Become a CRNA

CRNA/nurse anesthesiologist preparation requires at least 7–8.5 calendar years of education and experience. You will need:

• A baccalaureate or graduate degree in nursing or another appropriate major
• An unencumbered license as a registered professional nurse and/or APRN in the United States or its territories
• At least one year of full-time work experience (or its part-time equivalent) as a registered nurse in a critical care setting
• Graduation with a minimum of a master’s degree from a nurse anesthesia educational program accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs (COA)

As of August 2022:

• 130 accredited nurse anesthesia programs in the United States and Puerto Rico, using more than 2,300 active clinical sites
• All nurse anesthesia programs approved to award doctoral degrees for entry into practice

Nurse anesthesia programs range from 24–51 months, depending on university requirements.

Graduates of nurse anesthesia educational programs have an average of 9,369 hours of clinical experience.

More than 2,400 resident registered nurse anesthetists graduate each year, then pass the National Certification Examination to become CRNAs/nurse anesthesiologists.

Today, more than 61,000 CRNAs/nurse anesthesiologists (CRNAs and CRNA residents) work in practice settings of every type.

What You Should Know

The 100+ accredited nurse anesthesia education programs across the U.S. have similar, but distinct, application processes. Common requirements include:

• Prerequisites, such as a GPA of 3.0 or higher, a GRE score of approximately 300, and one year of acute-care nursing experience
• A curriculum vitae indicating significant or advanced career achievements
• An interview (in-person, virtual, or phone) with program administrators/instructors
• A writing test

Unique perspectives on what to expect when applying to a CRNA program and working as a CRNA/nurse anesthesiologist.

• Guide to CRNA Admission
• So You Want to Be a Nurse Anesthetist
• From RN to Nurse Anesthetist (CRNA): This is Why I Chose a Doctorate Over MSN

Program administrators will also consider your passion for the profession, leadership attributes, and willingness to learn.

Nurse anesthetists have provided anesthesia care to patients in the United States for more than 150 years. Nurses first provided anesthesia on the battlefields of the American Civil War. During World War I, nurse anesthetists became the predominant providers of anesthesia care to wounded soldiers on the front lines.

The Certified Registered Nurse Anesthetist (CRNA/nurse anesthesiologist) credential came into existence in 1956 and in 1986 CRNAs/nurse anesthesiologists became the first nursing specialty accorded direct reimbursement rights from Medicare. In 2001, the Centers for Medicare & Medicaid Services (CMS) changed the federal physician supervision rule for nurse anesthetists to allow state governors to opt out of this facility reimbursement requirement.

Today, CRNAs/nurse anesthesiologists have full practice authority in every branch of the military and are the primary providers of anesthesia care to U.S. military personnel on the front lines, navy ships, and aircraft evacuation teams around the globe.

CRNAs/nurse anesthesiologists safely administer more than 50 million anesthetics to patients each year in the United States. As advanced practice registered nurses, they are among the nation’s most trusted professions according to Gallup. Nurses have topped Gallup’s Honesty and Ethics list for 20 consecutive years and are ranked second in U.S. News & World Report’s 2021 “Best Health Care Jobs” report.

CRNAs/nurse anesthesiologists practice in every setting in which anesthesia is delivered: traditional hospital surgical suites and obstetrical delivery rooms; critical access hospitals; ambulatory surgical centers; ketamine clinics; the offices of dentists, podiatrists, ophthalmologists, plastic surgeons, and pain management specialists; and U.S. military, Public Health Services, and Department of Veterans Affairs healthcare facilities.

CRNAs/nurse anesthesiologists represent more than 80% of the anesthesia providers in rural counties. Many rural hospitals are critical access hospitals, which often rely on independently practicing CRNAs/nurse anesthesiologists for anesthesia care. Half of U.S. rural hospitals use a CRNA-only model for obstetric care, and they safely deliver pain management care, particularly where there are no physician providers available, saving patients long drives of 75 miles or more.

Numerous peer-reviewed studies have shown that CRNAs are safe, high quality and cost-effective anesthesia professionals who should practice to the full extent of their education and abilities. A 2010 study published in the journal Nursing Economic$ indicated that CRNAs acting as the sole anesthesia provider are the most cost-effective model for anesthesia delivery, and there is no measurable difference in the quality of care between CRNAs and other anesthesia providers or by anesthesia delivery model. Researchers studying anesthesia safety found no differences in care between nurse anesthetists and physician anesthesiologists based on an exhaustive analysis of research literature published in the United States and around the world, according to a scientific literature review prepared by the Cochrane Collaboration, the internationally recognized authority on evidence-based practice in healthcare.  More recently, a study published in Medical Care (June 2016) found no measurable impact in anesthesia complications from nurse anesthetist scope of practice or practice restrictions.

CRNAs/nurse anesthesiologists provide anesthesia in collaboration with surgeons, dentists, podiatrists, physician anesthesiologists, and other qualified healthcare professionals.

When anesthesia is administered by a nurse anesthetist, it is recognized as the practice of nursing; when administered by a physician anesthesiologist, it is recognized as the practice of medicine. Regardless of whether their educational background is in nursing or medicine, all anesthesia professionals give anesthesia the same way.

As advanced practice registered nurses, CRNAs/nurse anesthesiologists practice with a high degree of autonomy and professional respect. They are qualified to make independent judgments regarding all aspects of anesthesia care based on their education, licensure, and certification. CRNAs/nurse anesthesiologists are the only anesthesia professionals with critical care experience prior to beginning formal anesthesia education.

The all-CRNA model, in which anesthesia delivery is wholly staffed and directed by CRNAs/nurse anesthesiologists, avoids duplication of services, promotes efficient utilization of anesthesia providers, and reduces cost. As interests compete for limited resources in healthcare, groups and facilities seeking to minimize the cost of anesthesia services can achieve excellent cost savings as compared to other anesthesia practice models by the implementation of an all-CRNA model.

Legislation passed by Congress in 1986 made nurse anesthesiologists the first nursing specialists to be accorded direct reimbursement rights under the Medicare program and CRNAs/nurse anesthesiologists have billed Medicare directly for 100% of the physician fee schedule amount for services. In 2020, the U.S. Congress passed legislation that included a nondiscrimination provision to prohibit health plans from discriminating against qualified licensed healthcare professionals, such as CRNAs/nurse anesthesiologists and other non-physician providers, solely based on their licensure.

In 2001, CMS changed the federal physician supervision rule for nurse anesthetists to allow state governors to opt out of this facility reimbursement requirement (which applies to hospitals and ambulatory surgical centers) by meeting three criteria:

1. Consult the state boards of medicine and nursing about issues related to access to and the quality of anesthesia services in the state,
2. Determine that opting out is consistent with state law, and
3. Determine that opting out is in the best interests of the state’s citizens.

To date, 22 states and Guam have opted out of the federal physician supervision requirement. Additional states do not have supervision requirements in state law and are eligible to opt out should the governors elect to do so.

On a nationwide basis, the average 2020 malpractice liability insurance premium for self-employed CRNAs/nurse anesthesiologists was 36 percent less than it was in 1988. When adjusted for inflation through 2020, the reduction in premiums was even greater, at 71 percent.

More than 61,000 of the nation’s CRNAs/nurse anesthesiologists and residents are members of AANA. That’s 86 percent of all U.S. nurse anesthetists/nurse anesthesiologists.