Certified Registered Nurse Anesthetist: Salary, Career and Job Description
Anesthesia is the most integral element in a pain-free surgery. Nurse anesthetists are the foremost healthcare contributors, who started working in the 1880s. At that time, they used to provide anesthesia to the injured armed forces on the battleground of the wars. In today’s era, Certified Registered Nurse Anesthetists (CRNAs) are the highly qualified and advanced nurses, who are admired for their services. They provide anesthesia to the patients in hospitals and healthcare institutions for various surgeries and treatments. More than two-third rural hospitals in the U.S. receive anesthesia from the CRNAs, and every year, these professionals direct about 30 million anesthetics to the patients. They work in the offices of dentists, podiatrists, surgeons, anesthesiologists and other experienced healthcare experts. Also, when a nurse anesthetist provides anesthesia, it is accepted as the practice of nursing, and when this is done by an anesthesiologist, it comes under the practice of medicine.
Skills Required for Becoming a CRNA
The educational credentials are not the only requirements to become a CRNA, but it is very important that an individual possess certain qualities and skills. These traits are required to work properly and become a successful certified registerednurse anesthetist.
1. Dedication and Patience
In order to work in the right direction, it is important that these professionals have patience to deal with all kinds of patients. They should be competent enough to learn the ways to handle the patients, who are experiencing pain.
2. Attention to Detail
When a patient is about to undergo surgery, it is the responsibility of a nurse anesthetist to organize and observe the signs of any pain, even the slightest one. This information needs the right amount of concentration and attention to detail.
3. Emotional Stability
At the times when the patient is suffering from life threatening diseases, like asphyxiation, or feeling pain, these nurses need to be firm and strong.
4. Stress Management
Stress management is an integral and essential part of the career of a nurse anesthetist. Nursing is a profession that demands a lot as you have to fulfill many responsibilities simultaneously. Sometimes, you may have to work night shifts and overtime. So, you must possess capabilities to manage the high level of stress and work under pressure.
5. Judgment and Decision Making
These professionals must have the ability to judge and make right and appropriate decisions. This is very crucial in order to run and manage the healthcare system successfully.
Besides the above mentioned skills, every nurse anesthetist must also possess other qualities, like management of personnel resources, operation monitoring, learning strategies, complex problem solving, social perceptiveness, etc.
Procedure to Become a CRNA
There are more than 36,000 nurse anesthetists in the United States of America, and approximately 45% of them are men. It requires a great deal of perseverance and dedication to become a CRNA. There are certain formalities which are to be fulfilled by an individual to pursue their dream career. The points below will give you a complete idea of the various requirements to be completed.
Step 1- Receive a Bachelor’s Degree in Nursing
First of all, you will have to complete your education and obtain a Bachelor of Science in Nursing (BSN) or other suitable baccalaureate degree. The courses to be considered are – pharmacology, path physiology, basic nursing skills, health assessment fundamentals, human anatomy, biology and psychology, etc.
Step 2- Obtain License as a Registered Nurse
You are required to show existing license as a registered nurse. This is mandatory before being authorized to practice and work. Different states may have their added requirements, rules and regulations to be fulfilled.
Step 3: Experience in Critical Care Settings
It is mandatory to get at least one year of experience in any health care setting. They can obtain experience by effectively working in the cardiac care unit (CCU), surgical intensive care unit (SICU) or intensive care unit (ICU).
Step 4: Master’s Degree in Nurse Anesthesia
You have to earn a master or doctoral degree from a recognized nurse anesthesia educational program. These courses may range from 2-3 years. The duration generally depends upon the university. Also, these programs consist of practical program in any healthcare setting or hospital.
Step 5: Become a Certified RN Anesthetist
After graduation, you have to clear the National Certification Exam (NCE), which is managed by the National Board of Certification & Recertification for Nurse Anesthetists (NBCRNA).
Step 6: Work as a CRNA
After completing all the above requirements, an individual can start practicing. To uphold certification, CRNAs are supposed to undergo 40 hours of continuing education after every two years and provide documents of valid certification/licensure.
Examination and Certification
The candidate has to submit completely filled and signed examination application form with a waiver of liability and agreement of authorization, to acquire an eligibility status.
The examination consists of 170 multiple choice question including 30 random, pretest questions. A candidate has to attempt a minimum of 100 questions out of which 30 must be these random questions and any other 70 questions.
The questions are widely from the sections:
- Basic Principles of Anesthesia (30%)
- Basic Sciences (25%)
- Equipment, Instrumentation and Technology (15%)
- Advance Principles of Anesthesia (30%)
If the student passes the test, a candidate gets the certificate and can use CRNA before his/ her name.
Expiration of Eligibility Criteria for Examination
Once a candidate has been issued an eligibility status after he has applied for the exam, the eligibility expires after 90 days, if he doesn’t sit for the exam.
Revocation of the Eligibility Status
Even if the candidate is granted eligibility status, the status may be revoked if:
- S/he fails to maintain the current certificate/ license of RN.
- If the candidate fails to complete the nurse anesthesia education program.
- If it is proved by the court that the candidate is mentally incompetent.
- If the applicant failed to pass the NCE within 2 years after graduation.
- Any case of abuse or conviction, related to the practice of nursing or nurse anesthesia.
