Schools and Degrees
A certified registered nurse anesthetist (CRNA) is a registered nurse with advanced training in administering anesthesia. These specialized nurses must have at least a master’s degree and prior experience in a surgical, operative or anesthesia unit. This guide discusses available degrees from CRNA schools and other professional qualifications, with advice from actual nurse anesthetists about training and career options.
Top 10 CRNA
|#1||University of Iowa Iowa City, IA|
|#2||Drexel University Philadelphia, PA|
|#3||University of Minnesota-Twin Cities Minneapolis, MN|
|#4||Columbia University in the City of New York New York City, NY|
|#5||Duke University Durham, NC|
|#6||University of Pennsylvania Philadelphia, PA|
|#7||Wayne State University Detroit, MI|
|#8||University of Cincinnati-Main Campus Cincinnati, OH|
|#9||University of Southern California Los Angeles, CA|
|#10||University of Pittsburgh-Pittsburgh Campus Pittsburgh, PA|
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CRNA Schools and Programs
In essence, CRNAs are trained nurses that administer anesthetics. The delivery of anesthesia is a critical and potentially dangerous procedure that requires specialized training and a graduate degree. Given the high level of responsibility and advanced educational requirements, CRNAs are some of the highest paid advanced practice registered nurses in the United States. Since CRNAs have a master’s or doctorate degree, training programs are usually found at nursing schools that have graduate level nursing programs, such as universities.
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Currently, in order to become a CRNA, one must have at least a Master of Science in Nursing (MSN) degree. However, there is a trend toward requiring a doctorate in order to become a CRNA, such as a Doctor of Nursing Practice (DNP) or Doctor of Nurse Anesthesia Practice (DNAP). Because of this potential change in requirements, many schools are offering doctorate level CRNA programs. This article will discuss the evolution in educational requirements further on. Nurses at an earlier stage of their studies need to stay abreast of industry regulations so they can be prepared for them.
CRNA Nursing Schools
Most CRNA programs, if not all of them, are offered by a school's nursing department. This also applies at institutions that have their own medical school. CRNA schools provide academic education and experiential training for either a master’s or doctoral degree in nurse anesthesia. Certain accredited schools specialize in anesthesiology, such as the Middle Tennessee School of Anesthesia, which offers a hybrid online/on-campus DNAP program for practicing CRNAs who hold a master's degree.
Path to CRNA
The road to becoming a nurse anesthetist begins with a registered nursing license. Additional steps could vary, depending on each individual's education and experience. Some nurses earn their RN credential after obtaining an associate degree or after working as a licensed practical nurse. However, most CRNAs today follow the steps below for becoming a full-fledged CRNA.
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1. Obtain a bachelor’s degree in nursing.
The degree must come from an accredited program, which is usually recognized by either the National League for Nursing (NLNAC) or the Commission on Collegiate Nursing education (CCNE). Not all CRNAs have a bachelor’s degree in nursing, but if not, they probably have an associate degree in nursing and another degree, such as a bachelor’s or master’s.
2. Pass the National Council Licensure Examination (NCLEX).
Passing this exam is necessary to practice nursing in the United States. Would-be nurse anesthetists need to take the exam targeting RNs, known as the NCLEX-RN. The exam covers coordinated care, safety and infection control, health promotion and maintenance, psychosocial integrity, basic care and comfort, pharmacological therapies, reduction of risk potential and physiological adaptation.
3. Gain at least one year of “critical care” experience.
All accredited nurse anesthesia programs have this requirement for admission, and some schools prefer two or more years of experience. What constitutes qualifying critical care experience depends on the program, but it generally includes skills developed in evaluating unstable or critical condition patients. This experience is necessary for students to learn how to make independent decisions based on their prior training and information provided by medical instruments and monitoring technology.
4. Obtain a master’s or doctorate degree in nurse anesthesia from an accredited institution.
Presently, only an MSN in nursing anesthesia is required to become a CRNA. However, it is expected that a doctorate such as a DNP or DNAP will be required by 2025.
