How to Become a Nurse Anesthetist (CRNA)

Nurse anesthetists ensure that patients can undergo both routine and life-saving medical procedures safely and without pain. They must develop much of the same expertise as anesthesiologists, who are medical doctors. This knowledge covers all types of anesthetic drugs, including analgesics that suppress pain, paralytics that keep patients still, and hemodynamic agents that manage complex blood-flow processes.

Because their work is complex and risky, nurse anesthetists must be licensed in order to practice. These professionals are called certified registered nurse anesthetists (CRNAs) once licensed.

CRNAs work closely with other healthcare professionals on a patient's care team. Some CRNAs work with anesthesiologists daily, while others work independently. In 2001, federal lawmakers amended the law requiring CRNAs to be supervised by anesthesiologists. Since then, 32 U.S. territories have adopted laws allowing CRNAs to work independently. CRNAs in densely populated areas may work under an anesthesiologist's supervision, but they're often the only person giving anesthesia in less populous areas.

CRNAs usually spend only a small portion of each shift administering drugs. An important preliminary task is evaluating patients’ eligibility for anesthesia — some people have complicating risk factors, such as a history of cardiac problems. Thus, CRNAs determine whether a procedure calls for special patient-specific provisions, such as intubation guidance equipment, particular medications, or additional monitoring devices.

If the patient is eligible, the CRNA can administer anesthesia at the appointed time and then monitor its effects. Critical points in the process include:

CRNAs also provide postoperative care, which may involve helping patients regain motor control and assisting with pain management.

Helpful Skills for Nurse Anesthetists

All nurses need an aptitude for science so they can understand their patients' biological and physiological processes. CRNAs in particular need a facility with chemistry to understand the physical make-up of the medications they use, along with their effects on human bodies.

Beyond technical knowledge, CRNAs need excellent communication skills to help them work closely with physicians and to put anxious patients at ease. Part of this communication may call for the courage to tell a surgeon that a patient is not eligible for surgery based on an anesthesia risk analysis. CRNAs must always use their best judgment to advocate for patients above all.

The job outlook is bright: the U.S. Bureau of Labor Statistics (BLS) expects a job growth rate of 13% in the 2020-2030 period, which is faster than the U.S. average of 8%.

According to labor market data from the analytics company Burning Glass Technologies, 75% of job posts for CRNAs require 0-2 years of experience. This indicates that most employers will be satisfied with hiring a relatively new CRNA. Burning Glass also notes that in 2021-2022, a travel-nursing company was the top employer of nurse anesthetists by a large margin. These companies send qualified nurses around the country on short-term assignments wherever they're requested, often in rural areas where staffing is a problem.

Nurse anesthetists earn median annual salaries of $195,610, which is more than four times the $45,760 median wage for all jobs combined. They earn the highest wages in Connecticut, New Jersey, and Illinois, though the greatest number are in Texas and Florida.

Career Advancement

Once you earn a CRNA license, you've already climbed a steep hill in your nursing career. At this level, the most common way to advance is to earn a supervisory or management role. This may involve a mixture of anesthetist duties and management tasks or it may mean you spend all your time as an administrator, though the latter is more common at large facilities such as hospitals.