Becoming a Certified Registered Nurse Anesthetist (CRNA) is one of the most competitive (and rewarding) career moves in nursing today. It calls for advanced training, precision under pressure, and a commitment to patient safety that few roles can match.
This is a high-demand field for a reason–one of the highest-paid nursing professions. And the CRNA job outlook is great, too, with 141,000 jobs to be added through 2033. The numbers say it all: strong pay, fast growth, and a critical role in the healthcare system.
Next, we’ll break down everything you need to know about how to become a CRNA, step by step: from nursing school to clinical experience to passing the certification exam. Let’s take a look.
TL;DR
If you’re short on time, here’s the quick summary:
- Becoming a CRNA starts with earning a BSN and passing the NCLEX to get licensed as a registered nurse.
- You’ll need at least one to two years of ICU or critical care experience before applying to a CRNA program.
- All new CRNAs must complete a doctoral-level program in nurse anesthesia, which typically takes three years.
- Graduates must pass the National Certification Exam (NCE) to enter practice.
- The full journey usually takes seven to ten years from start to finish.
- CRNAs enjoy autonomy, strong job stability, and a meaningful role in patient care.
What Does a CRNA Do?
A Certified Registered Nurse Anesthetist (CRNA) is an advanced practice nurse who manages anesthesia care from start to finish: preparing patients, monitoring them during procedures, and ensuring safe recovery afterward.
Day-to-day responsibilities of a CRNA include:
- Assessing patients before surgery to plan anesthesia care.
- Administering anesthesia and monitoring vital signs during procedures.
- Managing pain control after surgery or in chronic conditions.
- Responding quickly to emergencies, such as complications with the airway or blood pressure.
CRNAs work in a wide range of environments: operating rooms, intensive care units, trauma centers, outpatient surgical clinics, and even military facilities.
In rural areas, CRNAs are sometimes the only anesthesia providers, making their role critical for access to care in such underserved regions. In fact, they represent more than 80% of anesthesia providers in rural counties.
CRNA vs. Anesthesiologist vs. RN
Key differences between CRNAs, anesthesiologists, and RNs include:
- Anesthesiologists: These are physicians with a full medical degree. They lead in complex cases, but may overlap in many duties with CRNAs.
- CRNAs: Provide anesthesia independently in many states or under the supervision of a physician, as required. They deliver the same core anesthesia services and, in some settings, are the sole providers of these services.
- Registered Nurses (RNs): While essential to patient care, they don’t have the advanced training in anesthesia required for this role.
Put simply: CRNAs are trusted anesthesia experts and a cornerstone of modern surgical and critical care teams.
Key Insight: Each year, they safely administer more than 58 million anesthetics in the United States.
What Are the Education Requirements to Become a CRNA?
As of 2025, anyone who wants to become a CRNA must have a Bachelor of Science in Nursing (BSN) and complete a doctoral degree in nurse anesthesia, either a Doctor of Nursing Practice (DNP) or a Doctor of Nurse Anesthesia Practice (DNAP). You can see the differences between the two here.
This is a shift from previous master-level requirements and aims to ensure that CRNAs are trained at the highest clinical level, as the Council on Accreditation of Nurse Anesthesia Educational Programs (COA) requires.
Shadowing a CRNA and holding a Critical Care Registered Nurse (CCRN) certification can strengthen your application.
However, keep in mind that nurse anesthesia school is highly competitive; as the AANA reports, approximately 3,000 nurses enter these programs each year, while many more apply. Once accepted, students typically complete 9,000+ clinical hours before graduating and sitting for the National Certification Exam (NCE).
This rigorous hands-on training ensures new CRNAs are fully prepared to handle every aspect of anesthesia care safely and independently.
Side note: Wondering where to start your CRNA journey? We’ve rounded up some of the top schools and programs out there. Check out the full list.
What Are the Steps to Becoming a CRNA?
The path to becoming a CRNA is more than meeting the minimums. You need to grow into the kind of clinician who’s ready to make critical decisions when it matters most.
Here’s the step-by-step path with the context you actually need, according to the AANA:
Step 1: Earn a BSN or an ADN + bridge program
A Bachelor of Science in Nursing (BSN) is the standard entry point. It gives you the foundation in nursing theory, pharmacology, and patient care you’ll need later in anesthesia.
If you start with an Associate Degree in Nursing (ADN), you’ll have to complete a BSN bridge program before applying to CRNA school. Schools almost always prefer BSN-prepared nurses because it shortens the learning curve.
Step 2: Pass the NCLEX and get licensed as an RN
The National Council Licensure Examination (NCLEX) is the exam every registered nurse must pass. Without an RN license, you can’t start the clinical work that will eventually get you into CRNA school. Think of it as your ticket into the professional world of nursing.
Step 3: Gain 1-3 years of ICU or critical care experience
This step matters more than many realize. CRNA programs want nurses who’ve cared for the sickest patients: those on ventilators, with unstable blood pressures, or recovering from major trauma.