5. Pass the National Certification Examination (NCE).
The NCE is administered by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA). The exam is used to ensure incoming nurse anesthetists have the requisite level of knowledge for competent entry-level performance. The NCE covers basic sciences and principles of anesthesia, as well as equipment, instrumentation and technology.
Additionally, CRNAs need to maintain their current certification and be recertified every two years. To do so, they must have at least 40 hours of continuing education, show evidence of substantial experience in the field and certify that they are physically capable of practicing anesthesia.
Top CRNA Programs
Nursing students fresh out of their bachelor’s program have the unique opportunity to pursue a master of science in nursing with an emphasis in nursing anesthesia, putting them on the path to a fulfilling career as a certified registered nurse anesthetists (CRNA). However, there is still one big decision to make: which school will you attend? By looking at student success rates, class sizes, and the variety of student services a school has to offer, we’ve been able to compile a list of the best CRNA programs offered around the country. Check out our findings below to find the CRNA program that will be best for you.
Students holding a bachelor’s degree in nursing can earn a DNP degree with specialization in Anesthesia Nursing through the University of Iowa College of Nursing, along with post-graduate certificates in additional DNP specializations. The Nurse Anesthesia program is a 36-month curriculum that prepares students for the national certification exam required to work as a CRNA. During the second and third year, students will gain advanced clinical experience in a variety of settings across the state, including hospitals, rural healthcare environments and outpatient surgery clinics. In addition to grants and loans, students may be eligible for federally funded nurse anesthesia traineeships and clinical stipends.
The College of Nursing and Health Professions at Drexel University offers a MSN in Nurse Anesthesia, and for those with a MSN degree, a post-master’s certificate in Nurse Anesthesia. Although the MSN anesthesia program is a full-time, 28-month program, students have the option of completing the MSN core requirements with part-time enrollment, through online courses, prior to completing the anesthesia core and science courses, which are only offered full-time and on-campus. Clinical rotations take place in various settings in Pennsylvania, New Jersey and Delaware. This program prepares students to sit for the national certification exam, to become Certified Registered Nurse Anesthetists.
A student planning a career as a nurse anesthetist can earn a DNP degree with specialization in nurse anesthesia through the University of Minnesota’s Nurse Anesthesia Program. This is a three-year, on-campus program, including summers, with curriculum consisting of nurse anesthesia specialty courses along with DNP coursework, and advanced clinical experience through practicum in both rural and urban settings. The program only accepts 12 students a year, with interviews granted by invite-only. Acceptance is based on criteria such as a GPA of 3.4-4.0, a current RN license, at least a year of adult surgical/critical care experience, three essays and a resume.
The Nurse Anesthesia Program (ANES) at Columbia University School of Nursing is a 27-month, full-time program in which graduates earn a MS degree in nursing and are prepared to take the national certification examination. During the first year, students will take advanced courses in science, core graduate and specialty courses, with clinical rotations beginning part way through the second year, in areas such as cardiothoracic and obstetrical anesthesia. Clinical residency is completed prior to graduation, and may take place in a variety of settings and location, including large, urban teaching facilities or community hospitals, under supervision of CRNA’s and anesthesiologists.
Duke University has several specialty nursing programs at the graduate level, including DNP, PhD and post-doctorate fellowship options. The DNP degree with specialization in nurse anesthesia is a 36-month, on-campus, full-time program with a combination of DNP, APRN and nurse anesthesia specialty courses, along with a capstone requirement, and clinical rotations throughout the state. Duke offers state-of the-art teaching facilities, including the Center for Nursing Discovery, and provides a variety of opportunities for experienced-based learning and research, through Duke’s various centers and institutes. Students may also be able to incorporate global clinical experience into their curriculum, through independent study or research projects.
The University of Pennsylvania (Penn), known for being a prestigious, private research university, offers several nursing degrees at both the undergraduate and graduate level, through the Penn School of Nursing. The DNP-NA (Nurse Anesthesia) program, which was the first program of its kind to be offered by an Ivy League university, is a 36-month, full-time program that prepares students to sit for the NBCRNA national certification exam. Students gain valuable hands-on experience through the high-tech Helene Fuld Pavilion for Innovative Learning and Simulation and through clinical rotations in a variety of settings, including teaching, community and children’s’ hospitals along with outpatient surgery and doctors’ clinics.
