Nurse Anesthetist Career Guide

What is a Nurse Anesthetist?

A nurse anesthetist is a registered healthcare professional who works together with surgeons, anesthesiologists, dentists and other healthcare providers to ensure the safe administration of anesthesia during medical and dental procedures. These nursing professionals work exclusively with patients and healthcare professionals administering, monitoring and logging the administration of varying types of anesthesia to patients.

They work in a variety of settings including, hospitals, clinics, dental offices, doctors’ offices, and out-patient care centers. While some nurse anesthetists work under the supervision of a doctor or dentist, many do not. They plan and administer anesthesia in the same manner that a physician does.

What is a Certified Nurse Anesthetist?

A Certified Registered Nurse Anesthetist (CRNA) is a highly trained nurse anesthetist that administers anesthesia to patients about to undergo surgery. Certified nurse anesthetists have a greater scope of education and experience than non-certified workers. In fact, to become certified, one must complete a master’s degree in nurse anesthesia, collect a number of hours of work experience, and pass a certification exam.

What is a Pediatric Nurse Anesthetist?

A pediatric nurse anesthetist specializes in administering anesthesia to children before a surgical procedure. Like other nurse anesthetists, pediatric nurse anesthetists work as part of a much larger medical team that’s tasked with carrying out the procedure in an efficient and safe manner.

In addition to actually administering anesthesia, these types of nurses also work closely with the family of the pediatric patient so that all parties involved understand the procedures used to anesthetize the patient as well as what to expect after the patient wakes up.

What Does a Nurse Anesthetist Do?

Nurse anesthetists, working under the purview of an anesthesiologist, often administer anesthetics. This could be the insertion of an epidural, spinal or nerve block and the administration of medication through the epidural. Epidurals are commonly used during joint replacement and during labor and delivery. Nurse anesthetists also administer and monitor general anesthesia to patients in various health care settings. Once anesthesia is administered, a nurse anesthetists may monitor the patient to ensure that the anesthesia is working to block pain and that the patient continues to be safe under anesthesia.

A nurse anesthetist often monitors patients during surgical procedures to ensure that anesthesia is continuing to be effective. Nurse anesthetists also monitor a patient’s vital signs during a surgical procedure.

A nurse anesthetists also works with patients before and after surgical procedures. Before procedures, the nurse will often ascertain if there are any allergies to the medication to be used and make sure there are no possible medication interactions that could cause complications during the anesthesia. A nurse anesthetists discusses possible side effects and complications with the patient. This means that these nurses must get a full medical history prior to the administration of any anesthetic.

After a procedure, a nurse anesthetists may monitor a patient for pain management and administer pain control medications as prescribed. This may include continued monitoring of vital signs, consultations with surgeons and other physicians, and the administration of emergency CPR if needed.

Legally, a certified nurse anesthetists (CRNA) can administer anesthesia and so can a licensed anesthesiologist. When a CRNA does so, the procedure is considered to be a nursing procedure, when an anesthesiologist does so, it is considered to be the practice of medicine.

What Do You Learn in a Nurse Anesthetist Degree Program?

In a typical nurse anesthetist degree program student learning will likely include, but is not limited to, the following:

• Advanced Anesthesia Practices and Principles: This includes direct application as well as equipment management, technology, pain management, research, and clinical work. This includes extensive coursework on the pharmacology of anesthetic agents, professional aspects of nurse anesthesia practice.
• Advanced Physiology: Understanding the various systems within the body and how they interact with anesthesia.
• Clinical Applications: The clinical curriculum typically requires a minimum of 2000 clinical hours in a variety of setting and with a variety of procedures and techniques.
• Chemistry of Anesthesia: Chemicals that are used in varying types of anesthesia. How they react with the body and how they induce anesthesia.
• Health Assessment: Contraindications for varying types of anesthesia; monitoring patients during the administration of anesthesia; monitoring a patient who is emerging from anesthesia.
• Methods of Anesthesia: This may include intravenous or inhalation induction, tracheal intubation, and emergence from anesthesia.
• Health Care Policies: Current health care policies are reviewed. Conflicts between insurance reimbursement and excellence in patient care are confronted and examined.