- An intentional misstatement or false details submitted to the authority.
The fee of NCE is $725 which must be paid electronically.
Recertification/ Continued Professional Certification (CPC)
Conditions For Recertification
- The current license of individual must not be suspended, revoked or limited by any state.
- S/he must not be convicted by the law and must not have evidence of gross unprofessional behavior.
- S/he must not be suffering from alcohol or drug addiction and should not be undergoing any treatment related to the same.
- Lastly, the candidate must have a good mental state and physical health and must not be suffering from any condition that might interface with the practice of nurse anesthesia.
To receive full certification the candidate must fulfill the below-mentioned criteria and must submit the following:
- S/he must have the receipt of initial certification.
- Current license as an RN with documents of compliance with state requirements and authority to practice as a nurse anesthetist.
- Documents of completion of a minimum 40 hours of continuing education programs during immediately preceding 2 years period, from the date of application.
- The candidate must complete at least 850 hours of practice during the 2 year tenure. If the candidate failed to provide the evidence of practice during the last 2 years of applying application, but has been engaged in the practice within the 4 year duration, then the decision for recertification is at discretion of NCBRNA.
- Along with the above-mentioned documents, the individual must submit the completely filled form and a fee of recertification.
Interim recertification is further divided into two categories: provisional and conditional recertification. This type of recertification is no longer granted and only the candidates who have been granted this type of recertification before March 1, 2016, will remain in that status until next cycle of recertification.
Earlier, the recertification was granted for two years but, from march 2016 the recertification is effective for a period of 4 years. The rectification expires at the end of this period, if not renewed again.
Job Duties and Responsibilities of CRNA
As mentioned above, this career is very demanding and requires you to shoulder manifold responsibilities at the same time. Some of the tasks performed by CRNAs are:
1. Assessment of the Patient
They assess the condition of the patient and discussion about the whole treatment and procedure. If the condition of the patient is such that it may influence the anesthesia experience, these professionals can refer them to other specialists.
2. Anesthesia Plan
It’s the duty of CRNAs to understand the medical conditions that can impact administration of anesthesia, and suggest the level and type of anesthesia accordingly. They prepare a plan, which includes the key points to be kept in mind during the whole procedure.
3. Patient Preparation
They prepare the patients for the entire procedure and also put in the required IVs. They check the temperature, pulse and blood pressure of the patients through monitoring devices.
4. Preparation and Administration of Anesthesia
CRNAs prepare and administer anesthesia and other medicines, and monitor the patient’s condition. After the procedure ends, they get the patient out of the anesthesia and help them to recover.
They check and supervise the patient for any unfavorable effects from the anesthesia. They also ensure that the documents of the patient pertaining to the anesthesia are updated and accurate.
6. Administrative Duties
They also manage other work and activities, like billing, inventory and restocking, patient record management, procedure coding and patient scheduling.
CRNAs work in every health care setting where anesthesia is required or delivered.
- Intensive Care Units (ICU)
- Private Specialized Physician Offices
- Dental and Oral Surgery Offices
- Outpatient Medical Facilities
- Cardiac Care Units
- Emergency Rooms
- Ambulatory Surgical Centers
- Obstetrical Delivery Rooms
- Podiatrists, Surgeons, Pain Management Specialists, and Ophthalmologists
- Public Health Services, U.S. Military, etc.
Salary of a CRNA
There are many aspects that influence salaries of nurse anesthetists, which include education background, area of specialty and employer. The average annual salary for CRNA in May 2017 was $169,450. Also, if you are a fresher, you can expect salary pay of $98,700. After some time, you can earn around $141,000.
CRNA Pay Statistics- Yearly
|Average Yearly Salary||$95,880 – $143,820|
|Starting Yearly Salary||$78,960 – $118,440|
|Top Yearly Salary||$112,800 – $169,200|
CRNA Pay Statistics- Monthly
|Average Monthly Salary||$7,990 – $11,985|
|Starting Monthly Salary||$6,580 – $9,870|
|Top Monthly Salary||$9,400 – $14,100|
CRNA Pay Statistics- Hourly
|Average Hourly Salary||$43 – $64|
|Starting Hourly Salary||$35 – $53|
|Top Hourly Salary||$50 – $76|
There are many states in the United States of America that provides handsome salary to the nurse anesthetists. The table below shows the top paying states for this profession.
Top Paying States for this Occupation
|State||Hourly Mean Wage||Annual Mean Wage|
|District of Columbia||$90.00||$187,200|
According to BLS, the employment for APRNs including CRNA is expected to grow by 31% during the years 2014-2024. Certified Registered Nurse Anesthetists can carry out their work in hospital surgical units, cardiac care units, pain management centers, outpatient surgery, etc. The prospects for getting a fine job in this field are outstanding. According to the U.S. Department of Health and Human Services, there is a considerable and huge requirement for CRNAs all over the country. This is majorly because of the boost in the demand of health care services by people of all age groups, the accessibility of care to the masses, and the technological advancements and growth. The need of these professionals has extended beyond the doors of the operating rooms. Now, they are also required in hospital labor and delivery units, and in military and government healthcare units. This whole occupation requires a high level of dedication and commitment. Their work can be hectic and nerve-wracking. If you are ready to accept challenges, then this gratifying profession is best suited for you.