The Wayne State University nurse anesthesia program, started in 1963, partners with several nearby research and teaching hospitals, providing students ample opportunities for experience-based learning alongside well-established mentors. The university currently offers a MS degree program in nurse anesthesia and a post-master’s program in pediatric anesthesia. The program is typically completed in 24-36 months, and offered on a full-time basis only. To be granted an admittance interview, students must have a current RN license and ICU care experience along with completed prerequisite courses prior to applying to the program. Credits earned at two-year colleges may be transferred in to meet pre-requisite requirements.
Nursing students planning to work as nurse anesthetists can earn a DNP degree with specialization in nurse anesthesia through the BSN to DNP program at the University of Cincinnati School of Nursing. This is a 36-month, nine-semester, full-time program that prepares students for the national certification examination and for work as CRNA’s in a variety of situations, including surgery and childbirth. The curriculum consists of science, core and anesthesia specific courses along with practicum, internships, seminars and capstone. Clinical rotations begin in the third semester, and throughout the program will include the areas of trauma, obstetrics, pediatrics, outpatient surgery and community hospitals.
Through the Keck School of Medicine Department of Anesthesiology at the University of Southern California, nursing students can earn a DNAP (Doctor if Nursing Anesthesia Practice) degree through the 36-month nurse anesthesia program. The curriculum combines core science and degree specific courses with hi-tech simulation and clinical residencies. Students are required to complete a doctoral capstone, with proposal during the first semester. Students gain clinical experience in several nearby prestigious medical facilities, including the USC Medical Center and Cedars-Sinai Medical Center, along with veterans’, children’s’ and community hospitals. Students may be eligible for financial assistance through federally subsidized grants, loans, private financing and paid traineeships.
At the University of Pittsburgh, students interested in nurse anesthesia are able to enroll in the BSN to DNP Nurse Anesthesia program offered through the School of Nursing. The nurse anesthesia programs meet all accreditation standards set forth by the Council on Accreditation of Nurse Anesthesia Educational Programs, so students can know that they are receiving the latest and vital information for the profession. Courses cover the entire process of anesthesia including pre-operative assessment to patient discharge procedures.
CRNA Schools Must-Have List
When deciding on a potential CRNA school to attend, prospective students should confirm it is accredited. Accreditation ensures the CRNA program meets certain standards for educational quality. The most common and prominent accrediting organization is the Council on Accreditation of Nurse Anesthesia Educational Programs (COA).
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Exam passage rates:
Would-be CRNAs must pass the NCE. If a school’s graduates are not able to pass the test, this is a warning sign. NCE passage rates generally differ for first-time test takers and test takers overall. The latter will ideally be very close to 100 percent. With first timers, it will be lower than the overall passage rate, but should be around or above the national average. If either rate is below the national average, contact the school to figure out why. Some schools have relatively small class sizes, so an outlier year where just two or three students fail can have a drastic effect on exam passage rates for that graduating class.
CRNA degree offered:
Does the school offer an MSN or doctoral degree in nurse anesthesia, such as a DNP or DNAP? The MSN degree minimum is expected to be phased out by 2025. Depending on when the prospective student intends to graduate, they may need the DNP or DNAP to become a CRNA. Also keep in mind that students who already have a prior graduate degree might be able to get a DNP or DNAP in as little as one year, depending on the school.
Clinical training sites:
CRNA schools require hands-on fieldwork for practical training. Students with an interest in a particular place of employment or region should look into where this training takes place. The American Association of Nurse Anesthetists notes that clinical training typically takes place in large community hospitals or those affiliated with universities. All else being equal, the more respected and advanced the clinical site, the better the clinical training will be.
Most of the time, the employment rate will be 100 percent or close to it. Given the demand for CRNAs and their marketability after graduation, an employment rate more than a few percentage points below 100 percent is a sign that further investigation is needed. There may be valid reasons for this, but prospective students must find out what those reasons are before enrolling.