How Do You Become a Nurse Anesthetist?

Educational Requirements

In order to become a nurse anesthetist, you must graduate from an accredited master’s program.  This is an advanced degree. A master’s degree is usually a two year program after the completion of a bachelor’s degree.

Any nurse anesthetist program must be accredited by the Council on Accreditation (COA). A candidate must already be a registered nurse. That means that the typical candidate has already had nurse’s training and has passed the state licensing examination as a licensed nurse. All nurse anesthetist educational programs require a bachelor’s degree, an RN license, and at least 1 year experience as a nurse in a critical care setting.

Foe candidates whose undergraduate degrees are not in nursing, some programs offer ways to bridge that gap. For a student whose undergraduate degree is in a related science field, the program may help the student with classes designed to aid in passing the Registered Nurse’s licensing exam.

Most nurse anesthetist programs require a combination of classes that incorporate both classroom knowledge and clinical skill. These include classes such as anatomy, physiology and pharmacology. Programs vary in length from 24 to 36 months.

While a master’s level is more common for a nurse anesthetist, some nurse anesthetists go on to earn a doctorate. This can be a Doctor of Nursing Practice (DNP) or a Ph.D. There has been a trend for CRNAs to obtain doctorate degrees. A doctorate allows further upward mobility into management positions.

Certification Requirements

Certification is mandatory for a nurse anesthetist. The certification exam is administered by the National Board of Certification and Recertification for Nurse Anesthetists. The exam is computerized and covers a very broad subject base including: anatomy, physiology, pathophysiology, respiratory diseases, the central nervous system, musculoskeletal diseases and disorders, the endocrine, hepatic, renal, hematologic, gastrointestinal, immune systems and disorders, as well as advanced pharmacology and advanced subjects in anesthesia.

Licensure Requirements

State licensure is mandatory for a CRNA. Most U.S. states require that a CRNA be licensed as an Advanced Practice Registered Nurse (APRN). To qualify, candidates must submit an application, application fee, proof of CRNA certification, and proof that of completion of an accredited nurse anesthesia program to the state board of nursing.

It is worth noting that depending on the state in which the CRNA practices, there are varying levels of supervision requirements for a CRNA. Some states allow the CRNA to practice without any medical supervision from a physician or dentist, depending on the work setting.

How Long Does It Take to Become a Nurse Anesthetist?

Most educational programs to become a nurse anesthetist vary in length from 24 to 36 months. This is in addition to completing a bachelor’s degree. As the doctorate degree is becoming more common, it may soon be required for all CRNAs  All CRNA programs must begin to change their curriculum from a Master’s of Science in Nurse Anesthesia to a Doctor of Nurse Anesthesia Practice. The changes must be implemented by 2025. A doctoral program will require at least 36 months and 94 units for graduation.

What Skills are Needed to Be a Nurse Anesthetist?

Critical Thinking and Analysis

Nurse anesthetist administer and monitor medications that can be dangerous. Patients’ lives can hang in the balance when there are problems with anesthesia. It is critical that the nuse is able to think critically and quickly to prevent and solve medical emergencies. Seconds can matter when a patient is having a bad reaction to an anesthetic. The nurse must know how to solve a problem quickly.

Attention to Detail

Small details matter. Failing to take a detailed history can mean that critical information about potential drug interactions are omitted. The results can be deadly. A nurse anesthetist must pay attention to the small details that may make a big difference for the patient. Following established protocols and making chart entries when monitoring a patient can be equally important.

Compassion

Patients requiring anesthesia are usually in a fragile state physically and emotionally, before, during and after the medical procedures involved. They are often trying to deal with pain and uncertainty. A compassionate nurse anesthetist can go a long way to alleviating anxiety and helping a patient have a positive experience, before, during and after their medical procedure.

