How to Become a CRNA: Education, Skills, and Opportunities

For aspiring certified registered nurse anesthetists (CRNAs), there’s some good news: U.S. News & World Report finds that nurse anesthetists rank #10 in Best Health Care Jobs in 2023

This highly rewarding, but demanding, job helps patients go through surgeries and other invasive procedures with minimal to no pain and discomfort.

Whether you’re a nursing student considering a career in anesthesiology or an experienced registered nurse (RN) looking to advance your career, this article is for you.

We will delve deep into the steps required to become a CRNA, including the education and training requirements, the certification process, and career opportunities open to you.

After reading this, you’ll know exactly what to expect if you choose this career path.

What do CRNAs do?

A CRNA is an RN with specialized training in anesthesia. Their main task is to keep patients asleep and comfortable during surgery.

Nurse anesthetists have various tasks, including:

  • Reviewing patients’ histories for allergies or conditions that could affect anesthesia
  • Evaluating and preparing patients for surgery and recovery
  • Educating patients about possible side effects and risks of medications
  • Determining the amount and type of anesthesia needed for the patient and the best way to administer it
  • Working closely with the surgical team, including surgeons, nurses, and anesthesiologists, to coordinate patient care
  • Monitoring patients’ biological functions
  • Acting quickly during emergencies
  • Thoroughly documenting anesthesia administration, patient assessments, and any significant events that occur during procedures
  • Giving patients pain relief after their procedures

What’s the job outlook for CRNAs?

CRNAs can work under the supervision of an anesthesiologist or independently. Their work settings can include hospitals, doctor’s offices, surgical clinics, the military, psychiatric institutions, respiratory therapy departments, emergency rooms, and outpatient care centers.

The overwhelming majority of CRNAs are satisfied with their jobs and don’t wish they’d chosen a different path.

Furthermore, the employment outlook for CRNAs remains favorable. Currently, there are around 46,500 employed nurse anesthetists in the US — and this number is projected to grow to 52,700 by 2028.

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According to the U.S. Bureau of Labor Statistics, the national anesthesiologist unemployment rate for CRNAs is less than 1%. This indicates a potential shortage of anesthesia providers.

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How much do CRNAs earn?

The average salary for CRNAs is $205,770. Realistically, you can expect to earn up to $190,000 per year as a newly graduated CRNA. Salary ranges can vary, however, based on geographic location, years of experience, level of responsibility, and the healthcare setting in which you work.

The highest-paying states for CRNAs include the following:

  • North Dakota
  • California
  • Connecticut
  • New York
  • Illinois

In rural healthcare settings, nurse anesthetists have a high degree of autonomy and often a higher salary, as few candidates are willing to relocate to remote areas.

Is becoming a nurse anesthetist right for you?

Working in anesthesiology has a lot of advantages, but it does require a lot of upfront commitment. For example, if a CRNA gets sick and takes a day off, patients’ surgeries may need to be postponed, and coworkers will have to cover, possibly overworking themselves in the process.

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In addition to commitment, there are other must-have soft skills for CRNAs. They include:

  • Observation skills. CRNAs must carefully monitor vital signs, accurately administer medications, and promptly recognize any changes in the patient’s condition.
  • Communication skills. Nurse anesthetists communicate daily with patients and colleagues, so they need to be able to effectively explain procedures, address concerns, and coordinate anesthesia care.
  • Motor skills. CRNAs often assist with airway management, establish intravenous lines, handle medical equipment, and perform regional anesthesia. To do these tasks, it helps to be tech-savvy and have a steady hand.
  • Physical fitness. Nurse anesthetists should be able to lift and carry a minimum of 35% of their own body weight. They should also be able to stand for most of the day.
  • Calculation. CRNAs work with controlled substances. It’s crucial for them to understand drug concentrations, how to convert different measurement units, and how to adjust doses based on patient weight and other factors.
  • Empathy. Nurses often interact with individuals who are anxious, in pain, or afraid of anesthesia or surgery. Showing understanding and providing emotional support can help alleviate patient anxiety.
  • Critical thinking. Nurse anesthetists should be able to anticipate potential complications or risks and adapt their anesthesia plans accordingly.
  • Resilience to stress. Every CRNA must have healthy coping skills and a solid support system to be able to bounce back from the stress their high-pressure work environment can cause.

It’s important to have realistic expectations for this job. A CRNA spends most of their workday in a windowless room, and snack and bathroom breaks can be rare.

Some surgeries take over six hours, excluding the preparation time. These kinds of working situations call for a mastery of patience and the ability to concentrate for many hours at a time.

Steps to becoming a CRNA

Discover how to join the CRNA field with our step-by-step guide below.

1. Obtain a bachelor’s degree in nursing

Start by completing a BSN program. This typically takes around four years of full-time study. Ensure the program is accredited by Accreditation Commission for Education in Nursing (ACEN) or any other recognized accrediting body.

