A CRNA is an advanced practice nurse who specializes in anesthesia. They are authorized to assist anesthetists and, in some states, make medical judgments and administer anesthesia independently. 

CRNAs are part of the operative staff who consult with patients before surgical procedures. They are anesthesia experts who are gaining popularity throughout the United States. Aside from attending medical school, they are now often recognized as equally reliable and educated as a fully licensed anesthetist. 

What does CRNA mean?

CRNA stands for certified registered nurse anesthetist. 

A CRNA is an advanced nurse who delivers continuous anesthetic care during surgical procedures. They work with an anesthesiologist and other nursing staff in the operating room. 

What is the difference between a CRNA and a registered nurse (RN)?

CRNAs and RNs differ in two ways:

  • Their education

  • Their role in healthcare

Education

CRNAs have master’s degrees or doctoral degrees in nursing. At a minimum, they must hold a Master of Science in Nursing (MSN) and CRNA certification through National Board for Certification and Recertification for Nurse Anesthetists (NBCRNA)

In addition to at least six years of college education, CRNAs must also complete a certified nursing anesthesia educational program accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs(COA). 

While CRNAs take the NCLEX and NCE, RNs only sit for the NCLEX.

RNs can become specialists by pursuing additional certifications and higher degrees (MSNs or doctoral degrees). 

Nurse anesthetists, CRNAs, are the highest level of specialized nurses. They fall under the same category as certified nurse practitioners.

Role and responsibilities 

A CRNA works with a variety of doctors, surgeons, and anesthesiologists. They generally work in hospitals, but some work in dental centers and some medical offices that provide general or local anesthesia. 

CRNAs are solely focused on anesthetic care. They consult with patients, prepare them for anesthesia, and care for them during and after surgical procedures. 

A CRNA is qualified to intubate patients, administer general and local anesthesia, and perform spinal, epidural, and nerve block procedures.

Registered nurse responsibilities vary from place to place. Some RNs specialize in geriatric care, offering assistance and medical support to patients in nursing homes. Others work in home care, some work in hospitals, while others prefer working in physicians’ offices. 

Generally, the RNs role is to coordinate with physicians and help manage patient care plans. In addition, they administer medication prescribed by a doctor, insert IVs and catheters, take vitals, draw blood, and treat wounds. They can also assist physicians during medical procedures.

What is the difference between a CRNA and an anesthesiologist?

An anesthesiologist has completed medical school and a residency. They are medical doctors who specialize in administering anesthesia. CRNAs are advanced registered nurses with master’s degrees and certification in anesthesiology care. 

In some states, CRNAs can work independently. However, aside from their title, they are given the same responsibilities as anesthesiologists. In other cases, they must work directly under an anesthesiologist and provide support during surgical procedures. 

In short: An anesthesiologist is a doctor, and a CRNA is a registered nurse specializing in anesthesiology. 

What qualifications does a CRNA need?

At a minimum, CRNAs must hold a master’s degree in nursing. They must also complete and pass the NCE certifying exam. With an MSN and CRNA certification, they are qualified to begin working as nurse anesthetists in their state. 

Before taking the NCE, you must complete a COA-accredited CRNA program. You can review a list of recognized programs for aspiring CRNAs here

What work does a CRNA do day to day?

CRNAs consult with patients, perform assessments and prepare them for surgical or medical procedures. They decide what type of anesthesia is best to administer, then monitor patients throughout operations to ensure there are no complications.

After a procedure, the CRNA will monitor patients’ vitals and ensure that they awake from their anesthesia without problems. They also provide support for people who receive local anesthesia. 

Additional CRNA responsibilities are: 

  • Completing medical evaluations and requesting lab work to check for allergies and illnesses before anesthesia

  • Develop a personalized anesthesia plan respective to a patient’s medical history, age, and procedure type

  • Consult with patients before procedures to discuss their anesthesia plans

  • Educate patients and family members on different types of anesthesia, side effects, risks, and recovery 

  • Prepare patients for anesthesia administration 

  • Administer anesthetics through general anesthesia or local methods (e.g., an epidural)

  • Intubate and monitor patients’ airways and respiratory performance during procedures

  • Intervene during emergencies, offering basic and advanced life support, as well as administering drugs to reverse the effects of anesthesia

  • Provide post-anesthesia care and evaluation, such as ordering medications and giving instructions to RNs in the ICU

The responsibilities of a CRNA are almost identical to an anesthesiologist. The training and educational requirements are intensive, and it takes commitment and dedication to achieve this title. 

In reality, CRNAs perform 99% of the same jobs as anesthesiologists. The greatest difference lies in their title. 

Because an anesthesiologist is a physician, they can perform more invasive procedures or surgical interventions. In some states, only anesthesiologists can write prescriptions, and they may have to always be present as supervisors to CRNAs. 

Where do CRNAs work?

CRNAs can work in hospitals, surgical centers, outpatient surgery centers, and dental offices. In addition, some CRNAs work as travel nurses and go where they are needed. Depending on your ideal work environment, there are various options to work as a CRNA. 

For example, you might choose to work in a medical office and become the lead administrator of anesthesia for all patients. In a hospital setting, you would work with a larger team and a greater variety of patients. 

What is it like to be a CRNA?

If you enjoy fast-paced, detail-driven work, you might like working as a CRNA. The job is incredibly intensive, and every second requires your full attention.

CRNAs are often administering drugs that could be life-threatening. Therefore, they must be ready to act at a moment’s notice if something goes wrong, and they need to know how to identify warning signs early in procedures.