Complex Problem Solving

Complex problem solving skills is the most fundamental skill of a nurse anesthetist. The human body is a complex, multilayered holistic machine. Subtle changes in vital signs can mean that an immediate change in medication is needed on the operating floor. A nurse anesthetist must be able to monitor and understand small changes in vital signs and what those changes mean for the patient and make immediate changes to ensure the health and safety of their patients.

Flexible Work Style

One must be able to both plan and implement anesthetic interventions independently and/or collaboratively as the situation warrants. Thus, a nurse anesthetist must be comfortable taking on a large amount of responsibility and must also be able to work comfortably with other health care providers.

Communication

Communicating with patients, doctors nurses and patent family members is vital. This includes the ability to speak, hear, and observe patients in order to gather information. It also includes effective and efficient oral and written communication with heath care team members.

Motor Skills

Adequate motor skills to observe and elicit information from patients through palpation, percussion and other assessment maneuvers is equally vital. A patient is often unable to speak during the anesthesia process and nonverbal assessment tools are critical to patient safety. In addition, the nuse must be able to help lift patients if needed and be able to stand for much of his or her working day.

Behavioral and Social Traits

Good emotional health on an ongoing basis in the face of stress in required for the full utilization of her or her intellectual abilities, the exercise of good judgment, and the detailed prompt care of patients. The nurse anesthetist must be able to adapt quickly and be able to form and maintain good working relationships with coworkers for the health team to function effectively. A nurse anesthetist must be able to manage people as well as problems. In many situations, the nurse anesthetist will have supervision over other nurses and must be able to work effectively in a supervisory capacity. 

What are the Pros and Cons of Being a Nurse Anesthetist?

Respect in the Field

This is the highest level of achievement for a Registered Nurse. Only a doctor with a license to practice medicine is above a CRNA. CRNAs are highly respected and highly sought after. The amount of training required for a CRNA closely rivals that of a physician.

Pay Scale

Pay is excellent. The median 2017 pay is above $150,000 annually. Even with the accrual of student loan debt, an entry level CRNA has a comfortable living financially.

Great Job Satisfaction

Registered nurses often report stress and burnout, leading to low job satisfaction. While CRHAs also experience stress, they tend to be happier in their work and report greater overall job satisfaction than do their registered nurse counterparts.

High Stress

The job can be stressful. A mistake can mean that a patient loses their life. When a mistake is made, there is a high chance of being sued for malpractice. In addition, a CRNA is not quite a nurse and not a physician. CRNAs work in this in-between level that can make a CRNA’s relationships with doctors and nurses feel more challenging.

Length of Training

Because the position requires at last a master’s degree,  you will spend a number of years in school, a minimum of 6 years after high school.

Cost of Education

This can vary quite a bit. Total educational costs include tuition, fees and expenses incurred while in the program. Tuition is free in exchange for an active duty service commitment with the Uniformed Services University of the Health Sciences/Military Nurse Anesthesia Program in Maryland. On the other end of the spectrum, the program can cost up to $178,000 at some private universities.

As CRNA requirements move from a master’s program to a doctoral program, costs are expected to exceed these levels.

How Much Does a Nurse Anesthetist Make?

Nurse anesthetist pay is excellent. According to the Bureau of Labor Statistics (BLS) the 2017 median salary was $165,120. This is much higher than a registered nurse earns  According to the BLS, a registered nurse’s median pay in 2017 was $70,000 annually or $33.65 hourly.

What is the Job Outlook for Nurse Anesthetists?

The job outlook for nurse anesthetists is also excellent. This job area is expected to grow 31% from 2016 to 2026, which is much faster than the average for all occupations, according to the BLS.

Nurse anesthetists are gaining more practice authority and are in high demand, driving up salary prospects. In addition, as more professionals obtain doctorate, it is expected that salaries will continue to increase accordingly.

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