Join the In-Demand Nurse Anesthetist Workforce

For RNs hoping to advance their careers and secure jobs in a challenging and growing field, studying to be certified registered nurse anesthetist (CRNA), offers the opportunity to work at the forefront of patient safety.

CRNAs are advance practice nurses certified in anesthesia. A growing area of advanced nursing, CRNAs administer anesthesia and monitor patients during surgery. Although a master’s degree in nursing used to be the minimum requirement for the field, that has changed, and by 2025, the American Association of Nurse Anesthetists (AANA) is requiring that all new CRNAs have doctoral degrees. This follows other health professions including physical therapy and pharmacy that have already moved towards requiring doctoral degrees.

The demand for CRNAs is expected to grow over the next decade, with the National Center for Health Workforce Analysis noting the demand for CRNAs is linked to the demand for surgery.

They cite the aging population, increase in chronic diseases requiring surgery and the shortage of anesthesiologists, as reasons for CRNAs to continue to have good future job prospects.

CRNAs provide anesthetics to patients in every practice setting and for every type of surgery or procedure. The AANA notes CRNAs are the sole anesthesia providers in most rural hospitals and are also among the highest-paid nurses in the country.

The average income for a nurse anesthetist is $169,450 a year, with some CRNAs earning more than $252,000. States such as Wyoming, Montana, Oregon, Wisconsin and California are among the top-paying states for CRNAs.

Educational requirements to become a CRNA

To qualify as a CRNA, nurses need a bachelor’s or graduate degree in nursing or another major; at least one year of full-time work experience or the part-time equivalent as a registered nurse in a surgical or critical care setting in the U.S (most nurses entering CRNA programs have an average of 3 years in critical care) and be a licensed RN.

As of August 2019, there were 121 accredited nurse anesthetist educational programs in the U.S. and Puerto Rico and 91 of those programs are approved to offer doctoral degrees.

A master’s level nursing program, master of science in nurse anesthesia or a master of science in nursing with a specialty in anesthesia can take between 28-36 months to complete. With the field soon requiring a doctorate, nurses may want to look at a combined master’s/doctorate program.

This new degree standard applies to all nurses who are applying to CRNA graduate programs through the year 2022, since doctoral programs typically are three years in duration. This new standard doesn’t apply to nursing students who are currently pursuing an advanced degree.

The median cost of a graduate nursing program is $50,000, although many colleges can help defray the cost through financial aid and scholarships.

Depending on the university, a graduate nurse anesthetist program leading to a doctor of nursing practice (DNP) or a doctor of nursing anesthesia practice (DNAP) can last between 36 months and nine semesters. Programs are typically held in classrooms, although some colleges offer a hybrid of online and in-person classes.

Most CRNA graduate programs are full time, although a few colleges offer a part-time schedule, allowing nurses to continue working while taking classes. Several DNP programs offering a specialization in anesthesiology have emerged, allowing a part-time 24-month schedule, with flexible, online classes and requiring only one in-person weekend per year.

Doctoral students can expect to take advanced science classes in pharmacology, pathophysiology, anatomy, physiology, leadership and research.

While students attend classes, they also get clinical experience by working with CRNAs and physician anesthesiologists to assess patients before surgeries and by developing an anesthetic plan tailored to the individual needs of each patient and their surgical procedure.

The average cost of a DNAP program is about $1000-$1700 per credit.

The AANA notes some DNAP graduates also go on to pursue fellowships in a specialized area of anesthesiology, such as chronic pain management or acute surgical pain management. These programs, which typically last four semesters, give CRNAs a higher level of pain management skills.

When considering potential graduate programs, consider each college’s class size, student-teacher ratio, graduation rates, certification exam pass rates, clinical training and job placement support.

CRNAs must pass a National Certification Examination for entry into practice and be re-certified every four years, in order to stay current on anesthesia techniques and technologies. In addition, the National Board of Certification and Recertification for Nurse Anesthetists’ Continued Professional Certification Program promotes lifelong learning, emphasizes patient safety and helps nurses remain current on anesthesia education.

Nurse anesthetists take a CPC assessment based on eight-year periods, composed of two four-year cycles.

In addition to practice and license requirements, depending on the CRNA’s initial certification date, the NBCRNA requires 40-60 credit hours every four years.

On the job

As the first point of contact before surgery, CRNAs are responsible for patient safety before, during and after a surgical procedure. They can work in hospitals, outpatient surgery clinics and physician’s offices, and are licensed to perform spinal taps and administer general and local anesthesia, as well as twilight sedation. They also monitor patients throughout the process.

Their scope of practice includes preoperative, intraoperative and postoperative care, pain management, performing advanced airway management and performing point-of-care testing. They also may place epidurals or regional nerve blocks with ultrasound guidance.

Some CRNAs also choose an area of specialty such as pediatrics, obstetrics, cardiology or plastic surgery. They work both autonomously and as part of surgical healthcare teams.

In recent years, nurse anesthetists have expanded their role to include working in other areas including MRI units and cardiac cath labs. There, they can place arterial lines, pulmonary-artery catheters and other lines.

Many CRNAs also work in leadership, advocacy and policymaking as administrators, managers, researchers, educators and advocates.

The role of CRNAs is expected to continue growing, given the looming shortage of anesthesiologists and the profession’s record of safe, high-quality, cost-effective care. A report by the American Association of Medical Colleges predicts a shortfall of 18,600 to 31,800 specialists, including anesthesiologists, by 2030.

The AANA states CRNAs can help to fill this gap if they are allowed to practice independently, to the full scope of their education, training, certification and licensure in states across the country. They cite studies showing that anesthesia care is equally safe when provided by a CRNA working solo. Currently, there are 40 states that don’t require physician supervision of CRNAs via their nursing or medical statutes or licensing requirements.

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