What Does a CRNA Do?
A Certified Registered Nurse Anesthetist (CRNA) is an advanced practice nursing specialty that takes nurses from the bedside to the head of the bed, primarily to administer anesthesia to patients undergoing surgery. More than 43,000 CRNAs practice in the United States, according to the U.S. Bureau of Labor Statistics (BLS).
CRNAs are advanced practice nurses trained to administer anesthesia to patients undergoing surgery or other procedures. CRNAs meet with patients and initiate a pre-operative interview to determine what anesthesia would be suitable given the patient's health history and unique needs.
CRNAs also answer any questions or concerns the patient may have before or after the procedure, monitor the patient closely under anesthesia, wake the person afterward, and may escort them to the recovery area. Some CRNAs work collaboratively with other anesthesiologists; others can work independently depending on their location. In some states, CRNAs can also prescribe medication independently.
What Are the Typical Responsibilities of a CRNA?
The responsibilities of a CRNA depend upon the care setting where they practice. For example, some CRNAs have their own practice, where they provide anesthesia independently at a hospital or physician’s office. Others work collaboratively in an anesthesia care team (ACT) model, which a physician anesthesiologist leads.
CRNAs provide anesthesia in the following settings:
- Labor and delivery
- Pain management clinics
- Trauma stabilization
Some of a CRNA’s responsibilities include:
- Conduct pre-anesthesia assessments and order laboratory and diagnostic studies as needed before a procedure
- Prepare and enact an anesthesia plan
- Perform airway management skills, such as intubation
- Monitor patients throughout surgical procedures
- Navigate any emergent or unexpected complications that arise
- Plan for and perform an emergence (wake-up) of a patient
- Perform regional anesthetic techniques, such as epidurals for labor
CRNAs do all this (and more) in a wide variety of healthcare settings. They can work in hospitals, surgery centers, and even physician's offices. They also frequently work in rural facilities and in the U.S. armed forces.
What Should Nurses Entering the CRNA Specialty Expect to Encounter?
To enter a nurse anesthesia program, a nurse must have their bachelor’s of science in nursing and work at least one to two years in an intensive care unit setting. They then must complete their graduate education.
Note that—and this is an important point—by January 1, 2022, all nurse anesthesia programs will be doctoral ones. Most programs will be at least three years, and some may be more. After rigorous clinical and classroom work over this periods, student nurse anesthetists must still pass a national certification exam.
Work your way to an ICU, especially at a well known academic hospital, if possible. Learn as much as you can from CRNAs, anesthesiologists, and more experienced nurses. You may want to ask to take care of sicker patients and express a willingness to float to other ICUs for a more well-rounded experience.
Also, consider working toward certifications such as Critical Care Registered Nurse (CCRN). If applicable, get your Cardiac Medicine Certification (CMC) and Cardiac Surgery Certification (CSC), too.
Day-to-Day as a CRNA
Even if a CRNA works in a practice that performs similar procedures all day (such as a dentist’s or ophthalmologist’s office), no two days are alike because every patient is different. Each day, a CRNA is assigned to different procedures and selects the best anesthetic plan for each case, taking into consideration a patient’s medical history and the procedure.
What Are Some Benefits of Working as a CRNA?
I love knowing I’ve made my patients as comfortable as possible during what can be a very stressful time in their lives. I value that certified nurse anesthetists work very autonomously and are able to select, prepare, and perform anesthesia plans based on their skills, knowledge, and experience.
In addition to the nature of the work, CRNAs are compensated for the time and schooling they put in. Nurse Anesthetists typically make between $93k - $189k, with a median salary of $147,237. The leading states with the highest annual average salaries for CRNAs are Wyoming, Montana, Oregon, Wisconsin, and California. For the most up-to-date salary information, check out Salary Explorer.
So yes, it's definitely possible for a CRNA to retire wealthier than a doctor.
Additional benefits to working at as CRNA:
- High degree of autonomy and professional respect
- Gaining the trust of anxious patients
- Satisfaction at the end of a surgery that goes well
- Increased responsibility but still can defer to anesthesiologists if needed
What Are Some Not-So-Great Parts About Working as a CRNA?
We have a saying about being a CRNA: “Anesthesia is 90 percent smooth sailing, 10 percent terror.” The potential for terror and your ability to respond quickly and effectively are the major stressors in a CRNA’s life.
I work as a CRNA in a Level I trauma center. I can spend a morning providing anesthesia for a cardiac bypass surgery, then go to the children’s hospital for surgery on a NICU baby, and finally finish my day doing anesthesia for a trauma situation. The potential to step into many varied and often-stressful situations is the challenge, but also the reward.
Additional downsides to working at as CRNA:
- Must obtain and maintain furthered education
- Increased liability risk and may need malpractice insurance
- Exposure to bodily fluids and air-borne communicable diseases
- Political differences with MD Anesthesiologists at times
My Advice if You’d Like to Become a CRNA
Pursuing this profession requires experience and academic commitment. When you’re a CRNA, you hold a patient’s life and comfort in your hands. You’ve got to have commitment to your studies and skills. You also need great stress management abilities that help you handle the often-challenging situations you may find yourself in.
The role of a CRNA can certainly be a fulfilling one, especially if you're ready to conquer the long road there!
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