A certified registered nurse anesthetist (CRNA) is a highly skilled advanced practice nurse who is licensed and certified to administer anesthesia. CRNAs are found in a range of practice settings, including hospitals, outpatient surgery centers, dental offices, pain management centers and public health centers. Requirements to become a nurse anesthetist include a graduate education, clinical practice and certification.

4 Steps to Become a Nurse Anesthetist (CRNA)

We review some common steps to become a certified registered nurse anesthetist below. Depending on your specific pathway, these may change.

• Step 1: Become a Registered Nurse
• Step 2: Apply to and Complete a CRNA Program
• Step 3: Apply for the National Certification Examination (NCE) from the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA)
• Step 4: Apply for CRNA Licensure in Your State of Practice

1. Become a Registered Nurse

Nurses who want to become a CRNA must be licensed and practice as a registered nurse in a U.S. state or territory. To become a registered nurse, you may need to complete an approved registered nursing education program and pass the NCLEX-RN exam. 

You may choose to complete an approved nursing program, associate degree, Bachelor of Science in Nursing (BSN) or a Master of Science in Nursing (MSN). Requirements for RN licensure will vary by state. 

2. Apply to a CRNA Program

CRNA programs are accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs (COA). In addition to RN licensure and practice requirements, common entrance requirements include a GPA of 3.0 or above and a combined score of 300 or more on the Graduate Record Examination (GRE). Be sure to check the programs you’re interested in for exact entrance requirements.

The length of CRNA programs vary depending on the institution offering them. Online CRNA programs may offer students flexible schedules and the ability to participate in live classroom discussions. The online programs are held to the same accreditation standards as the on-campus programs.

3. Apply for the National Certification Examination (NCE) from the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA)

The certification exam’s primary function is to ensure that nurse anesthetists have the knowledge and skills to practice safely and effectively. It also protects the value of the CRNA credential. Students can sign up to take the Self-Evaluation Examination during their educational program to gauge their progress and prepare for the National Certification Examination evaluation. After the initial exam, CRNAs must take the Continued Professional Certification Exam every four years.

NBCRNA certification is required in all states to use the title “nurse anesthetist,” according to the American Association of Nurse Anesthetists.

4. Apply for CRNA Licensure in Your State of Practice

CRNAs are licensed to practice in all 50 states and the District of Columbia. In many states, CRNAs are classified as a type of advanced practice registered nurse and must be licensed by the relevant state licensing authority. Check the nursing licensing requirements in your state.

There are multiple routes to pursue a career as a CRNA, with different options for degree programs and certifications. The starting point is to earn your RN license and gain practical experience.

A master’s in nursing may help prepare you to become an advanced practice registered nurse (APRN). Online MSN programs are available and may allow you the flexibility to go to school while working.

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The RN to MSN program route is for people who have an associate or bachelor’s degree and are practicing RNs. Some applicants may have to complete prerequisite courses before proceeding to the MSN program. The program will require clinical experience as well.

The Post-Master’s Certificate is for those who have a master’s degree or doctorate in another area of nursing but want to become a CRNA.

The Doctor of Nursing Practice (DNP) is a terminal degree focused on practice-based clinical nursing. A DNP program helps prepare professionals for advanced roles in clinical research trials and executive positions in the healthcare industry. DNP programs usually take two to five years to complete, depending on your level of education when you start. 

Beginning in January 2022, all students matriculating into an accredited program must be enrolled in a doctoral program, according to the American Association of Nurse Anesthetists (AANA).

You can become an advanced practice nurse with a BSN to DNP program. The DNP is a terminal degree focused on evidence-based practice that prepares you for leadership roles in improving patient care quality and outcomes. The BSN to DNP route allows students to earn an MSN degree via a pathway to earning their DNP. A typical BSN to DNP program takes three to four years and may require more than 1,000 clinical hours.

What Is a Nurse Anesthetist?

CRNAs are advanced practice nurses with a graduate-level education who work without physician supervision in many states according to the AANA Fact Sheet on CRNAs. They provide access to safe, high-quality, cost-effective anesthesia and related services to meet the community’s needs. CRNAs shoulder heavy responsibility and practice with a high degree of autonomy and professional respect. CRNAs may move into research and leadership positions that use their specialized knowledge and skills.

All CRNAs are board-certified by the NBCRNA.

Becoming a CRNA takes considerable time, depending on your career path. However, the job outlook is good, with 13% more nurse anesthetists projected between 2020 and 2030, according to the Bureau of Labor Statistics (BLS). The growth is due to increased demand for healthcare and preventive care, according to the BLS.

Apart from job growth and availability, CRNAs are known as the primary anesthesia professionals in many rural hospitals. They work in many settings from simple to complex, such as pre-operational surgery, delivery rooms, dentist offices and more.

Compensation for a CRNA will vary by location and the institution for which they work. According to the BLS page on Nurse Anesthetists, the mean hourly wage in 2020 was $90.96, with a mean annual salary of $189,190. Highest salaries are found in outpatient care centers, with a mean yearly salary of $224,810. Here are the five states where CRNAs had the highest salaries:

CRNAs administer different types of anesthesia to all kinds of patients in any healthcare setting. Nurse anesthetists deliver comprehensive care using all accepted anesthetic techniques including general, regional, sedation, local and pain management. CRNAs also provide consultation and implementation of respiratory and ventilator care and identify and manage emergencies. They provide a range of clinical support services outside the operating room.

According to the AANA CRNA Scope of Practice (PDF, 405KB), a CRNA may provide:

Nursing certification and nursing licensure are two different processes that CRNAs must navigate. State boards of nursing or other relevant agencies manage licensure. CRNA certification, administered by NBCRNA, indicates compliance with the professional standards for practice for this clinical nursing specialty.

Information below is current as of October 2021. Be sure to check with the NBCRNA for the most up-to-date information.

National Certification Examination
Eligibility Requirements: Active unrestricted RN license, completion of an accredited nurse anesthesia education program and granted eligibility status to take the NCE.
Fee: $995

CPC Assessment
Renewal: The assessment must be taken every four years.
Eligibility Requirements: Active CRNA certification
Fees: $295

Certified Nurse Midwife (CNM)

Certified nurse-midwives focus on women’s health, including pregnancy and postpartum care. The first step to becoming a CNM is to become a registered nurse by completing an approved nursing education program. Then a graduate-level midwifery program may help prepare you for taking the Certified Midwifery Exam. Like the CRNA, the CNM program is an advanced practice program that prepares a nurse to go beyond primary care delivery.

Clinical Nurse Specialist (CNS)

This advanced practice registered nurse role requires practicing as an RN, completing a master’s degree in nursing and certification to become a clinical nurse specialist. A CNS specializes in an area of practice, such as adults, pediatrics, oncology, cardiology or pain management. The CNS is a consultant and coaches other staff members in clinical practice.

Nurse Practitioner

A nurse practitioner is an RN who has earned a master’s in nursing degree or a doctoral degree from a nurse practitioner program and is certified by an approved national licensing body. Often RNs advance their careers with additional education and focus on one of a variety of specialty care areas. It’s a broad-based practice area as opposed to the specialty focus of the CRNA path.

Nurse Educator

A nurse educator combines clinical experience and academic training to prepare current and future generations of nurses. Educators teach at different levels, from vocational to graduate-level coursework and clinical experience. Educators typically focus on courses that align with the clinical experience. Nurse educators help prepare CRNAs for their careers.

Family Nurse Practitioner

To become a family nurse practitioner, you could complete an on-campus or online FNP program. An FNP—like a CRNA—is an advanced nurse practitioner, but focused on family health rather than on administering anesthesia.

Last updated October 2021.