The American Association of Nurse Anesthetists (AANA) defines certified registered nurse anesthetists (CRNAs) as anesthesia experts who are qualified to administer every type of anesthesia, for any types of procedures, in every healthcare setting, and for patients of all ages. These nursing specialists carry out more than 34 million anesthesia procedures each year to patients in the U.S.
Nurse anesthetists possess expertise in:
- General anesthesia
- Regional anesthesia
- Pain management
The Clinical Practice of Nurse Anesthetists
The AANA organizes the work of nurse anesthetists administer into four, general categories:
- Pre-anesthetic preparation and evaluation
- The induction and maintenance of anesthesia
- Post-anesthesia care
- Peri-anesthetic and clinical support
The job duties and responsibilities of nurse anesthetists therefore include:
- Developing and implementing an anesthesia plan, including selecting the planned anesthetic technique
- Performing and documenting the patient’s pre-anesthetic assessment and evaluation
- Obtaining the patient’s informed consent for anesthesia
- Selecting and administering pre-anesthesia medications, fluids, and other treatments
- Selecting and administering the anesthesia, as well as any necessary adjuvant and accessory drugs and fluids
- Inserting and/or applying monitoring techniques for collecting and interpreting the patient’s physiological data while under anesthesia
- Monitoring the patient’s airway and pulmonary status through a number of techniques, such as:
- Endotracheal intubation
- Mechanical ventilation
- Pharmacological support
- Respiratory therapy
- Managing the patient’s emergency/recovery from anesthesia through ventilatory support and the administration of fluids and medication as to ease pain, prevent/manage complications, and maintain homeostasis
- Evaluating the patient through post-anesthesia follow-up care and releasing/discharging the patient from the post-anesthesia care area
- Ordering, initiating, and modifying pain relief therapy using drugs or regional anesthetic techniques
- Providing life-saving techniques such as airway management, basic or advanced cardiac life support, and/or the administration of emergency fluids or drugs
Similar to all anesthesia professionals, nurse anesthetists collaborate with other members of the healthcare team, such as surgeons, anesthesiologists, podiatrists, and dentists. Like doctor anesthesiologists, nurse anesthetists may practice in any setting in which anesthesia is delivered, such as:
- Traditional hospital surgery suites
- Critical access hospitals
- Ambulatory surgical centers
- Physician’s offices
Nurse anesthetists often also provide clinical support outside of the operating room in settings such as cardiac catheterization labs, MRI units, and lithotripsy units.
Nurse anesthetists are the primary providers of anesthesia in many rural healthcare facilities. In fact, the AANA reports that nurse anesthetists serve as the sole providers of anesthesia in nearly 100 percent of all rural hospitals.
The Administrative Practice of Nurse Anesthetists
Outside of the operating room, nurse anesthetists perform important professional roles and administrative functions, which are critical to the operation of the anesthesia department. The administrative functions of nurse anesthetists, which have a direct effect on the efficiency and the quality of the anesthesia services provided, include:
- Personnel and resource management
- Financial management
- Quality assurance
- Risk management
Nurse anesthetists may also serve as instructors in staff development and continuing education programs, and are integral staff and committee members of any number of agencies (both state and federal) and standards-setting organizations such as:
- State boards of nursing
- S. Food and Drug Administration
- American Society for Testing and Materials
How to Become a Nurse Anesthetist
Nurse anesthetists possess, at a minimum, a Master of Science in Nursing (MSN) in nurse anesthesia. As of November 2014, the AANA reported about 114 nurse anesthesia programs offered through nursing schools in the U.S. All nurse anesthesia programs range between 24 and 36 months in length.
To be eligible to enter an MSN program in nurse anesthesia, candidates must possess a current and unencumbered RN license and a Bachelor of Science in Nursing. However, because many RNs complete a nursing diploma program or Associate Degree in Nursing for their pre-licensing education, they may complete an RN-MSN program that results in both a BSN and an MSN.
RN to MSN programs in nurse anesthesia, which are designed for the practicing RN who has a pre-licensure nursing diploma or ADN, allow for the accelerated completion of both a BSN and an MSN, as they take into consideration the nurse’s previous education and experience.
Many RN to MSN programs allow for the completion of online courses, although all programs include clinical training in university-based or large community hospitals. Clinical residencies provide students with a number of supervised experiences in anesthesia techniques and the application of knowledge to clinical problems. Clinical residencies allow students to gain experience in all patient populations.
A typical MSN in nurse anesthesia includes graduate coursework such as:
- Chemistry and physics in nurse anesthesia
- Advanced principles of anesthesia
- Perioperative technology
- Basic principles of anesthesia
- Advanced principles of anesthesia
National Certification Requirements
All states require nurse anesthetists to achieve national certification through the National Board of Certification and Certification of Nurse Anesthetists as to earn state licensure as a Certified Registered Nurse Anesthetist (CRNA).
To earn eligibility to take the CRNA examination, candidates must possess a current and unrestricted RN license; they must have completed an educational program accredited by the Council on Accreditation of Nurse Anesthesia Programs; and they must have at least one year of acute care experience as an RN.
Recertification requires the completion of at least 40 hours of approved continuing education every two years. CRNAs must also provide proof of documented anesthesia practice and a current state RN license.
Nurse Anesthetist Salary Statistics
According to the US Bureau of Labor Statistics, the median salary among nurse anesthetists was $151,090, as of May 2013. The top 25 percent earned more than $179,270 during this time.
The top-paying jobs for nurse anesthetists are found in the following settings:
- Offices of dentists: $179,570
- Specialty hospitals: $174,850
- Outpatient care centers: $169,770
- General medical and surgical hospitals: $165,340
- Offices of other health practitioners: $158,930
The top-paying states for nurse anesthetists, as of May 2013, were:
- Nevada: $221,240
- Wisconsin: $200,3500
- Wyoming: $197,310
- Maryland: $196,690
- District of Columbia: $187,200
Additional Resources for Nurse Anesthetists
- American Association for Nurse Anesthetists
- International Anesthesia Research Society
- American Society of Regional Anesthesia and Pain Medicine
- American Society of PeriAnesthesia Nurses
- American Pain Society
- Society for Obstetrical Anesthesia Perinatology
- Society for Ambulatory Anesthesia