CRNAs work with various medical staff and meet a wide range of patients. They are independent workers, but they value teamwork and know how important it is to coordinate with other members of the operative staff. 

You’ll have to be a self-starter and be comfortable taking on significant responsibilities by yourself for prolonged periods. Additionally, you must enjoy working closely with patients and having long conversations about their care.

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How much do CRNAs work?

With such high educational credentials, CRNAs are some of the top earners in nursing. However, you won’t likely find any CRNA earning under six figures a year. The national average salary for nurse anesthetists is $140,357.

Are there different specialties of CRNAs? 

Yes, CRNAs can choose to specialize in a medical discipline they’re passionate about! The CRNA specialties are: 

  • Cardiovascular

  • Dental care

  • Obstetrics

  • Pediatrics

  • Plastic surgery

  • Neurosurgical 

You can also pursue additional certifications in critical care or respiratory care to further provide support for your patients. 

Advantages and disadvantages of a career as a CRNA

Below are some of the pros and cons of working as a CRNA. Understanding the benefits and drawbacks of this position can help you decide whether it’s the right career path for you. 

Advantages

1) High earning potential

Certified registered nurse anesthetists make over $100,000 a year, and some may earn close to $200,000 with enough experience. They are some of the most highly educated and certified nurses in the medical field, so they qualify for some of the best pay in the field. 

2) Dynamic work opportunities

CRNAs can work in various settings, including hospitals, surgical centers, and dental offices. You can also specialize in a subspecialty of anesthesia, such as pediatric care or plastic surgery. So whatever you’re most passionate about, you can find opportunities as a CRNA. 

The ability to shape your career in such detail makes this an appealing path for many nurses. 

3) Work independently

If you value working independently, then being a CRNA could be right for you. Because they oversee many aspects of patient care, nurse anesthetists enjoy much personal freedom in their roles. 

4) Flexible schedules

Not all CRNAs work regular hours; some choose schedules that give them more time at home with their families or greater flexibility during the day. It all depends on how you choose to work and your environment. 

CRNAs can be found in hospitals, doctor’s offices, plastic surgeon’s offices, dental clinics, and even research facilities. Some CRNAs join the military, while others turn to academia and teach other aspiring nurse anesthetists. 

You can choose to work full-time, part-time, or per diem (as needed). Some CRNAs even hit the road as travel nurses and work short assignments (usually 13 weeks or fewer) in different parts of the country. 

5) Always be in-demand

CRNAs are highly qualified specialists, so there is always a demand in the medical field for them. You won’t have to worry about not being able to find work if you choose this path. Healthcare is a staple industry, and your unique skills as a CRNA will make you an even more valuable candidate. 

Disadvantages

1) High-pressure work environment

As a CRNA, a patient’s life is in your hands. You may sometimes have to provide intubation and anesthesia in critical situations where people are in dire need of surgery. During an operation, anything can happen, and you must be able to keep calm and swiftly respond without a second of hesitation.

The pressure of having so much responsibility can be stressful, so this isn’t a role for the faint of heart. 

2) Expensive and lengthy education

The combined cost of your education will likely exceed $70,000. Scholarships can help lower your financial burden, but you will probably need to borrow student loans to pay for your education. Furthermore, you must study for at least six years to get the basic academic requirements to become a CRNA.

3) You must gain experience beforehand

Becoming a CRNA doesn’t happen with minimal experience. As an RN, you’ll need to work in critical care and gain experience with patients requiring a higher nursing level. In addition, most CRNAs spend six to eight years preparing for their exam, and most employers require several years of direct experience. 

4) Schedules can be demanding

Although they are flexible, some CRNA schedules are hectic. You also risk frequently working overtime if procedures take longer than expected. You also have a great deal of work to do after patients wake up from surgery, such as maintaining their records and following up with nursing staff. 

5) Risk of lawsuits

All CRNAs have to carry malpractice insurance, just like regular physicians. As a result, CRNAs are some of the most sued healthcare professionals in the country. Anesthesia carries a high risk when administered incorrectly. Even minor errors can result in organ failure, permanent brain damage, tissue damage, and, in severe cases, death. 

You must be willing to assume the liability for risks associated with your job. In addition, there are emotional tolls to consider. 

It can be traumatic and devastating if a patient is severely injured or dies under your care. In addition, you can lose your license and face jail time when you are found at fault. 

Make sure that you are fully aware of the risks and willing to accept any consequences.

How to become a CRNA

CRNAs begin their careers like any other nurse: earning a degree. To become a CRNA, it’s best to pursue a bachelor’s degree in nursing (BSN). Having a BSN makes it easier for you to enter a master’s program after gaining some nursing experience. 

To become a fully qualified nurse anesthetist, you must:

  • Earn a BSN and become a nurse

  • Work as an RN in your state

  • Earn an MSN from a school with a CRNA program

  • Pass the NCE-certifying exam 

Frequently asked questions about CRNAs

How long does it take to become a CRNA?

It takes approximately eight years to become a certified CRNA. The largest amount of time is spent in school and earning enough clinical experience to take the NCE.

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How long do you have to be in ICU before CRNA school?

With a bachelor’s degree, you will need to work as an RN for 1 to 2 years in critical care before entering a CRNA program. You may also require additional critical care certifications to qualify for ICU nursing jobs.

How do I get critical care nursing experience?

Many nurses are confused about CRNA requirements because they aren’t sure what qualifications they need to get started. In addition, critical care nursing is its own specialty, so you likely won’t be hired immediately upon getting your RN.

You will most likely need to work for at least one year as an RN in an acute care setting. Plan to spend time gaining experience outside the ICU before you qualify for open positions in it.