What is a CRNA?

The role, the salary, and the route — from 154 accredited programs and BLS data

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Quick Answer

What is a CRNA?

A CRNA is a Certified Registered Nurse Anesthetist: an advanced practice registered nurse who administers anesthesia and manages patients before, during, and after surgery and other procedures. CRNAs are licensed in all 50 states, practise independently in many of them, and are the sole anesthesia provider in a large share of rural hospitals. There are about 47,810 working in the United States, earning a median of $212,650, which makes it the highest-paid nursing specialty the Bureau of Labor Statistics tracks.

What does CRNA stand for?

CRNA stands for Certified Registered Nurse Anesthetist. The "certified" comes from passing the National Certification Examination after graduating from an accredited nurse anesthesia program.

So the CRNA meaning is literally in the acronym: a nurse, certified and registered, who practises anesthesia. You will see a few related terms used around it. Nurse anesthetist means the same thing. SRNA means Student Registered Nurse Anesthetist, someone currently in a program. And since every accredited program is now a doctorate, new graduates hold either a DNP or a DNAP: 117 of the 154 programs we track award the DNP and 36 award the DNAP.

What does a CRNA do?

A CRNA runs the entire anesthetic, not one slice of it. The work splits across three phases:

  • Before the case. Reviewing the chart and history, interviewing the patient, assessing the airway, and choosing the anesthetic plan for that specific person and procedure.
  • During the case. Inducing anesthesia, securing the airway, titrating agents, and managing ventilation and hemodynamics as the surgery changes what the patient needs.
  • After the case. Emergence, extubation, handoff to recovery, and managing post-operative pain and nausea.

They also deliver regional anesthesia, including spinals, epidurals, and peripheral nerve blocks. In obstetrics, placing labour epidurals is a large part of the job.

Where do CRNAs work?

Operating rooms are the most common setting, but the range is wider than most people expect: obstetric units, pain management clinics, endoscopy and interventional radiology suites, dental and plastic surgery offices, and outpatient surgery centres.

The detail that matters most for understanding the profession: in a large share of rural hospitals, the CRNA is the only anesthesia provider in the building. That is a significant part of why nurse anesthesia holds practice rights in all 50 states.

How much does a CRNA make?

The median is $212,650, per the Bureau of Labor Statistics May 2023 Occupational Employment and Wage Statistics (OEWS) survey. That makes it the highest-paid nursing specialty BLS tracks, ahead of every other advanced practice nursing role.

State and setting move that number a lot, and independent or rural practice often pays better than metropolitan care-team work. Our salary by state breakdown shows the figure where you actually plan to live, and whether the investment pays back runs it against tuition and the income you give up while training.

How do you become a CRNA?

  1. Become an RN. A BSN, or an ADN plus a bachelor's degree, then the NCLEX.
  2. Work in an adult ICU. One to two years minimum, building experience with ventilated patients, vasoactive drips, and invasive monitoring.
  3. Complete an accredited program. A median of 36 months, across 154 programs in 46 states.
  4. Pass the National Certification Examination.

Realistically seven to eight years from starting nursing school. The ICU step is the one people underestimate, because programs judge the acuity of that experience rather than just its duration. Our full guide to how to become a CRNA walks through each stage in detail.

How is a CRNA different from an anesthesiologist?

Both administer anesthesia. The difference is the route and, in some settings, the supervision structure.

  CRNA Anesthesiologist
Background Registered nurse Physician
Training BSN, ICU experience, doctorate (36 mo median) Medical school plus residency
Practice Independent or care team, varies by state Independent or supervising a care team

We go deeper in CRNA vs anesthesiologist, and if you are weighing advanced practice nursing routes, CRNA vs nurse practitioner compares those directly.

Were nurses the first anesthesia providers?

Yes, and it surprises most people. Nurses were administering anesthesia in the United States in the 1800s, before anesthesiology existed as a physician specialty. Nurse anesthetists worked through the Civil War era, and the role expanded substantially during both World Wars, where they provided the majority of anesthesia care to wounded soldiers.

The professional organisation that became the American Association of Nurse Anesthesiology was founded in 1931. So nurse anesthesia did not branch off from physician anesthesiology. The two developed in parallel, and nursing got there first.

Frequently Asked Questions

What is a CRNA?

A CRNA is a Certified Registered Nurse Anesthetist, an advanced practice registered nurse who administers anesthesia and manages patients before, during, and after procedures. The role requires a registered nursing licence, critical care experience, and a doctoral degree from an accredited nurse anesthesia program. There are roughly 47,810 CRNAs practising in the United States. They are licensed in all 50 states and, in many rural hospitals, are the only anesthesia provider on site.

What does CRNA stand for?

CRNA stands for Certified Registered Nurse Anesthetist. The "certified" refers to passing the National Certification Examination administered by the NBCRNA after graduating from an accredited program. You will also see the title nurse anesthetist used interchangeably, and students in training are called SRNAs, or Student Registered Nurse Anesthetists. All accredited programs now award a doctorate, so newly qualified CRNAs hold either a DNP or a DNAP.

What does a CRNA do?

A CRNA manages the whole anesthetic. Before a case they review the chart, interview the patient, assess the airway, and build an anesthetic plan. During the case they induce anesthesia, secure the airway, titrate agents, and manage ventilation and hemodynamics as the surgery proceeds. Afterwards they handle emergence, extubation, the handoff to recovery, and post-operative pain and nausea. They also deliver regional anesthesia including spinals, epidurals, and peripheral nerve blocks.

How much does a CRNA make?

The median CRNA salary is $212,650 according to the Bureau of Labor Statistics May 2023 Occupational Employment and Wage Statistics (OEWS) survey, making it the highest-paid nursing specialty BLS tracks. Pay varies substantially by state and by practice setting, and independent or rural practice frequently pays more than metropolitan care-team roles. The CRNA Club's salary by state breakdown shows what the figure looks like where you actually plan to work.

How do you become a CRNA?

Four steps. Become a registered nurse with a BSN or an ADN plus a bachelor's degree, work at least one to two years in an adult intensive care unit building high-acuity experience, complete an accredited doctoral nurse anesthesia program running a median of 36 months, then pass the National Certification Examination. Realistically that is seven to eight years from starting nursing school. The ICU requirement is the stage applicants most often underestimate, because programs evaluate the quality of that experience rather than simply its length.

Is a CRNA the same as an anesthesiologist?

No. Both administer anesthesia, but an anesthesiologist is a physician who completed medical school and an anesthesiology residency, while a CRNA is an advanced practice nurse with ICU experience and a doctorate in nurse anesthesia. Depending on state law and facility policy, CRNAs practise either independently or within an anesthesia care team alongside anesthesiologists. In much of rural America the CRNA is the only anesthesia provider available.

How long does it take to become a CRNA?

About seven to eight years from the start of nursing school. That breaks down to roughly four years for a BSN, one to two years of required ICU experience, and a nurse anesthesia program with a median length of 36 months across the 154 accredited programs we track. Most applicants spend longer than the minimum in the ICU, both because competitive applicants tend to have two or more years and because application cycles add time.

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