The nursing field can take you anywhere, especially after gaining bedside experience. In my opinion, whatever road you choose, someone will be impacted for the better; it is just the nature of nursing. I recall that when I was in nursing school, I heard of people who started in nursing school but later left to attend medical school. This was to pursue a career in anesthesiology.

Little did they know that they could have pursued a career in anesthesiology as a nurse. Maybe they did know, but I sure did not know that at the time. If you have never heard of a certified registered nurse anesthetist (CRNA) or you are thinking about pursuing a career as a CRNA and have questions, keep reading!

What is the Role of a CRNA?

A CRNA is an advanced practice registered nurse (APRN) who administers anesthesia. In addition to administering anesthesia, a CRNA provides care before, during, and after procedures. CRNAs are not limited to just the hospital operating rooms. Their work settings vary, including post-anesthesia care unit (PACU) recovery rooms, emergency departments, outpatient surgery centers, dentist offices, labor and delivery units, and pain management clinics.

CRNAs can work independently or as part of a team, collaborating with surgeons, dentists, orthodontists, podiatrists, physician anesthesiologists, and other healthcare professionals. Some state regulations require that a CRNA practice under the supervision of a physician. They also currently have full practice authority in all military branches as the primary anesthesia providers to U.S. military personnel. This includes front-line, navy ships, and aircraft evacuation teams.

While the role of nurse anesthetist seems like a fairly recent popular trend of nurse endeavors, nurses have been administering anesthesia for over 150 years. This level of care existed during the American Civil War and World War I. CRNA credentials were granted over 65 years ago. CRNAs were the first nursing specialty to be accorded direct reimbursement rights from Medicare in 1986. More recently, in 2001, the Centers for Medicare & Medicaid Services changed the federal rule related to required physician supervision. This allowed state governors to opt out of the facility reimbursement requirement.

What Education Do I Need to Become a CRNA?

Step 1: Bachelor of Science in Nursing (BSN) and Registered Nurse (RN) Licensure

If you currently have an Associate of Science in Nursing with RN Licensure, do not worry. You are in the right place to possibly take advantage of your organizations tuition reimbursement to take additional credits to obtain a BSN. This will put you in a position to apply for graduate school.

Step 2: Critical Care Experience

The Council on Accreditation for Nurse Anesthesia Programs developed standards for both masters and doctoral programs, which require at least one year of experience as a nurse in a critical care setting. For doctoral programs, there must be a minimum of one year full-time work experience, or its part-time equivalent, as a registered nurse in a critical care setting.

The purpose of this experience is to ensure that nurse anesthesia program candidates have professional preparation. Critical care units provide experience with complex, highly acute patients and a wide range of conditions. This exposure prepares nurses for the variety of scenarios that they may encounter as CRNAs before, during, and after procedures. According to the standard, nurse anesthesia program applicants must be an independent decision-maker capable of using and interpreting advanced monitoring techniques based on knowledge of physiological and pharmacological principles. As a CRNA, there will be times when quick decisions must be made and acted upon. Critical care experience exposes nurses to opportunities to develop skills in advanced patient assessment, monitoring, and interventions. Critical care experience can be obtained in, but is not limited to, the following intensive care units: surgical, cardiothoracic, coronary, medical, pediatric, and neonatal.

During my time as a nurse, I have seen an influx of nurse residents who come in ready to move on to roles such as nurse practitioner, nurse anesthetist, nursing informatics, etc. I would never deter anyone from moving into advanced practicing roles. However, my personal opinion is that to be considered an Advanced Practice Registered Nurse, it makes sense to first learn the basics of being a registered nurse. Although the standard requirement for entry into a nurse anesthesia program is one year, to be competitive, nurses should gain at least 2-5 years of experience in a critical care setting.

Step 3: Graduate/Doctoral Degree

Becoming a CRNA requires a minimum completion of a graduate-level anesthesia program accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs. Nowadays, CRNA candidates typically opt for a Doctor of Nursing Practice (DNP) or a Doctor of Nurse Anesthesia Practice (DNAP) degree. With that said, when you add together baccalaureate degree completion, critical care experience, and completion of a nurse anesthetist program, CRNA preparation requires at least 8-8.5 calendar years of education and experience. Depending on university requirements, nurse anesthesia programs range from 36 to 51 months, averaging over 9,000 hours of clinical experience.

Step 4: Certification and Licensure

After graduation, you must pass the National Certification Examination (NCE) administered by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA) in order to practice as a CRNA.

