Delivering some forty-nine million anesthetic procedures annually (AANA 2019 Member Profile Survey), certified registered nurse anesthetists (CRNAs) are prolific providers of anesthesia care in the U.S.
CRNAs provide anesthesia and pain management care for surgical, obstetrical, diagnostic, and therapeutic procedures. You’ll find these well-respected and highly-paid APRNs in any setting in which anesthesia is delivered, including hospital surgical suites, obstetrical delivery rooms, ambulatory surgical centers, pain management clinics, dentist offices, and more.
Their expertise is highly valued among surgical teams and, of course, the patients they serve.
Their scope of practice includes:
- Pre-anesthetic preparation and evaluation
- Anesthesia induction, maintenance, and emergence
- Post-anesthesia care
- Perianesthetic and clinical support functions
CRNAs also often provide their services to outpatient units, such as MRI, lithotripsy, and cardiac catheterization units, where they are able to initiate or participate in respiratory and ventilatory care and airway support, something that has made them critical in the fight to save patients with the worst effects of COVID-19. Their services also often extend to areas such as the management of blood and electrolytes and in emergency situations, CPR, ventilation, and tracheal intubation. They also often place pulmonary-artery catheters and arterial lines and administer nerve blocks.
CRNAs are fierce advocates for their patients, trusted providers of outstanding patient care, and a cost-effective alternative to anesthesiologist care. Whether they’re providing safe, reliable care for patients with acute and chronic pain, participating in critical care and trauma stabilization procedures, or overseeing departments of anesthesia, CRNAs have earned a reputation for being among the most respected, esteemed healthcare providers.
Nurse Anesthetists and the Road to Practice Autonomy
CRNAs enjoy a high degree of autonomy, yet in some states, they must still practice under a collaborative physician agreement.
These advanced nursing professionals are board certified and licensed in all states to practice anesthesia care. CRNAs enjoy independent practice authority in 30 states, with the remaining states requiring CRNAs to practice under some type of formal physician supervision agreement.
Achieving independent practice authority for CRNAs throughout the country remains an incredibly important issue. In rural and other medically underserved settings throughout the country where anesthesiologists are either scarce or non-existent, CRNAs often serve as the sole providers of anesthesia care. They are also the primary providers of care to our nation’s military personnel around the world.
Fortunately, there has been a strong push for independent practice authority nationwide, and significant ground is being made in a number of states.
How to Become a Certified Nurse Anesthetist as the DNP Becomes the New Standard Minimum for Certification
The minimum requirement to earn national certification and state licensure as a CRNA is an MSN nurse anesthesia program and one year of full-time work experience as a registered nurse.
However, in recent years, there has been a distinct movement toward the DNP instead of the MSN, both for current and aspiring CRNAs. In addition to the DNP being an excellent opportunity to advance your career and move into areas such as personnel and resource management, financial management, quality assurance, and risk management in anesthesia departments, it also often comes with a larger paycheck.
Most importantly, many are choosing the DNP because of a changing requirement for CRNAs throughout the U.S. The Council on Accreditation of Nurse Anesthesia Educational Programs, in response to a recommendation made by the American Association of Nurse Anesthetists, voted to transition all nurse anesthesia programs to a doctoral framework no later than 2022. Therefore, by 2025, all new CRNAs must hold a doctorate. As of 2020, 97 of the nation’s 121 accredited nurse anesthesia programs have been approved to grant doctoral degrees (both the DNP and the DNAP – Doctor of Nurse Anesthesia Practice).
While currently practicing CRNAs with MSN degrees will not be required to earn a doctorate, many CRNAs are choosing the DNP in an effort to remain competitive in the workforce. With this in mind, 24 programs now offer a CRNA completion degree, which allows currently licensed CNRAs to earn their doctorate. These programs are often offered partially or fully online to accommodate working professionals.
Education and Certification Requirements
Choose a DNP program and you’ll have the option of entering it with your BSN or MSN:
- MSN-DNP: This traditional DNP path includes about 36 credits and three years of full-time study.
- BSN-DNP: This combined program is designed for practicing RNs with at least one year of full-time RN experience (often in critical care); it features about 83-90 credits and three years (9 terms) of year-round, full-time study.
These programs contain all the necessary coursework and clinical requirement to meet the AACN’s DNP Essentials and qualify for national certification. Graduates must have earned at least 1,000 clinical hours in their MSN and DNP programs.
Some of the coursework unique to DNP-CRNA programs includes:
- Advanced Principles of Anesthesia
- Advanced Clinical Care: Neurosurgical, Trauma and Emergency
- Advanced Clinical Care: Synthesis of Perioperative Care
Graduates of an accredited DNP-CRNA program qualify to take the national certification through the Council on Accreditation of Nurse Anesthesia Educational Programs (COA).
Post-graduate fellowships are encouraged, as they provide graduates with opportunities to specialize in areas such as obstetrics, cardiovascular, plastic, dental, or pediatric anesthesia.
Salary Expectations for Nurse Anesthetists
According to recent salary stats by the Council on Accreditation of Nurse Anesthesia Educational Programs (COA), certified nurse anesthetists earn an annual, average salary of $180,000.
A 2019 Medscape APRN Compensation Report revealed that CRNAs earned the top annual, gross salary among all APRNs, at $188,000. CRNAs who earned an hourly wage earned slightly more, at $189,000, and CRNAs with a DNP earned the highest gross annual salary of $195,000 – about $7,000 more annually than their MSN-prepared peers.