Ideally, this would be zero, but it rarely is as the top schools have an attrition rate of over 5 percent and life is generally unpredictable. However, if this rate is over 10 percent, potential applicants should figure out why it’s that high. If the attrition rate is explained by students failing out, that is a sign that the school is not effectively teaching its students, or in a best case scenario, is admitting students who are not yet ready or prepared to become a CRNA.
The quality of the faculty is an important factor in determining the quality of education in a CRNA program. Look for faculty with doctoral level degrees in CRNA related fields and actual anesthesia experience in a clinical setting. Is the faculty member still actively practicing medicine? Continuing experience means that skills are being maintained and updated with recent developments. Other key considerations include the instructors' level of teaching experience and current research projects.
CRNA Degrees and Certificates
In the past, only a bachelor’s degree and/or a certificate was needed to become a CRNA. Today, a graduate degree is a minimum requirement, and different types of these degrees are available.
The first option is an MSN in nurse anesthesia. This educational path often consists of about 72 credit hours beyond the baccalaureate and takes about two to three years, depending on the program and whether the student is enrolled part-time.
The second option is to earn a DNP or Doctor of Nursing Practice. This program usually takes three years to complete and consists of 74 to 92 credits, depending on the school. Most students entering a DNP program have a bachelor’s degree in nursing.
The third option is a DNAP or Doctor of Nurse Anesthesia Practice. Many students who enter a DNAP program already have a graduate level degree. As a result, DNAP schools have several options for completion, ranging from one year and approximately 30 credits (for students with a graduate degree) to three years and about 100 credits (for those without a graduate degree).
There are no longer any CRNA certificate programs. Historically, one could become a CRNA without a master’s or even a bachelor’s degree. But over time, the educational requirements have risen, such that becoming a CRNA with only a certificate is no longer possible.
CRNA MASTER’S DEGREES
As previously discussed, the MSN is the minimum degree needed to become a CRNA. As one would expect, the MSN in nurse anesthesia covers various aspects of anesthetics, from the scientific basis and background to medical techniques and administration. Also discussed are some policies related to the use of anesthetics. Lastly, there are fieldwork and clinical classes that provide hands-on experience.
While an MSN is the requisite to being a CRNA, it is expected that a DNP or DNAP will become the minimum degree by 2025. Both the Council on Accreditation of Nurse Anesthesia Educational Programs and the American Association of Nurse Anesthetists have endorsed this educational requirement change. Many schools have phased out their MSN nurse anesthesia programs or are in the process of doing so, replacing them with doctoral programs.
Below is a chart of several classes and course descriptions that students can expect to take in a typical MSN program:
PAIN SCIENCE AND PRACTICE
Prepares students to effectively assess acute and chronic pain of patients. Also covered are both pharmacological and non-pharmacological pain treatments.
PRINCIPLES OF NURSE ANESTHESIA PRACTICE I
Covers various methods for the administration of anesthesia as well as the reasons for choosing one method over another. Complications for specific anesthetics and their mode of delivery are also covered.
CLINICAL FIELDWORK IN NURSE ANESTHESIA PRACTICE I
Students obtain hands-on clinical experience in a medical setting, applying their knowledge to relatively healthy patients and integrating this knowledge with real world situations where ethical and diagnostic judgments need to be made.
CRNA DOCTORATE DEGREES
A doctoral degree is not yet required in order to become a CRNA, but students would be remiss if they did not strongly consider attending a school that offered a doctoral CRNA related degree. This is especially true if the time requirement for the doctoral degree is the same or less than a master’s degree, which is possible at some schools, especially if the student already has a graduate degree.
Besides preparing for the change expected in degree requirements, students should explore a Doctor of Nursing Practice or Doctor of Nurse Anesthesia Practice degree due to increased professional potential. A doctorate provides training for potential leadership and teaching positions, thus broadening the employment horizons. There are few significant differences between a DNAP and a DNP.
