personal essay)
    • Background check (after admission)

    Prior to applying to nurse anesthetist programs, review the admission requirements carefully. The Council on Accreditation of Nurse Anesthesia Programs (COA) has the most up-to-date list of accredited programs for nurse anesthetists.

  5. Graduate from the accredited nurse anesthesia program

    All nurse anesthetists must complete an accredited program which generally takes 24-36 months. While these students graduate with a minimum of a master’s degree, 16 of the 113 programs across the U.S. award a doctoral degree. All nurse anesthesia programs have courses such as:

    • Anesthesia pharmacology
    • Geriatric anesthesia
    • Obstetric anesthesia
    • Pain management
    • Anesthesia biology
    • Anesthesia pathophysiology

    Additionally, the nurse anesthesia programs include clinical practice in university-based or large community hospitals where students are exposed to a range of procedures requiring anesthesia such as pediatric, plastic, and open-heart surgeries.

  6. Pass the National Certification Examination through the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA)

    Upon completion of an accredited program, nurse anesthetists must pass the National Certification Examination (NCE) to become a CRNA. This computer exam typically takes three hours. Each student must answer between 100 and 170 questions. The responsive design of the exam adjusts the tested material depending on the test-taker’s answers to previous questions. For the complete information about the exam, visit the NBCRNA Exam Handbook.

  7. Get a job as a CRNA

    After certified nurse anesthetists graduate from an accredited program and pass the exam, they are eligible for entry-level employment. Some employers seek individuals who can work among several major departments, whereas others seek CRNAs with more specialized qualifications and experience to work in specific departments such as obstetrics, pediatrics, or endoscopy.

  8. Maintain certification

    According to the AANA, approximately 2,000 student nurse anesthetists graduate and pass their certification exams each year. Nurse anesthetists must recertify through the NBCRNA every two years, a process which includes:

    • Proof of valid RN license
    • 40 hours of continuing education
    • Verification of work in anesthetics during the prior two years
    • Absence of mental or physical conditions that could interfere with the practice of anesthesia