One year is the minimum, but most successful applicants bring at least two. This experience trains you to stay calm under pressure and make fast, accurate clinical decisions.
Step 4: Apply to a CRNA program
This is where the competition kicks in. A strong application usually includes:
- GPA of 3.0 or higher (competitive schools may want a GPA of 3.4+).
- CCRN certification (shows you’re serious about critical care).
- Shadowing hours with a CRNA (shows commitment to the field).
- Letters of recommendation from ICU supervisors and, ideally, an anesthesia provider.
- A personal statement that makes clear why you want this role and what you’ll bring to it.
- Interview readiness, because programs want to see maturity, resilience, and communication skills.
Side note: Some CRNA schools still require GRE scores, but many top programs, including Johns Hopkins, have made them optional. Your clinical track record usually speaks louder.
Step 5: Complete a DNP or DNAP program (average 3 years)
Once admitted, you’ll start an intense doctoral-level program. Expect advanced coursework in anatomy, pharmacology, and physiology, alongside thousands of hours of clinical practice.
On average, students graduate with over 9,400 clinical hours under their belt. This hands-on training prepares you to handle every aspect of anesthesia care, from pre-op evaluation to emergency airway management.
Step 6: Pass the National Certification Exam (NCE)
The NCE, run by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA), is your final hurdle. In 2024, the first-time pass rate was 89.3%. Once you pass, you’re officially a CRNA and can start practicing.
How Long Does It Take to Become a CRNA?
On average, it takes 8–10 years to go from nursing school to CRNA certification. Time is one of the biggest considerations when planning a CRNA career.
Here’s the breakdown:
- BSN degree: 4 years
- ICU/critical care experience: 1 to 3 years
- CRNA school (doctoral program): 2.5 to 3 years
Total: 7.5 to 10 years.
That timeline can vary. If you already have an ADN and need a bridge to BSN, add extra time. On the other hand, if you move directly into ICU work after your BSN, you can sometimes shorten the experience phase.
It’s also important to remember that CRNA programs are competitive. Many applicants don’t get accepted on their first try, which can extend the journey. But once you’re in, the structure is clear: finish your DNP or DNAP, pass the NCE, and step into practice.
What can speed it up?
- Going straight into an ICU role right after earning your BSN.
- Having a strong GPA and CCRN certification can help you get accepted into programs faster.
What can slow it down?
- Needing extra time to gain competitive ICU experience.
- Not getting into a CRNA program on your first try (common, given the competitiveness).
- Starting with an ADN instead of a BSN, since you’ll need to bridge before applying.
According to the AANA, most nurses take 7 to 8.5 years to complete the journey. Meanwhile, Forbes estimates around 10 years when you factor in professional experience.
The key takeaway: it’s a long road, but a predictable one, and the payoff is worth it.
What Are the Certification and Continuing Education Requirements?
Finishing a CRNA program isn’t the end of the road. You’ll need to maintain certification throughout your career.
Here’s what that looks like:
Initial certification:
- After graduating from an accredited nurse anesthesia program, candidates must pass the NCE, administered by the NBCRNA.
Recertification:
- CRNAs must recertify every 4 years under the Continued Professional Certification (CPC) Program.
- This process includes:
- Earning continuing education credits.
- Completing modules on core anesthesia knowledge.
- Meeting clinical practice requirements.
Why is it required?
- Certification ensures CRNAs stay up to date with the best practices, medications, and anesthesia technologies.
- Ongoing learning protects patient safety and strengthens professional credibility.
In short, getting certified is hard work, but keeping your credentials is just as important. CRNAs who invest in ongoing education maintain both their license and their competitive edge in the field.
What Skills and Traits Help You Succeed as a CRNA?
Technical knowledge is critical, but it’s not the only thing that defines a great CRNA. The role demands a mix of hard and soft skills that let you perform under pressure while earning the trust of patients and surgical teams.
Essential traits and skills include:
- Attention to detail: Even small miscalculations in anesthesia dosing can have serious consequences. CRNAs must be precise.
- Calm under pressure: Emergencies happen. You’ll need to think clearly and act fast when patient stability changes in seconds.
- Strong communication: Explaining anesthesia plans to patients, coordinating with surgeons, and guiding nursing staff all require clear, confident communication.
- Empathy: Many patients fear anesthesia. Reassuring them and building trust is part of the job.
- Advanced medical knowledge: From airway management to pain control, CRNAs need deep expertise in physiology and pharmacology.
- Collaboration: You’re part of a surgical team. Success depends on working seamlessly with physicians, nurses, and other providers. But it’s also important to establish boundaries, so you get the respect you deserve.
Soft skills often separate the good from the exceptional. A technically skilled CRNA who can’t communicate effectively won’t thrive in high-stakes environments.
On the other hand, those who pair clinical expertise with emotional intelligence seamlessly move into leadership roles within hospitals or even academic positions, training the next generation of CRNAs.
How Much Do CRNAs Make and What’s the Job Outlook?
As of 2025, CRNAs and nurse anesthesiologists earn a median salary of $251,000 annually, according to the AANA. For those working in the 1099 market (independent contractors), pay often ranges from $200 to $250 per hour.