Coursework covered in DNAP or DNP programs is similar to that of MSN nurse anesthesia programs, except for a capstone or doctoral project, leadership related coursework and other classes that are not included in MSN programs. The below chart lists several classes and course descriptions for a DNP or DNAP program that are typically not found in an MSN CRNA program:
Provides students with the opportunity to research an issue that is of relevance in anesthesia practice. Students identify current problem(s) and suggest a method of correcting or improving the situation.
LEADERSHIP, EVIDENCE BASED PRACTICE
Analysis of the theories and practices used by effective CRNA leaders. Concepts such as project planning, improved medical quality and efficiency, and healthcare policy will be covered.
LEGAL AND ETHICAL ENVIRONMENT
Teaches students ethical, legal and regulatory considerations in the clinical setting as they related to the CRNA and DNP practice.
In order to be admitted to CRNA schools, succeed academically and thrive in nurse anesthetist roles after graduation, it's vital to develop and strengthen the traits and skills below listed:
Understanding of pharmacology:
One of the cornerstones of a CRNA’s skillset is the ability to determine the proper dosage, type and method of anesthesia. This requires a solid understanding of how the human body interacts with drugs, such as anesthetics.
Quick thinking and analytical skills:
CRNAs must be able to apply their prior experiences, training and educational background to new and unfamiliar real world situations in order to accomplish their job duties and effectively and safely treat patients.
- Interpersonal skills:
Attention to detail:
For accurate and consistent administration of anesthesia to patients, CRNAs need to confirm that the medical staff and equipment are doing exactly what they are supposed to be doing. Also, it might be possible to mix up medications or confuse decimal places and administer 1.5 cc instead of 0.15 cc — but CRNAs pay close attention to prevent this from happening.
Acute/critical care experience:
All accredited CRNA schools require at least one year of this experience, but some highly recommend additional years. This extra experience could help aspiring CRNAs get into the school of their choice and also increase chances of success for students once they're admitted.
Critical care certification:
While not required, most schools prefer to see applicants with CCRN certification. Such certification indicates that a nurse is certified to work directly with critically sick patients. The CCRN certification from the AACN Certification Corporation is usually granted to nurses who work in intensive care, surgical and trauma units.
Nurse anesthesia is a specialization in and of itself. Most CRNA schools, whether at the master’s or doctoral level, do not offer further specializations within the nurse anesthesia practice area. Focused studies, for example, work with children or infants, would be possible through clinical training if students can choose their fieldwork sites. However, prospective students should look into each school to confirm that this flexibility is allowed.
Graduates from CRNA programs are trained and educated to be able to enter most areas within the field of anesthesia. Limitations in scope of practice are likely to be based on the fact that the CRNA is not an anesthesiologist, an MD who has graduated from medical school and completed a residency and fellowship.
Direct From the Field: Interview With a CRNA
Below is an interview with Alena Curry, a currently practicing CRNA.
After CRNA School: What’s Next
Once students graduate from CRNA programs and pass the National Certification Examination, they become certified registered nurse anesthetists and are ready for employment. CRNAs practice in a wide variety of public and private settings, including hospitals, private practices, medical centers, outpatient surgery clinics and physicians’ offices. Basically CRNAs can work wherever anesthesia is administered. They play a more integral role in the United States military than in most civilian settings because they are usually the only licensed medical professional who can give anesthesia. In many civilian settings (and depending on the state), CRNAs work under the supervision of an anesthesiologist.
CRNA Salary Facts
Median Annual Wage: $164,030
- 18% for more than 20 years experience
- 8% for pediatrics experience
- 5% for obstetrical anesthesia
Sources: Bureau of Labor Statistics (May 2016) and PayScale.com
Advice From a CRNA
Nick Angelis, MSN, CRNA and the author of How to Succeed
in Anesthesia School (And RN, PA, or Med School), has the following advice to future CRNA students: “Stretch yourself and welcome uncomfortable situations that stretch your knowledge and abilities (preferably with backup available). Without an objective understanding of your own skills and weaknesses, it's difficult to become a nurse ready for the independent decision-making required of a nurse anesthetist. For example, in basketball games such as HORSE or Around the World, a player selects shots they know they can make but their opponents will miss. The winner isn't usually the best player. Rather, it's the player who understands their own abilities and limitations the most.”