Step 5: Maintain Certification/Licensure

In order to maintain certification, CRNAs are required to complete a designated number of continuing education units (CEUs). This helps to stay current with the ever-evolving anesthesia practices and maintain a cadence of professional growth. The recertification process also includes completing an examination at a frequency determined by the NBCRNA.

What are the Pros and Cons (Rewards and Challenges) of Being a CRNA?

I prefer not to use the terms pros and cons when encouraging others to make decisions about career opportunities. Every role has its ups and downs; however, what some may consider to be downs (or cons) are not necessarily bad things to other people. The cons should not discourage or deter you, but help you to make an informed decision. So, for the purposes of this discussion, I will use the terms challenges and rewards.

Challenges

Time Commitment: Becoming a CRNA is a serious commitment that requires you to invest a lot of time and energy to complete school and certification successfully. This will come with the sacrifice of cherished events with family and friends. It does not mean you cannot attend anything. However, you will have to mentally prepare to say no a lot.

Stressful Work Environment: The demands of the job can be stressful. Whether it is patient volume or the severity of the case, there is some level of stress. However, the challenges of the job can make you a better CRNA. After you cross over one hurdle, you are better equipped to handle the next.

Lifelong Learning: Do not think that passing your certification examination is the end. As stated before, the world of anesthesia is ever evolving. You will need to stay updated with the newest practices, techniques, and technologies.

Communication Barriers: In emergent situations, it can be a challenge to communicate effectively when anxiety levels are high. Fine-tuning your communication skills should be a high priority.

Rewards

Autonomy: As stated before, CRNAs often work independently. When nurses remain autonomous, it brings a sense of purpose and responsibility. This makes the job rewarding and leads to job satisfaction. We can also look at this from another interesting perspective. There is something called the all-CRNA model. In this model, anesthesia delivery services are staffed and directed by CRNAs. The benefits of this are: avoidance of duplication of services, promotion of efficient anesthesia provider utilization, and reduction of cost.

Job Security: As long as procedures requiring anesthesia exist, CRNAs will be needed. With CRNAs being in high demand, the opportunities are extensive.

Salary: Money isnt everything, but it sure is a nice perk of hard work. CRNAs are among the highest-paid nursing professionals. The salary varies by state; however, the average annual pay is $212,650. Currently, the top 3 highest paying areas are Washington state, Washington D.C., and New York.

Flexibility: If you want flexible opportunities in various settings, obtaining a locum tenens position may be for you. These positions allow CRNAs to take temporary assignments. There are definitely perks to being able to choose when and where you want to work. Some CRNAs choose this route for the sake of work-life balance and the love of travel. The opportunity to work in different settings removes some of the mundaneness and helps expand the network of professional connections. These positions often offer higher pay and provide for travel and lodging.

Conclusion

As I stated before, nursing in any form is impactful. Being a CRNA is not just about putting people to sleep. It is about putting a nursing spin on a very vital service role, creating more access to anesthesia services, and much more. Becoming a CRNA is a wonderful mix of challenges, rewards, lifelong learning, and professional growth. With the right passion, purpose, and preparation, you can be successful. So, if you are contemplating making the move, go for it! I hope this was helpful. I wish you all the best.

About the Author:

With over 20 years of healthcare experience, Karen has been a registered nurse for 16 years. Her direct patient care background is critical care, with 6 years of experience in the medical intensive care unit. She is Master's-prepared in Nursing Education through Towson University with 14 years of nursing education experience. A portion of her nursing education experience was in the university setting as a clinical instructor, clinical practicum nursing instructor, lecturer, and lab instructor. Her current work and most of her nursing education experience have occurred in the hospital setting, facilitating nursing and interdisciplinary education as a systemwide Nursing Professional Development Specialist II, certified by the American Nurse Credentialing Center (ANCC).

Karen is a published scholarly nursing journal corresponding author, blogger, and continuing education course writer. She is also a certified trainer for Crisis Prevention Institutes Nonviolent Crisis Intervention with Advanced Physical Skills and Johns Hopkins Activity & Mobility Promotion (JH-AMP). In addition, she is a member of the American Nurses Association, the Maryland Nurses Association, the Delaware Organization of Nurse Leaders, the Association of Nursing Professional Development, and the American Association of Critical Care Nurses (AACN).

Karen is an independent contributor to CEUfast's Nursing Blog Program. Please note that the views, thoughts, and opinions expressed in this blog post are solely those of the independent contributor and do not necessarily represent those of CEUfast. This blog post is not medical advice. Always consult with your healthcare provider for any health-related questions or concerns.

If you want to learn more about CEUfast's Nursing Blog Program or would like to submit a blog post for consideration, please visit https://ceufast.com/blog/submissions.