Salary ranges can vary widely depending on:
- Location: States with higher demand or fewer anesthesia providers, especially rural areas, often pay more.
- Setting: CRNAs in outpatient surgery centers may earn differently than those in large academic hospitals.
- Experience: Like most healthcare roles, pay increases with years in practice and specialized expertise.
If you’d like a closer look at how salaries compare, take a look at our CRNA pay rates breakdown. We go over all the key details.
Beyond salary, the job outlook is strong. The U.S. Bureau of Labor Statistics projects 35% growth in employment for nurse anesthetists, nurse practitioners, and nurse midwives from 2024 to 2034, far above the national average.
Another factor shaping demand is demographics. The average CRNA today is about 53 years old, and nearly 20% of the workforce is expected to retire by the end of 2025. Combined with rising surgical needs in an aging population, this creates significant openings for new CRNAs.
What Are the Pros and Cons of Becoming a CRNA?
Like any high-level healthcare career, becoming a CRNA comes with major rewards and serious challenges.
On the upside, the role offers key advantages:
- High earning potential: With median salaries above $250,000, CRNAs are among the highest-paid nursing professionals.
- Independence and autonomy: In many states, CRNAs can practice without physician supervision, giving them a high level of clinical authority.
- Job stability: Demand is rising, and the retirement wave in the workforce is opening up even more opportunities.
- Meaningful work: CRNAs directly impact patient safety and outcomes, from routine surgeries to trauma care in rural hospitals or military zones.
However, it also brings significant challenges:
- Long and competitive education path: Expect 7-10 years of schooling and clinical experience before certification. Also, admission to CRNA programs is highly competitive.
- Intense responsibility: You’ll be the one managing anesthesia and monitoring patients whose lives may hang in the balance. The stakes are high.
- Stressful or long shifts: Surgical cases can run for hours, and emergencies don’t always follow a schedule. The workload can be mentally and physically draining.
This career is not for everyone. But for those who thrive under pressure and want both autonomy and impact, the rewards outweigh the challenges.
Side note for healthcare leaders: If your organization needs anesthesia coverage, check out our CRNA recruitment services for both W-2 and 1099 nurses or use our Locum Tenens CRNA staffing services to secure experienced professionals to fill in urgent roles.
Your Path to a CRNA Career Starts Here
Becoming a CRNA is a long, demanding journey, but also one of the most rewarding in healthcare. Every step builds the expertise you need to deliver safe, effective anesthesia care.
The process can take close to a decade, but the payoff is good–high income, professional respect, and the ability to provide life-changing care across hospitals, surgical centers, and underserved communities.
At AAG Health, we believe in empowering healthcare professionals with the insights and resources they need to reach their goals. If becoming a CRNA is your next step, this is your moment to begin the journey.
If you’re a CRNA looking to start a rewarding career, contact us, and we will help you kickstart that journey with the right facility.
FAQ
What is a Certified Registered Nurse Anesthetist (CRNA)?
A CRNA is an advanced practice registered nurse (APRN) who specializes in anesthesia care. They prepare patients for surgery, administer anesthesia, monitor vital signs during procedures, and manage pain afterward.
What is the Fastest Way to Become a CRNA?
There are no real shortcuts. To become a CRNA, you’ll need a BSN, ICU experience, and a doctoral degree (DNP or DNAP) in nurse anesthesia. If everything aligns, the timeline can be as short as seven to eight years.
Is the GRE Required for All CRNA Schools?
No, not all schools require GRE scores. Many top programs list them as optional. Admissions committees put more weight on GPA, ICU experience, CCRN certification, and interview performance. However, if you’re lacking in one of those areas, a good GRE score could be helpful. It’s best to review each program’s requirements carefully before applying.
Can I Become a CRNA Without ICU Experience?
No. ICU or critical care experience of one is a mandatory requirement to get into the CRNA program. However, two or more years will make you more competitive. This experience prepares you to manage unstable patients safely under anesthesia.
What’s the Difference Between a CRNA and an Anesthesiologist?
Anesthesiologists are physicians who complete medical school and residency. Meanwhile, CRNAs are advanced practice nurses who complete a doctoral-level nurse anesthesia program.
Both provide anesthesia and monitor patients, but anesthesiologists train longer and may take on more complex cases. In many hospitals, especially rural facilities, CRNAs provide the same core anesthesia services independently.
Do CRNAs Have to Work in Hospitals, or Are There Other Options?
No, hospitals are not the only option. CRNAs also work in outpatient surgery centers, trauma and critical access hospitals, obstetric delivery units, pain management clinics, and military medical facilities. This flexibility gives them the chance to shape a career around different practice settings.
Can CRNAs Specialize in Certain Types of Anesthesia?
Yes. While every CRNA is trained to handle the full range of anesthesia care, some choose to focus their practice in areas such as pediatric anesthesia, obstetrics, cardiac anesthesia, or pain management. These specialties usually develop through experience on the job or additional training after certification.