In some cases, those with an associate’s degree may be eligible for entry into an accelerated nursing program that leads to a BSN. However, the vast majority of CRNA programs in the US do require applicants to have a bachelor’s nursing degree.

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During your bachelor program, you will participate in clinical rotations, where you’ll gather valuable hands-on experience in various healthcare settings. The program also consists of classroom lectures and laboratory work.

2. Become licensed as an RN

After completing the BSN program, you will need to pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN) administered by the National Council of State Boards of Nursing (NCSBN).

This is a standardized exam that assesses your competency to practice as an entry-level RN.

The NCLEX-RN adjusts the questions’ difficulty level based on your performance. It consists of multiple-choice questions and alternative-format questions.

The minimum number of questions is 75, while the maximum is 145. The time limit for the exam is five hours.

3. Gain experience working as an RN in an acute care setting for at least one year

Most CRNA programs require applicants to have a certain amount of clinical experience in critical care settings, such as intensive care units (ICUs) or emergency departments. It often takes at least one to two years of nursing practice to meet the experience requirements for CRNA programs.

For that reason, you should research CRNA programs well in advance to find the one that best aligns with your career goals and preferences. Then, make sure you meet its admission requirements.

4. Obtain certifications to enhance your application while you’re employed as an RN (optional)

Some CRNA programs prefer or require applicants to have certain certifications, such as Critical Care Registered Nurse (CCRN), Basic Life Support (BLS), Pediatric Advanced Life Support (PALS), or Advanced Cardiac Life Support (ACLS).

Certifications demonstrate your commitment to professional development, highlight your specialized knowledge and skills, and showcase your dedication to providing high-quality patient care.

However, CRNA programs also consider factors such as GPA, clinical experience, recommendation letters, personal statements, and interviews.

5. Get a master’s or doctoral degree in nurse anesthesia

CRNA programs usually lead to a Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP) degree.

These programs’ respective durations are typically two to three years for full-time students and include a combination of in-class training and clinical rotations.

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In 2025, all nurse anesthetists will need a doctorate in nurse anesthesiology (DNP) to enter the field. So, going forward, it makes the most sense to choose a CRNA program that leads to a doctor’s degree.

6. Pass the National Certification Examination

After completing the nurse anesthesia program, you’ll need to pass the National Certification Examination (NCE) administered by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA). This will grant you the CRNA credential.

This exam, just like the NCLEX-RN, is variable in length and computerized. It includes multiple-choice, multi-select, short-answer, drag-and-drop, and hotspot questions. The first-time pass rate for this exam is 83.4%.

Once you’ve earned CRNA certification, in the majority of states, you will also need to obtain state licensure as an Advanced Practice Registered Nurse (APRN). Depending on the state where you want to practice, you may also need to apply for full prescriptive authority.

7. Obtain recertification every four years to retain your status

After becoming a CRNA, you’ll need to maintain certification through the Continued Professional Certification (CPC) program administered by the NBCRNA. Renewing this credential every four years helps you stay on top of the new trends, technologies, and drugs in anesthesiology.

The NBCRNA will notify you when your renewal period window opens. You’ll also be required to validate your APRN license every two years.

FAQs about CRNAs

Can you be a CRNA with a biology degree?

Yes. Having a biology degree can be helpful, but you’ll still need to fulfill additional educational and clinical requirements.

To become a CRNA, you’ll typically need to complete a Bachelor of Science in Nursing (BSN) degree, obtain an RN license, gain nursing experience, and then pursue a graduate-level nurse anesthesia program.

How long does it take to become a CRNA?

The entire educational journey can take seven to eight years. Completing a BSN program typically takes around four years of full-time study. Then, you’ll gain clinical experience as an RN for a year or two.

Completing a nurse anesthesia program will take two to three years. Finally, you’ll need to pass the National Certification Examination (NCE) and obtain a state license.

Can you be a CRNA without being a nurse?

No. To become a CRNA, you must be an RN first. CRNA programs typically require applicants to have a Bachelor of Science in Nursing (BSN) degree and an active RN license.

Is there financial aid available to nursing students?

Yes, there are various scholarships, grants, loans, and work-study programs that can help offset the cost of your education.

In particular, nursing students may be eligible for federal financial aid programs, such as the Pell Grant and Federal Direct Student Loans.

Start your training to become a CRNA

Becoming a CRNA can be a lucrative career choice — that is, if you’re prepared to invest money and time into your education and obtain the necessary license and certificates. The endeavor can take up to eight years.

As a CRNA, you’ll take on high-precision, challenging tasks, which can be both thrilling and rewarding. You’ll also get high pay in the profession, which is certainly a nice perk.

Hopefully, this post has helped you better understand what this occupation is all about.

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